Tampons in Bullet Holes (Again)

[Muppet]

We have not had it very long, and I think the only reason the hospital bought into it was because it's ATLS 'best practice.' I have been shocked at how many hospitals don't have it, though.

There is only so much you can do to affect a positive outcome in the field for trauma and I just don't understand the intransigence of some people who want to limit the very few tools in the toolbox. There are several drugs in the drug box the medic will almost never give, yet "protocol" demand they stay in the drug box, even if they have to be recycled every 'n' years because they expire. The illogic is boggling.

Agreed

 

[policemedic]

I'm aware on the second part, just never really dug into it before.

I know EMS is starting to see it, here in PA it's being discussed, not sure if it will make it in urban/suburban settings where we are trauma center dense.

Philly is doing it.

 

[policemedic]

Yeah. In all cases the best fix is bright lights and cold steel. As long as these protocols do not inhibit transfer time, I am all about it. The argument of distance is great and I agree, that one unit in transport could be the difference.

In other news, my hospital doesn’t even have whole blood.

Time on scene is not the bugaboo many people make it out to be.

 

[policemedic]

Philly is doing it.

Also coming soon: POCUS

 

[TLDR20]

Time on scene is not the bugaboo many people make it out to be.

Can you explain what you mean?

 

[Muppet]

Also coming soon: POCUS

Philly is doing POCUS!?

 

[policemedic]

Philly is doing POCUS!?

Yup

 

[Muppet]

Yup

Fucking 3/4 of the medics there are lazy bastards that walk STEMIs into Temple while the penetrating trauma is being transported by PPD and they expect medics to do blood AND POCUS?

I'm not buying it. Lol

 

[Muppet]

Yup

Next you're telling me is that they will start/pilot finger thoracotomy. ;)

 

[policemedic]

Finger popping means something different in Philly.

 

[policemedic]

Fucking 3/4 of the medics there are lazy bastards that walk STEMIs into Temple while the penetrating trauma is being transported by PPD and they expect medics to do blood AND POCUS?

I'm not buying it. Lol

Remember all the pushback against 12-leads back in the day?

In any case, they’re doing it. It’ll be interesting to see how it goes.

 

[Muppet]

Remember all the pushback against 12-leads back in the day?

In any case, they’re doing it. It’ll be interesting to see how it goes.

We'll see no doubt broheim.

 

[amlove21]

Fucking 3/4 of the medics there are lazy bastards that walk STEMIs into Temple while the penetrating trauma is being transported by PPD and they expect medics to do blood AND POCUS?

I'm not buying it. Lol

BRO. Do you know how many times during my clinical rotations at Einstein or Jeff I listened for police sirens knowing I was gonna get the trauma EMS wouldn't touch?

It was more than once, which was 1 too many times.

 

[Muppet]

BRO. Do you know how many times during my clinical rotations at Einstein or Jeff I listened for police sirens knowing I was gonna get the trauma EMS wouldn't touch?

It was more than once, which was 1 too many times.

It's crazy brother.

PPD has been doing this for years. Decades. I did medic ride time at PFD M-11 in South Philly, 1999.

I can't count how many times we would be sent to a shooting only for a paddy wagon to stretch em, let him bleed out to Jefferson.

Meanwhile, PPD would call us for fucking drunks and psychs. Lol.

I get the concept as long as PPD are treating the victim. I get that PFD is over worked with absolute bullshit going to 1 end of the city to the other but for petes sake, where I'm at, Cheltenham Township on border of North Philly, we'd get a double shooting on the Ave the separates us, we and PFD would go.

We both take em as trauma alerts to Einstein, I trauma naked, bilat 16s, O2, chest seals, maybe needle chest, all in the 6 min ride, get to trauma...

PFD gets there, pt still clothed, nothing done.

It's bad when trauma staff are heard saying, "fucking county medics doing their jobs and fire gives taxi rides".

Unreal.

 

[policemedic]

BRO. Do you know how many times during my clinical rotations at Einstein or Jeff I listened for police sirens knowing I was gonna get the trauma EMS wouldn't touch?

It was more than once, which was 1 too many times.

In fairness, it’s not that EMS wouldn’t touch them. Policy was—and is—for police to scoop and run with penetrating trauma. Since we were almost always there before EMS, a lot of trauma was transported by cops.

Treatment? TQs when we got them. Before then, 87 octane bolus and burnt brake pads.

But the interesting thing is the data showed no difference in survival.

 

[Devildoc]

In fairness, it’s not that EMS wouldn’t touch them. Policy was—and is—for police to scoop and run with penetrating trauma. Since we were almost always there before EMS, a lot of trauma was transported by cops.

Treatment? TQs when we got them. Before then, 87 octane bolts and burnt brake pads.

But the interesting thing is the data showed no difference in survival.

Actually, I'm not sure that's true. I read a paper that showed better outcomes. I'll see if I can find it.

 

[Muppet]

Agreed. Medics spending too much time fucking around on scene. I get on the young cats that do that.