21 June 2010

The Portland Trip: Part Deux

Read here (only a couple of posts ago, but, hey, it's good stuff) for part one.

Less narrative today, more musings.

The Rosehips' training was pretty awesome. Lots of good knowledge. The most useful thing, I think, for me at least, was learning an organized way to approach & assess a situation before starting treatment... I've picked up ways of dealing with stuff before (whether from NB or other friends with WFR or WEMT training, or from personal experience), but that's less useful if I'm getting myself or other folks around me into situations where we become patients, or if I overlook something that's more immediately important in my rush to treat something obvious.

My reflections on how I did in the scenarios...

Scenario One: Earthquake
The group of trainees were outside after a session and one of the Rosehips came up to us and laid things out: there'd been a significant earthquake, we'd all made sure that our homes/families were safe; the building we were outside had already been checked by engineers and it wasn't about to come down, so we could go in and check to see if anybody was hurt.

Being as how, hey, we were at a street medic training, it was a pretty safe bet that folks were hurt inside. We walked in. Dark room, loud music playing, lots of folks scattered around. My partner and I surveyed the situation, saw a person lying on the ground under a table, guarding her lower abdomen. We identified ourselves, obtained consent for treatment, checked airway (good), breathing (good), external bleeding (none). I began taking her history while my partner administered a full-body exam. Upper left abdomen was rigid and painful to touch [not actually; it felt fine, but we had to pretend], and the patient told us that a chandelier had fallen on her in that area. With nothing else seeming to be wrong (and the patient noting that there was no chance she was pregnant), we figured there was a high chance of internal bleeding and arranged to stay with her until we knew where to take her for more advanced treatment.

At about this time, another subject approached us, clutching at her throat and struggling to breathe. She indicated that she was having an asthma attack, but had lost her inhaler, and began to panic. My partner began trying to help her calm down, but was unable to do so; subject went unresponsive and stopped breathing. I grabbed another trainee (one who knew CPR) and asked him to begin administering it to our nonbreathing subject. At about this point, one of the Rosehips walked in and informed us that (1) he was a city official, and (2) there were four ambulance spots available; the rest of the group needed to get itself to a treatment area (identified in this case as the back exit from the building). There was, those of us he was not talking directly to found out later, also something about aftershocks and our needing to get out immediately.

So. Four spots. We had one person nonresponsive from a head wound; one painfully responsive but nonmobile with significant ongoing bleeding from a series of glass-induced gashes in his side; one who'd fallen, landed awkwardly, and had what was presenting as a probable (fairly major) c-spine injury and absolutely needed to be secured before being moved; one patient whose major injury I can't, a week later, recall (not being directly involved in his or her treatment); and a number of others. Five serious / life-threatening injuries, none of whom could really be moved, and four spots to get them to the hospital. Hurrah.

Anyways, all moral dilemmas aside, I think my partner and I did pretty well (even though we didn't find out about the aftershocks until after the scenario was over). Neither of us panicked when we were confronted with a situation that was out of control (and explicitly designed to be overwhelming) - we just got in, did what we were able to, helped to keep some people calm and get some people some help, and then got out again.

Scenario two later. Peace!

HH & SH - awesome having you guys out for a bit.
MH - happy Father's Day!
DAJ - tried calling again. your number's changed. you okay?

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