[ARCHIVED THREAD] - Two First Aid hypotheticals (Page 1 of 2)
Posted: 4/18/2011 8:43:53 AM EDT
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These aren't trick questions or jokes or anything and I certainly don't claim that I know the right answer, I am curious to hear what you guys think, particularly if you have any advanced medic type training. Obviously if you are as big an idiot as me you are welcome to spout off because, well, that's what the internet is all about  You know he's going to put up a stink about putting off the trip and getting looked at by a doctor, do you let it go and keep an eye on him or tell him "Fuck that, you're going to the ER if I had to knock you out with that rock again and drag you outta here." You know if you really put your foot down with him you can talk him into hiking out to get looked at. #2 Your buddy tells you he's taking a bunch of the older kids from his son's Scout Troop out to clear the trails at the Scout camp before it opens. He says he's seen you have a tourniquet on the body armor you own and tells you that he has never learned how to use a tourniquet and that the training the Scouting council sent him to just said to use direct pressure on a cut and did not instruct him on the use of a tourniquet. Do you tell him that it sounds like good advice or do you show him how to use a tourniquet and let him take a few? |
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IMHO head injury= auto hospitalization for a CAT scan of that precious chrome dome
as an eagle scout and former SPL I would advise against carrying a tourniquet because scouts are still kids that get retarded ideas of how to do things despite the best trainers/training. Besides, if it comes down to it you can fab one up real quick out of a triangular bandage and a stick (standard issue BSA shit haha) |
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Quoted: #1, depends. Chances are slim that it's a life-threatening thing, but it happens. I've SEEN it happen. But even professionals can't force someone to go against their will.... it's kidnapping. I can do everything in my power to persuade them to go if I feel it's the right thing to do, but in the end it's their choice. I think that if he was adamant about not going, I'd just keep an eye on him and watch for ANY, even the slightest, sign of a bleed. Any confusion, repetitive questioning, slurred speech, balance problems, etc.... you tell him the hunt is over, you're leaving, and he can either come with you and get checked out, or die in the woods alone. Subdural bleeds can take many hours to present symptoms, but by the time they do it can be quite advanced. How far away from civilization is your hunt taking place? A lot of things to take into consideration.... (ETA: I misread the last part of that question. If you think you can convince him without hog tying him, then do it. There are other weekends to hunt.)These aren't trick questions or jokes or anything and I certainly don't claim that I know the right answer, I am curious to hear what you guys think, particularly if you have any advanced medic type training. Obviously if you are as big an idiot as me you are welcome to spout off because, well, that's what the internet is all about You know he's going to put up a stink about putting off the trip and getting looked at by a doctor, do you let it go and keep an eye on him or tell him "Fuck that, you're going to the ER if I had to knock you out with that rock again and drag you outta here." You know if you really put your foot down with him you can talk him into hiking out to get looked at. #2 Your buddy tells you he's taking a bunch of the older kids from his son's Scout Troop out to clear the trails at the Scout camp before it opens. He says he's seen you have a tourniquet on the body armor you own and tells you that he has never learned how to use a tourniquet and that the training the Scouting council sent him to just said to use direct pressure on a cut and did not instruct him on the use of a tourniquet. Do you tell him that it sounds like good advice or do you show him how to use a tourniquet and let him take a few? #2, tourniquets are coming into use more and more frequently because of new studies and statistics that have come to light from the war efforts of the last several years. I would teach him how to use it, and teach him when it's appropriate to use it. We have actually done to using them here in professional EMS for any major bleeding that's not immediately controlled by direct pressure. That's because our transport times are so short that tissue death won't generally occur within that time frame. They are still NOT, however, first line in bleeding control for most situations out in the middle of nowhere. The old rules still apply that if you're *hours* away from definitive care, and you put a tourniquets on someone, then chances are that they may lose that limb. It's a great tool, and should be used when appropriate. |
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Quoted: 1) Loss of consciousness = abort mission, seek medical attention ASAP. 2) My gear is for my training, your gear is for your training. If there is time, I will share some of my training with you, but it's not a priority for me. Um, okay for # 2 your great uncle died and left you his tourniquet factory so you have plenty of spares. That was a poorly worded example as it implied you were giving up necessary supplies. Forget the part about being Scouting related if that's a big trip up on not being taught to use a tourniquet. This is too complicated
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1 - ER. I've seen people die from the possible head bleed. Of course he'll refuse. I even refused after a recent concussion, but wifey dragged me in for the evaluation.
