Stabilising patient to be transported to hospital via ambulance (ems)


#1

Hello Nurse Janx forum,

I have been sticking around reading on most of the informative post on nurses sharing their experiences and skills which I am really grateful.

Yesterday I had a patient who met with a motorcycle accident. He collided with a car while going straight while the car is turning right. Judging from the impact of the motorcycle on the car, he must have been going at road speed. Here in Singapore that is 50km/h He had lacerations on his head, face, high up his right thigh and maybe groin. We bandaged his head and did spinal management on him. We did not examine his right upper thigh and maybe groin injury.
That could be better on our part.

Patient was alert when we arrive at scene and throughout the journey of 15mins. His eyes were open. Was trying to breathe. Did not ask him questions. Decorticating when we were in the ambulance about 10 mins in.
His bp was stable. Rr 60. My prm said he has agonal breathing.

How can I stabilise my patient before reaching the hospital?

Sorry for the lack of Vital Signs. I will be more attentive next time.

Yours Sincerely,
Haziq


#2

Kinda hard to say when so many things might be wrong with this trauma patient. If the issue was the respiratory distress, I would assume he has chest trauma. This could be fractured ribs, hemo/pneumothorax, lacerated organs, etc. I don’t work in the field so I don’t know your limits in the ambulance but I assume you cannot do chest tubes, or anything too major. I would make sure the O2 saturation is maintained as best you can, and drive fast. Maybe put him in a TLSO brace to stabilize the spine and thoracic area. He may have spinal injuries causing spinal shock which made him crash on you. Decorticate posturing indicates severe brain trauma, and there’s really nothing you can do about that in the ambulance.