Welcome to the new Tamingthesru
Same great content - new look - improved search
Flights - A Stab in the Dark - Curated Comments and Expert Commentary
Thanks to everybody who contributed to an excellent discussion of the care of the patient on our second “flight.” If you didn’t get a chance to check out the case and the discussion, check it out here. Below is the curated comments from the community and a podcast from Dr. Hinckley and Flight Nurse Practitioner Jason Peng
Q1 - Walk through your initial assessment of this patient. What are the critical aspects of the assessment of this patient?
In response to this question, most everybody wanted to first act on the bleeding wound in the patient’s right antecubital fossa. As explained by Dr. Renne, “I would want to be systematic but efficient, probably using a C-ABCD approach to these kind of critical patients, with the first C being any sort of life-threatening but "C"ontrollable hemorrhage.” Dr. Renne also had a fine point with regards to checking for other potential, as of yet unseen, injuries. This is a patient with multiple stab wounds, it is crucial to conduct a quick, but thorough search for stab wounds to the back, axilla, groin, and/or other locations where significant blood loss could be caused by a stab wound.
Flights - A Stab in the Dark
You are working overnight as the H2 doc based at Butler County Regional Airport. It’s bitter cold out (for Ohio that is). Its only 11 PM and already the temperature has dropped to 9 degrees fahrenheit on its way to a low of 0. You are in the lounge refamiliarizing yourself with the contents of the critical care cells when the tones go off: “Scene: stab wound – Hamilton Ohio”
You and the nurse grab your equipment, the blood cooler, and head to the helicopter. You put the critical care cells back in their spot in the rear of the helicopter and then buckle in for the short flight to the scene.
Your patient is a 23 year-old female who was in an argument with her boyfriend earlier in the evening. The verbal argument quickly escalated, her boyfrienf pulling a knife and stabbing her multiple times in the right arm and right chest. He fled the scene and she managed to call 911. The first responders found the patient with significant active bleeding from her arm as well as chest. She was initially responsive, but is now only awake to painful stimuli.
You meet the EMS crew in the back of the squad truck and assess the patient from the head of the bed.
Flights - One Road too Far - Curated Comments & Expert Commentary
Thanks to everyone who chimed in for our first ever "Flight"!! If you didn't get a chance to read the case, take a look here. There was some excellent discussion on how best to care for the blunt polytrauma patient. Below is the curated comments from the community and Dr. Hinckley's take on the questions posed to the community.