You’re called for a “baby not breathing” at a residence. You’re responding mutual aid to the EMS responders in a neighboring community so your response is delayed. You proceed to the scene with lights and sirens, but just as you arrive, your dispatch center reports the family has called back to cancel the ambulance, stating the baby is now breathing and crying normally.
The call came into the Pittsburgh 9-1-1 communications center at 7:42 a.m. for a young female unconscious and not breathing, found lying outside on a stairwell. Pittsburgh EMS Medic 5 was advised en route that bystanders thought the patient was deceased, but when law enforcement arrived a few minutes later, they detected a weak pulse and rapidly moved the woman inside to get her to a warmer environment.
Bleeding is the leading cause of preventable death in both civilian and military trauma.1 There’s a clear consensus that control of bleeding is the top priority during patient care; every second of uncontrolled bleeding worsens outcomes.2 There are many ways to control bleeding, and each technique has advantages and shortcomings.
It’s 2 p.m. on a Saturday when you’re dispatched to the northbound lanes of Interstate 75 at mile marker 80 for reports of a motorcycle accident. En route, highway patrol notifies you there’s a single male rider involved in a high-speed crash. On arrival, you find a 22-year-old male lying on the highway 40 feet from his motorcycle, wearing a helmet and body gear. He’s conscious but confused. His breathing is fast and shallow. A radial pulse is barely palpable and his skin is cool and pale.
The Research Weaver MD, Rittenberger JC, Patterson PD, et al. Risk factors for hypothermia in EMS-treated burn patients. Prehosp Emerg Care. 2014;18(3):335–341.
Crash Data Hunold KM, Sochor MR, McLean SA, et al. Ambulance transport rates after motor vehicle collision for older vs. younger adults: A population-based study. Accid Anal Prev. 2014;73C:373–379.
The Centers for Disease Control and Prevention (CDC) recently published its third “Interim Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public Safety Answering Points (PSAPs) for Management of Patients with Known or Suspected Ebola Virus Disease in the United States.” This third version is dated Oct. 24, 2014, and is the current version at press time.
Fire-rescue and EMS units from Goshen, Malvern and Fame (West Chester County, Penn.) fire companies work to extricate the entrapped victim of a single car. The driver and only occupant of the vehicle collided with a utility pole. Initial access to the patient was hampered by the vehicle’s entanglement in energized power lines. (See inset photo.) The patient was transported to the trauma center at Paoli Memorial Hospital for chest injuries.
It’s 11 p.m. on a Saturday night when you’re dispatched to a local nightclub for reports of a young male who’s suffered multiple gunshot wounds. En route, police notify you the scene is safe and there’s a single patient bleeding profusely from multiple extremity wounds. On arrival you find a 25-year-old male lying on the street in a rapidly expanding pool of blood. He’s nearly unconscious but breathing spontaneously. His skin is cool, moist and pale. His pulse is rapid and barely palpable.
Trauma is one of the leading causes of death and disability—with injuries accounting for 9% of global mortality—and has an enormous worldwide impact on health.1 Preventing and decreasing the burden of trauma are among the chief challenges for public health agencies around the world. Development of a trauma system able to accurately measure the incidence, process of care and outcomes of traumatic injuries—while getting the right patients to the right hospitals at the right time in an organized and coordinated way—is paramount.