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Medical Questions (Hospital Procedures)


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#1 Pen

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Posted 12 February 2017 - 02:48 PM

This is for a Sci Fi story.

 

I have a character that is brought into a medical facility by a robot. He's in critical condition. He's been shot, stabbed, and poisoned. The people in this society tend to ignore him. Due to his lowly status he's not important to society in some great way.

 

So he's in the medical center's waiting room fighting for his life. The staff, busy with other more important people, just leave him there to die.

 

Luckily another group has been following him. They arrive in time to stabilize his condition for transport to another facility. He's been laying on the floor for 3 minutes. Major arteries have been missed. Appropriate amount pain relieving drugs used. (whatever that should be)

 

So what are (or could be) the procedures for something like this?

 

What should, would or could the team do when they arrive?

 

If you're an EMT,LPN, RN, or MD what would you do?

 

Thank you for your time.



#2 mwsinclair

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Posted 13 February 2017 - 02:59 PM

As an EMT, I find the premise a bit hard to comprehend. A well-run ER handles things on a triage basis, in which the most severe cases are addressed first, and someone who has been shot and stabbed would not be left in the waiting room. That's a well-run ER, of course. If the place is extremely busy, and/or if you've already established the caste system that this society seems to employ, perhaps it can be believed in the context you create.

 

But back to your question: What should the team do when they arrive? Where are they arriving? If they're arriving in the waiting room with a patient bleeding out, they would press the charge nurse to get the patient seen immediately. You might want to consider having the charge nurse be a robot, too, that runs things by some sort of electronic protocol in which it explains why the patient is waiting -- "Patient has life expectancy less than 5 percent. Below range for immediate admittance to ER." The team would need to know how to circumvent or bypass the rules.



#3 SRPasternack

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Posted 18 February 2017 - 09:43 AM

Where has he been shot and stabbed? What kind of poison is it? (Also, dang who did he make mad? They really wanted him dead!)

I would think if the shooting and stabbing missed major arteries (and veins?), stabilizing the bleeding should be relatively straightforward. It's the poison I'm concerned with. The team needs to know what poison so they can counteract it. And the mechanism of the poison would factor into how serious the stab/GSW is. If he was poisoned with warfarin, for example, it doesn't matter what the team does. He's going to bleed to death unless they use warfarins' antidote (vitamin K).

And for the record, most pain relieving drugs are narcotics, and these have the unfortunate side effect of CNS depression, which means tanked blood pressure and respiratory drive. So in reality (especially if they don't know what poison was used) he might not get pain relief anyway. It would be too dangerous.

In a normal for-realsies hospital, this guy would go to surgery, then a trauma ICU, and he'd get a central line, blood products, vasopressors (if his BP were low), possible intubation based on the poison, about a thousand blood tests, and uhh... oh yeah, a Foley catheter!

P.S. After he gets intubated he'd start getting narcotic pain meds (dilaudid, prolly) because the tube breathes for him so it doesn't matter how low his own respiratory drive is.

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#4 WinterBliss

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Posted 21 February 2017 - 10:01 AM

I read your post and I was thinking about general complications. I feel it is important to know what kind of poison. Due, the fact if some poisons can thin blood or create problem blood clots. Different poisons can do different things. Also how bad (I presume that the major artery was cut.) Because you can bleed out in thirty seconds. 

 

Also, is the poisons administered before the shot and knife wound or after that can change the situation a bit. 

 

Your M.C. would need to hold pressure to the wound to stop from completely bleed out and be able to get or retain 1/4-1/2 of the blood quantity so their blood pressure won't drop because normal people would go into shock and that will kill someone. 

 

First priority is to deal with what they can deal with.

1) apply pressure to stop bleeding, if it is the leg or arm they'd do a tourniquet. (A/N: not the neck that would kill them.)

 Depilatory will most likely be brought in with them in case. 

3)They'd take the M.C into the ambulance to give Iv drip and blood transfusion. Even if M.C. could die. 

4) They would take M.C to the hospital if not at the hospital. If at the hospital they'd have some protocol to be seen but that only because of our laws that have been set up in our systems. 

 

 

 

The only problem that really comes to mind besides bleeding out is that fact that if the team doesn't know he has also been poisoned the author needs to know how long it takes for the poison to take effect. If he/she is unconscious how are they supposed to know the patient was poisoned even if they stopped the bleeding and removed the bullet they might mistake a sudden death in the patient from the poison as shock. The M.C. would have to be awake to tell them if they don't know. 






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