nerrollus

Time to get creative. =) Depending on how dirty the blanket is, I'd take a few seconds to shake it out to get an large grass/dirt peices off it. I'd consider ripping off my own cloths (or others around me) and putting them between the patient and the blanket to help keep the direct contact to a minimum. Out in the field you're not going to be able to keep their wounds 100% clean anyways. Hypothermia should take priority I think. If they're burned bad, their wounds are going to be all dirty anyways from the smoke/trash around the site. The hospital is going to clean them up and give them antibiotics anyways.

Gotcha ... Figured I was way off there. :) Here you've gotta be EMT-B to ride an ambulance. Most of the services here either run EMT-B with EMT-P or 2x EMT-P on ambulances. Fireresponders are what the police and volley firedepartments start with. Thanks for the info =)

Curious to see how many nurses have ever gone through EMT training? I ask because I originally wanted to switch careers and chose a firefighter. Can't be a firefighter around here without having your EMT-B, so I signed up for the course. Once I got into the course I actually enjoyed it so much I decided I was going to be a paramedic instead of firefighter. Then after doing my ED clinical I feel head of heels in love with working in an ED and nurses. Went down the next day and signed up for nurses school. :) So, I was thinking about just dropping my EMT class now since I'm not going for that anymore anyways, but decided I'd go ahead and stick with it till the end, even if I don't go test for the national/state cert. Figured it would give me a better understanding of what goes on before the patients hit the ED and what the EMT/Paramedics were thinking out there. If nothing else it would give me a jump start on my nursing classes, since I'd already know how to do patient assessments, vitals, etc ... Anyways, I was wondering how many nurses out there went through EMT training at one point and how it helped/didn't help you along your path to nursism. :wakeneo:

Thanks! =) Had my moment of clarity not too long ago and I'm still pretty pumped up about being in EMT school and starting nursing school in the fall. Was pretty excited to see a question I could answer! Sorry for the spelling errors and such ... Between work, school, and clinicals I'm a bit out of it right now .. :wakeneo:

Maybe I'm just off in left field, but I thought to qualify as BLS you had to be an EMT-B or higher?

good question ... If it was really taking the EMT's that long to get there, I wonder if you could have 911 contact med control and have them give you permission to do it? I wonder if that would fall in the good sameritan act or what ...

UGh, had a long reply typed out and my inet connection dropped after I hit submit. I'll try to get it all back up here again. Just went over this in EMT school, so I'll try to repeat this all back best I can. :) 1) AIRWAY/BREATHING!! Primary concern should be the airway. Burn victoms will often times breath in super heated air, smoke, toxic fumes, etc that will cause their airway to swell up and stop them from breathing. Steps are A) Open airway: Use the held tilt chin lift, or jaw thrust manuver depending on if there's a chance of a c-spin injury or not. B) Look: Look in their mouth and make sure there's no obstructions. #1 cause of airway obstructions for unresponsive patients is their own tongue. Head tilt or jawthrust should help with this. Make sure there's no vomit, dirt, rocks, wild animals, etc in there. C) Listen: Put your ear down on their mouth and listen. Make sure air is going in and out. D) Feel: Put your hand on their chest and make sure their chest is moving and they're getting good tidal volume. Also feel against your cheak to see if you can feel air coming out of them. You may need to do rescue breathing if they're not breathing well enough. (Think it's less than 8 breaths per minute or not getting good tidial volume) Basically you do mouth to mouth, BVM, mouth to mask, whatever 1 breath every 5 seconds for adult or 1 breath every 3 seconds for children. This ensures they're getting oxygen in their lungs. Odds are you won't have the following things available to you, but some firefighters/EMT/Paramedics/etc cary jump kits with them in their personal vehicals. You can use oral/nasalpharangils(sp?) depending on the patients LOC to help maintain an airway. The might also have a BVM (Bag Valve Mask) if you need to do some breathing for them. And of course high flow oxygen at 15 LPM. Like I said, that stuff probably won't be there, but just in case... 2) Second part is going to depend on how bad their burns are. If they've got major burns all over, you're want to use clean/DRY blankets, sheets, whatever to keep them warm. Whenever the skin gets burned with 2nd or 3rd degree burns it looses its ability to regulate the bodies temp. This can lead to hypothermia if they're not kept warm. This is also why you don't want to use damp/wet towls, sheets, whatever. It remotes heat faster, making them hypthermic faster, and the water also allows bacteria stick to the wounds and leads to infection. Never get 2nd or 3rd degree burns wet!! Warm and dry! Can't stress this enough. If they've got a 1st degree, also called superficial, burns you need to remove any clothing around the area, flush with sterial water to get any junk off it, then cover the area with clean/DRY dressings. If someone has sustained burns to their hands or feet and you're going to dress the areas, make SURE you put clean/DRY dressings between their fingers and toes. This keeps the skin from sticking together and tearing apart later when the burns are being treated. Never put any kind of burn cream, neosporin, disinfectents, alchol, hydroden poroxide, etc on a burn (or any wound for that matter) out in the field. This just makes baceria and such stick to the wonders and promotes infection. This should only be done in a hospital setting in a controlled enviroment where they can make sure the wound is clean and stay that way. 3) Once you've got their airway maintained and patent, got them warm and dry, and of course away from the fire: Get them to a hospital ASAP. 911 should have already been called so they can get a bus ride there. Try not to move them around too much if you can help it. Once the skin gets burned real bad, moving them can cause the skin to tear or rip off them. It's best if they can get them on a spine board and stap them down to minimize movement. Any questions let me know ... I'll try to answer the best I can, or at least look them up in my book.

you handled it better than me ... Call me over protective, but the first time anything went missing off my desk I would have went around punching people in the neck until I got my stuff back. Seriously though, the last time I had people surfing my drawers taking my favorite types of pens and pads, I left a note in my drawer that said, "If you can read this then you're probably trying to steal my stuff and you're on video." That put a stop to it ...

Looks like it's dependant on the state. Here in Oklahoma, if they're pregnant or have a baby they're treated as an adult when it comes to pre-hospital care. I would assume it's the same for hospital care.