Re: peds transport

[Wildmedic75@cs.com]

I couldn't agree more. While I agree that safety is always of paramount 
importance, I think it is a bit naive to think that we will NEVER, EVER find 
ourselves in situations where the patient would benefit from us bending the 
rules a little.

If you all would allow me to make an analogy, the scenario described below 
reminds me of a call I had when I was a full-time ambulance medic....5 y/o 
male, struck by a car  doing 20-30 MPH...femur deformity and some superficial 
bleeding, but no other obvious injuries. The poor kid was so scared and in so 
much pain that he was ABSOLUTELY HYSTERICAL. No parents around to comfort him 
(they left him him alone while they ran to make a score...); for some reason, 
they ONLY person he would let even touch him was me. No firemen, no cops, not 
my partner....the only way I could keep him calm and minimize movement of his 
femur and spinal column was to hold him in my arms, tight to my chest. 

Now, could I have wrestled this poor, screaming, flailing kid onto a 
backboard, strapped him down, gotten a full set of VS, done a detailed 
assessment, started two lines, etc..etc...? Sure I could have. Heck, I 
probably could have tubed him with a number 7 and a Mac 4, too....but would I 
have been helping him or potentially causing even more harm?

Did the ER staff at the pediatric trauma center (only about 5 minutes from 
the accident scene) see it my way? Of course not....they took turns giving me 
more than an earful.....but I don't expect any different from people who only 
see the scene from their ivory tower....

Just some food for thought.

Allan

<< a perfect world of "cooperative" pediatric patients, there is no question 
 that practice supports and regulation requires securing the little tyke 
 (infant, toddler or child). However, given the choice of a screaming, 
 hysterical, flailing tyke with respiratory distress in a car seat with 
 increased oxygen demand and exacerbation of bronchospasm, vs. a quiet tyke 
 sitting in moms lap with a nebulizer. It all depends on the specific case, 
 circumstances, risks and benefits. >>

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