2 - Have him get first aid merit badge book and read it. I instruct on TQT as last-ditch life-saving procedure for scouting trips; last time I checked they were still in the training. They don't need to learn TCCC, just know what tools are there. I even demonstrated a TQT on myself with a dish towel & stick to a group of camp-bound youth, to help drive home the idea to use what they have available. If they remember the crazy guy making a TQT, then maybe they'll realize to use a t-shirt as a dressing instead of leaves or doing nothing in an emergency. |
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Um, okay for # 2 your great uncle died and left you his tourniquet factory so you have plenty of spares. That was a poorly worded example as it implied you were giving up necessary supplies. My concern was not about giving up supplies. My concern was that you have (presumably) been trained in the correct application of the tourniquet, while your partner has not. You're there to camp and do some scouting, not to train others in FA. Like I said, if time permits, and you're comfortable with training someone in the techniques, do it, but don't make it Item 1 on the agenda. |
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Quoted: Serious question.... who trains the scout leaders? Do they just wing it and read through the books, or do they have to go through the same (or more) training as the scouts?Quoted: Um, okay for # 2 your great uncle died and left you his tourniquet factory so you have plenty of spares. That was a poorly worded example as it implied you were giving up necessary supplies. My concern was not about giving up supplies. My concern was that you have (presumably) been trained in the correct application of the tourniquet, while your partner has not. You're there to camp and do some scouting, not to train others in FA. Like I said, if time permits, and you're comfortable with training someone in the techniques, do it, but don't make it Item 1 on the agenda. I've taught the Boy Scout First Aid classes before, but I was asked because I work professionally in EMS and as an EMS instructor. Can non-professionals 'officially' train each other? |
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1 - ER. I've seen people die from the possible head bleed. Of course he'll refuse. I even refused after a recent concussion, but wifey dragged me in for the evaluation. 2 - Have him get first aid merit badge book and read it. I instruct on TQT as last-ditch life-saving procedure for scouting trips; last time I checked they were still in the training. They don't need to learn TCCC, just know what tools are there. I even demonstrated a TQT on myself with a dish towel & stick to a group of camp-bound youth, to help drive home the idea to use what they have available. If they remember the crazy guy making a TQT, then maybe they'll realize to use a t-shirt as a dressing instead of leaves or doing nothing in an emergency. Tourniquet use in the prehospital care setting is seeing a shift, likely due to experiences learned in Iraq and A-Stan, from being the last resort to step number two. When I went through my last full course in 2002 the bleeding control skill sheet called for direct pressure > direct pressure with second bandage > elevation > pressure point > tourniquet. Now it is direct pressure > tourniquet. Ref. That being said, I'm not sure what the Red Cross or other first aid training agencies are teaching as appropriate protocol. |
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1) I would want him to get checked out, head truma is nothing to mess with. He could be fine and end up with internal bleeding/swelling in another hour of exercise....
2) Never ever let someone who is not trained no the proper use of a tourniquet use one. They could end up doing more harm than good if they use it incorrectly, or use it in a circumstance where its not necessary. I suppose if you have time to train him it might be ok, but I would want him to have more under his belt than ONE training session, imho. |
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Follow up on the IM...........
