Please can anyone help? I have sent this question to Ambulence dept all over UK and no help.?

Question

I am researching a novel in which i have the following scene, more or less. I want to be accurate in the conversations that take place and as I am interested in First aid ect i do not want to skip it and it is a really important scene. As I said I have e-mailed and writen to Ambulence forces all over the UK and most do not reply those that do are either to busy or say they will help but then never do. So i am appealing to anyone with Emergency medicine knowlege to help me sort this scene out;

Scenerio is as follows.

It is late one Sat night (around 12-ish). I have

> four friends on their way back from a party they

> have all been drinking, There is accident (not sure

> of circumstances yet) but car is driven off the road

> on a stretch of roadway circumventing the lake by

> their town, ends up going over a small ditch and

> crashes into a big tree at around 50mph. The driver

> (my 20 year old) is very badly injured and he dies

> later. Back passengers fare a little better but

> still have very bad whiplash and a couple of broken

> bones. My Main Character the youngest (16) is in

> front pass seat , takes full brunt of impact with

> tree and fractures 6 ribs (I was thinking 4 one side

> 2 on other) one of the broken ribs has punctured his

> lung and he is bleeding into his lung cavity. I was

> thinking of various cuts and bruises too. I suppose

> after that kind of impact he would be trapped, not

> sure. I need some sort of complication to make it

> life threatening, although he has to survive. He is

> having difficulty breathing.

>

> I need to know 1) how it would be dealt with

> specifically what medications he would get and the

> doses that sort of thing as I have a bit of

> conversation between the paramedics to do. He is

> only semi conscious i.e. very vague but can just

> about answer simple questions, although I was going

> to make him loss consciousness later on, maybe in

> the ambulance.2) I also need to know what the

> paramedics would tell the trauma team once he

> arrived in hospital and 3) what the trauma team would

> do (although I have e-mailed hospital to ask this

> bit and they are supposed to be getting back to me,

> it take some time though as they busy, obviously)

>

> Any suggestions would be very much appreciated.

>

> Ta Wendy

Answer 1

Try talking to the Red Cross or your local St Johns ambulance brigade they might be able to help

Answer 2

your character would most likely have a chest tube inserted into the side with the punctured lung.  She/He would receive an IV immediately, have xrays of his entire body and have lab work drawn right away as part of a trauma protocol in the er.  Before coming to the ER paramedics would place them on a back board, have a c-collar on neck and transport to ER....most likely would be put on oxygen.  Also pain medication such as morphine or demerol would be given for pain.  Standard dose of morphine 2-6mg and demerol is 25-50mg both can be given through the IV or a new drug dilaudid 2mg which can also be given through the IV....hope this helps

Answer 3

1) If I encountered this patient in the field this is how I would treat it.

First off they would need to be extricated from the vehicle. This would be done by using pneumatic tools (jaws of life type stuff) A c-collar would be placed around the patient's neck and they would be slid carefully out of the car seat on to a backboard. Next they would be placed on a stretcher and in to the back of the ambulance. I would then have someone drive us to the hospital, emergency traffic (lights and siren) Dialogue wise I would tell the driver I will do everything for the patient enroute to the hospital. In EMS language we would say something like "This kid is sick, we need to Load and Go". Enroute to the hospital I would first give them oxygen by placing them on a non-rebreather mask, then I would listen to their lungs to to make sure they are breathing okay. If they are breathing too slow/fast/shallow I would intubate them (place a tube down their throat into their trachea) and assist with their ventilations. Next I would cut ALL of the patient's clothes off and quickly check their whole body for injuries. Then I would I would then cover them up with a sheet. Next I would have my partner check the patient's vital signs B/P respirations, pulse, and put them on the cardiac monitor. While they are doing this I would start 2 large bore IVs (14-16 gauge.) Running normal saline "wide open" next I would attempt to stabilize the patient's broken rib segments with a soft pillow splint.

2)Here is what I would say to the trauma team at the hospital ( I am just going to assume that they were wearing their seatbelt, that they were traveling 50mph (80 km/hr) and that the airbag went off.)

"This is a 16 year old female restrained front passenger of single vehicle mva with airbag deployment. It is estimated the vehicle was traveling approx. 80km/hr when it went of the road and hit a tree. Patient has a GCS of 9, flail rib segments on the left, and crepitus over the right 5th and 6th ribs. Cardiac monitor has showed sinus tach. through out transport, and he has 2 large bore IV's established in the right and left ACs, running wide open."  

This would all be said as I am moving the patient over to the hospital's gurney from my stretcher.

3) The trauma team would place chest tubes in the patient's chest, take x-rays, get a head ct scan, and quickly rush him to the operating room for surgery.

Let me know if you have any questions!

Answer 4

hiya, I may be able to help a little,

as there is ore than one casualty there would need to be more than one ambulance,  the first crew on scene would radio through to there control to inform them there are more ambulances required. also if the car is  badly damaged they may need the fire and rescue service to cut the car, as the character has been involved in a rtc there would be reason to suspect spinal damage even if there isn't, with this type of accident you should always suspect that there is.  Either one member of the crew or a bystander should be in the back of the car, while the other crew member gets the spinal equiptment as it may be a while before the fire service remove the roof you would also need blankets and oxygen, the attendant would place a neck collar of the casulaty, they would check pulse rate, blood pressure, breathing rate/rythem and pupil size. once the fire service have done there job then you extricate them from the vehicle carefully and place them on the spinal board, I'm unsure on the meds and someone may correct me if i am wrong but i don't think they are given much medication as it may impair consciousness?  on arrival to hospital the crew state the important facts in a verbal report, so they would say we have a 16 year old male, passanger in rtc, trapped for ?? mins, gcs ?? (glascoma scale) bp 100/60 resps 14 and a brief desciption of their treatment and if any meds were given.