A question for EMTs/Paramedics?

Question

I'm writing a story that has an ambulance crew responding to a scene where a man has a deep cut. I have no medical training, but I'd like the scene to be somewhat realistic.

What kind of things would two EMTs/Paramedics check for and say to each other when assessing the patient's injuries?

Also, do medical professionals have a slang term they use for ambulances?

Answer 1

I call it the "boolance" but that's something me and a coworker invented and it's certainly not something most medics call the ambulance. Mostly they refer to them as the "bus" or the "truck".

As far as how the scenario would go, the above answerers pretty much cover that, but here's my two cents.

If the call is to a residence, they would bring in a trauma bag (basically an ambulance in a bag- has all the supplies necessary to stabilize most injuries and illnesses). If the call is for an assault, they would have police onscene first, to make sure it's safe.

First thing on my mind whenever I go into a call, is to check to make sure the scene is safe. Any assailants lurking in the corner? Large crowds of people that may turn violent? Broken glass that I might step on? I don't make a big deal about checking, but I always at least glance around to make sure that everything looks safe.

Another thing that happens at the same time, is to make sure I'm wearing appropriate protective gear. Latex gloves are mandatory on every call, and most paramedics these days wear some kind of safety glasses.

When I make contact with the patient, I introduce myself first, 'Hi, my name's Rita, and I'm a paramedic. What happened?". While I'm listening for the patient's response, I'm visually checking the patient for any obvious life threatening bleeding, paying attention to how the patient speaks (does he appear oriented, are his words slurred, does he speak at all?). If he's talking well, then he obviously has a good airway and is breathing well. If he's making sense, then he's probably alert and oriented. I also check his skin color to see if he looks flushed, cyanotic (blue color), diaphoretic (sweating). If I see any life threatening bleeding, I would immediately apply pressure to the wound with a gauze 4x4 square.

I'd find out what happened, if he's hurt anywhere else, what was the object that cut him, if he lost consciousness or hit his head (if he lost consciousness and hit his head, I would seriously consider backboarding him and taking appropriate spinal precautions, just in case he hurt his cervical spine during the fall).

I'd ask what medications he takes on a daily basis, his allergies, and any known medical problems. I'd bandage the wound after bleeding is controlled.

You might want to think about if it's an arterial bleed, or a venous bleed. Arterial bleeding is bright red, gushing, and a patient will bleed out within a few minutes. Venous bleeding (while still dangerous) is slower, more of a steady flow, with dark red blood.
Arterial bleeding is more of a serious emergency, that would require direct pressure on the wound, raising the wound above the level of the heart, and applying pressure to a pressure point.

Meanwhile, while I'm doing patient assessment, I'd direct my partner to get a set of vitals (blood pressure, pulse, respiratory rate, SpO2), and place the patient on oxygen.

Afterward, I'd place the patient on my stretcher, and load it in the ambulance. One paramedic rides in the back, while the other drives. En route to the hospital, I'd start an IV in the patient's arm, preferably an uninjured extremity, and give a saline bolus (to help restore blood volume and blood pressure). I'd recheck the patient's vitals, and about 5 minutes from the hospital, I'd call the nurse at the ER to let them know I'm coming in (if it's an arterial bleed, or the patient looks unstable - really low blood pressure, or the bleeding is not well controlled - I'd ask to speak to a doctor). My report would go something like this "Hi, this is Rita, with *insert ambulance service's name here*. I'm coming in with a 23 year old male, laceration to rt arm, aprox 4 cm long, bleeding controlled. He's alert and oriented, no other injuries. Blood pressure is 120/80, pulse 88 and regular, respiratory rate 20 and regular, SpO2 98%. We're about 5 minutes out."

When we get to the hospital, we'd take him to the assigned room (security tells us the ER room assignment when we walk in the door). We'd have the patient move from our stretcher to the hospital bed, and when a nurse arrives to the room, I'd give her the same report I gave over the phone, with added details like approximate amount of blood lost, medical history, current meds, any allergies, etc. Then I'd leave, and he'd be in the hands of the hospital now.

Hope this helps...

Answer 2

Here is a brief bit for your project.
Scene survey is the first thing you do at a call, make sure you don't become secondary victims to whatever happened to the victim. You assess the scene according to what you encounter, example (MVA or motor vehicle accident) open gas tank, spilling liquids, powerline involvement (shock hazard), traffic and road conditions is there a danger of a 2nd collision because of the vehicle position?
What mechanism caused the cut, if it was an assault is the suspect onscene (many EMS SOPs rule out going in until the scene is declared safe by law enforcement). Do you see pulsing bleeding (splashes with every heart beat indicating grave danger).
As far as the ambulance there are different terms depending on where you are, here it is called a "truck" some places it is a "bus".
Hope that helps a little bit.

Answer 3

Hi Jeff, The first thing we look for is Danger, what caused this accident? eg, power tool. Or did someone intentionally slice him
The next would be how it happened, stuff like did he trip, did someone push him, did he faint because he is a diabetic, epileptic or has a heart condition.
The next thing would be a primary survey.
It flows something like this.
D-danger- is there a further risk
R-response- is the person conscious
A-airway- airway is not occluded
B-breathing- breathing is adequate
C-circulation- do they have adequate cardiac output

Once its ascertained that all is safe the next thing would be to arrest any haemorrhage and initiate a secondary survey to make sure there are no other injuries.

So you could have one Paramedic taking care of the haemorrhage and the second Paramedic taking a pulse, blood pressure(BP) and asking the patient exactly what happened. If the haemorrhage is severe enough you could also have the paramedic insert a Cannula and administer fluids, you could use compound sodium lactate or even Hartmanns solution.

As for Ambulances here, they are mainly called units, but they are also referred to as trucks or vans.

I hope this helps you out, give us a yell if you need more info.

Answer 4

I'm from Iowa and we call ambulances Meat Wagons hahaha

Answer 5

in our town we call the ambulances A1 and A2 because we have 2 of them.