In a pulseless, apneic patient with an impaled rod in the leg, which sequence of actions represents the EMT's best order of care?

In a pulseless, apneic patient with an impaled rod in the leg, which sequence of actions represents the EMT's best order of care?

• A. control the bleeding, begin CPR, stabilize the steel rod, immobilize his spine, and transport immediately.
• B. immobilize the spine, stabilize the steel rod, control the bleeding, transport immediately, and begin CPR.
• C. begin CPR, immobilize the spine, control the bleeding, transport, and stabilize the rod.
• D. stabilize the steel rod, immobilize his spine, control the bleeding, begin CPR, and transport immediately.

Answer: (A)

The situation tests how to prioritize interventions in a trauma patient with a life-threatening bleed and an impaled object. The most critical step is to address external bleeding quickly because massive hemorrhage can kill fast. You can do this around the wound and around the impaled object without removing it. Once bleeding is controlled as much as possible, begin CPR immediately to restore circulation and oxygen delivery to vital organs. After CPR starts, stabilize the steel rod to prevent movement that could worsen tissue damage during chest compressions, then immobilize the spine if a spinal injury is possible, and rapidly transport to definitive care. Other sequences delay CPR, move or remove the impaled object, or neglect hemorrhage control, which increases risk of death or further injury.

The situation tests how to prioritize interventions in a trauma patient with a life-threatening bleed and an impaled object. The most critical step is to address external bleeding quickly because massive hemorrhage can kill fast. You can do this around the wound and around the impaled object without removing it. Once bleeding is controlled as much as possible, begin CPR immediately to restore circulation and oxygen delivery to vital organs. After CPR starts, stabilize the steel rod to prevent movement that could worsen tissue damage during chest compressions, then immobilize the spine if a spinal injury is possible, and rapidly transport to definitive care. Other sequences delay CPR, move or remove the impaled object, or neglect hemorrhage control, which increases risk of death or further injury.