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Evaluating Blunt Trauma Patients

Evaluating Blunt Trauma Patients

A quick and thorough evaluation of patients with traumatic injuries is extremely important.  The ideal approach is regimented, practiced, expeditious, and flexible to the environment in which it is performed.   Advanced Trauma Life Support (ATLS) courses do a great job of teaching the guiding principles to the approach to the trauma patient.  However, while it is relatively simple to become facile with the exam of victims of trauma in the (relatively) controlled setting of the trauma bay, it can be especially challenging to examine the same patient in the field.

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On Tourniquets and Lives Saved

On Tourniquets and Lives Saved

Though tourniquets were likely in use since Roman times, the term “tourniquet” was originally turned by Louis Petit, the 18th century inventor of the screw tourniquet.  Though numerous design advancements have occurred and new devices have been made in the centuries that have followed, the basic principles of tourniquet use are essentially unchanged.  A tourniquet applies an external pressure to a limb (usually) that exceeds the arterial pressure in that extremity.  In this way the inflow of arterial blood to an extremity is stopped.  For a surgeon, in the setting of a prospective extremity surgery, this allows for the creation of a bloodless operative field.  For Emergency Medicine providers, tourniquets can aid in the exploration of extremity wounds, allowing the identification of injuries to tendons, joints, and vascular structures.  And perhaps most importantly, tourniquets applied proximal to the site of penetrating traumatic extremity injuries can cease bleeding from arterial injuries.

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Reconfiguring the EC145 for Two Patients

Reconfiguring the EC145 for Two Patients

Our EC145 aircraft have the capability to fly two patients.  However, doing this is never our preference.  Those of us who have had the chance to fly two patients can attest that it’s quite challenging, especially if one or both are truly critically injured.  Your crew:patient ratio is halved.  And if you’ve ever thought that ergonomically your space was limited in the helicopter with only one patient, it’s much worse when there are two.  Therefore, we always teach our EMS colleagues: if you’ve got two patients you need to fly, ask for two helicopters.

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