A Long Day
Today I worked another triathlon, one that kept us quite busy. Right off the bat, injured people. Minor stuff, but an indication of the day, IMHO. And that was before the race started. Swim went portion went well. We kept an eye on a few swimmers, but everyone made it out of the water. Got a few more folk with minor injuries, easy to treat (bandaids and such).
Ended up with a bike crash near the beginning of the bicycle portion of the race (which was also a loop-around point). Two racers collided, with one going over a metal pipe-type gate. Based on MOI (Mechanism of Injury), we chose to C-Spine him in preparation for transport to the hospital. Fire Department got there, and before they even evaluated the patient, essentially convinced him not to go to the hospital. Argh. But, at that point, they had "control" of the patient (and legal liability if something goes wrong... we chose to be cautious). We stood back, and let them evaluate him after they got him off the board. We still think it was a bad idea, but the patient and the medics made the choice, not us.
Had some other slides/crashes, but none so serious as the one I described above.
During the run portion, we were notified of a runner down on the course at one of the aid stations. That was all we had. We kept trying to get the aid station on the radio, and finally got a garbled message, the gist of which we heard, "heart attack". Damn! We got on scene, and found a runner down with crushing chest pain, diaphoretic, low blood pressure, and thready pulse. Not good. Got the patient on O2, and began transport in our Jeep to meet up with the ambulance at a major intersection nearby (We are on-scene BLS only). Re-evaluated vitals, pain level, and pulse ox while the fire department and ambulance were en route.
The FD got there, took control of the patient, re-evaluated vitals again, and then decided to give him nitro spray under his tongue. Nitro is used to dilate blood vessels, allowing more blood flow to the heart, and reducing pain. Problem is, the FD EMT sprayed it several inches from the patient. While it did make it into his mouth, he sprayed me as well. Nitroglycerin can be (and was) absorbed by the skin and mucous membranes. While I didn't take a breath at this time, I suspect my face and eyes took a hit from the spray. As a result, I entertained a minor headache for around a half hour that ensued from the exposure. Not horrid, but he should have been a lot more careful. And hey, more medication would have gotten into the patient. He was then moved onto a gurney, and headed off to the hospital. FYI: Looked like an Left Anterior Descending MI (Aka "Widowmaker") on the ECG, according to my partner.
That pretty much wrapped up the race. While we were out with this patient, one of the other EMT's was dealing with a line of "road rash" from crashes, minor falls, etc. As I said, it was a long day. But hopefully one that everyone will be ok, including the possible MI (Heart attack).
Oh, all this occurred in around 3 hours.
Ended up with a bike crash near the beginning of the bicycle portion of the race (which was also a loop-around point). Two racers collided, with one going over a metal pipe-type gate. Based on MOI (Mechanism of Injury), we chose to C-Spine him in preparation for transport to the hospital. Fire Department got there, and before they even evaluated the patient, essentially convinced him not to go to the hospital. Argh. But, at that point, they had "control" of the patient (and legal liability if something goes wrong... we chose to be cautious). We stood back, and let them evaluate him after they got him off the board. We still think it was a bad idea, but the patient and the medics made the choice, not us.
Had some other slides/crashes, but none so serious as the one I described above.
During the run portion, we were notified of a runner down on the course at one of the aid stations. That was all we had. We kept trying to get the aid station on the radio, and finally got a garbled message, the gist of which we heard, "heart attack". Damn! We got on scene, and found a runner down with crushing chest pain, diaphoretic, low blood pressure, and thready pulse. Not good. Got the patient on O2, and began transport in our Jeep to meet up with the ambulance at a major intersection nearby (We are on-scene BLS only). Re-evaluated vitals, pain level, and pulse ox while the fire department and ambulance were en route.
The FD got there, took control of the patient, re-evaluated vitals again, and then decided to give him nitro spray under his tongue. Nitro is used to dilate blood vessels, allowing more blood flow to the heart, and reducing pain. Problem is, the FD EMT sprayed it several inches from the patient. While it did make it into his mouth, he sprayed me as well. Nitroglycerin can be (and was) absorbed by the skin and mucous membranes. While I didn't take a breath at this time, I suspect my face and eyes took a hit from the spray. As a result, I entertained a minor headache for around a half hour that ensued from the exposure. Not horrid, but he should have been a lot more careful. And hey, more medication would have gotten into the patient. He was then moved onto a gurney, and headed off to the hospital. FYI: Looked like an Left Anterior Descending MI (Aka "Widowmaker") on the ECG, according to my partner.
That pretty much wrapped up the race. While we were out with this patient, one of the other EMT's was dealing with a line of "road rash" from crashes, minor falls, etc. As I said, it was a long day. But hopefully one that everyone will be ok, including the possible MI (Heart attack).
Oh, all this occurred in around 3 hours.
Labels: EMS, Misc Rants
posted by First On Scene EMS at Sunday, October 14, 2007
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