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ER docs: Respect the boots!

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  • #61
    Originally posted by Donkerbruin View Post
    If I were unconscious or had a broken leg or something, I wouldn't mind them being cut off. If I were awake with a non-life threatening broken arm, etc I would certainly want them removed properly.
    Hehe. When I broke my arm last spring, the ED nurse actually complained that she wouldn't get to cut boots off of me. I found this VERY unfunny so I refused to let her cut off my tops and sports bra. I was conscious and semi-mobile so I out-voted her and her scissor happy hands. Yes, it hurt like hell, but I love that sweater and I have very strong feelings about my beloved Enell bra. If she hadn't been snide, I likely wouldn't have been so dang stubborn.

    She kept muttering, "horse people are crazy. Why are they so crazy?" Honey, I was lucid, polite, and able to civilly articulate my preference. And since I was the one hurting, the only harm was to myself. And yes, we are crazy. But in hindsight, I do wonder if that's why the good drugs got held until after they set my arm....
    Flip a coin. It's not what side lands that matters, but what side you were hoping for when the coin was still in the air.

    You call it boxed wine. I call it carboardeaux.

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    • #62
      Originally posted by 2ndyrgal View Post
      If you can't afford to have them, removed for you, perhaps you shouldn't wear them.
      From the thread in Off Course on Kaley Cuoco:

      http://m.youtube.com/#/watch?v=6v7Vd...%3D6v7VdUJ9Www

      I guess only TV stars can afford to wear tall boots.
      Last edited by Bristol Bay; Dec. 21, 2012, 03:14 PM. Reason: Sp
      A helmet saved my life.

      2017 goal: learn to ride like TheHorseProblem, er, a barn rat!

      Comment


      • #63
        When I almost broke my shin (whatever that bone is called...) at a show at the beginning of summer, the medic or whatever who was there told me they'd cut my boots off in the ER, and probably my breeches. I promptly grabbed a pair of sweatpants from a friend and asked to be carried into the dressing room of my trailer. They were NOT cutting off those boots or brand new breeches! I will say that having the stupid boot pulled off was one of the least comfortable sensations of my life, and that I've never worn that pair since. Only zippers from now on.
        Trying a life outside of FEI tents and hotel rooms.

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        • #64
          Originally posted by Calvincrowe View Post
          I've either been driven or drove myself to the hospital the other 3 times (collarbone, ACL, shoulder/ribs) after doffing my boots.
          See, this is why you can teach middle school.
          A helmet saved my life.

          2017 goal: learn to ride like TheHorseProblem, er, a barn rat!

          Comment


          • #65
            I still feel the need to make some corrections here. When medical personnel want to cut something of, there is a reason beyond you believe they think it is fun. Believe me, I would much rather pull off somebody's boots than have to get my shears through the leather which is going to probably be more difficult than the pulling. However, if you have a broken leg, pulling the boot off could cause more damage (A LOT more damage). God forbid you have a spinal injury and you demand somebody pull your boot off before it is cleared to do it safely and you could go from something that would have taken a few weeks to recover from to sitting in a wheelchair. This is something to consider for those demanding that somebody remove their boots and clothing before EMS. We also do not find it fun. Trust me, we get our fill of cutting stuff off of people as it is and I can guarantee you that removing your clothing or boots will NOT be the highlight of our day. Also, medical personnel is not going to withhold the "good drugs" from you because you didn't let them cut your boots or clothing. Trust me, they don't want to have to listen to you whine or complain but there are time when giving the medication will mask symptoms and increase the chance that something (such as a head injury) will be missed. So next time you come off your horse to the point of needing to call EMS, here is what you should do or consider.

            1) Stay still and remain in the spot your landed. You want to keep still to prevent any further injury or possible injury to your spinal cord. If you are cold, have somebody bring you a blanket. You can also have somebody hold your head and neck in line with your body to keep you from moving it.

            2) You can be upfront with EMS or ED staff that you don't wish for X,Y, or Z to be cut but allow them to determine what needs to be cut.

            3) Remember when we suggest that something needs to be cut, there is a REASON why we are suggesting it beyond being scissor happy or that we all dislike horse people (remember, there are a lot of medical personnel who are horse people themselves)

            4) be polite (it will make things much easier).

