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This transcription provides information on the use of Life Flight for transportation of patients in emergency situations. Life Flight can be called for various reasons, such as being time-sensitive, requiring a higher level of care, or needing additional ambulances. It is also useful for reaching remote patients. The importance of transporting pediatric patients to pediatric trauma centers is emphasized. The transcription also includes information on assessing and treating injuries, such as facial fractures, chest trauma, and pelvis injuries. It concludes with a discussion on various types of motor vehicle impacts and their associated injuries. a 25 minute extirpation and a 10 minute transport, I can call Life Flight and they can come and land and I can bring the patient to them. It's still faster than me driving the patient to the hospital, because they're there. So I can call them because they're time sensitive. I can call them because they're a higher level of care. They have more tricks in their toolbox and more tools in their toolbox. And I can also call them just because I want another ambulance. I got a bus rollover with 30 patients. I can't generate 30 ambulances in the area. I can call Life Flight, give them the sickest patient. That's another patient gone, another ambulance that can be used. Or any one of those three reasons added together. Or patients that are remote. Life Flight has gone to purgatory chasms. The patients are two miles into the woods and we can't get to them. They'll land in the field and get them. They land on the highway. They land on the mass cycle. Prequels. Trauma centers are categorized as either adults or pediatrics. That's the beauty of UMass. UMass has a pediatric ER. They have a level one pediatric ER that is as good as Boston Hospital. Do not transport a pediatric patient to an adult trauma center when a pediatric trauma center is available, unless you don't have, unless the transport would be life-threatening to the child. If I have a pediatric trauma and I don't have a pediatric trauma center and the patient won't survive the transport, I go to the adult trauma center. They'll stabilize the child and then call for transport to a pediatric center. Closest appropriate facility. Ground UMass is staffed by EMTs and paramedics. ER units are usually staffed by critical care staff, which would be flight medics, flight nurses, or flight nurses and flight respiratory therapists like they do at Dart. This algorithm, I'm gonna go over this in a minute. I'm gonna give you a handout that's gonna be easier to read. I want you to read through that, which is on page 925, but I'm gonna give you a hand, oh, I gave you the handout already. I gave it to you. So we're gonna go over that in a minute. So special considerations. Remain calm. The old saying in EMS is the faster your patient's pulse rates go, the slower yours should be. Slow down, focus. Complete an organized assessment. Do the same assessment every time. Correct life-threatening injuries to airway, breathing, circulation. Do no further harm. Call ALS. Don't be afraid to call medical control if you're not sure. Call Doc in the Box. So one, kinetic energy is the calculation of weight and speed. One half mass times velocity squared. A 20-year-old man has major open facial fractures after his vehicle struck a tree head-on, which is the following findings within the car would most likely explain his injury pattern. What do you think his face hit? The steering wheel. You think the steering wheel? Grandmas do, but everybody else kind of drives like this, right? Airbag won't cause major open facial fractures. Crushed instrument panel. What do you drive like this? What do you drive? Non-intact steering windshield. Sometimes you can even find blood and hair fibers in the windshield. You're gonna go over the steering wheel and hit either the header or the windshield itself. Sometimes patients go through the windshield if they're not wearing seatbelts. Which of the following would most likely result from the third collision in a three-collision effect that occurs during a high-speed frontal motor vehicle crash? Third collision. Air rupture. Air rupture because it's very... That's internal. Why would you... The third collision is internal, right? That's the only internal injury, right? Does that make sense? That's that force causing everything to shift forward and it literally pulls the aorta. The heart pulls the aorta away from the spinal cord. A young male experienced severe blunt chest trauma when his passenger car struck another vehicle head-on. During your inspection of the interior of the vehicle, you would most likely find... So now his chest. What does the chest hit? The... B, the steering wheel. So look for steering wheel deformity. Very good. Another strange driver collided with a bridge pillar. Upon inspection of the interior of the vehicle, you note that the lower dashboard is crushed. During your assessment of the patient, you would most likely encounter... Tremor of the lower... Lower dashboard of the vehicle. Tremor of... A? A. A. Lower... The lower dashboard... Of the vehicle. Trauma to the pelvis, because there are two paths you can take. You can take down and under, and up and over. So if you like to drive low in the car, you're gonna go down and under. If you drive up high, you're gonna go up and over. I have a quick question. So when it comes to like, once chest injury when you have a steering wheel, do you think like having a steering wheel cover can cause more damage than... My brain crashed into a cover? Yeah, so you know how like, if someone has a cover on their steering wheel... I don't think that would make a difference. It wouldn't make a difference? No, I don't think that would make a difference. I mean, unless there's a knob on it. You got a suicide knob, yeah, that might. There's that right in the face, maybe. Yes. Yeah, it's a real one. Whiplash injuries are most commonly followed with what type of impacts? A. A. Rear end. Rear end, very good. That's what the headrest is for. Deaths from rollover motor vehicle crashes most often secondary to? Ejection. Wait. Which one's the worst injury pattern? Ejection. Ejection from the motor vehicle. Partial ejection is even worse than regular ejection, full ejection. Severe abrasion injuries can occur when motorcycle riders are slowed after a collision by road drag. Road drag is often associated with which type of motor vehicle impact? Wait, ejection, sorry. Ejection because you're going... Right, right. And you're ejected from the motor vehicle most of the time. Yeah. Very rarely do you stay on. When assessing a stab wound, it's important for the EMT to remember that? I heard one in particular, Larry. I heard D, everybody agree? Right, more internal damage than may be present from the external. Again, the ice pick goes in, it's got a little tiny hole, doesn't even bleed. But that ice pick is this long, and it moved when it was in there, so you may not have tremendous damage. A 40-year-old man was standing there revealing what building went and exploded. He has multiple injuries, including a depressed skull fracture, severe burns, and an impaled object in his abdomen. His head injury most likely is caused by what? Territory. Tertiary, right, because he got picked up and thrown. 40% of deaths from blast injuries are caused by the tertiary phase. Patient, this guy's not gonna do very well, no matter what. All right, why don't you take a quick five, and we'll get into the next chapter. Which I believe is Thursday. Yes, John. All right. With your shock and bleeding, they complement each other, and then you'll do correct.