Pre-hospital care 2

00:00

  • Pre-hospital care 2
As a medical doctor of the aeromedical services you arrived to these two scuba divers with suspicion of the DCS. The patient with breathing problems - Antonio - is vomiting and shortly after your arrival becomes unconscious. What are your next steps?

Management of the patient on site (intubation). Both patients stay on 100% oxygen inhalation and are given enough fluids IV (balanced solution). We contact the HBO specialist and transport both patients by aviation medical services (flight under 300 meters flight level) to an HBO medical center.

Correct answer

Fantastic! As this is a diagnosis with a very specific treatment, it is necessary to contact a specialized HBO medical center. HBO is essential for the DCS treatment and it is not rational to transport the patient to a facilty without this treatment option. According to guidelines the fluid resuscitation would be done exclusively by balanced crystalloids, never by a glucose solution. A patient with a DCS must be transported by aviation services under the 300 meters flight level.


Continue

We intubate the uncounscious patient and keep both on 100% oxygen inhalation and IV fluids. Both are transported as fast as possible to the nearest hospital.

Wrong answer

What if there is no HBO treatment at the nearest hospital? Every patient with the DCS suspicion should be transported as fast as possible to a center with the HBO option. It is not rational to transport him/her to a hospital without an HBO.


Back

Management of the patient on site (intubation). Both patients stay on 100% oxygen inhalation and are given enough fluids IV (glucose solution). We contact the HBO specialist and transport both patients to an HBO medical center.

Wrong answer

Near miss! Your answer is almost correct but we never resuscitate the fluids by a glucose solution!


Back

?

Help

HBO - hyperbaric oxygen×
 
RR

14 bpm

HR

120 bpm

SpO2

70 %

BP

90/50 mmHg

ECG

sinus rythm, regular pace, BPM 109 bpm, 110° axis, S I, Q III, negative T wave in V1 - V3 (acute cor pulmonale)

 

Gly

results

ABG

not available

CBC

not available

biochemistry

not available