(no subject)

OH HAPPY DAY!

I love starting my morning with Trauma patients. It's so much better then coffee!

Appx 50 y/o altered male, restrained driver of a pickup truck swerving all over the road (S-101 1.5 miles N of Washington). He was being reported to CHP as a drunk driver according to the officer that arrived on scene, but they were unable to catch up before he TC'ed into the trees off of 101. Left the roadway at appx. 20-30 mph, cleared a section of brush (by flattening it), and went head on into a tree, almost like he aimed at it.

Initial actions- Scene assessment. Safe, off roadway, engine off, no smell of fuel, no air bags deployed (older truck, doubted he had them, but I asked as I gloved up and he said "no airbags"). Ok to approach safely. Minor Lac on his forehead, C-spined him (I need a new Collar now, they kept mine on him) as he was seated in his car. Since I had no backboard and there was no danger to us there I saw no need to remove him from the vehicle alone, it wasn't warranted. He kept trying to restart his car. This didn't make me happy, it was like babysitting a child in a way telling him "No, please don't sir, we don't need your car on, ok?" and taking his hand away from the keys. So I started assessment, with CHP questioning him about the accident also. That officer needs to learn to not question a patient while I'm assessing them, but he was a cool cop. No signs of ETOH, learned he was diabetic and hadn't taken in food or medication in a day.

Respirations 10, easy and clear but shallow, volume overall ok for the short term. Pulse 80, BP 80 palp (when you don't have time to get an actual pressure, the ability to get a pulse in the wrist means pressure is at least 80, and is called "80 palp", for palpating at the wrist). I couldn't get an actual pressure because I was relieved by the fire crews after my 8th minute. 1 minute to get stopped and get to the scene, 1 minute to assess safety, 1 minute to clear brush and tree limbs to get in close, 1 minute to properly C-Spine a person that was not totally with the program, 4 minutes worth of assessment/history time and application of a 4x4 pad to the temple to soak and prevent more bleeding from the Lac on his head.

The diagnosis as I saw it while I transferred care to firefighters- Minor TC injuries with a high index of suspicion for a diabetic emergency in progress based on patient LOC and history findings/witness reports, and the need for standard C-Spine precautions due to the Mechanism of Injury (MOI).

And I got what you don't always get, confirmation before I left the scene. I was correct. Paramedics measured his sugar at 21. Normal/ok is about 90-120 depending on what's normal for your body, and everyone is a little different. He was risking falling into a coma with a sugar that low, and then death. You cannot sustain that low level, you'll die when your body just, shuts down. Crashing might have saved his life when you think about it.

The moral of the story- Get your medical training , it will come in handy all the time!

Happy Wednesday!