Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

On the Clock: Hole

On the Clock: Hole

With all of the recent discussion of the research and the pathophysiology of massive hemorrhage, Medic61 at On The Clock does a great job of making it real and showing how the ALS personnel can easily get caught up in things that cause them to ignore more direct methods to control the bleeding. A manual blood pressure cuff is a tourniquet – one that is often overlooked.

A blood pressure cuff, the fancy name is sphygmomanometer, works by blocking the arterial flow of blood. It allows for the slow release of the pressure applied, usually to the brachial artery, so that the return of arterial blood flow can be observed as the systolic blood pressure. If it were not an effective tourniquet, it would not be effective at measuring the systolic blood pressure.

Or, as the often used saying states –

Paramedics save lives.

EMTs save paramedics.

At some point everybody ignores the basics. If we are lucky, we have someone with more sense around. If we are even luckier, they remind us gently.

If we are unlucky, really the patient is the unlucky one, we have more certification than sense and this is not challenged by anyone around.

On The Clock is a great blog for putting patient care into a well written narrative, not something that is easy to do or easy to find.

Here are a bunch of recent posts on tourniquets, Trendelenburg, bleeding control, and hubris.

ParaCynic:

Tourniquets, Trendelenburg, Tampons, Toilet Paper

Standing Trendelenburg on it’s Head

Too Old To Work, Too Young To Retire:

Tourniquets

And my own posts:

New Series of Rants – ParaCynic

New Series of Rants follow up

New Series of Rants Second follow up

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Comments

  1. “At some point everybody ignores the basics. If we are lucky, we have someone with more sense around. If we are even luckier, they remind us gently.” Not everybody learns from their foolish attempts to kill patients. Sometimes protecting the patient only means the dangerous ones look less dangerous.

  2. first rule of fire,This is true. If you don’t have good medical direction, all you are doing is protecting the patient while you are there. You can’t always be there. They will complain that it makes them look bad when you correct their dangerous behaviors. This is the kind of environment where management will probably side with the poor incompetent killer.

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