Tuesday, October 25, 2011

Update on the Helicopter ride

So in answer to the question of why the 'copter waited for 45 minutes or so last Sunday AM, here is the scoop.

So some kid got a 'copter ride early Sunday morning for broken legs. Maybe very badly broken legs, but broken legs nonetheless. Even with a broken back, they transported one of the victims to a local hospital by ambulance.

Again: I am not a doctor.Nor am I an EMT. (although, last Halloween I did go to a party as Dr Feelgood...)

But I fail to see how any of the injuries from a drunken car crash, especially broken legs and ankles, is a reason for a whirlybird ride.

But whether the helo ride was justified or not, there is no way that the 44 minute wait was a good idea.  

I always was under the impression that a 'copter ride was for circumstances where every second counts....like when you had a 4" pipe through your abdomen and were bleeding to death internally....and the 'copter brought you to the waiting surgical team...or when your melon was so badly injured that you needed a neurosurgeon as soon as possible so it didn't explode or something like that...Not mangled legs.

Or am I missing something here?

And what kind of friends sit outside the car while you lay trapped inside?

3 comments:

  1. Well, depends on where the legs are broken. You can lose up to 2 liters of blood from an isolated femur fracture.

    With the blood volume of the average adult male between 5 and 6 liters, that's easily enough to put you into shock. Both femurs doubles the potential for circulatory compromise. Plus, femur fractures are often associated with pelvic fractures, and the pelvis is slam full of important vessels. You can literally bleed to death from pelvis and femur fractures.

    On the other hand, the signs of that circulatory compromise are pretty hard to miss for any EMT worth their paycheck, and if they're not present, there probably isn't a need for that helicopter.

    With bilateral long bone fractures, the trauma center is an appropriate destination, however, but it's likely that the patient could have been driven there safely if he wasn't showing signs of shock.

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  2. After reading the article, it sounds like he had distal tibia and ankle fractures - very painful, but not nearly the potential for circulatory compromise as with femur fractures.

    I'd not put much stock in the police statements that he couldn't move his legs. In my experience, reporting of such events is more often wrong than right, and cops are pretty bad judges of most things medical. It's very possible that the kid couldn't move his legs because they were broken, and it hurt too damned much.

    Were it me, I'd have flown the kid in the back seat with the facial fractures who kept going in and out of consciousness. That just screams head injury and potential airway compromise to me, and he'd have gotten the helicopter ride before anyone with broken bones.

    Then again, everyone's an expert about someone else's call...

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