Did the use the Jaws of Life?

[Guest guest]

1) Sorry but that's GOTTA hurt!

2) Better a set of Jaws than say a re-bar cutter?

3) If there ever was a justification for flying a patient this may well be

it!

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

[Guest guest]

In a message dated 10/18/2006 3:05:30 PM Central Standard Time,

bbledsoe@... writes:

August Voegl, 59, from Jennersdorf, fired a four-inch nail into his left

testicle with the compressed air nail gun he was using.

Emergency medics were called in after Voegl was unable to extract the nail

by himself.

He was later airlifted to a nearby hospital where he is reportedly

recovering well after surgery

no, more likely a K12 diamond saw to cut a roof slab off with him on it like

roast on a dinner tray...

Apples anyone?

ck

[Guest guest]

Should have just used a claw hammer.....

[Guest guest]

Wes,

Simple answer is think back to the EMT-B class you sat in when they talked

about injuries to the genitalia. I bet all the guys in the room were squirming

when they saw the various photos of said injuries to the male of the

species, right?

Odds are it was a male crew and well that alone is enough right to call for

a bird?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

[Guest guest]

In a message dated 10/18/2006 4:00:56 PM Central Standard Time,

paramedicop@... writes:

On 10/18/06, _jkaymdc@..._ (mailto:jkaymdc@...) <_jkaymdc@..._

(mailto:jkaymdc@...) > wrote:

>

> 1. Did they save the testicle? Seriously... 1. Did they save

> " extricated " him and if the testicle could be salvaged..

The " easy " way would be to cut the head off the nail and " lift him

off. " It would be a stretch, but you could likely use pliers with the

snips in them if you were careful.

> 2. HOW did he accidently DO that... Talk about DISTRACTED!!

That's probably it. OSHA will be intrigued. He was probably

squatting on the roof, nailing down shingles, and went to move or put

the nail gun in front of him, " betewen " his legs, and somehow

negligently discharged it. Enough folks do it with firearms, nail

guns aren't a stretch of the imagination.

Now, here's the question - did it actually get testicle, or just scrotum?

Mike

Mike, OSHA will have nothing to say about this one...the guy is Austrian,

and despite the current Governator of California, US law has little to say about

working conditions in the European Union...

And 4 inch (10 cm) nail argues that he was probably framing something on the

roof rather than setting deck boards (usually 6 cm/2 3/4 inches) or putting

up shingles (normally 2.5 cm/1 inch staples)...

I've treated a similar case some years ago...roofer in January, NE

Louisiana...managed to drive a 1 inch staple into his left thigh just above the

knee...while his leg was folded under him...he wasn't able to straighten his leg

because the staple had literally bound the tendons together.

After cutting through five layers of coveralls, jeans, long underwear, etc.,

and getting x-rays confirming that the staple wasn't into the femur, the

staple was fairly easily extracted, even if he did get sent to the trauma

center

for ortho evaluation and further care.

In this case, to leave the staple impaled would have been to compromise the

blood flow to the lower leg due to pressure on the popliteal vessels.

ck

[Guest guest]

In a message dated 10/18/2006 4:04:12 P.M. Central Daylight Time,

paramedicop@... writes:

Or, would you need etomidate, versed and/or propofol?

Yes!

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

[Guest guest]

If you really want to cringe take in Dr. Chuck 's lecture on Sexual

Trauma, he made a great lecture and a few really good articles from his

experiences as San Francisco General's ED in his early years as a Resident

circa

the mid 70's or so.

Let's just say that the anecdotes are funny as hell and the pictures are not

pretty at all but the topic is fascinating.

In a message dated 10/18/2006 3:47:34 P.M. Central Daylight Time,

jkaymdc@... writes:

OKAY.....I'm not a guy and that made ME cringe! <G>

Jules

Re: Did the use the Jaws of Life?

Should have just used a claw hammer.....

[Non-text portions of this message have been removed]

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Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

[Guest guest]

In a message dated 10/18/2006 4:20:05 P.M. Central Daylight Time,

wjince@... writes:

I guess you have to ask the doc because you don't believe in quality of

life? That is why this pt should fly.

HUH?

1) if he hit the testicle it's likely gone (MD/DO's correct me if I am

wrong).

2) if he only hit the scrotum it's akin to a flesh wound (granted it's a

PAINFUL one).

3) if 1 or 2 how's it justification to fly this guy?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

[Guest guest]

Alright now. It would appear that the " fly everyone " crowd has made its

appearance on the list again. Let's do what we should ALWAYS be doing as

prehospital care professionals -- making an ethical decision.

There are a couple of fundamental questions and concepts that we should

examine.

1) What is in the patient's best interest?

2) What does the patient want?

