Medics performed emergency C-section on dying crash victim who wasn’t pregnant - Sensationalist Headlines

https://sg.news.yahoo.com/medics-performed-emergency-c-section-dying-crash-victim-wasnt-pregnant-084434421.html Jesus fucking christ

could they not have even done a quick xray at all before major surgery? or maybe even ultrasound? if they literally just starting slicing with no investigations then it is literally negligence.

As an advanced ems paramedic student, the problem on the field is time, a trauma case like this is a load&go situation and anything besides administering painkillers, controlling critical bleeding and getting the patient on a spinal board is considered a huge mistake. According to studies, a trauma patient has what is a called a golden hour, it is the time in which a patient must get to a trauma surgeon, since life expectancy drops down pretty steep since you have the lethal triad to handle too. In this case, they should have palpated the stomach and even a stethoscope would have been sufficient in hearing a heartbeat. Even a ultrasound would have been better than the course of action they took. I'd also like to note, emergency cesareans are a means of saving a another life and if the outcome looks bad, it a procedure that has to be done. E.g a case which was in the paper here a few years back, a woman had a massive aneurysm and was pronounced brain dead on scene, the ems-doctor made the call and delivered the baby via emergency c-section. What really bothers me is why they didn't ask her if she was pregnant (every pregnant mother ask's hows the bady, in experience that is) , or access her patient file records, and in my opinion it could amount to negligence for not asking the patient, or getting they're facts straight before going down the most invasive route there is.

Generally you get "urgent" caesarians, and emergent caesarians. For the latter, you are talking less than 5 minutes from decision to operate to the operation being done. The article is thin on details, but states the patient had arrested multiple times, and had been correctly trauma called by EMS. My guess, and this is a guess, is they decided to do a perimortem emergent c-section - "the patient is likely going to die (or has died) no matter what, but we can try to save the baby". In regards to major trauma, they probably rolled the patient into resus, then took them immediately up to the OR, which is an established practise - depending on the patient, bypassing resus to go straight to CT or the operating theatre is an appropriate clincial decision, you'll see it at MTCs fairly often. General portable x-rays done in resus are CXRs and pelvis XR, with the pelvis XR usually being done when they suspect an open book fracture. If I have a DR setup, I can take a supine CXR or pelvis XR working around a trauma team in about 2 minutes. If I have a CR setup, it would take 5 minutes or so, factoring in processing cassettes which is simply too much time for this patient. In the time I am taking the x-ray, you would need hands off the patient, and those two minutes are legitimately time we do not have. Would be nice to have done a US if a POCUS was available (likely one in resus, but it might be a shitty GE vescan...), but if they decided to carry out a perimortem c-section, they likely believed that they didn't have time, which is up to the consultant in charge of the patient, who is acting on over a decade of experience in medicine, at least 6 years of which are in EM. The Trust definitely fucked up though, if they didn't talk to the family properly. I honestly can see every clinical decision made being correct (as a radiographer - fuck imaging in this patient, time simply isn't there), given the severity of the patient's illness, as can a couple of my doc friends. This was one of the cases where they had cause to believe that every second counts (as it does!).

an xray in an emergency situation takes minutes. she may have died anyway due to her injuries but mutilating a body without cause is not a good idea.

Minutes that the patient in cardiac arrest doesn't have. Everything happens really fast and if you dont react in time, the patients condition will deteriorate extremly fast. In a pre-hospital setting, an xray is only going to slow down acute patient care, since in a case like this, the patients hemodynamics and supply of oxygen to the brain must be kept at a stable level until they get into the or. Furthermore ambulances or even HEMS (Helicopter emergency services) dont have an x-ray on-site. Also here in Finland, you'd have to be a radiographer if you want to operate any kind of equipment that contains radiation, and thus is not feasible at all.

Don't xray the baby!

I'm a HCPC registered radiographer, and have worked in multiple trauma centres and I can tell you that in this case, an xray would have not been an appropriate use of the limited time they have for this patient, particularly since we don't xray ?baby, the only film in that area would be for ?open book pelvis fx, pt too unstable to get in CT, and they were more concerned about other stuff (like the ruptured aorta...) The patient likely spent less than a minute in the ED as they went straight through to theatre.

It takes less than 90 seconds from the cessation of breathing for brain damage to begin. "Minutes" is time you literally do not have when someone is in arrest.

ah i didnt read properly, i read she complained of back pain and assumed she was still conscious. with multiple cardiac arrests, there's really not much to do but keep her alive. https://www.lincolnshirelive.co.uk/news/lincoln-news/heartbroken-family-say-woman-killed-2589824 better article. she lost a lot of blood and had internal bleeding so they would have had to go to theatre to investigate anyway.