this would be considered on scene treatment. please be specific the answer would likely be in a percent % form and time parameters if you know as well. by the way this does not refer to tilting the patient for vomiting or securing C-Spine Thanks.
I'm not sure what you are asking for here if not for positioning the patient to prevent aspiration from vomiting, protecting for a possible back, neck or head injury. If one arrived on a scene and all that you knew was that the patient had fallen, was vomiting and losing consciousness, then you would position to prevent aspiration and protect the spine and head in the event of possible injury to these areas plus monitor airway/breathing and cardiac status in case you would need to initiate CPR. Is there any more information you can add as to what you are looking for in a percentage? Perhaps one of the other medical professional on here will understand what you are looking for better than I do. Sorry.
Dear Joe... nothing u stated alluded to a brain bleed. Yes, projectile vomiting is a hallmark sign of increased intracranial pressure for which 30% positioning would be a good choice. But you have to look at what is immediately wrong... you are talking about coming up on a scene of an accident I suppose. Dzoo has already stated the obvious. The number ONE thing ALWAYS ALWAYS ALWAYS is protecting the airway... oxygen to the brain... this is why in the ABC's of CPR... the 'A' is AIRWAY... airway is always the very first thing that MUST be secured. AIRWAY, BREATHING CIRCULATION... IN THAT ORDER.
So... if I came up on a scene of an accident and I see this person is going into loss of consciousness (LOC) I am going to FIRSTLY do the "head down/tilt maneuver." This is of course to prevent aspiration of gastric contents into the lungs which is well documented as having a high mortality rate. Once I have done that and had the airway secured i would then go to the "B" of the "ABCs" which is breathing. I would make sure that if not breathing then i would then have to somehow breathe for this person... either mouth to mouth hopefully with a mouth/mask airway or even better via an endotracheal tube if that equipment (laryngoscope and tube) is available... and then of course i would make sure that the circulation be evaluated, i.e., heart rate, pulses, etc... which would determine whether chest compressions must be started... then and only then would I position for a "intracranial bleed." I would examine the ils which would indicate increased ICP along with the LOC which would indicate that something intracranial was going on... Glasgow coma scale if u will. All of the aforementioned described maneuvers happens in a matter of seconds with someone who is highly trained in resuscitation and airway management. Then a 30 % positioning could and would be considered if the ABC's of resuscitation were fully evaluated and secured.
Sorry... you just ignited my "soap box!!! "... be well and if you are some kind of student... I hope I have helped to educate you a bit...
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