At 11:59 AM 24/04/01 +0100, Andrew wrote:
>Hi Martin
>Do you think his loss oxygenation was due to airway obstruction, poor
>ventilation or circulatory hypoperfusion?
>My initial impressions are:
>Obtunded head injury but reasonable airway and short extrication/transit.
>Difficult physical access to patient during 40 minute extrication. NP airway
>would be dodgy with maxillary injury - too much danger of associated basal
>skull fracture - Guedel is my choice too. Slightly low sats but the good air
>entry and tachycardia suggests C rather than A as cause. You established IV
>access early (?volume infused - might have been candidate for deliberately
>hypotensive resuscitation)(but poor access to patient/quick transit might
>have meant no BP available). Was hypothermia an issue?
>Other options - delay on scene, Combitube/PTLA for airway control (easier
>skill retention),
Combitube & PTLA may not be appropriate with certain facial injuries
Charles Brault EMT-P
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