Treat first what kills first

The above sentence sounds obvious. But how do you know what kills first?

As a paramedic, I have to constantly think about what would help the patient the most. What would be the best thing we could do in a situation. In most situations, we can’t do much. We don’t have an x-ray view, we are not allowed to applicate medicine (besides oxygen).

Heart attacks and strokes are common in the target group that calls the emergency line. As a “simple paramedic” the only thing I can do in severe cases is ordering an emergency doctor. Otherwise, it is “load and go”, meaning getting the patient into the ambulance vehicle and drive to the nearest possible hospital as soon as possible.

With trauma, it is a little bit different, because we can splint them. What needs to be treated first? A broken leg or a broken arm?

It is one of the first things I learned in Anatomy. Although I don’t have the exact numbers in my head, the following applies to most people.

If you break your forearm there is space for about one to two litres of blood. Two to three litres if you break your upper arm. Two to three litres if you break your lower leg and three to four litres if you break your thighs. Five litres and more can go missing if you break your pelvis.

What? Humans only have five to six litres of blood. Yes, that’s true and that is the reason why breaking something can get you into a lot of trouble.

Back to the example above. What do we treat first, the broken arm or leg? With the information above, definitely the leg, then the arm.