            5) please don't have somebody take your helmet away to prevent EMS from harming it (we actually do need to see your helmet either to assure us that you didn't hit your head or to give us an idea of where you hit your head and how hard). If you hit your head pretty hard, your helmet will most likely accompany you to the hospital as a lot of ED Dr's and neurosurgeons will want to see it. If you fall off and hit your head and you have somebody drive you to the hospital, consider taking your helmet with you to show the Dr.

            6) Please, please, please don't pull your boots off before going to the ED or before EMS gets there. You are risking more injury and possible permanent damage by doing so. Allow them to be removed once you have been assessed by trained medical personnel. While you might think you are saving your boots and saving money, you could be causing yourself to have to undergo a surgery that might have been unnecessary had the boots stayed on and trust me, surgery is A LOT more expensive than your boots. 1 day in the hospital is A LOT more expensive than your boots. 1 ED visit is A LOT more expensive than your boots. And you are risking possible permanent disability or severe injury causing you to not even be able to ride again (but hey, at least you will be able to say you saved you boots that you can never put back on anyways). You don't have x-ray vision and while you may feel that something in your leg hurts but not too bad you are not able to tell for yourself what is going on inside that boot. I have seen people who had very, very obvious fractures not realize anything was wrong until they looked at that limb and saw the deformity because they had some much adrenaline going through their system that they were not feeling any pain or had very mild discomfort at the time.

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            • #66
              Not riding related, but several years back, I managed to slide/fall down a flight of icy exterior stairs, and landed standing up on one foot (yes, I'm pretty awesome.) Unfortunately I broke that foot in 3 places. I cleverly walked back to my room (across campus) and by the time I got there and my roommate said, "I am calling security and an ambulance" it was already swelling and hurting terribly. The first EMT on the scene nixed my pleas to take my sneakers off - in case it was all that was holding the pieces together. She also said it might help slow the swelling.

              When I got to the ER they were very kind about carefully and gently unlacing and removing the sneaker - but they DID say it was good that we'd left it on, just for the reasons the EMT had given. So for all of you who are yanking tall boots off... just do it with the knowledge that you may be making things worse for yourself!

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              • #67
                rescueme, I work in a hospital and have spent a fair amount of time in the ED, so please understand that I'm not some ignorant hack off the street. While I agree with your advice listed in the numbered section, I found your first paragraph to be a bit offensive. Most emergency personnel (EMS, FD, hospital staff, etc) are fabulous. But there are some, like the nurse that I encountered who very much epitomize the worst fears of many here. I walked into the ED with a broken humerus. Totally sound otherwise. But that nurse was disappointed that she wasn't going to get to cut off boots! I could understand if it was a lower extremity injury or a possible spine problem. But it wasn't even close. I stated that I would prefer to see if I could get undressed before cutting any clothing off and proceeded to get a lecture from her and, "well, I bet THAT hurt," several times while I undressed unassisted because she couldn't even be bothered to put the dang scissors down on the counter and help.

                Do I think meds got withheld, I don't know. I do know they were ordered from pharmacy and arrived in the ED well prior to my arm getting set. And they sure weren't administered until afterwards. And not by her. Although she did place my PIV, saline isn't exactly an analgesic.
                Flip a coin. It's not what side lands that matters, but what side you were hoping for when the coin was still in the air.

                You call it boxed wine. I call it carboardeaux.

                Comment

                • Original Poster

                  #68
                  I think EMT and ER folks are generally not vindictive toward their patients. And I know I'm not the biggest PITA to have ever entered an ER. But I do think some useful meds have been withheld from me. IMO, they were just busy and I wasn't a big ol' priority. No problem, but when I saw how well they worked and how much the buggers cost, I would have been happy to have had them sooner.

                  This thread has convinced me that I should get zippered boots- as a Public Service for those who have to look at me on a horse and for those who have to pick up the pieces afterwards should I come off a horse.
                  The armchair saddler
                  Politically Pro-Cat

                  Comment


                  • #69
                    Originally posted by mvp View Post
                    Anyone gone to the ER and had their Very Expensive tall boots respected?

                    Speaking from the pre-zipper era, I always carried a seam-ripper with me in my hunt coat pocket and told the people I was with that it was there.

                    Were I to show up in the ER unable to do my own instructing, my friends were told to make sure no one cut the $1K boots off me. Use the seam ripper if needed, but no cutting 'em off!

