Blunt Trauma

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And as for the "Why Not" part:

1: Functional recovery from prehospital arrest in the context of blunt
trauma runs something less than a fraction of one percent on either side
of nil.  Sticking needles in the chest will have about the same effect
as painting the patient's toenails.  And all the while there may be an
overpolite guy in the passenger seat with a decent pulse and a busted
spleen.

2: Needle decompression carries discrete and absolute indications, of
which pulselessness is merely one (and, as above, the least useful).
The patient should be showing signs of tension pneumothorax (which in
this degree of extremis would include absent breath sounds, little or no
ventilatory movement, an expanded and hyperresonant thorax, and most
likely a startling general somatic inflation, observable in real time).

3: See #1.

There's argument of course that needles will do little if any harm under
the circumstances; but data is accumulating that most of these needles
don't reach the pleural space anyhow.  So we're back to the pedicure
analogy.

Pret Bjorn, RN
Bangor, ME USA

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of kmattox
Sent: Monday, August 10, 2009 9:18 AM
To: Trauma-List [TRAUMA.ORG]
Subject: Re: Blunt Trauma

No
------Original Message------
From: Keith Carter
Sender: trauma-list-bounces at trauma.org
To: trauma-list at trauma.org
ReplyTo: Trauma-List [TRAUMA.ORG]
Sent: Aug 10, 2009 8:18 AM
Subject: Blunt Trauma

Pre- Hospital Cardiac Arrest due to blunt trauma.  Is Standing Order for
bilateral needle decompression by paramedics warranted and justified?
Why or why not ?

paramedicmd at msn.com


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