EMR in Action, ctd.

Team member Mikel Kinser was at home, where his wife was hosting a couple’s baby shower for one of her coworkers:

“I was outside when I heard a loud crash and my wife yelled from inside for help. I ran inside and found one of her guests prone on the floor next to a chair that had fallen over. My wife said she fell over after saying she was dizzy and had asked for a glass of water.

Her head hit the ground hard and she lost consciousness for a moment. I told my wife to call 911. As the guest started to come around, I began speaking to her, asking her questions. She was A&OX3, not knowing what happened to her, but did know her name, where she was, and what day it was. I also took her pulse and respiration. I began feeding this information to my wife, who was on the phone with 911.

She also had a large bump on her head where she hit the ground, but no blood. She had free motion with her head and neck so I did not feel there was any spinal or neck injury. I checked her eyes for PERRL and all was good. I kept her on the ground where I found her, and checked with her for comfort (warm or cold). Paramedics arrived within five minutes of the call and took over. I relayed the info again to them: patient name, what happened and patient vitals. From there I just observed the five emergency workers. They did an EKG on her (normal) but they did find that when she stood up her BP dropped a lot. She refused transport, and I had to sign as a witness.

She remained at our house until a friend of hers could come and pick her up. We told the friend to keep an eye on her as she had hit her head and could have a concussion. She returned the next day for her car and was fine except for the bump.

Looking back on it, I felt calm going through the steps, but could have done better (I had a BP cuff in my office and I did not think about it until later). I also did not do CMSTP, which I should have. I feel worse for the things I did not do than good about what I did do, because I know from my EMR training what is supposed to be done. I can see that continued exposure to this is the only way to stay on top of it and do it correctly.”

EMR in Action, ctd.

Today, after pulling an all-nighter for last night’s search, team member Wilma Murray was trying to shake the cobwebs by taking her dog for a walk when she was suddenly called upon to exercise her medical skills:

“We came upon a group of men converged on the sidewalk. They were gathered around a young man who sat (in a rather crumpled position) up against a retaining wall. 

The men were asking him if he was all right and what they could do for him. As I approached, I was told one of the men had seen him sitting there an hour before and when he returned, the young man was still in place. I asked the subject a few questions and getting no response, I took a closer look. His eyeballs were rapidly flickering and he was clearly in distress. I asked one of the men to call 9-1-1, asked another to please hold my dog's leash and explained I was trained in first aid. 

I bent down to the subject's level and introduced myself. My request for consent was met with a vague noise I took to be affirmative. I had no gloves with me (lesson learned), so I had to barehand it. I continued to try to get a response from him and was able, after repeated tries, to get his first and last names. His pulse was 120, respiration 24, forehead cold and clammy but face very hot. But it was the lack of awareness and the rapidly moving eyeballs that most concerned me. 

I saw no visible mechanism of injury or blood and did not conduct a head to toe (another lesson learned) as I instead busied myself with trying to get him comfortable leaning against me while trying to elicit information from him. One of the men handed me a bottle of water and I was able to get the subject to sip a few times. When help arrived, I gave the responders the subject's name, his vitals and told them what I had observed. 

It took six strong men to lift this very thin young man onto a stretcher.  The subject then began to seize and they had to strap him down before loading him into the ambulance. I have no idea if he will be all right, but I can only hope.

Once again, SAR training proved invaluable, but I was made painfully aware of how easy it is to make mistakes or not be thorough enough in a real-life situation. It only encourages me to practice, practice, practice. The good news is that my training kept me calm throughout the whole experience. Thank you SAR!”