Re: Re: peds transport

[<copterrn@bellsouth.net>]

The key here is what is best for the patient in the long run. Does anyone care to see a child suffer? No, but what service would be served with this child being emotionally soothed for his journey to the Trauma Center if his subtle Cervical spine fracture then subluxated while in your arms?  How often are ground EMS units involved in collisions?
Hysterical to me means an open airway and cognitive thought.

Buckle them everytime.

David Summers RN, etc
Pediatric Trauma Nurse Coordinator
West Palm Beach, FL

> 
> From: Wildmedic75@cs.com
> Date: 2002/02/15 Fri PM 12:20:56 EST
> To: flightmed@flightweb.com
> Subject: Re: peds transport
> 
> 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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