and you want the pt in trendelenburg?

[RyanEMVFD]

This is just a rhetorical question which deserves no response but still...

what is it with all the calls i've had lately where the patient has no legs and is hypovolemic with no IV access? How the heck do you put this patient in trendelenburg?

Never mind, the tourniquets tied together can make a harness so the patient can stand on their head..

(Walks off muttering to self.)

[firechic]

How many legless patient calls have you gone on lately?? :hehe:

[RyanEMVFD]

seems like a rash of them lately. I can think of 4 in the last month.

At least I don't have to worry about them running off.

[SteelMaiden]

At least I don't have to worry about them running off.

OMG:wow: I know it is just plain wrong, but I just snorted my coffee out of my nose. Do you get a lot of runners? Ours usually don't run til we get to the hospital, then they are mysteriously cured enough to complete their trip to the local wal-mart on foot.

As for legless patients and trendelenburg...You can place the pt at the bottom half of the stretcher to raise the buttocks slightly, place the pt on the stretcher with head toward the foot, or just use some extra pillows, blankets or towels to adjust the pt's position slightly. But, it does seem that without legs, the whole theory is rather limited, since raising the "legs" is to help keep plenty of blood supplied to internal organs/brain (yes, i know the brain is an internal organ too:rotflmao: )....guess the value of the practice would depend on how long the stumps are?

One of those things where someone looks only at the protocol, not at the situation?

[hageremtp]

You wonder about no leg patients. Here is the one that I always wonder...


As a BLS provider, you are taught to treat bleeding with direct pressure, elevation, pressure point, and lastly the tourniquet. So lets say your called to a home for a guy with major rectal bleeding (or even a sever hemorrhoid bleeding). How do you put direct pressure on that? I know I am not going to stick my hands there. Maybe some gauze between the cheeks and have the rookie hold the cheeks together? Then if it keeps bleeding, you want to elevate that part above the heart.....imagine how you would need to transport someone to keep their rear above their heart.

If the bleeding continues, then we move to a pressure point. Which one stops bleeding in that region????? ANYONE? And last but not least, where do you tie the tourniquet??

[RyanEMVFD]

ahh, the rectal bleed scenario. Direct pressure is best applied by grabbing the patient's feet (in case of legless patients, substitute for the arms) and firmly plant your foot up their ***. Make sure bandages are applied before hand (or foot in this case) and you have those surgical booties on.

[EMSsquirrel]

I've had people who were bleeding from the head. I applied direct pressure around their neck, and when my hands got tired, I just went with the tourniquet.

As for people without legs... Trendelenberg is designed to increase bloodflow to the vital organs, kinda like PASG/MAST trousers are designed to squeeze blood out of the legs and up into the body when the patient's in shock. But my question is, is blood volume constant, even if the legs aren't there? Will a 5'10", 200 pound man with legs have the same volume of blood as the same 5'10" 200 pound man without legs? And as a result, will the legless man already have more volume in what remains of his body because his legs are gone, thereby nullifying the need to Trendelenberg?

- Greg

[hageremtp]

Will a 5'10", 200 pound man with legs have the same volume of blood as the same 5'10" 200 pound man without legs? And as a result, will the legless man already have more volume in what remains of his body because his legs are gone, thereby nullifying the need to Trendelenberg?

- Greg


Would a man without legs really be 5'10"?? :hehe:

[Nate]

I like to raise their feet on the cot to keep them from slidding off...the cot.

[celestialdaisy]

WOW, I am just about in tears after reading this one through. MY $.02 - watch out for the legless guy with a prostesis...he may not be able to run very far, but he can sure take it off and beat you with it. But if you got the rectal beel in that situation, you could use his own foot to shove up there. :D

[WELLAGEDEMT]

This post is leading to a story about a man with no arms or legs. This man goes to a "house of illrepute" rings the doorbell and the "Lady" of the house answers the door and starts laughing and says, "What do you want?" He says that he would like to come in and enjoy some of the services. She said, "How do you expect to do that with no arms or legs?" He replies,," I rang the DOORBELL didn't I?" Some areas of EMS just leave me in stitches. :rotflmao:

[SteelMaiden]

oh, wow, wellaged, that IS an old one!

[Garyb3985]

Would a man without legs really be 5'10"?? :hehe:
I'd like to see that! ! :rotflmao: