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Wolves don't lose sleep over the opinions of potatoes.
SlantDuffy joined on Jun 29th, 2011, since that has made 237 posts that are still accessible today, 5 of which are threads. Helping shape the community, SlantDuffy has given 274 upvotes, and was last online on May 22nd, 2013.
15 or 16 or some shit.
Age 15 or 16 or some shit.
Set his family on fire.
Here is a url that will shed light about the killings:
When you call for help, give the following information:
This will help them find you and the patient. If you give a house address, give the specific location, (i.e. room number, lobby, roof, attic, basement, etc.) If you give a generalized location, i.e. intersection of 2nd Ave and 3rd Street, give them a description where to find you. (North/East/South/West sidewalk on 2nd Ave next to a the Newspaper Stand, in front of the Jewelry Store, etc.) Once you give them your location, try your best not to move from the location unless it's absolutely necessary (eminent danger resurfaces).
Number of Patients by Precedence
Urgent:May lose their life if they aren't helped immediately
Priority: May become an Urgent Patient if they aren't helped in the next 2 hours.
Routine: No medical attention needed/at responder's leisure, i.e. minor injury or dead person]) Also, let them know how many of these patients are Litter Patients (Can't walk, they need to be removed from the scene by stretcher or litter)
Example: I have 2 Urgent and 3 Priority. Total of 3 Litter Patients.
Mechanism of Injury
Give the dispatcher a brief explanation of how the patients became injured, i.e. Explosion, Gunshot Wound, Car Wreck, Collapsed Building, Stabbing, Bear Attack, etc. This will help EMT paint a picture of what to expect/what specialized equipment they may need to borrow from other departments.
Any Additional Information You May Need to Pass For example, patient is a woman advanced in her stage of pregnancy, the scene is dangerous and they should send the police, visibility is obscured due to smoke dust or debris, the location is inaccessible by vehicle, there is a fire or chemical hazard present, etc.
After Help Arrives: Stay at the scene and become a liaison for the response, they will need you to answer questions and shit. Also, notify them of ANY drugs administered (Painkillers, Morphine, Epinephrine, Cough Medicine, it doesn't matter what it is, if it entered the patient, the response needs to know) and a brief explanation of medical care given to patients.
Let's say you stumble upon an injured victim. First thing to do is: Call 911! Have someone else call 911 or get help if you are unable to do so. Let's say you and the victim are the only people at the scene, then it looks like you'll just have to move on to Step 1 even if you didn't call for help. Assuming that the victim is alive. If the victim is dead, move onto someone you can help.
Step 1: Evacuation.
Does the patient need to be evacuated in order to be triaged? Is the patient in a dangerous environment that may cause further injuries? (I.e. burning building, flying bullets/mortars, coffined inside of a burning vehicle, or right next to a building or dam that is about to collapse?)
If yes, then you would need to evacuate the victim, but before you evacuate the victim, is he or she conscious? Can the victim walk on his or her own? Can the victim walk if he or she used you as a support?
If the victim is conscious and ambulatory (able to walk with or without help), THEN HELL YEAH! Do that! :D
If you must evacuate an unconscious victim, or a victim that is conscious and unable to walk (the term is litter patient), it will suck. As you evacuate the victim, try not to toss the victim's head around, just in case he or she suffered damage to his or her cervical vertebrae (neck!). You would need a stretcher and other people to evacuate someone in the safest and easiest manner. If you don't have a stretcher or other people to help you, it's okay, you can drag or carry the victim. It's preferred to carry, but a drag will do.
Collar drag: Drag by holding the back of the victim's collar. Use both your wrists to support the victim's head and prevent it from flopping around like a retarded fish. When you place the victim on the ground, do it gently as to not cause further injuries or give the person's head a boo-boo. Here is an image. http://t1.gstatic.com/images?q=tbn:ANd9GcRJoWaJaVLederTttrpfbmPGYMGFfMBEjC2V6ytlNdbehMe2cxC3A
Fireman Carry: it's hard to explain in words so I am providing just a picture:
There are other ways to get people into the fireman carry. Look it up on google.
Step 2: Prepare Your Anus for Triage.
Now that you are in a safe location, place the victim, or ask the victim to lay on his or her back.
Remove gear (backpacks, fanny packs, shoulder bags, purses, rigs, vests) and clothing. This will help you visually find wounds and feel for blood if the victim is wearing dark clothing.
