Treatment

Health, I’m saying this with the best of intentions so I’ll be a little vague, but please brush up on your people skills.

You should assume possible driver impairment as the cause of a 1 car accident.

Heart attack, stroke, drug use, drunk, suicide, etc.

I thought of that, but doesn’t driver impairment also cause 2-car crashes?

I suppose it’s a matter of relative likelihood.

Seems to me though, it should be an important consideration in all cases.

Probably just another fairly minor distinction useful for selling books and courses, and demonstrating ones knowledge of little known unimportant matters.

Feivel that is not correct, first as Popa pointed out, all of these factors can be the cause of a multi car MVA.

Also, assuming its a trauma pt unless there is reason to believe that there is a medical cause, pt will not get a medical workup such as 12 lead, especially if its a multi system trauma pt.

All of that changes if there is suspicion of a medical cause.

That doesn’t make any sense. There is no more higher probability of driver impairment causing a 1 car crash than a 2 car crash, and even if it is higher, I don’t believe it would be so significantly higher as to make checking for impairment protocol in one and not the other.

You’re making this up. Give us proof.

and i didnt take the crash course…

popa_bar_abba,

That doesn’t make any sense. There is no more higher probability of driver impairment causing a 1 car crash than a 2 car crash, and even if it is higher, I don’t believe it would be so significantly higher as to make checking for impairment protocol in one and not the other.

You’re making this up. Give us proof.

Assuming the first responders do not know the cause of the crash and are just transporting patients to the hospital, in the case of a single car crash, the patient you are transporting is more likely to be the cause of the crash than in the case of a multiple car accident.

So as a simplistic model, let’s say that 20% of the people who cause wrecks do so because they are impaired in some way, and 0% of the people involved who didn’t cause it are impaired. Next, you have two incidents, a single car (1-occupant) crash, and a crash involving two vehicles (1-occupant per vehicle). In each crash, there is one injury. For the single car crash, there is a 100% chance that you are transporting the person who caused the wreck, so there is a 20% chance of impairment. In the second case, there is only a 50% chance that you are transporting the person who caused the wreck, so there is only a 10% chance of impairment.

I would also argue that impairment is more likely in the single car crash, because you remove a component of human error from the potential causes.

That is purely your own logic, but there is no difference in real life on assessing a pt of a one car crash vs multi.

Health care providers will always make sure that there is no underlying medical problem once the apparent threats to life are taken care of.

Assessment is ALWAYS, ABCs, airway (patent or established), Breathing (spontaneous or Positive Airway Ventilation and Make sure there are no signs of tension Pneumo), Circulation (control any bleeding, and maintain MAP of at least 60)

Depending on the findings, further assessment is done according to the situation. For example if pt is is still unresponsive after stabilizing ABCs , BGL 12 lead and if possible Neuro exam.

The same is for Patients from a one car or multi car MVA. the fact that you believe (and could very be true) that pts from single car MVAs are more likely to have an underlying medical that caused the accident does not change the assessment or treatment at all.

Regardless of the fact if there is suspicion of a medical, the receiving facility will level the trauma accordingly, if necessary consider CT Scan, FAST if suspicion of internal injury and have sub specialties as needed and resources the facility has.

this is a cookbook scenario, of course each case is different and should be assessed and treated accordingly but in reality there is no difference in the amount of cars involved.

In many crashes you can tell who is at fault. So is a rear end collission like a 1 car collission? Or if one car veered into oncoming traffic?

popa_bar_abba,

In many crashes you can tell who is at fault. So is a rear end collission like a 1 car collission? Or if one car veered into oncoming traffic?

Probably.

Health

“Are you in EMS? “

Nope.

“Let me explain it further.”

thanks, isnt that why you started the thread?

“The point I was making is that you evaluate for both medical & trauma at the same time. This is only for a single car accident.”

If you dont mind, id like further explanation. SO EKG would be done for a one car accident but not for multi-car?

I don’t believe you. Proof, or you’re making it up.

In any two car crash, there’s a high likelihood that one car caused it, which could imply an underlying medical cause.

Health

I still dont get it. so they both get EKG’s so wether you suspect heart attack or not doesnt really matter. ITs not like either case is having troponins drawn in the field or are they?

Do you only check fingerstick with one vehicle?

If the driver has pinpoint pupils, barely breathing would you only give narcan if only one vehicle was involved?

In what way is the managment different?

No difference, the EMS protocols in NY and surrounding states make no differentiation between single or multi car MVA, same is with the in hospital trauma assessments.

However it could very much be that more single car crashes are the result of an underlying medical, yet this does not make any two car MVA to be excluded from this suspicion.

Health

“Are you involved in EMS?”

nope (you aksed that already)

” Whether is with a “h”.””

Thanks though you mean “an h” (2 can play that game).

Thanks for your reply. Very interesting. However I’m inclined to go with PBA (first time!) It think even if what you say is true it is more of a cute factoid than part of any medical algorithm.

Does any EMS actually follow this? Or do you just believe they should?

Is this written anywhere?

It isn’t fair for you to ask someone at their medical degree is, when you’ve refused to tell us your degree for the past 5 years, and just insisted you are in a “medical field”

Yes health PLEASE.

your statement is completely illogical to a number of us here.

PLEASE reference the source, any source, even one please, that there is a different protocol to follow for first responders providing emergency medical care to victims, for a one vehicle accident as opposed to a multi vehicular accident.

Please give us one source we can look into to decide if this discussion is worth pursuing.

Exclamation marks do not add any validity to your claim.

I suspect you have no source. Or perhaps you heard it from an instructor during a course you took. Or perhaps it’s your own chiddush

PLEASE let us know

Health

“Anything liberal with Israel or life “

Aderaba! my views on ISrael are quite conservative. And I am not liberal with life at all. Also I’m not sure how not difirentiating betwen the number of cars in an accident as far as treatment goes is being “liberal with life”

No I dont know emergency medicine at all (nor do I pretend to ahem ahem).

“Look I have an EMS book that states -“Trauma – Are there medical causes? (e.g. diabetes, CVA, MI, etc.)”

Thanks, thats all I wanted to know. Though name of book please? (a google search only reveals this thread)

“I asked about your degree. What area of medicine are you in? “

Internal medicine. you?

Yes, source to your claim.

I’m a retired trauma surgeon.