I worked my first shift as a paramedic in Hartford in January of 1995. Hartford was in the final stages of a gang war between Los Solidos (The Solids) and the Latin Kings. Homicides were at an all-time high. And there were far fewer medics on the streets then. It was a good introduction to trauma care.
Here’s what we had then for critical trauma patients:
ET tubes as the only advanced airway. If we needed one quick, we did it digitally.
The scalpel from the OB kit for surgical airways.
IV dressings for chest seals.
14 gauge IV 1.5 inch for needle decompression.
Normal Saline and Lactated Ringers 1000 cc bags, wide open.
MAST Trousers for blood pressure support,
C-spine immobilization on a long backboard.
10 minute or less scene times and…
Lights and Sirens to the Hospital.
27 years later, while shootings have been on the rise in recent years, they still aren’t close to what they were in the old days (and we have many more medics on the streets) , but what has caught up is technology and science.
Here’s what we have:
I-Gels as an alternative airway. I can put one in in less time than it takes for me to unzip my ET kit and attach the blade to the handle.
A commercial surgical airway kit. No more makeshift airway.
A commercial chest seal.
10 Gauge X 3.25 for needle decompression. A needle that actually can get through the chest wall of an adult male.
Permissive Hypotension.
Whole Blood.
Mast Trousers and spinal immobilization for penetrating trauma are gone.
But we still have 10 minute or less scene times and…
Lights and Sirens to the Hospital.