--


Untitled

by Alan

 
If the patient is in cardiac arrest, CPR is indicated whether or not the patient has broken ribs and a punctured lung. CPR may break ribs anyway.

Now this is where I am confused. This is one patient? Well anyway...

Looking at the vital signs pre-code and assuming all injuries are closed you may have initially normal vitals except respirations which may be labored and rapid to compensate.

However, as the patient begin to decompensate the BP will drop and the heart rate increase. Level of consciousness will decrease.

Pre-Code treatment will involve airway managment including O2 via a mask, stabilizing the fractures including the ribs, initiating a pair of large bore IVs running either NSS or LR (or 1 and 1), and keeping the patient warm. As the patient's condition gets worse then a vasopressor such as dopamine may be in order. MAST pants may even be used to stabilize the femur and slow internal bleeding. As the pt goes down hill intubation may be required. Also, as a pneumothorax may develop, chest decompression may be in order.

The patient you describe has many complications which require surgical intervention. EMS may only buy time.

Post-Code treatment depends on the rhythm. However, depending on the extrication time still needed, pt access etc., the patient may not be worked at all.

I know I am missing something here but hope it is a start.



Posted on Jan 3, 2001, 10:55 AM

Respond to this message

Goto Forum Home
Responses

  1. Thank you. Pina, Jan 3, 2001
  2. Who'd have thought.... , Sep 10, 2001

Create your own forum at Network54
 Copyright © 1999-2008 Network54. All rights reserved.   Terms of Use   Privacy Statement