Removing Clothing and Gear from a Conscious Victim: Let the victim know what you are about to do. If he or she refuses, let him or her know why it's necessary for him or her to remove his or her gay-ass clothing. The fastest way is to cut or snip the clothing off, if you don't have a knife or trauma shears, you'll have to unbutton and unzip clothing and pull it off.
Removing Clothing and Gear from an Unconscious Victim: Just do it. They won't mind.
The preferred method to remove clothing is using trauma shears. If you are using scissors, cut from the head to toe, waist to toe. If you use a sharp knife, be careful not to further injure the victim as you do it. Actually, place the knife with the sharp end facing AWAY from the victim and push it along the clothing.
Let's say you need to remove the clothing by hand. There are complications when it comes to removing clothing and gear by hand:
Burns: If clothing is burned onto the victim (Synthetic fibers like NYLON and POLYESTER will do this. I guarantee it.), do not remove the portion of clothing that is burned onto the victim. If you do so, you may cause pain and bleeding. Shit, ask the victim if they think they are burned. Use your hands to tear the clothing that isn't burned from the burned portions. If you can't do that, well, looks like you have to triage while the victim is clothed.
Open Fractures: As you pull fabric and shit, it may snag on bones that protrude from the wound. This can cause lots of pain and bleeding. In order to mitigate this, you have to the do the same thing as you would burnt clothing: tear the clothing into portions with your hands. If you can't do it by hand, then use your teeth.
Chemical Contamination: You might accidentally pull contaminated clothing across uncontaminated portions of the body, thus contaminating the victim further. After reading this, you probably want to carry scissors and shit around. The only exception to this rule is if there is a caustic (shit that will melt human skin) compound or solution on the person's clothes. REMOVE IT AT ALL COST. Like, yank that shit off and try not to get it on you.
Okay, let's say you have the victim undressed and laying on his or her back, conscious or not, you can now triage.
Step 3: Triage
The acronym I use is ABC, because it's fast and I'm dumb. I was taught MARCH, but more medically qualified people use that. I'm going to cover MARCH because it's in depth and encompasses ABC. I'm gonna bold the acronyms for you. And yes, you must triage and treat in this order, assuming you have no idea what the mechanism of injury was, or if multiple injuries are likely. You may skip steps if it's fucking obvious that certain injuries are impossible (i.e. if someone gets gassed, or has a heart attack or chokes on something, you won't have to check for bleeding now, will you? [Exception to this rule is if you and the victim are being shot at with guns and shit])
1) Massive hemorrhaging. (Mass bleeding!) M can kill someone in 12 seconds (completely severed carotid artery[artery located on your neck that provides oxygen rich blood to your brain) to a few minutes (amputated leg or arm).
To treat mass bleeding or amputated arms and legs, use a tourniquet. A tourniquet's job is to 100% cut off circulation to extremities by cinching the arteries that supply blood to the extremities. You can improvise a tourniquet with a belt or the arm or leg sleeve of clothing.
Here is how to apply one: http://t1.gstatic.com/images?q=tbn:ANd9GcSNkzvkQg61NKp_oks0qCxh04zKqFNhdL5d10JXnwsY1Qts6iECzw
Tip: Always apply tourniquets above the elbow and knee, where there is one bone to which the arteries will be cinched. If you place a tourniquet on someone's shin or wrist, which have two bones running right next to each other, it won't do any good because there are arteries and capillaries between the two bones won't get cinched and cut off. Never apply a tourniquet to the neck.
Bleeding of the neck: To treat this, apply a pressure dressing on the wound and cinch it using the OPPOSITE armpit, i.e. if my RIGHT neck is bleeding, I would want you to place the gauze pad on the wound, then tightly wrap the long ass bandage from my RIGHT neck to my LEFT armpit to apply constant pressure. I'll thank you for this.
Additional remarks: Don't rush yourself when you treat bleeding, but don't take too long either because the next portion is just as important. Also, if hemorrhaging occurs above the belly button and below the collar bone...and you can visually see or hear blood bubbling in the wound...then holy shit, you may have a sucking chest wound or tension pneumothorax.
Airway. An obstructed airway can render the victim unconscious in 30 seconds to 2 minutes, and cause permanent brain damage after 5 minutes or more, depending on the victim's core temperature and VO2 , but I'm not going to cover that.
Conscious Victim: this is easy as fuck to triage. Ask the victim, lol. If he or she says "Yes, "I can/can't breathe," or can't speak because of the obstructed airway, CONGRATS, you learned it either way.
