Did I help or hurt him???? :( - page 2

I am a c.n.a/ starting nursing student and I got my first taste of some critical care tonight. Long story short a young boy got shot on my block and I ran to the scene to help him(couldn't help it,... Read More

  1. by   CherylRNBSN
    Quote from traumaRUs
    I am a prehospital provider and scene safety is always always always the first thing. To run to the scene of a GSW is to ask to be shot yourself. A GSW to the head can certainly cause a spinal cord injury so keeping them still, not moving them at all is the best idea.

    I certainly wouldn't beat yourself up about this - just learn from it and move on - good luck in school.
    Yeah, but if they are chocking on their own blood or not breathing, you need to address Airway Breathing, right? So support head/neck/spine and roll them to side as a log to clear airway.
  2. by   mikeicurn
    You did good!
  3. by   Piglet08
    Wow. I'm glad you're okay. You rushed into a very dangerous situation. I hope if I'm in that kind of situation, for my loved ones' sakes, I am more careful.
    And I hope, for my loved ones' sakes, that someone is there willing to help them if they're shot in the street.

    So there I am, firmly on both sides of this fence.
  4. by   Pets to People
    First rule when treating someone in public...never listen to bystanders. Lol, just kidding, safety is the first rule and that's no joke. The emergency field calls it "white knight syndrome". You may feel that you JUST HAVE to help someone, even if you have to put your life at risk, but think of it this way. If you enter a scene to help somone and become injured yourself, you will not be able to help ANYONE and now the police, EMT's, etc have to take time away from the person who first needed help in order to help/save you. So just think that when you worry about your safety first, you are also helping your patient.

    I once treated a person who was in the middle of eating and had a seizure and fell on the floor. He hit his head and had some blood on his scalp and the floor. In this order, I quickly turned him to his side to help clear the airway of foam/spittle and food, held his head steady to keep him from banging it on the tile floor, then had someone use a towel to hold to his head wound then took the time of his seizure. While sitting there with him I had several people crowding me, telling me I JUST HAD to put a spoon or some other random object in his mouth which they then tried to force into my field of vision. I said, NO, and no one is to touch him or put ANYTHING in his mouth unless I ask for your assistance or you have medical experience, get back and give hime some air. Control the scene and don't back down...it's great that people want to help, but they mostly just get in the way. Number one rule of treating a seizure pt, never ever ever put anything in their mouth, especially not your darn fingers if you plan on keeping them.

    When the medics came he was just coming out of his seizure, I gave them a very short run down of what happened, that he hit his head, still had some food in his mouth and the length and severity of the seizure. One lady saw that he had a drop of blood on his chin, probably from biting his tongue or lip when he fell or during the seizure and said it wouldn't have happened if I had put the spoon in his mouth that she tried to give me. I just laughed and walked away and gave myself a little pat on the back, I knew I did good and there was nothing I could have done better.

    When you get experience, you will gain more confidence, and that will help you do what is right even in the face of opposition, and that is not an easy thing. Never back down from what you know is right for you or your patient, whether the opposition is coming from the public, your family, a fellow nurse or even a doctor.

    For the wound you describe, I don't see any reason to turn him onto his side, but I also do not see where it would cause a problem unless he was hit near the spinal area in the back of the head/neck. In his situation, put pressure on the wound, monitor his airway, his breathing, his heart rate, be ready to start CPR if he becomes critical and wait for the ambulance.
  5. by   BuckyBadgerRN
    Quote from Misslady113
    I am a c.n.a/ starting nursing student and I got my first taste of some critical care tonight. Long story short a young boy got shot on my block and I ran to the scene to help him(couldn't help it, I was the only one). Gunshot wound to the head and everyone was panicked. I turned him to his side to help him breathe,but someone told me not to do it, so I don't know if that was right. I asked some of his friends for some shirts and applied pressure to his head to stop the bleeding. It helped alot and for 15 min i held on to that boy, talking to him telling him to hold on while taking his pulse.I'm just shaking and freaked out right now. I was just hoping to hear that I followed the right procedures and what else could I have done maybe to make it better? I also tried to raise his head up off the ground hoping the blood would flow a bit downwards..... I don't know if I did the right thing. This boys blood was all over my hands and I have no cuts but also wondering what's my risk for exposure . I hope I did the right thing..his pulse was fading when he went into the ambulance. I hope he makes it.
    Everyone's first thought is to not move a victim in case you cause more damage, but ABC's have to come first, if he couldn't breathe, the extent of his injuries wouldn't have meant a thing.
  6. by   ClearBlueOctoberSky
    Quote from ColleenRN2B
    Everyone's first thought is to not move a victim in case you cause more damage, but ABC's have to come first, if he couldn't breathe, the extent of his injuries wouldn't have meant a thing.
    If he is not breathing from this type of injury, there is nothing you are going to accomplish by starting CPR or rescue breathing, except for messing up a crime scene. I know that it sounds callous, and y'all can flame me if you want, however with penetrating head wounds, dead is dead.
  7. by   Jess_Missouri_RN
    Good for you! That boy was lucky to have you there. Although I agree with the others that your safety comes first!!! My husband was in a car accident 7 years ago. He was working out of town and was a back seat passenger when he took off his seat belt to lay down and get sleep (and he knew better!!). The next thing he knew he woke up on the highway unable to see anything and in severe pain. He remembers feeling hands all over his body and people talking to him. At one point he remembers being rolled to his side and then taken away in an ambulance. All said and done he shattered his L1 and L2, had two surgeries, rehab and if you saw him today you wouldn't know anything was wrong with him! Aside from a few limitations (standing too long or walking too long) he recovered.

