Rural Trauma Resuscitation and Prevention
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Rural Trauma Resuscitation and Prevention
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Mike Abernethy runs you through the pitfalls and challenges of rural trauma resuscitation and prevention. The farm is a dangerous workplace. Accidents have an unusually high morbidity and mortality not only for the worker, but also his/her family members. The reasons are multi-factorial but are the result of a complex interaction of environment, equipment and human factors. The vast majority of agricultural deaths involve tractors. No other industry uses 70-year-old machinery operated by workers whose age ranges from 10 to 90. How can we prevent such incidents? Mike is a prehospital physician (who is a wannabe farmer & tractor mechanic) and long-time resident of an agricultural community. In this talk, he will examine the details of a life-threatening accident involving one of his neighbours which perfectly illustrates the multifaceted nature of agricultural trauma. He will then discuss agricultural trauma more broadly. The statistics are similar across the globe, from the United States to Australia, Cambodia to Ireland. Fatalities involve heavy machinery (usually tractors) and the farmer or their family. Furthermore, deaths occur between 18-60 years of age in most industries. In farming however, fatalities can occur across the whole life span. Whilst there are equipment changes that have made things safer, they have a poor uptake amongst farmers. This is due in a large part to interference with productivity and functionality. Mike believes change can only come about through community engagement and education at a meaningful, personal level. Rural and farming communities are faced with inherent risk of injury and death on a daily basis. It is pertinent to be aware of this and to educate these communities when the opportunity presents itself. After all, if it is made of steel, sharp and moving… It will %^&* you up! For more like this, head to our podcast page. #CodaPodcast
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Rural Trauma Resuscitation and Prevention
- Of Ploughshares, Broadswords & Apple Pie When PHARM meets the Farm
- Mike AbernethyMike Abernethy @FLTDOC1@FLTDOC1
- Once I was thirty years old…
- ..and they shall beat their swords into ploughshares Book of Isaiah 2:4
- The Accident
- People who live on farms are more difficult to kill than most ordinary people. But they try much harder -Mark Reid MD
- Old Farmers & Old Tractors
- Roll Over Protection System ROPS
- ..and they shall beat their swords into ploughshares Book of Isaiah 2:4
- If it is: • Made of steel • Sharp • Moving • And you are not constantly vigilant
- It WILL f*ck you up!
- @FLTDOC1
Editor's Notes
- DON’T CARE IF YOU ARE FROM %&^ *(& &* THE BEHAVIORS AND MINDSET OF THE AGRICULTURE COMMUNITY ARE AMAZINGLY SIMILAR AND KNOW NO GEOGRAPHIC BOUNDRIES – ITS ALMOST GENETIC
- RSAME INTENSE WORK ETHIC, SAME CONCEPTS self relianceAND IMPORTANCE OF FAMILY, FIERCE INDEPENDENCE AND RESILENCE
- Intro to my neighbor. Ex marine- clint eastwood character with gravely voice. Got a call at 11p very strange late december. Skys hurt pretty bad. Called the boys they are here -
- I arrive 5 mins – cold out. One of the livestock buildings is lit
- I walk in – sky leg is wrapped arounf floor auger- used to remove manure/refuse. Looks bad open fx, deglove bleeding bad. 2 sons are there disassembling auger. Skys alert talking thready rapid pulse. Im going to have to amputate. I place a CAT. Guys how much longer. Give us 5 mins- dodged that bullet. Knew was bad –just BLSon the way called helicopter
- 2nd assesment –isolated LL injury. Hows the pain oh 5/10. Im going to start an IV –Give you something for pain, make you sleepy so we can get the leg out. Whats that doc - Its K – isnt that the stuff you knocked down bull. Auger freed unwound leg. Splinted. Damn cold he has 3/3 of leathal triad of coag. Get him inside
- Pamela Hart Vinton Brown Ravenel (1883-1955), the farm accident Younf man obvsly injured in a tractor roll over Perfectly illistrates the point I just talked about – family is the first to respond. Also not sure if artist realized it- indicator of severe mechanism
- When I respond to a MVC or car vs ped – and I see one or two shoes lying about …….The the shoes are knocked off a person in an auto crash or pedestrian
- Even worse if there is an isolated foot
- This is a 1952 Mccormick Farmall H – that’s 64 years old. Its not a museum piece or in someones collection – It is a working piece of farm equipment regularry driven by its 84 y/o owner. Old tractors – compared to cars. Turn over the whole domestic fleet in 7-10 yrars. Not so with farm equipment 1948 farmall h
- Old farmers – no other industry has 80+ year olds operating heavy equipment. Less likely to use safety equip. Slower reflexes, more co morbidities Old tractors - + equipment Long hours, isolated – espc in spring and fall
- The farm mindset – first of all don’t come running to the doc/er for every injury – most likely will finish work. For severe incidents- don’t think EMS will be called first. First delays in finding incident, then family then fieinds,neighb then EMS. Use their expertise when dealing with entanglements/extrications – know how to disassemble equipment
- Rural EMS –god bless them – mostly volenteers may have long response times, and long transport times. May be limited in skill sets Unlike “regular EMS –pretty good chance your pt is a friend, neighbor and/or relative
- Education is the key – best done on their home turf. No lectures or
- To paraphrase CR – I don’t care if it is a BS or a PS – if it is made of steel and it is sharp and it is moving and you are not constantly vigilant–it will fuck you up i