3) Providing benefit to the patient

4) Avoidance of harm

Let's address these in order:

1) What is in the patient's best interest? Is it in the patient's best

interest to fly them? If so, why? I cannot justify placing this patient with

these injuries in a helicopter when, in all likeliehood, the flight crew will

provide the same treatment (bleeding control and possible pain management)

that a ground crew can just as easily provide at a significantly lower cost.

Additionally, it is unlikely that the injury is critical enough that the

reduced

transport time from a helicopter would be of any benefit.

2) What does the patient want? In this case, I don't have information from

the newspaper article that provides any insight into the patient's needs.

3) Providing benefit to the patient. Other than possibly reducing the

transport time, I can see no benefit that the patient would receive from a

helicopter that a competent ground crew could provide.

4) Avoidance of harm. Considering the greater possibility of a helicopter

accident, and the limited benefit of helicopter transport in this case, I

cannot see justifying the potential harm of subjecting the patient to flying

them. Additionally, the added cost of a flight that might or might not be

reimbursed by insurance is a very real financial burden to the patient.

If EMS ever wants to be taken seriously as a profession, we need to uphold a

set of ethical standards with every patient interaction and quit performing

interventions just because they're " cool " to try.

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

In a message dated 10/18/2006 4:58:03 PM Central Daylight Time,

lnmolino@... writes:

In a message dated 10/18/2006 4:20:05 P.M. Central Daylight Time,

_wjince@..._ (mailto:wjince@...) writes:

I guess you have to ask the doc because you don't believe in quality of

life? That is why this pt should fly.

HUH?

1) if he hit the testicle it's likely gone (MD/DO's correct me if I am

wrong).

2) if he only hit the scrotum it's akin to a flesh wound (granted it's a

PAINFUL one).

3) if 1 or 2 how's it justification to fly this guy?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/FF/N

Freelance Consultant/Trainer/Freelance CoFreelance Consultant/Trainer

_LNMolino@..._ (mailto:LNMolino@...)

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with

unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the

original author.

[Non-text portions of this message have been removed]

[Guest guest]

In a message dated 10/18/2006 5:20:17 PM Central Standard Time,

pmanemt@... writes:

Do you think he can file this under his workers comp

claims.

probably...the other chap did...

but then, the EU has some *different* laws...

ck

S. Krin, DO FAAFP

[Guest guest]

Man Accidentally Nails His Testicles To Roof

October 18, 2006 2:10 p.m. EST

Komfie Manalo - All Headline News Foreign Correspondent

Austria (AHN) - An overzealous Austrian workman accidentally nailed his

testicles to the roof, with a nailgun.

August Voegl, 59, from Jennersdorf, fired a four-inch nail into his left

testicle with the compressed air nail gun he was using.

Emergency medics were called in after Voegl was unable to extract the nail

by himself.

He was later airlifted to a nearby hospital where he is reportedly

recovering well after surgery

[Guest guest]

Doc Bledsoe:

I've got to ask you..... why was this guy airlifted????

-Wes Ogilvie

Did the use the Jaws of Life?

Man Accidentally Nails His Testicles To Roof

October 18, 2006 2:10 p.m. EST

Komfie Manalo - All Headline News Foreign Correspondent

Austria (AHN) - An overzealous Austrian workman accidentally nailed his

testicles to the roof, with a nailgun.

August Voegl, 59, from Jennersdorf, fired a four-inch nail into his left

testicle with the compressed air nail gun he was using.

Emergency medics were called in after Voegl was unable to extract the nail

by himself.

He was later airlifted to a nearby hospital where he is reportedly

recovering well after surgery

[Guest guest]

Two questions:

1. Did they save the testicle? Seriously....wondered how they

" extricated " him and if the testicle could be salvaged..

2. HOW did he accidently DO that...don't y'all protect them with your

lives? not to mention your HANDS, that seem to be adjusting down there

ALOT! <G>

Talk about DISTRACTED!!

Jules

Did the use the Jaws of Life?

Man Accidentally Nails His Testicles To Roof

October 18, 2006 2:10 p.m. EST

Komfie Manalo - All Headline News Foreign Correspondent

Austria (AHN) - An overzealous Austrian workman accidentally nailed his

testicles to the roof, with a nailgun.

August Voegl, 59, from Jennersdorf, fired a four-inch nail into his

left

testicle with the compressed air nail gun he was using.

Emergency medics were called in after Voegl was unable to extract the

nail

by himself.

He was later airlifted to a nearby hospital where he is reportedly

recovering well after surgery

[Guest guest]

I guess you have to ask the doc because you don't believe in quality of

life? That is why this pt should fly.

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of ExLngHrn@...

Sent: Wednesday, October 18, 2006 3:11 PM

To: Paramedicine

Cc: texasems-l

Subject: Re: Did the use the Jaws of Life?