    I am so grateful to those who assisted him after the accident. My thoughts are he was obviously having trouble breathing or blood coming from his mouth that he was turned to his side. Did this hurt his back more? Who knows, but he is alive and I hate to think if he had remained on his back he would have choked on his blood and not survived. He was 2 hours away from home so by the time I saw him he was a bloody mess so I can imagine what they were thinking. You do what you can when you are thrust into an emergency. Aside from first responders I dont think anyone can prepare for something like that.
  8. by   mads1mom
    Bless you heart! I am sure that was very traumatizing. Gun shot wounds to the head are most often fatal. Be careful about compromising your own safety. The police want to help, but they don't want to add to the body count and you shouldn't either. From your description it's hard to say if you did exactly what you should have done or not. If his skull was fractured, you want to dress the wound with something sterile, but not apply direct pressure. If he was bleeding in his airway then moving to the side is good, but if his breathing was compromised due to CNS damage then you wouldn't want to move him. But in the end, honestly, even if you immediately did everything that you were supposed to do exactly how it should be done ...this boy most likely would have died anyway. The bullet is what hurt him, not you. <3
  9. by   Anna Flaxis
    My first thought is to apply pressure while holding c-spine, and inspect the oropharynx for the presence of blood or foreign bodies. Only if his airway were compromised would I have rolled him, and then I would have asked for bystanders to assist in log rolling him while I continued to hold c-spine. But that's just me.
  10. by   Elladora
    You did a good thing. Thank you.
  11. by   Misslady113
    I just want to reassure you all that I absolutely assessed the scene first, not just rushed in naively. From what I saw, it was clear, and evidently I'm still here so I made the right choice. He was still breathing and I am so glad I did turn him on his side because it was only then that I noticed blood coming out of his mouth. When I turned him I did think about spinal injuries but from my prior e.m.t training I knew that he needed to be able to breathe before anything so I made that decision quickly. And btw... he's still ALIVE... it was only a rumor that he died and I'm absolutely joyous again and thankful as well for all of your input on this situation. If I could do it over... I would have and I truly believe that if i didnt, he wouldn't even be at point B right now. Thank you all and I surely next time will try to be more careful
  12. by   CrunchRN
    I think that you did great under the circumstances and it was generous of you to do it. I hope you can contact the health department so that they can possibly do the testing to make sure he didn't have any infectious blood borne pathogens for you to worry about.

    Good job.
  13. by   Misslady113
    To madsmom1.... it was very traumatizing. I think the worst part wasn't seeing him or all the mess but the utter despair and hopelessness and shock of his friends when he got shot. They were hysterical and in their minds that was it.... their friend was dead in that moment, just like that. Like they never thought he might have a chance and they just left him there. Without a person to hold his hand or just say something to him. It was heartbreaking. To walk in the street and still see his blood stained on the ground is heartbreaking. Whenever I see a puddle it almost brings me to tears. I guess at work when someone dies its just so different than being there in the moment this boys life was almost taken and having to see his familiar face and those I know and to go through the aftermath with these people and look out my window and see his blood. Last night it rained and I watched his blood get wet again and start going down the street. I am traumatized and thank you so much for recognizing that.