My general philosphy of LoC head trauma, is that you NEVER put yourself further from care, and seek further evaluation as soon as is possible. When there is a head trauma significant enough to cause unconsciousness, there has been a blunt injury to the brain of a fairly decent magnitude. Bleeding may not be immediately apparent, but it is common enough to warrant CT, or at a minimun, observation in an appropriate environment. If there is a bleed, and pressure builds up slowly to the point clinical symptoms become obvious, it is too late. You are not gonna then solo carry an uncounscious, unstable victim back to the trail head, and set ot for the hospital. Continuing with your hike is, IMO, flirting with disaster. He who learns to (get CT), lives to (hunt) another day |
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It all depends on the requirements of the training plan you're working under. When I had my previous company, we had to be MSHA certified for surface and underground mine work, both safety and FA. We always had at least one MSHA-certified trainer, so that we could train new employees. That meant that we had to have two separate plans: a plan for training, and a plan for training the trainers. It was a lot of paperwork, but worth it in the end.
Serious question.... who trains the scout leaders? Do they just wing it and read through the books, or do they have to go through the same (or more) training as the scouts? I've taught the Boy Scout First Aid classes before, but I was asked because I work professionally in EMS and as an EMS instructor. Can non-professionals 'officially' train each other? In the work that I do through the University, we don't train the trainers. We get all of our FA training from an outside entity, usually the local Red Cross. |
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1 - ER. I've seen people die from the possible head bleed. Of course he'll refuse. I even refused after a recent concussion, but wifey dragged me in for the evaluation. 2 - Have him get first aid merit badge book and read it. I instruct on TQT as last-ditch life-saving procedure for scouting trips; last time I checked they were still in the training. They don't need to learn TCCC, just know what tools are there. I even demonstrated a TQT on myself with a dish towel & stick to a group of camp-bound youth, to help drive home the idea to use what they have available. If they remember the crazy guy making a TQT, then maybe they'll realize to use a t-shirt as a dressing instead of leaves or doing nothing in an emergency. Tourniquet use in the prehospital care setting is seeing a shift, likely due to experiences learned in Iraq and A-Stan, from being the last resort to step number two. When I went through my last full course in 2002 the bleeding control skill sheet called for direct pressure > direct pressure with second bandage > elevation > pressure point > tourniquet. Now it is direct pressure > tourniquet. Ref. That being said, I'm not sure what the Red Cross or other first aid training agencies are teaching as appropriate protocol. I like TQT, but don't pimp it as hard to laypeople scouts & leaders as aggressively to not confuse them with what they may have heard in formal classes. |
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I guess to be more upfront, I was at a first aid class recently and disagreed with the teaching on the two scenarios above. I wouldn't make the call of allowing someone with an apparent concussion, or any loss of consicousness/memory to continue on further into the wilderness if I had it in my power to convince them to return. I also disagreed with not teaching people tourniquets. Admittedly I had the advantage of having heard from people with recent military combat experience where I think they have gotten away from the "OHMIGOD TOURNIQUETS" attitude that permeates some civilian first aid training. I understand the concern of stupid people improperly using them, but I don't think that justifies not teaching someone something that could save a life and in most situations in the US isn't going to result in a loss of limb.
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I guess to be more upfront, I was at a first aid class recently and disagreed with the teaching on the two scenarios above. I wouldn't make the call of allowing someone with an apparent concussion, or any loss of consicousness/memory to continue on further into the wilderness if I had it in my power to convince them to return. I also disagreed with not teaching people tourniquets. Admittedly I had the advantage of having heard from people with recent military combat experience where I think they have gotten away from the "OHMIGOD TOURNIQUETS" attitude that permeates some civilian first aid training. I understand the concern of stupid people improperly using them, but I don't think that justifies not teaching someone something that could save a life and in most situations in the US isn't going to result in a loss of limb. You are famous and wise, with a smattering of legal knowledge to boot. Get cracking & run for POTUS already.  Posted Via AR15.Com Mobile |
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#1
While he is likely going to be fine, you have to worry about an epidural hematoma. You hit your head, then feel fine. But the torn artery is pumping blood into your head, squishing the brain, followed by loss of consciousness and death. You gave away the evac time and now he is dead. So, you gotta ask yourself. 
