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Subject: Mounted search and rescue
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- From: "Hill, Victoria L." <Victoria.L.Hill@saint-gobain.com>
- To: "Mounted search and rescue" <msar-riders@lists.ibiblio.org>
- Subject: Re: [MSAR] treatment protocols
- Date: Fri, 18 Dec 2009 17:23:55 -0500
Like I said....if the pt is A&O x3
the procedures I mentioned are acceptable SOP'S universally. I didn't
bother going into the what if's/frostbite/etc. All I was referencing was
an alert, conscious hypothermic pt. and yes, there is nothing to get away with
in Indiana as it IS well within our scope of practice to provide this and much
more. It's treatment PROTOCOL here. All states are different as to
what they will allow different levels of EMS personnel to do as far as
treatment. Yes....I am well aware of what an AED is, as you can see by my
signature I am well versed in the matters of AHA and EMS "stuff". There
are heart monitors and AEDS...different breeds, different words.
Good day! From: msar-riders-bounces@lists.ibiblio.org [mailto:msar-riders-bounces@lists.ibiblio.org] On Behalf Of IRVIN LICHTENSTEIN Sent: Friday, December 18, 2009 4:57 PM To: 'Mounted search and rescue' Subject: Re: [MSAR] treatment protocols If a hypothermic
patient is still conscious and sufficiently coherent to accept fluids, and to do
it themselves (core temp is barely depressed) maybe you will get away with it.
Administering anything as a treatment beyond Oxygen is usually outside the
scope of practice of an EMT-B. An AED is a heart monitor by the way.
Our BLS protocol says pack’em up, ship them to an ALS capable facility, without
spot warming of any kind, anywhere. Complications, such as frostbite or
reduced extremity warmth, pulse, or circulation we stay away from also, because
the field treatments for these are contraindicated by the hypothermia.
Depending on where the subject is found, they may have hours of “lug out”
to get to a road or LZ and may actually cook the way some wrap them up in
sleeping bags and foil in the Stokes. Use of any device, medical or
otherwise, beyond blankets, is also outside the scope of practice at present.
One of the problems is
that warming is a treatment for frostbite, but should not be attempted in the
field for hypothermia. The definition of hypothermia is also constantly changing
in terms of how cold the patient is and how the temp was taken. This lack
of uniformity in treatment is what allegedly lead to our state’s EMS bureau now
requiring all wilderness SAR to become licensed special operations Vasodilation causes the
blood vessels to enlarge causing a huge increase in blood volume required to
maintain flow and pressure levels. The form of shock is hypovolemic (sp?)
and is similar to bleeding out, without the blood loss. It can also happen
during the body’s reaction to any trauma where blood volume changes rapidly.
Irv Lichtenstein
From:
msar-riders-bounces@lists.ibiblio.org
[mailto:msar-riders-bounces@lists.ibiblio.org] On Behalf Of Hill, Victoria L. If I
may....if the hypothermic subject is still A&Ox3 then you can begin the
warming process by removing them from the cold environment, taking their wet
clothes off and covering them with a blanket/s, providing those hand warmer
packets to them to be placed in the axilla (armpits), groin area, and the back
of the neck. DO NOT re-warm the limbs first as this will cause
vasodilation and cause the body to go into a fatal form of shock. You can
also give them WARM liquids or broth. Do NOT rub the affected areas, and
if shivering is absent transport in an ambulance. Do not allow the pt. to
walk around, do not re-warm too quickly or jostle them around as this will cause
arrhythmias. We don't require hypothermic pts to be placed on a heart
monitor as none of us can carry them in our backpacks or saddlebags without a
whole lot of red tape and a medical license at about the Paramedic
level. This is pretty basic first aid stuff for our state and of
course as you advance up the Just wanted
to throw my 2 cents in. I wish all of you a very Merry Christmas and
a safe and wondrous New Year. Respectfully, Victoria
L. Hill Clay Co. Sheriff's
Posse Clay Co. Search &
Rescue AHA CPR
Instructor EMT -
B 812-878-0216
Cell Victoria.L.Hill@saint-gobain.com P
Please
consider the environment before printing this e-mail To know what is right and not do it is the worst
cowardice. ~Confucius From:
msar-riders-bounces@lists.ibiblio.org
[mailto:msar-riders-bounces@lists.ibiblio.org] On Behalf Of IRVIN LICHTENSTEIN I usually buy through
REI as there is a store nearby (Conshohocken). Most of the hiking socks
are available in synthetic only. Polyproplene is a wicking material and
the fabrics made from it are good for the innermost layer. Gore product
Gore-Tex is a membrane used as a vapor barrier in various products. If it
says You can become
hypothermic at +60F if there is a wind (like riding at 7 MPH) or rain (even a
mist) if you get wet and then cool by evaporation. The biggest argument
for spending the bucks for Clarification: My
Dehners have ribbed soles, not slicks. I ride with wide, leather covered,
stirrups and a padded seat roping saddle. I usually wear full suede
schooling chaps over jeans. I carry a rain hoodie, CAUTION: When
encountering a hypothermic subject current protocols are not to warm them up
until a heart monitor is available and they will be warm from then
on. There is a danger of
arrhythmia during the warming process and there is no sense warming someone and
then getting them cold again. What you want to do is stop any further
cooling by removing wet clothes, wrapping loosely in a blanket, or
similar. Consult with your medical director for a proper protocol consist
with BLS or ALS in your jurisdiction. Irv Lichtenstein
From:
msar-riders-bounces@lists.ibiblio.org
[mailto:msar-riders-bounces@lists.ibiblio.org] On Behalf Of Lila Corey |
-
Re: [MSAR] People Boots,
Kate Beardsley, 12/18/2009
-
Re: [MSAR] Socks,
Laurie Hanahan, 12/18/2009
-
Re: [MSAR] Socks,
Thor Burfine, 12/18/2009
-
Re: [MSAR] Socks,
John-Faye Neff, 12/18/2009
- Re: [MSAR] Socks, Una Smith, 12/18/2009
-
Re: [MSAR] Socks,
John-Faye Neff, 12/18/2009
-
Re: [MSAR] Socks,
Lila Corey, 12/18/2009
-
Re: [MSAR] Socks,
IRVIN LICHTENSTEIN, 12/18/2009
-
Re: [MSAR] Socks,
Hill, Victoria L., 12/18/2009
-
Re: [MSAR] treatment protocols,
IRVIN LICHTENSTEIN, 12/18/2009
-
Re: [MSAR] treatment protocols,
Hill, Victoria L., 12/18/2009
- Re: [MSAR] treatment protocols, Una Smith, 12/18/2009
-
Re: [MSAR] treatment protocols,
Hill, Victoria L., 12/18/2009
- [MSAR] Hypothermia, Una Smith, 12/18/2009
-
Re: [MSAR] treatment protocols,
IRVIN LICHTENSTEIN, 12/18/2009
-
Re: [MSAR] Socks,
Hill, Victoria L., 12/18/2009
- Re: [MSAR] Socks, emboote, 12/18/2009
-
Re: [MSAR] Socks,
IRVIN LICHTENSTEIN, 12/18/2009
- Re: [MSAR] Socks, Jorene Downs, 12/18/2009
-
Re: [MSAR] Socks,
Thor Burfine, 12/18/2009
-
Re: [MSAR] Socks,
Laurie Hanahan, 12/18/2009
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