Unconscious Victim: Ugh, this one is hard. You have to open the victim's mouth and visually inspect the throat for any large obstructions, such as like...idk, pieces of dry wall or the victim's tongue itself. Also, a burned airway (indicated by smell) can cause difficulty breathing, even in an unconscious victim! Read below!
Foreign Debris/Obstructions in the Mouth: Shove your first two fingers to either side of the mouth, then sweep to the other side. You need to sweep from side to side, to mitigate the possibility that you might accidentally poke the obstruction down into the throat. Once you have the obstruction to the side of the victim's mouth, scoop that shit out.
Burned Airway or Obstructions in the Throat and below: The only thing you can do for this is place an artificial airway. Which you can't do, leave this to the EMT. Learn about it more: http://en.wikipedia.org/wiki/Artificial_airway
After you clear the obstruction, tilt the victims head all the way back as far as it goes. DO THIS GENTLY. Don't jerk the victim's head in case he or she suffered damage to his or her C-Spine.
Respiration: This is to make sure the victim is breathing, regardless of a clear airway.
Conscious victim: Ask the victim if he or she is able to breathe. If yes, then holy shit. Great. If he or she complains about pain, it may be a sucking chest wound.
Unconscious Victim: Place your ears at the victims mouth and listen/feel for their breath. Look at their chest as you do this, look for bilateral rise and fall of the chest during breaths. This means the right and left side of the chest rises and falls the same depth at the same time. If the either side raises more than the other, it could mean the victim is suffering from a sucking chest wound, or tension pneumothorax [when fluid fills the space between the lungs and chest wall.] Read about it here:
Here is a drawing to explain why it can be lethal.
To treat pneumothorax, you need to seal the holes that are allowing air into the pleural space. Apply a Bolin Chest Seal if you have one. If you don't you can improvised an occlusive dressing with clean plastic bag, seran wrap, an ID card, or the plastic packaging around medical supplies and tape or tightly wrap it to the hole.
Applying the occlusive dressing doesn't completely relieve the victim of their tension pneuomothorax. What you are doing is preventing or slowing it from becoming lethal. Once the patient is completely evacuated, the EMT or the medical dudes at the hospital will decompress the pleural space with a 14 gauge needle. This method is known as Needle Thoracentesis. Read about it here: http://en.wikipedia.org/wiki/Thoracentesis
Let's say the victim was never breathing to begin with. If they were never breathing to begin with, how would you know if they had tension pneumothorax? Their trachea gets pulled to the opposite side of the collapsed/collapsing lung, as shown in the diagram. You would look at the victim's neck to determine this.
If they were never breathing or stop breathing during triage, you may have to do CPR. Google it. It's not hard to do, however it rarely works for trauma patients.
Circulation Main concern with this is to make sure the heart is beating. You will use the same method for both conscious and unconscious patients. Place your first two fingers on the victim's Radial Artery (on the wrist on the thumb's side), Carotid Artery (neck), or either temple (side of head next to eye) and feel for their pulse. If it feels weak, slowed, or unsynchronized, you're fucked, you won't have anything to help the person other than trying to keep the victim from going into shock by using your comforting words.
If there is no pulse, well, you must use CPR. CPR won't resuscitate someone whose heart stopped due to traumatic force, such as their chest smashing into a steering wheel, or the concussive shock from an explosion damages their internal organs. CPR rarely does anything. Defibrillators don't restart a stopped heart. This is a TV and movie myth. They only resynchronize the heart's ECG/EKG should the ECG/EKG get desynchronized or get fucked up. So the shit they show on TV is a lie. If the victim's heart is stopped...shit, there isn't much you can do except manually pump the victim's heart using your hands to rhythmically apply pressure to their chest. If you do this, you can't move onto the next step, unless you have another person to manually pump the victim's heart for you.
Tip: Don't feel for the victim's pulse on any spot below a tourniquet, you dipshit. That's a given, but I think I still have to explain this to most people.
Finally, Head Injuries: This is tricky as fuck. You can't treat head injuries except for superficial injuries, like the eyes and shit.
Concussions: Though they aren't life threatening at the moment, they can kill the person later on, especially if intracranial bleeding occurs.