Doc Bledsoe:

I've got to ask you..... why was this guy airlifted????

-Wes Ogilvie

Did the use the Jaws of Life?

Man Accidentally Nails His Testicles To Roof

October 18, 2006 2:10 p.m. EST

Komfie Manalo - All Headline News Foreign Correspondent

Austria (AHN) - An overzealous Austrian workman accidentally nailed his

testicles to the roof, with a nailgun.

August Voegl, 59, from Jennersdorf, fired a four-inch nail into his left

testicle with the compressed air nail gun he was using.

Emergency medics were called in after Voegl was unable to extract the nail

by himself.

He was later airlifted to a nearby hospital where he is reportedly

recovering well after surgery

[Guest guest]

OKAY.....I'm not a guy and that made ME cringe! <G>

Jules

Re: Did the use the Jaws of Life?

Should have just used a claw hammer.....

[Guest guest]

But , his quality of life would be greatly enhanced by a helicopter

ride.

G

>

> In Austria EMS is almost all BLS. The helicopters are physician-staffed. The

> helicopter was probably called for analgesia and physician evaluation.

> Otherwise, there would be no justification for HEMS transport. In this

> country, and in this state, with capable ALS ground crews there would be no

> need for HEMS as this injury is not time sensitive.

>

> BEB

>

> _____

>

> From: texasems-l@yahoogrotexasem [mailto:texasems-l@yahoogrotexasem] On

> Behalf Of Ince

> Sent: Wednesday, October 18, 2006 3:34 PM

> To: texasems-l@yahoogrotexasem

> Subject: RE: Re: Did the use the Jaws of Life?

>

> I guess you have to ask the doc because you don't believe in quality of

> life? That is why this pt should fly.

>

> _____

>

> From: texasems-l@yahoogro <mailto:texasems-mailto:texasems-mai> ups.com

> [mailto:texasems- [mailto:te<mailto:texasems-mailto:texasems-mai> ups.com]

> On

> Behalf Of ExLngHrn (AT) aol (DOT) <mailto:ExLngHrn%mailto:Ex> com

> Sent: Wednesday, October 18, 2006 3:11 PM

> To: Paramedicine@ <mailto:Paramedicinmailto:Paramedicmai> yahoogroups. ya

> Cc: texasems-l@yahoogro <mailto:texasems-mailto:texasems-mai> ups.com

> Subject: Re: Did the use the Jaws of Life?

>

> Doc Bledsoe:

>

> I've got to ask you..... why was this guy airlifted???

>

> -Wes Ogilvie

>

> Did the use the Jaws of Life?

>

> Man Accidentally Nails His Testicles To Roof

>

> October 18, 2006 2:10 p.m. EST

>

> Komfie Manalo - All Headline News Foreign Correspondent

>

> Austria (AHN) - An overzealous Austrian workman accidentally nailed his

> testicles to the roof, with a nailgun.

>

> August Voegl, 59, from Jennersdorf, fired a four-inch nail into his left

> testicle with the compressed air nail gun he was using.

>

> Emergency medics were called in after Voegl was unable to extract the nail

> by himself.

>

> He was later airlifted to a nearby hospital where he is reportedly

> recovering well after surgery

>

>

[Guest guest]

>

> 1. Did they save the testicle? Seriously....wondered how they

> " extricated " him and if the testicle could be salvaged..

The " easy " way would be to cut the head off the nail and " lift him

off. " It would be a stretch, but you could likely use pliers with the

snips in them if you were careful.

> 2. HOW did he accidently DO that... Talk about DISTRACTED!!

That's probably it. OSHA will be intrigued. He was probably

squatting on the roof, nailing down shingles, and went to move or put

the nail gun in front of him, " betewen " his legs, and somehow

negligently discharged it. Enough folks do it with firearms, nail

guns aren't a stretch of the imagination.

Now, here's the question - did it actually get testicle, or just scrotum?

Mike

[Guest guest]

> > 1. Did they save the testicle? Seriously....wondered how they

> > " extricated " him and if the testicle could be salvaged..

Side question - how much analgesia would be required if you had nailed

your testicle to the roof, were stuck, and saw a paramedic coming at

you with a pair of pliers/snips saying " trust me, you'll be okay! "

Or, would you need etomidate, versed and/or propofol?

Mike

[Guest guest]

Well, personally speaking..............I'd need a testicle

first.............THEN...SNOW ME!!!

Jules

Re: Did the use the Jaws of Life?

> > 1. Did they save the testicle? Seriously....wondered how they

> > " extricated " him and if the testicle could be salvaged..