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These aren't trick questions or jokes or anything and I certainly don't claim that I know the right answer, I am curious to hear what you guys think, particularly if you have any advanced medic type training. Obviously if you are as big an idiot as me you are welcome to spout off because, well, that's what the internet is all about You know he's going to put up a stink about putting off the trip and getting looked at by a doctor, do you let it go and keep an eye on him or tell him "Fuck that, you're going to the ER if I had to knock you out with that rock again and drag you outta here." You know if you really put your foot down with him you can talk him into hiking out to get looked at. #2 Your buddy tells you he's taking a bunch of the older kids from his son's Scout Troop out to clear the trails at the Scout camp before it opens. He says he's seen you have a tourniquet on the body armor you own and tells you that he has never learned how to use a tourniquet and that the training the Scouting council sent him to just said to use direct pressure on a cut and did not instruct him on the use of a tourniquet. Do you tell him that it sounds like good advice or do you show him how to use a tourniquet and let him take a few? #1... Sounds fishy. Dude would get a CT scan if he showed up to the ER with that story. Depending on his age, medical condition, and how far away from civilization we were, I'd probably just make him take it easy for a couple hours and see how he was after that. Playing it safe would require cutting the trip short and getting checked out. #2... Tourniquets are for idiots, poseurs, or a victim who's knocking on death's door. It's fine to teach him how to make one, as long as you give him the caveat, "Only use it if the limb has already been severed." You and he are better off if you teach him the axillary and femoral pressure points. |
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You and a buddy are hiking out into the woods on a Friday evening to hunt for the weekend. Your buddy slips on wet rock crossing a shallow stream and hits his head on the rock. He appears unconscious. You are right behind him so you quickly grab him and start to drag him to shore. He regains consciousness before you even have him out of the stream, stands ups, says he is fine. He is oriented as to time and place, knows his name and appears to be fine now except he doesn't remember actually falling down. He insists on continuing with the trip. You look him over and he only has a small scratch from the fall and he's up and walking around, he's not throwing up or complaining of a splitting headache and he appears normal and tells you he wants to keep going and it's no big deal. You know he's going to put up a stink about putting off the trip and getting looked at by a doctor, do you let it go and keep an eye on him or tell him "Fuck that, you're going to the ER if I had to knock you out with that rock again and drag you outta here." You know if you really put your foot down with him you can talk him into hiking out to get looked at Your buddy tells you he's taking a bunch of the older kids from his son's Scout Troop out to clear the trails at the Scout camp before it opens. He says he's seen you have a tourniquet on the body armor you own and tells you that he has never learned how to use a tourniquet and that the training the Scouting council sent him to just said to use direct pressure on a cut and did not instruct him on the use of a tourniquet. Do you tell him that it sounds like good advice or do you show him how to use a tourniquet and let him take a few? Your buddy needs to get checked out for his own good. The consensus on tourniquets has changed over the past few years, thanks largely to OEF/OIF. Better to have it and use it than not have it. Sure, you can improvise, but there are some very compact designs on the market nowadays. I don't know where your friend would need more than one loaner tourniquet. Make sure that he gets trained on its use. |
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knocked = hospital as soon as possible. i might not go as far as getting to a main road and calling an ambulance but he NEEDS to be checked asap.
