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Sun Aug 5 08:26:58 BST 2007



> ---------- Mensagem inicial -----------
> De	: "Lorick Fox PA-C" <Lorick at Lorick.org>
> Para	: "Trauma & Critical Care mailing list" <trauma-list at trauma.org>
> Cc	: 
> Data	: Sat, 04 Aug 2007 20:41:33 +0300
> Assunto	: Re: Casualty extrication from a fire risk area
> 
> 
> Never heard of any such, and my tendency would be to say that you 
> will need both hands to move the patient, and your safety plus the 
> patient's safety require you move the patient to where you can work.
> 
> If you find a cardiac arrest in a bathtub, you presumably immediately 
> move them to a place you can work (airway, IV, etc) and where you can 
> shock without water hazard.
> I would think this situation is analogous to removing a patient from 
> a smoke filled, hot environment with acutely toxic gases present.
> 
> I doubt there would be any data to even suggest that the delay of 1-2 
> minutes will change outcomes when the alternative to increase risk to 
> yourself and the patient and attempting to treat the patient in a 
> toxic environment.
> Also consider the risk to other fire fighters of you needing 
> protection in the middle of a fully involved room trying to 
> resuscitate.  You can't "tie-up" a crew on a line(hose) to shelter 
> you while you use a demand valve or such.
> In my brief tenure as a volunteer fire-fighter (before I figured out 
> that running a building that everyone else was running out of was BAD 
> idea, and moved to strictly the EMS side of the house), in most cases 
> you could have a victim out to safety in < 1 minute and they had 
> already been "down" for 5-15 minutes depending on how the call 
> originated and distance to fire station.
> 
> I guess you COULD strap a demand valve, attached to a small capacity 
> oxygen cylinder on the face of a spontaneously breathing patient, but 
> those masks are rarely airtight and 100% oxygen+fire is usually a 
> really bad combination.
> 
> Lorick
> 
> At 07:05 PM 8/4/2007, tuganddawn at talktalk.net wrote:
> >Dear all,
> >
> >     I am a firefighter and paramedic working in Oxford UK.  I am 
> > currently researching the extrication of casualties from smoke 
> > logged and fire risk buildings by Breathing Apparatus (BA) 
> > crews.  I am currently undertaking my BA training and am acutely 
> > aware of the dificulties encountered when working in this type of 
> > environment but, as a dual professional, feel that there must be a 
> > better way of dealing with casualties. Current practice is still 
> > quite archaic and simply follows the "just get them out" mantra.
> >   Does anyone on the list know of any programs or ideas that allow 
> > a BA crew to secure a basic airway, administer clean air and 
> > manually handle the casualty in an ergonomic and practical way 
> > without sacrificing the safety and efficacy of the crew?
> >    In any event, thanks for your time and trouble ladies and 
> > gentlemen and I look forward to hearing your ideas.
> >
> >  yours with Kindest Regards
> >
> >   Tristan "Tug" Crumpton
> >-
> 
> 
> LFFox, MPAS, PA-C
> Fellow, AAPA
> CCA, American College of Cardiology
> Associate, Society for Critical Care Medicine
> Associate, Underwater and Hyperbaric Medical Society
> 
> Lorick Fox, MPAS, PA-C
> SEAVIN/Peace Vector IV
> Unit 64903, Box 1201
> APO, AE 09868-4903
> (cell) +20-18-230-4448
> (landline) +20-45-240-9450
> www.lorick.org
> 
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