Wednesday, March 7, 2001

Not much is new these days... Just sort of going through the motions until spring break, which is just a little over a week away! Very excited.

As I've been mentioning on occasion, the EMT class is really picking up the pace on treatment. We, as EMTs are actually doing something, rather than just preparing the patient for more advanced care. Today in lab we practiced with a Kendrick Extrication Device (KED) and Pneumatic Anti-Shock Garment (PASG, or MAST). The KED is a vest with inflexible slats running vertically along it. It is strapped tightly around the upper torso and head so as to stabilize the entire spine for movement and rotation onto a full backboard. Those white buckles attach to straps which are, well, very tight around the legs, such that great care must be taken with male patients. There are true stories of... damage... resulting in very costly lawsuits.

PASG, also called medical anti-shock trousers, is a piece of equipment that was adopted from military use in the early 20th century. Pelvic fractures, as well as shock (hypoperfusion, or lack of adequate bloodflow to vital organs), were killing a staggering number of soldiers on the front lines. Pelvic fractures become unstable very quickly, and a patient loses up to 2-3 pints of blood in a very short amount of time, also resulting in shock. They devised a system that inflated balloons surrounding the lower extremities and abdomen so as to increase radial bloodflow resistance, which increases blood pressure, and thus brings back adequate bloodflow to the vital organs. An easier way to put it... it squeezes blood from the legs back into the upper half of the body. In the case of the pelvic fracture, it provides external support to the injury to control blood loss.

This is the same technology that the military later adopted for pilots of high speed aircraft when pulling "high G" maneuvers. It effectively keeps blood from pooling in the legs, and increases upper body blood pressure to keep bloodflow to the head (avoiding black out).

Unfortunately, PASG has quite a few contraindications as well as side effects. That's why they're not in use everywhere, and the indications for their use are fairly conservative. If they are inflated on a patient, it's a last ditch effort to prevent death by shock.

No calls last Friday overnight shift. Not boring though--got to meet quite a few CUEMS alumni at Collegetown Bagels. They, and a few of our current members, had a bit party for an hour or so.

Only one week and a couple days till spring break! I am coming back home to Portland for the week, and will quite possibly ride along again with American Medical Response in Wilsonville. Next week will signify the halfway point in our school year! Exciting times!

By Saturday I will know where I'm living next year. Most likely on West campus, but exactly where is up in the air. I won't be able to decide until Saturday, and I'll be given a period of about 5 minutes to decide (when my number is called). Fun stuff being a lowerclassman.

Aaron

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