LOC from trauma could easily coincide with intracranial bleeding that couls get worse as time progresses. the last thing i'd want is to be another hour into the woods and have him go into a coma or become debilitated to the point of not being mobile. tourniquets IMHO can do more damage than good in most situations. the only time i EVER use one was in an amputation. even with an arterial bleed i found use of pressure points with drect pressure to be effective for stopping most bleeders. Now i did have the luxery of having IV fluids and advaced gear close by along with transportation. tourniquets used improperly can cause a LOT of damage to the point of losing a limb that could have been saved. jmho |
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Quoted: These aren't trick questions or jokes or anything and I certainly don't claim that I know the right answer, I am curious to hear what you guys think, particularly if you have any advanced medic type training. Obviously if you are as big an idiot as me you are welcome to spout off because, well, that's what the internet is all about You know he's going to put up a stink about putting off the trip and getting looked at by a doctor, do you let it go and keep an eye on him or tell him "Fuck that, you're going to the ER if I had to knock you out with that rock again and drag you outta here." You know if you really put your foot down with him you can talk him into hiking out to get looked at. #2 Your buddy tells you he's taking a bunch of the older kids from his son's Scout Troop out to clear the trails at the Scout camp before it opens. He says he's seen you have a tourniquet on the body armor you own and tells you that he has never learned how to use a tourniquet and that the training the Scouting council sent him to just said to use direct pressure on a cut and did not instruct him on the use of a tourniquet. Do you tell him that it sounds like good advice or do you show him how to use a tourniquet and let him take a few? |
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I guess to be more upfront, I was at a first aid class recently and disagreed with the teaching on the two scenarios above. I wouldn't make the call of allowing someone with an apparent concussion, or any loss of consicousness/memory to continue on further into the wilderness if I had it in my power to convince them to return. I also disagreed with not teaching people tourniquets. Admittedly I had the advantage of having heard from people with recent military combat experience where I think they have gotten away from the "OHMIGOD TOURNIQUETS" attitude that permeates some civilian first aid training. I understand the concern of stupid people improperly using them, but I don't think that justifies not teaching someone something that could save a life and in most situations in the US isn't going to result in a loss of limb. Most situations in the US, and certainly at a Scout camp with what sounds like plenty of other people and ready access to vehicles, a tourniquet would not provide any advantage over direct and/or pressure point compression. In other words, if you're close enough to advanced medical care that a tourniquet won't do any damage, then you're close enough to advanced medical care to use other methods of controlling blood loss. 
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Quoted: I guess to be more upfront, I was at a first aid class recently and disagreed with the teaching on the two scenarios above. I wouldn't make the call of allowing someone with an apparent concussion, or any loss of consicousness/memory to continue on further into the wilderness if I had it in my power to convince them to return. Absolutely, if it's in your power. But like was said.... you can't kidnap him. Unless he's a really good friend. Or a spouse.  Then again, you can always clock him over the head again to knock him unconscious, and then it's 'implied consent.'  I also disagreed with not teaching people tourniquets. Admittedly I had the advantage of having heard from people with recent military combat experience where I think they have gotten away from the "OHMIGOD TOURNIQUETS" attitude that permeates some civilian first aid training. I understand the concern of stupid people improperly using them, but I don't think that justifies not teaching someone something that could save a life and in most situations in the US isn't going to result in a loss of limb. |
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#2... Tourniquets are for idiots, poseurs, or a victim who's knocking on death's door. It's fine to teach him how to make one, as long as you give him the caveat, "Only use it if the limb has already been severed." You and he are better off if you teach him the axillary and femoral pressure points.[/div] Kindly state your credentials to make such a claim. Recent ATLS, PHTLS, or combat medic/corpsman training? Your aggressive & dogmatic stance, replete with name-calling of those who potentially disagree with you, smacks of poseurism rather than contemporary medical knowledge. Mine? MD, latest ATLS trained, high familiarity using tourniquets in surgery, and personal experience using one to save a life after traumatic partial amputation with artery tear. Your turn. We can disagree, but you need to back up your position. Posted Via AR15.Com Mobile |
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They always forget "go through the victim's wallet." [at this point you should make sure he's dead]
