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Post by skiechj on Apr 2, 2016 1:20:17 GMT
Stabbing to the chest. Chef's knife sticking out of the chest. Patient is in V-Fib. do you remove the knife? do you shock with the knife in place? do you do CPR with the knife in place?
How would you proceed?
Idea from an article in EMS1 I read a while back.
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Post by stevejackowski on Apr 8, 2016 17:28:17 GMT
That is an interesting case study concept. I think this is a catch 22. It would be nice to see a set of vitals because that may help come to a decision. I would be apt to remove the knife if it looks from an anatomical standpoint that it has missed vital arteries and the actual heart(even though we are trained to NEVER do so) - in which case I would be treating for a sucking chest wound and then monitor respiratory function. Then I would proceed to convert the heart back to a normal sinus rhythm. It is a very tough call. Either way you treat can result in death, whether it is from v-fib or a bleed. Only other option would be to do nothing other than treating for hypovolemic shock and get them to a hospital asap.
Good post. I will be looking further into this scenario for sure.
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