I feel a scenario coming on

[Guest guest]

For those of you who have no plans for the weekend, here's a scenario to work

on. This is based upon a true injury I encountered when I worked as a rig

medic in the Gulf of Mexico some years ago.

You are dispatched to the site of an oil drilling rig about 25 miles out into

the county on a bumpy gravel road. Your response time is 40 minutes.

On arrival you drive up to the rig and find a two men sitting on the tailgate

of a pickup. One has an oil drenched rag wrapped around his right arm from

the elbow up. He is obviously in severe pain.

His partner tells you that he was working on the rig when a pressurized

hydraulic line burst and injected hot hydraulic fluid into his right arm.

You bare the wound and see an entry wound that looks for all the world like a

..45 caliber entry wound in the right antecubital fossa. But the patient's

whole upper arm, from elbow to shoulder is purple/black and swollen three times

its normal size all the way up to the shoulder.

The patient tells you that the hose that burst was under about 7,200 psi

pressure and the temperature of the oil was about 200 degrees F. The accident

happened one hour ago.

Describe in detail how you will manage this patient, from immediate treatment

until completion of transport. Assume that your nearest hospital is a Level

III 65 miles away. The weather is clear, 92 degrees F and winds are 5-7

mph.

A level 1 trauma center is 135 miles in one direction and another 200 miles

in the other direction.

Gene Gandy, JD, LP

**************

New MapQuest Local shows what's happening at

your destination. Dining, Movies, Events, News & amp; more. Try it out

(http://local.mapquest.com/?ncid=emlcntnew00000002)

[Guest guest]

,

You are correct

>

> Gene,

>  

> Think you are dealing with a burn and compartment sydrome. The

> other consideration  Think you are dealing with a burn and compartment

sydrome. The

> other consideration <wbr>would be to contact poison control to inquire

> about the hydraulic fluid. I would wrap the arm in sterile

> Just my thoughts

>

>

>

>

> From: wegandy1938@wegandy <wegandy1938@wegandy>

> Subject: I feel a scenario coming on

> To: Paramedicine@ParamedicinePar, texasems-l@yahoogrotexasem,

> WEGandy@...

> Date: Friday, October 10, 2008, 10:15 PM

>

> For those of you who have no plans for the weekend, here's a scenario to

> work

> on. This is based upon a true injury I encountered when I worked as a rig

> medic in the Gulf of Mexico some years ago.

>

> You are dispatched to the site of an oil drilling rig about 25 miles out

> into

> the county on a bumpy gravel road. Your response time is 40 minutes.

>

> On arrival you drive up to the rig and find a two men sitting on the

> tailgate

> of a pickup. One has an oil drenched rag wrapped around his right arm from

> the elbow up. He is obviously in severe pain.

>

> His partner tells you that he was working on the rig when a pressurized

> hydraulic line burst and injected hot hydraulic fluid into his right arm.

>

> You bare the wound and see an entry wound that looks for all the world like

> a

> .45 caliber entry wound in the right antecubital fossa. But the patient's

> whole upper arm, from elbow to shoulder is purple/black and swollen three

> times

> its normal size all the way up to the shoulder.

>

> The patient tells you that the hose that burst was under about 7,200 psi

> pressure and the temperature of the oil was about 200 degrees F. The

> accident

> happened one hour ago.

>

> Describe in detail how you will manage this patient, from immediate

> treatment

> until completion of transport. Assume that your nearest hospital is a Level

> III 65 miles away. The weather is clear, 92 degrees F and winds are 5-7

> mph.

>

> A level 1 trauma center is 135 miles in one direction and another 200 miles

> in the other direction.

>

> Gene Gandy, JD, LP

>

> ************ **

> New MapQuest Local shows what's happening at

> your destination. Dining, Movies, Events, News & amp; more. Try it out

> (http://local. mapquest. com/?ncid= emlcntnew0000000 2)

>

>

[Guest guest]

Gene,

 

Think you are dealing with a burn and compartment sydrome. The

other consideration would be to contact poison control to inquire

about the hydraulic fluid. I would wrap the arm in sterile dressing, treat with

Fentanyl for pain, and I would transport to level I trauma center.

Just my thoughts

Subject: I feel a scenario coming on

To: Paramedicine , texasems-l , WEGandy@...

Date: Friday, October 10, 2008, 10:15 PM

For those of you who have no plans for the weekend, here's a scenario to work

on. This is based upon a true injury I encountered when I worked as a rig

medic in the Gulf of Mexico some years ago.

You are dispatched to the site of an oil drilling rig about 25 miles out into

the county on a bumpy gravel road. Your response time is 40 minutes.

On arrival you drive up to the rig and find a two men sitting on the tailgate

of a pickup. One has an oil drenched rag wrapped around his right arm from

the elbow up. He is obviously in severe pain.

His partner tells you that he was working on the rig when a pressurized

hydraulic line burst and injected hot hydraulic fluid into his right arm.

You bare the wound and see an entry wound that looks for all the world like a

..45 caliber entry wound in the right antecubital fossa. But the patient's

whole upper arm, from elbow to shoulder is purple/black and swollen three times

its normal size all the way up to the shoulder.

The patient tells you that the hose that burst was under about 7,200 psi

pressure and the temperature of the oil was about 200 degrees F. The accident

happened one hour ago.

Describe in detail how you will manage this patient, from immediate treatment

until completion of transport. Assume that your nearest hospital is a Level

III 65 miles away. The weather is clear, 92 degrees F and winds are 5-7

mph.

A level 1 trauma center is 135 miles in one direction and another 200 miles

in the other direction.

Gene Gandy, JD, LP

************ **

New MapQuest Local shows what's happening at

your destination. Dining, Movies, Events, News & amp; more. Try it out

(http://local. mapquest. com/?ncid= emlcntnew0000000 2)