Trauma Week Day One

December 9, 2024 with EMS

---

In this scenario, an ATV accident occurred in which the boyfriend was driving and the girlfriend, who was riding in the back, was thrown off. The accident took place in the middle of the woods at a hunting camp. The boyfriend called 911, and the dispatcher guided him through the situation until EMTs arrived on the scene. By the time EMS arrived, the girlfriend was unconscious, with low blood pressure, visible deformities, and labored breathing on the left side.

EMS performed a needle decompression to treat the patient's labored breathing on the left side. This procedure helps remove air or blood from the chest cavity, allowing the lungs to expand and aiding in ventilation. Chief Ben McKenna, from District Four, shared that about 2 cubic centimeters of fluid per kilogram of body weight is typically administered, with 1,000 mL (or 1 liter) being a key target in stabilizing blood pressure. This was important in this case to address the patient's breathing issues and improve circulation.

After the initial action, EMS performed a full assessment of the patient to check for any other injuries, such as cuts, scrapes, or open wounds. The focus remained on airway management. Ideally, intubation would be performed to secure the airway, but in field settings, EMS typically avoids intubation unless absolutely necessary due to the risks involved. Instead, the paramedics focused on bagging the patient to help with ventilation. This is a delicate process, as over-bagging a trauma patient can worsen the situation by causing complications like hyperventilation, so careful monitoring is essential.

One of the I asked was how the outcome might have been different had the patient been wearing protective gear. Chief McKenna explained that it would depend on the type of protective gear she was wearing, such as a regular helmet versus a motorcycle helmet, or the presence of shoulder or knee pads. The level of protection offered by gear could certainly have reduced some of the injuries, particularly those to the head, neck, or limbs, depending on the circumstances of the crash.