 Eeeeeh, look who knows so much! As it turns out, your friend is only *mostly* dead. Now, mostly dead is still slightly alive. But with "ALL dead," there's only one thing you can do. What's that? Go through his pockets for spare change. |
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#2... Tourniquets are for idiots, poseurs, or a victim who's knocking on death's door. It's fine to teach him how to make one, as long as you give him the caveat, "Only use it if the limb has already been severed." You and he are better off if you teach him the axillary and femoral pressure points.[/div] Kindly state your credentials to make such a claim. Recent ATLS, PHTLS, or combat medic/corpsman training? Your aggressive & dogmatic stance, replete with name-calling of those who potentially disagree with you, smacks of poseurism rather than contemporary medical knowledge. Mine? MD, latest ATLS trained, high familiarity using tourniquets in surgery, and personal experience using one to save a life after traumatic partial amputation with artery tear. Your turn. We can disagree, but you need to back up your position. Posted Via AR15.Com Mobile I use Tourniquets all the time in surgery...they work great (and control a bleeding from a cut nutrient artery until you can tie it off)......don't have (or hopefully need) the advanced training that our Gas Passer has, but I'd use one if someones life depended on it... AFARR |
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First post partial fail, 
Loss of consciousness secondary to head trauma REQUIRES follow up. I don't care how fine he feels, you drag his ass to the ER for evaluation. I don't know, I've seen a lot of people get knocked out and be fine but I've heard you can have real trouble from it, I guess it would depend on how hard he hit his head. I knew a kid growing up that could get knocked out extremely easily, I must have personally seen him get knocked out more than a handful of time and heard of him getting knocked out even more than that. Anything would knock him unconscious, I saw him go out from a missed basketball pass that he caught in the head and even saw him knocked out from getting slapped in the face, open palm not a back hand. So if the friend that hit his head on a rock crossing a stream didn't hit his head very hard I wouldn't be too worried about it unless he was; acting weird, having trouble with his eyes(not just seeing but tracking) or had a headache that seemed unrelated to the bump on the head. As for the tourniquet I'd give it to him with instructions but I'd be surprised that he didn't already know how and when to use one and how to improvise one. I'd just make sure he was updated on their modern use. |
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They always forget "go through the victim's wallet." [at this point you should make sure he's dead]
Eeeeeh, look who knows so much! As it turns out, your friend is only *mostly* dead. Now, mostly dead is still slightly alive. But with "ALL dead," there's only one thing you can do. What's that? Go through his pockets for spare change. Wow, I didn't know we had that many Doctors posting on here..... 
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They always forget "go through the victim's wallet." [at this point you should make sure he's dead]
Eeeeeh, look who knows so much! As it turns out, your friend is only *mostly* dead. Now, mostly dead is still slightly alive. But with "ALL dead," there's only one thing you can do. What's that? Go through his pockets for spare change. Wow, I didn't know we had that many Doctors posting on here..... It's the internet. Everyone is a doctor, rock star, porn star, or pro athlete. Posted Via AR15.Com Mobile |
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I agree with you and most of the posters, LOC demands further care, always. I have many ancedotal examples of folks who "felt fine", but later had serious complications from a bleed. A well publicized example was actor Liam Neesons wife Natasha Richardson, who died after taking a tumble skiing. She was reported to have initially refused transport or treatment after the fall. link. I always try to talk them into the trip to the ER. Live to hunt another day.
20 year career FF/EMT working in a Dual service(FIRE/EMS). As for tourniquets, kind of like my carry gun, if all else fails, pull it out and put it in action, I 'd risk a limb against bleeding out any day. Teach 'em the basics and hand them out....... Just my opinion, I could be wrong
EDIT: I see the docs weighed in while I was typing, NO WONDER IT TAKES SO LONG TO BE SEEN, GET BACK TO WORK!
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They always forget "go through the victim's wallet." [at this point you should make sure he's dead]
Eeeeeh, look who knows so much! As it turns out, your friend is only *mostly* dead. Now, mostly dead is still slightly alive. But with "ALL dead," there's only one thing you can do. What's that? Go through his pockets for spare change. Wow, I didn't know we had that many Doctors posting on here..... It's the internet. Everyone is a doctor, rock star, porn star, or pro athlete. Posted Via AR15.Com Mobile I was referring to how we get our money.....don't you roll the victim patient when they're unconscious in addition to padding the insurance bill as much as possible and overcharging for band-aids and aspirin? I thought Podiatry school was the same as Osteopathic and Allopathic schools....2 hours of Medical classes, 1998 hours of "How to Screw The Patient out of As Much Money As Possible" business classes.... 
