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Case #59


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#1 Jack Frost

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Posted 29 April 2013 - 02:01 PM

Hi All,
I am by no means a Mike McKinnon, but I thought I'd kick off another case presentation.
Please feel free to join in, experienced or newbie (Please! It's a bit sad me sitting here typing away to myself. :D)
If you don't understand any Aussie-isms, please ask away…

-Tim.




Introduction:

It's 1230 on a routine Thursday, and you're providing a tour of the base and aircraft to a group of enterprising young paramedic students. Your partner asks them if they have any questions and a voice pipes up from the back "is it always so quiet here?" The words have barely died away under the glare from your partner when the pager starts beeping.




1) The Story.
You've been kicked out to back up the local EMTs to a 'Person Collapsed, Altered Conscious State' at a Boarding school which is approximately 50 minutes RW flight away. The EMTs are still 30 minutes away from the scene.

35 minutes into the flight, the EMTs come up on air to provide a situation report:
"G'day HEMS 1, just a heads up you'll be able to land on the school oval. Were in the main school office and we've got a grade A, class one goat rope here. Two patients, altered conscious… *KKKPPPFFFTHHHBBBTTT*"
The radio report dies into static, dispatch tries to contact the EMTs multiple times, but the reply is unreadable every time [gotta love technology!].

On arrival overhead you spy a normal looking boarding school for rural kids and make a routine touchdown on the school oval. You grab the gear and start wandering toward the sign saying 'Administration Office'. As you approach you spot a man lying on the ground in a doorway off to one side, a lady kneeling next to him calls out "Help, he collapsed five minutes ago. I think he's in shock!" As you approach about 30 feet away, you clock the man lift his head, spot you, drop his head and firmly screw his eyes shut again.



7) Discussion Points
What's the plan?
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Tim D.
BN/BP, RN, GAP

#2 striker21w

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Posted 02 May 2013 - 12:28 PM

What is "KKPPFFTHHBBT" representing? explosion? gun shot? radio static?

Even before landing I'm having my pilot do several circles while we assess for anything out of the ordinary. Do I see any industrial buildings in the area, gasses in the air, signs of an explosion, people wandering about? if yes, how are they acting? Do I see the first responders vehicles, how many of them are there? Any police or just EMS? How about Fire? With two patients I'm instantly am thinking about haz-mat. What are the local resources and are they in route?

Before we land, me and the whole crew are going to have a conscious discussion about what may be going on and what the best approach to the situation is. If we don't see any immediate threats and everybody agrees, we land. I may look for a landing site up wind just to be cautious. I also may have the pilot take back off and provide over watch and radio relay as necessary. With this I'll remind the pilot to watch the fuel and save us enough gas to get home.

Once on the ground, we are approaching very cautiously taking note of anything out of the ordinary. With this first patient who collapsed I'm going to maintain a stand-off distance while asking the lady what is going on? How many patients are there? Where are the first responders? From here I'll relay information to dispatch and make sure they are as informed (or confused) as we are.

I'm still not entering any buildings and keeping my distance from everybody.
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#3 Jack Frost

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Posted 04 May 2013 - 12:17 PM

To answer your questions

What is "KKPPFFTHHBBT" representing? explosion? gun shot? radio static?


Nothing too exciting; radio static :).

Even before landing I'm having my pilot do several circles while we assess for anything out of the ordinary. Do I see any industrial buildings in the area, gasses in the air, signs of an explosion, people wandering about? if yes, how are they acting? Do I see the first responders vehicles, how many of them are there? Any police or just EMS? How about Fire? With two patients I'm instantly am thinking about haz-mat. What are the local resources and are they in route?


Standard industrial buildings for a mid-large sized rural town are at least a mile away.
No gases, smoke or explosions evident.
There's a couple of police cars, a fire engine and the local ambulance parked adjacent to the school.
There's what appears to be a PE class going on on the basketball court, standard groups of kids happily waving at the aircraft and ogling the emergency vehicles. Essentially the idyllic rural boarding school (apart from the fact that you've just landed on their playing field and there's a guy collapsed in a doorway!).

"Before we land, me and the whole crew are going to have a conscious discussion about what may be going on and what the best approach to the situation is. If we don't see any immediate threats and everybody agrees, we land. I may look for a landing site up wind just to be cautious. I also may have the pilot take back off and provide over watch and radio relay as necessary. With this I'll remind the pilot to watch the fuel and save us enough gas to get home. "


Based on what you've seen how would you play it now?


"Once on the ground, we are approaching very cautiously taking note of anything out of the ordinary. With this first patient who collapsed I'm going to maintain a stand-off distance while asking the lady what is going on? How many patients are there? Where are the first responders? From here I'll relay information to dispatch and make sure they are as informed (or confused) as we are.

I'm still not entering any buildings and keeping my distance from everybody."



As you approach, the whiff of stale booze and unwashed body hits your nostrils (You can even reminisce about the ED on a Friday night!)
The lady replies "I don't know, there was a fuss in the dorms earlier and someone was taken to the First Aid room. I was walking to my next class and one of the students pointed this man out to me. I think he's in shock so I sent someone for a blanket and I've tried to raise his legs."
You manage to raise dispatch on a cellphone, the radios seem to be in a deadspot...

What's the plan now folks?
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Tim D.
BN/BP, RN, GAP

#4 striker21w

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Posted 14 May 2013 - 03:42 PM

Ok if nobody else wants to play I'll keep going...


Based on the additional information I'm comfortable going in for the landing. I'm OK with the pilot remaining on the ground although I'd encourage him to keep a hightened awareness.


As we approach the kid (who was able to lift his head and look at us) I'm looking for skin color, temp, condition, respiratory effort, etc. Basically playing the "sick or not sick" game. If he's not looking sick I'm going to politely give some basic instructions (recovery position) to the lady and continue into the building. I want to make contact with somebody who resembles an on scene commander or triage officer. If the kid does look sick (more than hung-over) I'll ask my partner to stay with them and assist. I'm continueing on to find somebody with better understanding of what's going on though.
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#5 flynrn

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Posted 05 August 2014 - 03:55 PM

I did get a report of 2 victims from the initial report.  As mentioned above, if the first one is "not sick" then I would proceed to be very watchful as I make my way to the admin office.  If safe, I would call 911 and find out what is going on if there are no EMS personnel in the office. 

 

So, 911, can you tell me what is happening here (after I identify myself).


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Cindy Covington, RN BSN