emergency prepared

Specialties Emergency

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Hi!

I am in no way an emergency nurse - I am an RN and have lots of medical and i have a degree in psych. Yesterday as i was accelerating onto a freeway from another (50 - 60 mph) a motorcycle flipped right in front of me - his bike landed and then he flipped several times (no helmet). I absolutely do not know how he is alive but I stopped my car and hung out with him until an ambulance came which seemed like forever. Other folks called 911 and some people got his bike off the rode etc. He told me he was having chest pain and left arm felt funny etc. I asked his name, got a strong pulse and inquired about cardiac issues. He stated he had high blood pressure but not on meds and was 38 and smoked - he was a large guy but looked healthy other than his head which had a steady stream of blood coming from an abrasion (didn't look deeper). He kept asking me to get out of the rode and was sitting up with my help (also said he was short of breath). I told him we were blocked by a car and safe where we were and were not moving until the ambulance arrived (clearly hit his head since there was blood all over) and it was 97 degrees with very high humidity and we were sitting on the asphalt with rush hour traffic so breathing etc could have been related to that. I used my fone to call his gf while we waited and got stuff from his bike for him etc but found myself very ill-prepared to help him other than talking to him and trying to reassure him. Before I stopped he had tried to get himself up several times and kept falling. Some work men came and gave him some water. Sorry about the essay - my question is can someone help me prepare an emergency kit for my car and truly even an er nurse couldn't do much without some equipment. And - would I be a bad nurse because if I had had some aspirin I would have given them to him - PERIOD. His only allergy was iodine and he was able to take asa if we had had some. I am simply wondering the best action legally and otherwise (minnesota) if i did anything like asa (as a human being I don't care about the law if it would have saved him) ADVISE PLEASE. I felt completely helpless. He went off to the er so I hope he was fine. The were putting a collar on him when I left. Suggestions for car stuff? THANK YOU SO MUCH!

As others have stated, hold pressure on any bleeding, hold c-spine, do NOT give anything PO.

Also, on the moving the patient thing, I would NOT move anyone unless there was imminent danger to them if they remain where they are. For example, if they're in the driver's seat, I'd leave them there until EMS arrives, unless they are pulseless and need CPR or the car is on fire or something like that.

Do not ever move a trauma patient without spinal precautions in place, unless there is a compelling reason to do so.

All you really need in your emergency roadside kit is gloves, a CPR barrier, and some supplies for holding pressure on bleeding wounds, like some ABD pads or even just maxi pads. Maybe some oral glucose in the event that the person is diabetic and has altered LOC and can protect their airway. Otherwise, you just stay with them and provide BLS until EMS arrives.

thank you ~*Stargazer*~ !

he was sitting up in the middle of the road cuz he had tried to get up several times before i got to him and he kept falling back so i hope you are saying just keep him in that position? and he was edgy and not sitting really still

Yes, I would keep him right there so long as the scene was safe, and encourage him to stay in one place and wait for EMS to arrive.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
thank you ~*Stargazer*~ !

he was sitting up in the middle of the road cuz he had tried to get up several times before i got to him and he kept falling back so i hope you are saying just keep him in that position? and he was edgy and not sitting really still

It is so scary when we, as nurses come upon these scenes. We feel obligated to do SOMETHING! We don't like to feel helpless...but we are. We are not prepared for emergent care i n the streets and most of us are not trained for this.....even I with 34 years of emergency experience and some on the streets know that you call for help and immobilize the patient and keep other do gooders away so they don't hurt the patient by trying to help.

The best thing you can do is call 911. DO NOT move the victim. DO NOT give them ANY MEDS! Give NOTHING BY MOUTH!!!!

For a trauma with chest pain it is probably NOT a heart attack.....but rib fractures/flail chest with possible great vessel injury (aortic injury/dissection) hemo/pneumo thorax!!

DO NOT MOVE the patient and keep them as immobilized as possible. unless they are in IMMEDIATE DANGER OF DYING BY FIRE...leave them where they are until the proper EMS personnel arrives.

This patients restlessness/agitation was probably neuro in nature and yes you leave them lying down...even if you have to use your best 'nurse' voice (I call it my Mommy no nonsense voice) and command them to "LIE DOWN NOW!" keep them as still as possible.

The only thing you need in an emergency bag is a blanket, gloves to protect you, a face shield if you HAVE to perform CPR, some ABD's to apply pressure to open wounds and a cell phone with a good battery for call for help. In most parts of the country these days rescue services are within minutes away.

Keep them calm. Ask them questions about meds medical history and allergies in case they lose consciousness. Find out contact information to give to EMS. Keep the crowd calm and the patient calm

Esme12 you are amazing - I am printing this :) thank you (please forgive but he was sitting so leave him that way dont make him lie down which would be moving him, correct?)

It is so scary when we, as nurses come upon these scenes. We feel obligated to do SOMETHING! We don't like to feel helpless...but we are. We are not prepared for emergent care i n the streets and most of us are not trained for this.....even I with 34 years of emergency experience and some on the streets know that you call for help and immobilize the patient and keep other do gooders away so they don't hurt the patient by trying to help.