Side question - how much analgesia would be required if you had nailed

your testicle to the roof, were stuck, and saw a paramedic coming at

you with a pair of pliers/snips saying " trust me, you'll be okay! "

Or, would you need etomidate, versed and/or propofol?

Mike

________________________________________________________________________

Check Out the new free AIM® Mail -- 2 GB of storage and

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[Guest guest]

Seriously - why should a testicular injury be flown? What special medicine do

you carry in the helo that I can't push in the ambulance? How critical is time

in this case?

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

Did the use the Jaws of Life?

Man Accidentally Nails His Testicles To Roof

October 18, 2006 2:10 p.m. EST

Komfie Manalo - All Headline News Foreign Correspondent

Austria (AHN) - An overzealous Austrian workman accidentally nailed his

testicles to the roof, with a nailgun.

August Voegl, 59, from Jennersdorf, fired a four-inch nail into his left

testicle with the compressed air nail gun he was using.

Emergency medics were called in after Voegl was unable to extract the nail

by himself.

He was later airlifted to a nearby hospital where he is reportedly

recovering well after surgery

[Guest guest]

In Austria EMS is almost all BLS. The helicopters are physician-staffed. The

helicopter was probably called for analgesia and physician evaluation.

Otherwise, there would be no justification for HEMS transport. In this

country, and in this state, with capable ALS ground crews there would be no

need for HEMS as this injury is not time sensitive.

BEB

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of Ince

Sent: Wednesday, October 18, 2006 3:34 PM

To: texasems-l

Subject: RE: Re: Did the use the Jaws of Life?

I guess you have to ask the doc because you don't believe in quality of

life? That is why this pt should fly.

_____

From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com

[mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com]

On

Behalf Of ExLngHrn (AT) aol (DOT) <mailto:ExLngHrn%40aol.com> com

Sent: Wednesday, October 18, 2006 3:11 PM

To: Paramedicine@ <mailto:Paramedicine%40yahoogroups.com> yahoogroups.com

Cc: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com

Subject: Re: Did the use the Jaws of Life?

Doc Bledsoe:

I've got to ask you..... why was this guy airlifted????

-Wes Ogilvie

Did the use the Jaws of Life?

Man Accidentally Nails His Testicles To Roof

October 18, 2006 2:10 p.m. EST

Komfie Manalo - All Headline News Foreign Correspondent

Austria (AHN) - An overzealous Austrian workman accidentally nailed his

testicles to the roof, with a nailgun.

August Voegl, 59, from Jennersdorf, fired a four-inch nail into his left

testicle with the compressed air nail gun he was using.

Emergency medics were called in after Voegl was unable to extract the nail

by himself.

He was later airlifted to a nearby hospital where he is reportedly

recovering well after surgery

[Guest guest]

Do you think he can file this under his workers comp

claims.

__________________________________________________

[Guest guest]

>

> I guess you have to ask the doc because you don't believe in quality of

> life? That is why this pt should fly.

How does a helicopter improve quality of life for isolated,

non-life-threatening trauma?

Mike

[Guest guest]

Wow. You got enough info from that article to not

only be certain that the patient should have been

flown, but to also insult a fellow member and question

his compassion?

Besides, Lance Armstrong only has one testicle, and I

would say his quality of life is pretty smoking!

Connie

--- Ince wrote:

> I guess you have to ask the doc because you don't

> believe in quality of

> life? That is why this pt should fly.

>

>

>

> _____

>

> From: texasems-l

> [mailto:texasems-l ] On

> Behalf Of ExLngHrn@...

> Sent: Wednesday, October 18, 2006 3:11 PM

> To: Paramedicine

> Cc: texasems-l

> Subject: Re: Did the use the Jaws of

> Life?

>

>

>

> Doc Bledsoe:

>

> I've got to ask you..... why was this guy

> airlifted????

>

> -Wes Ogilvie

>

>

> Did the use the Jaws of Life?

>

> Man Accidentally Nails His Testicles To Roof

>

> October 18, 2006 2:10 p.m. EST

>

> Komfie Manalo - All Headline News Foreign

> Correspondent

>

> Austria (AHN) - An overzealous Austrian workman

> accidentally nailed his

> testicles to the roof, with a nailgun.

>

> August Voegl, 59, from Jennersdorf, fired a

> four-inch nail into his left

> testicle with the compressed air nail gun he was

> using.

>

> Emergency medics were called in after Voegl was

> unable to extract the nail

> by himself.

>

> He was later airlifted to a nearby hospital where he

> is reportedly

> recovering well after surgery

>

> [Non-text portions of this message have been

> removed]

>

>

__________________________________________________________

> Check out the new AOL. Most comprehensive set of

> free safety and security

> tools, free access to millions of high-quality

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> free AOL Mail and more.

>

> [Non-text portions of this message have been

> removed]

>

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

>

>

>

>