Conscious: Ask the person math questions, their name, or factual details that there is only one question for. If they appear delirious, or answer their name wrong and shit like that, it could mean DRAIN BAMAGE. Which you can't treat. Once you determined the victim is alert and oriented, ask them to close their eyes and raise both arms until they think they are at shoulder level. While the victim has their eyes closed, and either arm doesn't go as high as the other, it means they are losing oxygen or function to the side of the brain OPPOSITE to the arm that didn't go as high, (Example: Left arm only goes half way, that means the RIGHT side of the brain may have an aneurysm, or suffered trauma, or intracranial bleeding is causing swelling or pressure on that side of the brain.)
Unconscious: Nothing you can do about intracranial injuries.
Eyes: If there is a foreign object wedged or stuck in the victim's eye, leave it in place and lightly place a dressing over BOTH eyes. This will prevent the victim from curiously looking around and damaging his or her eyes even further. This applies to both conscious and unconscious victims.
Cranial Damage: Let's say the person's head is cracked open and his or her brain matter is exposed. Do not attempt to relocate brain matter that has left the head. Do not attempt to replace lost cranial fluid. At this point, cover the wound. DO NOT APPLY PRESSURE. Cover the wound to prevent debris and shit from entering their brain space. You may moisten the bandage with STERILE or BOTTLED WATER PRIOR to applying it to prevent the bandage from drying out the cranial space even further.
There are many cases where people get fragments of their heads blown off and their brains exposed, yet they remain fully conscious.
Congratulations. Now you can treat other injuries that don't fall under MARCH. Such as protruding entrails, burns, crushed or broken bones, etc.
Additional Additional remarks: Burns: If the victim is on fire, put him or her out before you evacuate/triage him. Extinguish fuel sources on the victim.
White phosphorus: You will use large amounts of mud or specialized bandages to treat white phosphorus. Do not use water. Water has enough free-floating oxygen molecules to sustain White Phosphorus's 5000 degree flame of passion.
Gasoline or Diesel fuel: You will smother this with a non-flammable blanket or water.
High Intensity Radiation Burns: You will treat this by removing the victim and yourself from the source of the radiation.
Also, DO NOT POP/LANCE ANY BLISTERS :3
Protruding Visceral/Abdominal Organs: Once the victim is on his or her back, first thing you want to do is bend the victim's knees toward the victim's chest. Wrap either his/her your belt around their thighs and shins to keep their legs bent in this manner. This relieves the victim's abdominal cavity of flexion, stress and tension. This will cause some of their organs to go right back into the wound cavity. Do not force organs back into the wounds. Instead, lightly wrap a wet bandage around their waist to prevent their organs from getting exposed to dirt, debris, and sunlight. Periodically pour clean water onto the bandage to prevent it from drying out and sticking to their protruding organs.
Broken Bones and Tourniquets: Do not place a tourniquet over a fracture. This will cause massive amounts of pain. If you must, place the tourniquet high up on their femur/humorous.
Sucking Chest Wounds: Wounds that breach the victim's pleural space can be located on their front, side, AND their backs. Most of you probably would have only checked and treated injuries on the victim's FRONT, and neglect holes that may exist on their back and sides.
Broken Bones: Treat them at your leisure. If you called for help, then let EMT take care of it, they'll do a better job than you. They'll have SAM splints, stretchers, braces and all that cool shit you won't have.
How to treat Broken Bones at Your Leisure: Keep broken bones stationary. Open fractures may be covered to prevent dirt and debris from entering the wound. Do not apply pressure to open fractures. Improvise splints to keep limbs immobilized.
Bleeding of Non-Extremeties: Use a pressure dressing, if you don't have a pressure dressing, TIGHTLY wrap a sterile bandage. If you don't have a sterile bandage, tie a knot into a long thick piece of cloth, place the knot over the wound and tightly wrap the knot so it applies pressure over the wound. You would use this on injuries to the buttocks, shoulders, armpits. Anything that isn't a head injury, abdominal injuries, or injury to an extremity.
Constantly Re-Assess Medical Treatment: Make sure bandages and tourniquets don't come lose over time. This shit will most likely happen when you move a patient after you've treated them.
Staff Registration Form:
Age: 21 at the time of this post
Height: 68 inches (172.7 cm)
Weight: 140 pounds (61.2 kg)
Transfer Student: N/A
Tell us about yourself:
I am 21 years old and I still have no bearing in my life. Ha! I am still searching for a passion to which I will devote my life. I am working as Groundskeeper/Custodian because I do not mind doing such a job.
Tell us about your past:
Graduated high school in 2009. Embarked on a trip around the world since then. Trip ends in July.
@akri do you have a deep voice?
The title says it all.