Now this is what scene calls were meant to be. Not too much blood, but just enough to be gory. Not too injured, but injured enough to require intubation. 🙂 This guy was in a motorcycle accident, he wasn’t wearing a helmet. he was drunk and acting goofy, didn’t want to lie flat and complaining of troubl ebreathing. When you’re making quick decisions with limited time, resources and personal thos symptoms addup to head & lung injury. The patient needs to have his airway definitively protected from vomting, blood, changes in mental status resulting in an inability to breath for themslves, and lung injury making the lungs difficlut for th epatient to fill with air.
Intubations are my favorate procedure, I think because it is so incredibly invasive and definitive of a treatment. First you sedate the patient, then you paralyze the patient, removing his or her ability ot breath for themselves. You have to assure that they are getting enough oxygen and ventilating enough carbon dioxide. After you have made the patient completely helpless, essentially giving the same medicines given during an execution, you use a metal blade with a light on the end to lift up the patient’s tongue and jaw, look down into their airway, find the vocal cords and insert a breathing tube of a prechosen size (bigger than a straw, smaller than a garden hose) into the lungs. If you put it accidentally down the esophagus (the openings are right next to one another), the patient will not get any oxygen, vomit all over you, and potentially may die if you don’t fix it in time.
Now imagine doing this procedure in the back of a bloody ambulance giving orders for medications and equipement, directing assistance for neck stabilization, cricoid pressure, external laryngeal manipulation, suction, ventilation…the works.
So ultimately, they get “tubed” (intubated), get more sedative medicines, and all the way bakc ot the hospital, somebody has to squeeze the bag to keep giving oxygen into the lungs.
You make them 100% helpless and dependant upon your actions, and if you make a mistake, they die. Sounds like fun, eh? That’s my kind of scene call! It makes me feel like a superstar.
BTW, we were right on the mark with our field diagnosis. Cerebral contusions and subarachnoid blood with right sided pulmonary contusion & aspiration.