Al_HikesAZ wrote:I round a curve in the trail, and there's this big ole Joe - half conscious (LOC A&O 1/2), bleeding profusely, leg bent at a might awkward angle. Now what? What do I need and what do I do?
1. Assess the scene. Is it safe for you to help him? (For example, were the injuries caused by unstable geology that might come tumbling down on you?) Also, what assets do you have? Do you have anyone to send for help? What's in your first aid kit? How far are you from help? Send someone for help if possible, after you can give a brief description of MOI, situation and injuries, GPS location, etc.
2. Check for which are his life-threatening injuries: (head injury, profuse bleeding, spinal injury, etc.) You say he is 1-2 on the consciousness scale, so he ain't talkin' to you, cowboy. MOI may show possible spinal and/or head injury. However, you also have the profuse bleeding. This needs to be stopped. If there is only one of you, you need to stop the bleeding. Hopefully the bleeding is not in a place where you have to move the patient in order to apply direct pressure on the bleeding. Check his head to see if you can find any evidence of him hitting it. It will be good if you have a second person to hold C-spine, since you have an awful lot of other things to check out.
3. Take his vitals. Since he is non-verbal at 1-2 it is crucial you take his pulse and respirations every 15 minutes and write it down. That way you can watch if it goes up a lot (compensation for the loss of blood volume due to the bleeding) or down a whole lot (he is starting to croak). Assess other vitals as possible. You probably don't have a cuff with you. So, look at his skin color, is he very pale? Is he becoming blue? If you are able to treat his other injuries, such as cleaning wounds, applying traction, or cleaning and covering a compound fracture, do these in order they seem necessary. But your priorities are his level of consciousness, his vital signs and making sure he does not bleed out. Due to his LOC I don't see him hobbling out of there, so I question application of traction (if this treatment is even possible). If you are by yourself, you may have to pick and choose which injuries to treat.
4. Keep him warm, continue to assess. If you were alone to start with, and have him as stable as you can make him, now go for help.
Did I forget anything?