SA Firefighter
General Discussion => SAAS => Topic started by: Knackers on March 09, 2008, 02:33:21 PM
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Hello all,
How would other Paramedics and ICP's treat an approx 70yo M, weight 110kg, lives at home c/o lumber back pain, in spine region, sharp, last 3-4 days, prescribed panadine forte but minimal compliance. Only other Hx gained is CA in groin region and says does not take any medications and has had a few glasses wine over the day?
Pain 10/10, difficulty getting on to bed, minimal complience with penthrane, bp 160/95, hr 110, unable to get other Hx or info, GCS 15 (4,5,6), warm dry skin.
??????
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what the ?? This is safirefighter not virtual doctor..
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Ok, seems to be a negative response. If you want this topic pulled, so be it. I know is a fire forum, but we all work together. Seems to be a lot of this negativity happening lately.
I thought maybe some people would be interested in discussion on learning without the negativity.
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Haven't you seen the site name change from SA fire fighter to SA emergency service operator?
... oh wait...
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Gentlemen, (and ladies), this is the SAAS board, which is meant for this exact type of question. What else would it be for?
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I swear that big white writing at the top of the page indicates the proposed content. :P
I'm keen to know the answer to the proposed back pain question...
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RING A FRIEND............
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Ill give it a crack Knackers, only have Cert 4BEC but ill give it a go. O2 @ 8lpm, Dot him up on the MRX cause HR/BP high, monitor & ascertain rhythm, if ok run with some pain relief (something better than penthrox),monitor BP/HR, make sure pain relief is working, if so make him comfortable, then transport to RDMC.
Not sure if im close, but if you or matrix can give some feedback that be cool.
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what the ?? This is safirefighter not virtual doctor..
Completely inappropriate response to a genuine question. Take a look at this boards description it is meant for clinical discussion.
If you can't add value to the topic don't post.
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It would depend on where the person is & what caused the pain ?? Can you elaborate please... :-)
If the person is in an isolated area (eg bushwalking or trapped after a grass fire has gone through), then it is a hard choice between waiting for medical people with better pain relief to walk in or begin to transport out on a rescue litter.
Being Senior 1st Aider training only, I would need to suspect the worst and treat as a spinal injury. So at minimum it is try to restrict movement to avoid further potential spinal injury. But at 10/10 pain level, restricting movement would be difficult because the patient would be trying to move to a more comfortable position constantly.
If SAAS is 30 to 60 mins away, what would the Firies do ?
From the SAAS or St John's people, what is the best treatment if the person is in an isolated location.
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If SAAS is 30 to 60 mins away, what would the Firies do ?
Apply First Aid, nothing different.
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If SAAS is 30 to 60 mins away, what would the Firies do ?
Apply First Aid, nothing different.
But would you transport the patient on a rescue litter to ambulance on a road which would be quicker but more painful, or would you wait until pain relief arrived via SAAS walking to the casualty before moving on the rescue litter or 4wd vehicle ??
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depends if theres any danger to him being where he was.
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unfortunately most CFS crews and vehicles in this situation wouldn't have a rescue litter with them as they are like hens teeth in CFS and hence not on rural trucks.
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more questioning:
Hx of same injury? or anything which pt has done which could have either exacerbated or caused this pain?
is it bony or muscular pain? "lumbar pain in spine region" is fairly broad descriptor......
radiating pain?
what does Abdo look/feel like?
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Pt not good with Hx, started 3-4 days ago no trauma cause identified. Nil other pain, eg abdo, chest. Nil radiating pain identified, neurovascular nil comprimise.
Abdo large, normal for pt however.
Pain worse on sitting, lying, not as bad on standing.
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I'd try to stabalise them as much as possible in a position that caused them the least amount of pain. Administer O2 until the ambos arrived.
As far as moving them without the ambos advice, I would be weary unless it was 110% necessary.
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why so wary numbers? He's had this pain for 3-4 days!!! in those 4 days he would have still had to go to the toilet, sit/lie down, stand up etc etc
this seems more musc/skeletal - unless someones hiding a AAA from us. :evil:
so given he's haemodynamically stable, and musc/skeletal injury - Morph to effect prior to transport.
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Ah true boredmatrix, still in the normal fire service "First aid? Call the ambos!" mode.
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Sounds possibly like a ruptured or bulging disk. I had a similar thing a year ago, triggered by bending down to pick something up. pain similar. locatalised to lower back and extremely restrictive. Lying is good (still painfull), but changing positions gets the swear words flowing.
I rested up for a few days. Took anti inflamitories, and saw a physio who identified the issue and gave me exercises to repair/prevent further damage.
Seeing a doctor is probably the best thing. That way prescribed pain and inflamation medication can be used, and they can recommend a further treatment such as physio etc.
Just as an afterthought, the treatment for me was to lie on stomach, and push torso off ground using arms, keeping pelvis on the ground. about 10 reps per session, a few times a day. Alternatively this can be done standing up. placing hands on lower back (top of bum cheeks) and slowly bending backwards keeping hips forward. Only go to limit of pain, and push further as pain subsides. If its working, it should get easier to go further after a day or two.
I would get professional advice first, but if its really bad i guess trying things can't make it too much worse!
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Thats my line of thinking gilly, im no Dr or ICP, even Paramedic, just plain old boring BEC Cert 4, gather DOLAR & AMPLE, make an assessment, treat , then transport to better medical help. (That being the nearest Paramedic is 2.5Hrs away and the need for us to get the patient to the Hosp/Dr is of the up most importance)
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Ah true boredmatrix, still in the normal fire service "First aid? Call the ambos!" mode.
fair call - but the question did ask how para/ICP would manage it.......