The best thing you can do is call 911. DO NOT move the victim. DO NOT give them ANY MEDS! Give NOTHING BY MOUTH!!!!

DO NOT MOVE the patient and keep them as immobilized as possible. unless they are in IMMEDIATE DANGER OF DYING BY FIRE...leave them where they are until the proper EMS personnel arrives.

The only thing you need in an emergency bag is a blanket, gloves to protect you, a face shield if you HAVE to perform CPR, some ABD's to apply pressure to open wounds and a cell phone with a good battery for call for help. In most parts of the country these days rescue services are within minutes away.

Keep them calm. Ask them questions about meds medical history and allergies in case they lose consciousness. Find out contact information to give to EMS. Keep the crowd calm and the patient calm

Esme brought up a very important point that most of us are not prepared for or trained to give emergent care in the streets. Years ago, before nursing school even, I remember my first responder class stressing the importance of checking the scene is safe firstly for yourself and then for the victim. But I did not learn how to assess the hazards present; a busy road, a damaged vehicle that could be a fire or explosion hazard, other people who want to help. And I did not learn how difficult it is to hold yourself back from the overwhelming impulse to rush in to help while only paying minimal attention to checking the scene is safe - those emotions are tremendously strong. The ability to hold back and properly check the scene is safe is something professional rescuers are trained to do and do in practice, but is not something we are properly trained to do in standard nursing training.

A few years ago as a pedestrian I was the person immediately closest to a motor vehicle accident, and the person who could most easily reach the victim. The victim's car was rear-ended forcefully by a larger vehicle, which I witnessed moments after the impact, and the victim suffered a head injury. Even though I knew to check the scene was safe for myself and the victim before approaching, it was so truly terrible to watch someone injured panicking and flailing around that I only briefly checked the road was clear for me to cross, and basically just assumed that the vehicle was safe to approach. I called 911, calmed the victim, held the person's hand (didn't notice it had blood on it) - I had gloves in my bag and never gave them a thought, and did my best to tell the victim to keep as still as possible until the paramedics arrived, which they did within minutes, although those minutes felt very long. I innocently and foolishly relied on everyone else on the road, other drivers, passers by, to behave sensibly, and fortunately people did: People sequestered the other vehicle involved in the accident; other drivers saw the accident and drove carefully around it (and me). The paramedics and police arrived and took control of the scene.

This situation made me think a lot about how as an untrained rescuer, (even though as nurses we know not to move the victim, unless for example, there is a fire hazard or we need to position them to open their airway or so they can breathe, or to avoid choking on vomit, or to perform CPR, and to always use c-spine precautions/logroll when it is necessary to move them, and know to keep the victim still and as calm as possible and to put pressure on bleeding wounds), one is not prepared for the sight of a badly injured person on the street/in a vehicle, and for the tremendous emotion of wanting to help. And there lies the danger.

Ugh, that's a tough call. I've never worked prehospital (except in a volunteer capacity with EMTs around), but if the person is up walking around, that's a good sign. It means they're capable of walking and talking. However, people can be capable of walking and talking with head injuries and hemo/pneumos. If you can encourage them to lie down and let you hold c-spine, that would be great. But if they are restless and not able to comply with your instructions, you can make a "chair" out of your knees and let them lean up against it until EMS arrives with their backboard and head immobilizer. If you can just get them to minimize movement, I think that is probably just fine.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I had a patient walk into triage after falling in the bathroom at home and had a cervical fracture...C3 C4 and ended up in HALO traction...you cannot assume that because they are ambulatory that hey aren't seriously injured....it just means the injuries may not have overwhelmed the system and they are in that fight flight mode only to develop symptoms and crump later.

I would try to make the patient a quiet as possible. If you can convince them to lie down that would probably be best...but allow them to assume the position of comfort IF they remain seated and quiet. Any intervention on your part can also cause additional damage which you will be responsible for......engage the patient make them pay attention to you ......keep others from moving them. You'd be surprised at how many people listen to the nonsense nurse/Mommy voice to sit and be quiet.

Assessing the scene for safety is important.....I lost a beloved friend and co-worker when she stopped at an accident scene only to be electrocuted by the downed wires.

You'd be surprised at how many people listen to the nonsense nurse/Mommy voice to sit and be quiet. (i love this part Esme12)sorry about your friendthank you EVERYBODY who helped me with this - i thought i was smart and i know better about the asa npo no moving etc i was just feeling helpless and that is not an excuse to be sans brain :) thank you thank you thank you :)

i thought about it and decided i would rather die helping someone than to already have a dead soul and walk away

"Dead soul" ? Those are strong words and a bit over-dramatic if you ask me. I don't think I'm totally dead inside :roflmao: nor would I consider myself a "wimp" for driving on past an MVC. I'd call 911 for sure but like the others have said, if you respond to an emergency and you are neither trained to do so, nor carrying proper supplies with you, you are at a huge risk for becoming a part of the problem. In other words, medics will be tending to you instead of devoting 100% to the person in the accident (ESPECIALLY if they find out you're a nurse!).

U did what u thought was best Never give a medication. Best thing to do is not let him get up and move around have them lie there and just hold C-spine until the ambulance arrives. People should not be trying to given anything to drink either. Just always carry a pair of gloves in your car

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