Interesting new medical development.

[Kevin L]

Rellgar and I may have to agree to disagree on the tourniquet issue.

With respect to everyone, I was a paramedic, a flight medic, and a relief worker with the Red Cross. I worked in EMS for almost 12 years, and this included mass shootings, industrial accidents, horrific car accidents, and so on.

I have probably seen perhaps 150 to 200 amputations which were caused by everything from a car accident to a machete fight between several idiots who were working the sugarcane fields.

I've never had to use a tourniquet to stop bleeding, although I routinely used them when starting an IV to make the vein pop up.

I'm very pushy about refraining from using a tourniquet, as--even when used correctly--they can cause considerable nerve damage and significant problems with the vascular system.

One of the few times I used a tourniquet (actually 3 of them) was for a procedure for treating congestive heart failure. It involves tying off 3 limbs, and then rotating the tourniquet to make sure that every limb gets a break.

This was called--for obvious reasons--"rotating tourniquets", although now the technique is considered antiquated and inappropriate.

Even in a traumatic amputation, using a tourniquet to control bleeding may do certian things that might prevent the surgeon from reattaching the severed limb.

 

[GaRp58]

I have 3 hemostats in my first aid vest. I would choose to clamp an Artery or two to save blood in exchange for the re-attachment of a limb. Only saw a few bad injuries in Croatia and open head cuts (8" long) from a motorcycle accident and one torn off leg below the knee from a trike accident. The leg got a soft tourniquet to save blood but not strong enough to damage the leg. He lost the leg anyway but I kept him up and alive till the SAR chopper got there, the open head wound just got closed with a compression over the top and under the chin...GP

 

[Kevin L]

I have 3 hemostats in my first aid vest. I would choose to clamp an Artery or two to save blood in exchange for the re-attachment of a limb. Only saw a few bad injuries in Croatia and open head cuts (8" long) from a motorcycle accident and one torn off leg below the knee from a trike accident. The leg got a soft tourniquet to save blood but not strong enough to damage the leg. He lost the leg anyway but I kept him up and alive till the SAR chopper got there, the open head wound just got closed with a compression over the top and under the chin...GP

It sounds like you did everything that you could.

 

[GaRp58]

both survived...it was enough. The head injury was a young mother on the first motorcycle trip after her first child. 6 months old. She now has 3 kiddies...
The torn off leg, was a young german soldier with his girl. He lost his leg, her right heel was torn off but sewn back on. She was in shock and went out, but he was talking to me like nothing even happened. Very strange. No shock, no trauma or such...

 

[KateMTx]

both survived...it was enough. The head injury was a young mother on the first motorcycle trip after her first child. 6 months old. She now has 3 kiddies...
The torn off leg, was a young german soldier with his girl. He lost his leg, her right heel was torn off but sewn back on. She was in shock and went out, but he was talking to me like nothing even happened. Very strange. No shock, no trauma or such...

It's strange how different people react so differently to trauma.

 

[Kevin L]

It's strange how different people react so differently to trauma.

I agree 100%. There is still much to be learned about trauma.

 

[Kevin L]

I agree 100%. There is still much to be learned about trauma.

Just so you all know: 12 years of EMS in a drug-saturated, poverty-stricken, crime-ridden South Florida barely scratched the surface of what's to be learned about trauma.

At one point (all paramedics go through this . . . usually early in their careers), I thought I was a bad-ass when it came to trauma . . . until I learned enough to realize how much I really don't know.

 

[DrJenner]

Just so you all know: 12 years of EMS in a drug-saturated, poverty-stricken, crime-ridden South Florida barely scratched the surface of what's to be learned about trauma.

At one point (all paramedics go through this . . . usually early in their careers), I thought I was a bad-ass when it came to trauma . . . until I learned enough to realize how much I really don't know.

"until I learned enough to realize how much I really don't know"
That says a lot about you sir. The more I learn, the more I realize I don't know. working in critical care, and recently certifying with ATLS taught me exactly how much I DON'T know about trauma.

 

[Kevin L]

"until I learned enough to realize how much I really don't know"
That says a lot about you sir. The more I learn, the more I realize I don't know. working in critical care, and recently certifying with ATLS taught me exactly how much I DON'T know about trauma.

Thank you. Back at you.

I was certified (and instructed) BTLS. We had just abandoned PHTLS and switched over to BTLS early in my career.

One of the biggest epiphanies that I had as a medic is that human stupidity is about 80% of my job security.

I never understood why people do half of the things that they do . . . but maybe that's just my lack of insight.

 

[tmttactical]

Thank you. Back at you.

I was certified (and instructed) BTLS. We had just abandoned PHTLS and switched over to BTLS early in my career.

One of the biggest epiphanies that I had as a medic is that human stupidity is about 80% of my job security.

I never understood why people do half of the things that they do . . . but maybe that's just my lack of insight.

No, they be stupid.

 

[DrJenner]

Thank you. Back at you.

I was certified (and instructed) BTLS. We had just abandoned PHTLS and switched over to BTLS early in my career.

One of the biggest epiphanies that I had as a medic is that human stupidity is about 80% of my job security.

I never understood why people do half of the things that they do . . . but maybe that's just my lack of insight.

Me either. Job security though

 

[Kevin L]

Me either. Job security though

Agree 100%. Are you an MD, DO, or APNP?

 

[DrJenner]

Agree 100%. Are you an MD, DO, or APNP?

I'm an ARNP, work in critical care- husband is a MD in the ER.

 

[Kevin L]

I'm an ARNP, work in critical care- husband is a MD in the ER.

You and your husband sound very accomplished. I was a medic for a very long time, and now I'm working on my RN.

 

[DrJenner]

You and your husband sound very accomplished. I was a medic for a very long time, and now I'm working on my RN.

Nice! Good luck to you! Lots of career opportunities.
One of my colleagues was a medic in the military and went back for his RN and eventually ARNP. He thinks quickly in stressful situations and is great with intubations! Covid has caused us to adapt when intubating and it's been interesting to say the least. When will you be done?

 

[Kevin L]

Nice! Good luck to you! Lots of career opportunities.
One of my colleagues was a medic in the military and went back for his RN and eventually ARNP. He thinks quickly in stressful situations and is great with intubations! Covid has caused us to adapt when intubating and it's been interesting to say the least. When will you be done?

I'll start the nursing school itself in about a year or so.

I'm sure that intubation can be an interesting challenge with COVID 19. We--years ago--had to adapt when intubating patients with multi-drug resistant tuberculosis. We didn't have the truly effective AIDS treatments that exist today, and we often had substance abusers with AIDS, MDRTB, and overdosing at the same time.

Those were the days. FUN FUN FUN!!!