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Priority 1 toddler and Priority 1 adult ???
Well I had another EMS class yesterday and they talked about Priority 1 toddlers. This is what my instructor told use we should do so this is not based on what I'd do.
You've got a 1 car rollover with a 5 year old toddler "Jake" and the Mother "Barb".
Your first on scene in your POV and your the only medic there. You find that Jake and Barb are both Priority one's. Jake can't keep his airway open unless you hold it open for him and Barb is bleeding out her nose, ears and is unconsious with a severe cut to her forehead. Who do you care for and why?
I was told that you black tag Jake and work on Barb since she is savable. This would be very hard for me to do since I'm a parent of 2 toddlers. My instructor said "if they can't maintain their own airway then you black tag them and go onto the next patient".
So what would you all do if you come around a corner and this was what your dealing with?
You've got a 1 car rollover with a 5 year old toddler "Jake" and the Mother "Barb".
Your first on scene in your POV and your the only medic there. You find that Jake and Barb are both Priority one's. Jake can't keep his airway open unless you hold it open for him and Barb is bleeding out her nose, ears and is unconsious with a severe cut to her forehead. Who do you care for and why?
I was told that you black tag Jake and work on Barb since she is savable. This would be very hard for me to do since I'm a parent of 2 toddlers. My instructor said "if they can't maintain their own airway then you black tag them and go onto the next patient".
So what would you all do if you come around a corner and this was what your dealing with?
Replies to This Discussion
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Permalink Reply by FETC on
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Responding in your POV again, LOL. This must be one tough EMS instructor.
What are you going to do for Barb from your POV jump kit? She is unconscious, which is a unprotected airway and bleeding from her nose, mouth and ears? ALL BAD, most likely with CSF and she has a basil skull fracture from the indication of the frontal lobe head trauma and is on the way to taking the big dirt nap.
Now your explaination of Baby Jake was he can't keep his airway open? Because of what? Is he conscious or not, is he breathing or not? Is he bleeding or not? Out of both patients you can at least maintain an airway on Jake which is the #1 priority in patient care. Now unless you are carrying a portable suction unit in your hopped up POV-EMS rig, then you are likely doing nothing for Barb's airway as well...
Kid wins in my world.
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Permalink Reply by T.J. on
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I agree with you, and Jake can only breath with you holding his airway open and he is unconsious. No more info than that on Jake.
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Permalink Reply by Capt.Alex Arnold on
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So it says you're the only medic there? So are there FFs? Bystanders that have some FA knowledge. Bystanders that are not shaken up and can follow directions? Boy I would get busy on Jake and give direction and guidance to those that are on scene. That's just me and not knowing the complete scenario. :)
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Permalink Reply by Jim on
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have to agree with the others. Go with Jake. If others are on scene and follow instructions you can have them help with c-spine and keeping the airways open while you triage until help arrives.
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Permalink Reply by dj lee on
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I'm going have to say go with Jake I have a two year old daughter and she means the world to me.I would want someone to try to save her befoe trying to save me!
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Permalink Reply by CHRIS on
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i carry my own medic jump bag so unless there were more severe trauma to the tod1 id work on the kid chances are the blood from the ears of the mother is a good sighn of a bad head injury
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Permalink Reply by John Rulli Jr. on
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I agree with FETC and Caleb on this one.
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Permalink Reply by John on
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same here save Jake 1st have others who can follow directions try and assist Barb.
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Permalink Reply by CHRIS STIMMELL on
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I agree, tough choice. The toddler for sure.
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Permalink Reply by Doc82 on
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Your instructor is right that you would black tag if the pt is not breathing or is unable to maintain an airway. However, that is in triage during a MCI.
In this scenario, I would initially check Jake, seeing as he can't maintain his airway on his own, yet can breathe when I maintain it, I would briefly hold, get a couple of breaths into him and move onto assess Barb.
Once you have assessed all your patients (in this case 2) you have found that Barb, while unconscious, is breathing, and (I am assuming since you didnt specifiy) has bilateral radial pulses, therefore you can go back and reassess Jake, and upon reasssessment you find that Jake can maintain, and breathe while you maintain his airway for him, keeping in mind that irreversable brain damage occurs in as little as 6 minutes without air.
Jake is the less stable of the 2 initially, and because there is only one of you, and "Barb" is breathing on her own, "Jake' should become your priority. It's still just ABCs.
As the initial responder, I know that there is someone else coming, so the next arriving set of hands can be put to maintaining Jake's airway until I can intubate and continue from there.
This not being an MCI, I can see the ambulance chasers having a field day if we were to focus on barb and let jake die of hypoxia when we could have easily corrected it. There is little to nothing we can do on our own, on the side of the road for Barb's head trauma other than stabilize and transport.
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