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I was referring to how we get our money.....don't you roll the victim patient when they're unconscious in addition to padding the insurance bill as much as possible and overcharging for band-aids and aspirin? I thought Podiatry school was the same as Osteopathic and Allopathic schools....2 hours of Medical classes, 1998 hours of "How to Screw The Patient out of As Much Money As Possible" business classes.... [/div]Meh. All I know is that if/when I come across an unconscious (or nearly so) person, the first step is to go through his wallet. Where he;s goin' he don't need that $34, anyway. That's just how I was trained.
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My opinion as an NREMT-B and current paramedic student.
1.) In addition I would check pupils for equal reaction. As long as thats good I would continue the trip. This is in the field with a buddy mind you. If I were working a scene as a fire fighter or EMT then I would insist on transport to the ER or at the least get a signed refusal....cya and all that. 2.) Inform him on proper use. Current line of thinking is they are not as harmful as once thought. Direct pressure is step one but if you can't wait for help and have to move or if direct pressure and elevation is not enough then a tourniquet is appropriate. |
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I was referring to how we get our money.....don't you roll the victim patient when they're unconscious in addition to padding the insurance bill as much as possible and overcharging for band-aids and aspirin? I thought Podiatry school was the same as Osteopathic and Allopathic schools....2 hours of Medical classes, 1998 hours of "How to Screw The Patient out of As Much Money As Possible" business classes.... [/div]Meh. All I know is that if/when I come across an unconscious (or nearly so) person, the first step is to go through his wallet. Where he;s goin' he don't need that $34, anyway. That's just how I was trained.
With my last ounce of strength, I sucked out my gold fillings and swallowed them . Those paramedics have such sticky fingers. –– C. Montgomery Burns |
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My astronaut, physicist, real estate magnate and chef duties keep me from pro sports. It's a choice.
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It's the internet. Everyone is a doctor, rock star, porn star, or pro athlete. Posted Via AR15.Com Mobile[/div] Underachievers may limit themselves to an or. |
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#1 Take him to ER ASAP for a check, if he refuses just tell him I'm canceling the trip and get him to head back with some verbal persuasion.
#2 I'd teach him how to use the tourniquet and give him one or two. I carry one all the time in my car, and a couple in my pack when hunting or in the woods. Better to have and not need, than need and not have. |
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1. Medical attention, now. Knocked out + amnesia counts as ALOC, even if he is A&O in other ways. 2. Teach him how and when to use a tourniquet. It's definitely not a tool to take out of the tool box. I teach people to use the CAT tourniquet as part of my duties. A bright Boy Scout should have no problem learning it in 20 minutes, tops. |
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I was referring to how we get our money.....don't you roll the victim patient when they're unconscious in addition to padding the insurance bill as much as possible and overcharging for band-aids and aspirin? I thought Podiatry school was the same as Osteopathic and Allopathic schools....2 hours of Medical classes, 1998 hours of "How to Screw The Patient out of As Much Money As Possible" business classes.... [/div]Meh. All I know is that if/when I come across an unconscious (or nearly so) person, the first step is to go through his wallet. Where he;s goin' he don't need that $34, anyway. That's just how I was trained.
