37 Soft Tissues

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(46:32) You get a story from after the show last week about German paramedic Niels first Louisiana field delivery to start the show. Then we talk about Ron’s test and how he didn’t do as bad as he thought.

Soft tissue injuries was the subject of the week. Kelly tells how to deal with crush injuries and a discussion of rhabdomyolysis or rambo or radbo to how ever it is pronounced. Ron had never heard of injection injuries before this week, and he now has two new drugs to memorize.

Ron did his first 24 hour shift and he talks about how it was and how he’s thinking about preceptors differently.

Listener Questions

Simon:
3. Finding veins. Do you prefer to find a vein visually, or by palpation?

4. After a recent trauma call on a very busy highway, we were left with a grossly disfigured body, a lot of distressed people standing around, and a huge procession of traffic all rubber-necking at the pool of blood spreading from the white sheet. How do you deal with those who are emotionally distressed in these situations? Apart from a brief few gentle words and a phone number for a counselling line to the bystanders, and letting the police divert traffic, I was all out of ideas.

Elias:
New EMT-B here, had my patch since the beginning of january, and am working for a paid volunteer rural service (very rural, frontier even) in a town of around 1000 people, with another 5k within the county lines. A part-time firefighters job has opened up in a town about 30 miles away and they run their ambulance through their fire service, so there’s a very good chance of getting a paid, part time ems position with this fire department. My question is: would it be considered “bad form” to work for two different services? I don’t really want to be a firefighter, but if it’d get me some consistent time in an ambulance rig before paramedic school starts in September, it’d be a good thing, right?

What book would you recommend for a person with no AandP experience to begin study for medic school, so as not to be totally lost?

Shawn in KS:
In regards to proper documentation of your scene reports, would using a digital voice recorder while on scene w/ a lapel mic for hands free operation be professional and reasonable? The idea would be to speak your notes out as you progress such as pt assessment, VS, and so on. You are intending to record yourself for your own use, so I don’t see a legal issue. Recordings would be deleted after their use. And shy of your partner, no one would likely notice you are even mic’d up.

Mentions:

A&P for Emergency Care

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  • Kj_reed

    Great show guys!! I know what your talking about Kelly about having a guy who doesn’t like OB. When we got to the OB section in our EMT-B class. We had a guy who had never seen a baby being born. He got white as a sheet and had to put his head to keep from passing out. Don’t get me wrong he is a really nice guy just very naive. At that time we weren’t able to practice deliveries in class because or simlady was out of town for repairs so all we could do is watch you tube videos of deliveries.

  • Bruce

    I understand that one needs to have a safe scene and that police can be called to a scene if needed.. but what are the limits of defending yourself if on a scene before PD could get there if someone is violent and not armed??

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  • Unlimitedhours

    Injection wounds: Hydraulics are not the only systems that cause this. Normally a hydraulic system running at 1725 PSI is not enough pressure to cause a major injection wound UNLESS it comes through a pinhole leak, which is rare. Military and aircraft systems run at much higher pressures approaching and sometimes exceeding 8,000 PSI which can easily cause these injuries. Another source of these injuries is WaterJet cutting machines, which use high pressure water to cut anything from Steel to glass and generate pressures from 55.000 PSI up to 90,000 PSI. These are very serious injuries which require aggressive treatment for both the damage and infection potential. (I wrote about one incident here: http://unlimitedunscheduledhours.blogspot.com/2010/08/i-dont-think-youve-ever-seen-this.html )
    Not often seen, but when you see it you will A) never EVER forget what it looks like, and B) gain a lifelong appreciation for what the term ‘injection wound’ really means.
    UU