DangerousDanR

This only makes a difference if you are unable to respond to the responders.

In my Fire/Medical days we always looked for a bracelet. If you have dog tags and are unresponsive we will find them too when we cut your clothes off. We didn't carry any blood products, so blood type didn't matter. The ER will do a type check when you arrive. Contact information is the most important thing you can have.

Our standard care for unresponsive patients was:

0) arrive on scene, make sure the scene is safe, protective gear in place as needed. Make a general assessment of the scene. Check for wrist bracelet. Are there any counterindications for any specific treatment? Maybe an LVAD? Fentanyl allergy? Anything else that could impact our care.

Now, we can go to work. Assuming an unresponsive patient are we looking at medical or trauma?

For trauma:

1)Airway : air can go in and out... tube if there is trouble.
2)Breathing : air IS going in and out. bag valve mask if assistance is needed. Everyone gets oxygen.
3)Circulation: pulse? BP? IV fluids if indicated. Oxygen level? No pulse triggers the need to switch to cardiac arrest protocol. If we get a pulse we will come back here. If we switch to cardiac we will find your dog tags at that point in time.
4)Disabilities: absent reflexes. Stroke scale if conscious but unresponsive. Pupillary response. Glasgow Comma scale. Not all unconscious people are equally unconscious. Brain swelling or brain bleeding changes things. Protect the patient with a backboard if indicated: Always for trauma. Splint as needed. Place a cervical collar if trauma. Once you are packaged nicely on a board we can move you to the back of the bus.
5)Expose: cut off as much clothing as respecting patient privacy will allow. Check for head injuries. Look for other hidden injuries. Recent surgical scars?

Once we have done the primary care, we will plug visible leaks, check for signs of internal bleeding, low BP and rapid pulse. Also, people who are bleeding internally have a pulse that we called thready. Doesn't feel quite right. And we don't have an ultrasound to see what is going on inside. No matter what, an unresponsive patient will have an IV line placed. If I couldn't get a conventional line I would place an inter-osseous line. Now take a quick blood glucose reading, Run a 4 lead Electrocardiogram. If you have dog tags we will have them by this point in time.

It is amazing chaos. A decent crew can package a critical patient in a few minutes. So we find that bracelet early in the game, like as soon as we roll up. The dog tags maybe 2 minutes later when we put you on a backboard and cut your clothes off. Don't worry about that. We are not likely to have pushed anything before we have you exposed.

Known diabetic? I will be taking a Blood Glucose reading on any unresponsive patient. If your 4 lead ECG is abnormal maybe go to a cardiac care protocol and run a 12 lead ECG.

Taking blood thinner? If you are leaking it is fairly obvious. May be the difference between ground transport and a helicopter, but obvious and depends on how big the leak is, if you respond to advanced external clotting agents, and how long is the ride to the hospital. If we suspect major internal bleeding, the ground/air decision for us was based on could we save 15 minutes for a critical patient.

My recent ride to the hospital when I broke my femur they didn't trust my existing blood type card, and I was alert and oriented to person, place, time, and event. I have my regular BP readings on my phone. Not wanted in the field or at the hospital.. The hospital put me in the cardiac care unit because my pulse was in the 40's. Fortunately no atropine for a sinus bradycardia who was A&OX4. They wanted my contact information so they could get my primary care provider and access my records.