Most of my patients are in gowns, so I'm left with the dregs; looking for loose change in fat rolls or scavenging empty soda cans from the trash after family members have had a Coke and a smile. I wasn't enough of a hard charger to do the fancy office stuff you mention. Maybe some remedial courses are in order for my future. |
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Quoted: Quoted: #2... Tourniquets are for idiots, poseurs, or a victim who's knocking on death's door. It's fine to teach him how to make one, as long as you give him the caveat, "Only use it if the limb has already been severed." You and he are better off if you teach him the axillary and femoral pressure points.[/div] Kindly state your credentials to make such a claim. Recent ATLS, PHTLS, or combat medic/corpsman training? Your aggressive & dogmatic stance, replete with name-calling of those who potentially disagree with you, smacks of poseurism rather than contemporary medical knowledge. Mine? MD, latest ATLS trained, high familiarity using tourniquets in surgery, and personal experience using one to save a life after traumatic partial amputation with artery tear. Your turn. We can disagree, but you need to back up your position. Posted Via AR15.Com Mobile  Wow. I'd missed that comment. He is wrong. Plain and simple.In 15 years of professional emergency medical experience, I have never ONCE used pressure points to control bleeding. It has always been either direct pressure/pressure dressings vs. tourniquets. |
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I was referring to how we get our money.....don't you roll the victim patient when they're unconscious in addition to padding the insurance bill as much as possible and overcharging for band-aids and aspirin? I thought Podiatry school was the same as Osteopathic and Allopathic schools....2 hours of Medical classes, 1998 hours of "How to Screw The Patient out of As Much Money As Possible" business classes.... [/div]Meh. All I know is that if/when I come across an unconscious (or nearly so) person, the first step is to go through his wallet. Where he;s goin' he don't need that $34, anyway. That's just how I was trained.
Most of my patients are in gowns, so I'm left with the dregs; looking for loose change in fat rolls or scavenging empty soda cans from the trash after family members have had a Coke and a smile. I wasn't enough of a hard charger to do the fancy office stuff you mention. Maybe some remedial courses are in order for my future. your a sleep dr. don't you rape search them after you knock them out for a sleep study? |
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Quoted: Quoted: Quoted: I was referring to how we get our money.....don't you roll the victim patient when they're unconscious in addition to padding the insurance bill as much as possible and overcharging for band-aids and aspirin? I thought Podiatry school was the same as Osteopathic and Allopathic schools....2 hours of Medical classes, 1998 hours of "How to Screw The Patient out of As Much Money As Possible" business classes.... [/div]Meh. All I know is that if/when I come across an unconscious (or nearly so) person, the first step is to go through his wallet. Where he;s goin' he don't need that $34, anyway. That's just how I was trained. Most of my patients are in gowns, so I'm left with the dregs; looking for loose change in fat rolls or scavenging empty soda cans from the trash after family members have had a Coke and a smile. I wasn't enough of a hard charger to do the fancy office stuff you mention. Maybe some remedial courses are in order for my future. One of my coworkers found an entire bar of soap in a fat roll of one of our frequent flyers.  So I guess the upside of that is that some patients could theoretically smuggle quite a bit of cash in their fat rolls. |
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I was referring to how we get our money.....don't you roll the victim patient when they're unconscious in addition to padding the insurance bill as much as possible and overcharging for band-aids and aspirin? I thought Podiatry school was the same as Osteopathic and Allopathic schools....2 hours of Medical classes, 1998 hours of "How to Screw The Patient out of As Much Money As Possible" business classes.... [/div]Meh. All I know is that if/when I come across an unconscious (or nearly so) person, the first step is to go through his wallet. Where he;s goin' he don't need that $34, anyway. That's just how I was trained.
Most of my patients are in gowns, so I'm left with the dregs; looking for loose change in fat rolls or scavenging empty soda cans from the trash after family members have had a Coke and a smile. I wasn't enough of a hard charger to do the fancy office stuff you mention. Maybe some remedial courses are in order for my future. your a sleep dr. don't you rape search them after you knock them out for a sleep study? I'm just a dumb anesthesiologist, not a sleep specialist with shiny shoes and nicely starched white coat.
I wonder how pathologists find a solution to this problem. I've heard that some of them drive around the parking lot looking for anesthesiologists to run over.
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