                    I have my priorities.
                    I did. Custom Dehners. Pull on...no zippers. Got trampled by green horse....long story but I'll just say my nickname for a while was speed bump. Collapsed lung, broken ribs..was initially coughing up blood. Got to the ER and begged them not to cut off my boots. They slipped off pretty easily. They pulled them off for me. I was very very thankful They joked with me that had I been a biker...they would have cut them off! I'm a nice person...and was polite. I also have a VERY high pain tollerance....so was not complaining or even moaning. Perhaps that played a part as well....


                    ETA: I also generally avoid the ER as much as possible. I had a broken collar bone a couple of years ago (on a weekend). Hit the ground, heard it pop--hurt like hell...knew what I had done. Friends caught my horse. We walked down to the barn. I changed out of my boots (with a little help), they put my horse away and when a friend had a minute, they drove me to the hospital. Walked in, said I was pretty sure I broke my collar bone. The ER doctor didn't believe me--until the xray showed it broken in two places. After that experience, I'll wait if I can and just go right into the specialist...as I did last year when I dislocated a finger.
                    Last edited by bornfreenowexpensive; Dec. 21, 2012, 02:40 PM.
                    ** Tact is the ability to tell someone to go to hell in such a way that they look forward to the trip. ~Winston Churchill? **

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                    • #70
                      Originally posted by jen-s View Post
                      Do I think meds got withheld, I don't know. I do know they were ordered from pharmacy and arrived in the ED well prior to my arm getting set. And they sure weren't administered until afterwards. And not by her. Although she did place my PIV, saline isn't exactly an analgesic.
                      I think it does depend on your nurse and your doctor when you are in the ER. Mr. Trub and I were both brought in by ambulance after a car accident (both only had lots of bumps and bruises). We were assigned different doctors. He was happy and high as a kite shortly after we arrived. The nurse had already done my discharge papers (couple hours after arrival, had X-rays, etc) and my pain drugs were still 'oh yeah, we should give you something' as my back, shoulder and leg got more and more cramped.
                      I do not think anyone was doing it to be malicious, just different doctor/nurses.

                      Comment


                      • #71
                        Originally posted by rescueme View Post

                        3) Remember when we suggest that something needs to be cut, there is a REASON why we are suggesting it beyond being scissor happy or that we all dislike horse people (remember, there are a lot of medical personnel who are horse people themselves)
                        It's nice that you and your colleagues do this...however, no one ever made a suggestion of cutting things off to my very conscious, all mental faculties in place self. They just came at me with scissors. I asked what they were going to do with them and if I hadn't stopped them, my $$$ breeches would've been in pieces. If it's necessary, I have not problem with cutting something off...however, when it is CLEARLY not necessary, keep your scissors to yourself.

                        Originally posted by rescueme View Post
                        5) please don't have somebody take your helmet away to prevent EMS from harming it (we actually do need to see your helmet either to assure us that you didn't hit your head or to give us an idea of where you hit your head and how hard). .
                        I had my helmet taken off because I knew I didn't hit it. I don't need an EMT or DR. that wasn't there to decide for me whether I hit it. I knew I didn't, I could tell you how and why I fell, how each piece of my body hit the ground and mostly where I was hurt (I thought I might have broken my collar bone rather than my arm). There was no need for EMT to see my helmet and therefore it was taken away. Oddly, they believed me when I said I had a helmet on, that I didn't hit my head and was fine in that dept....probably because I was conscious, could answer all the questions, follow their directions and was cracking jokes.

                        As for meds: Sometimes nurses forget, sometimes that have to determine if what you are saying is true, sometimes they've got drug seekers wanting more and more. I don't blame anyone that all the Morphine I was given didn't work at all. But I do still think fondly of the ER doctor who finally believed me about it not working and switched me to another pain med that worked in seconds.
                        Keith: "Now...let's do something normal fathers and daughters do."
                        Veronica: "Buy me a pony?"

                        Comment


                        • #72
                          Not only does it depend on the Dr. but it depends on the day you catch them on. My son breaks his leg, 3 days later, my friends daughter breaks her shoulder. We were treated by the same Dr at the same ER(in the end, we both went to different initial places). That Dr bullied them and treated them so bad they made a formal complaint on him, required a CAT scan for a broken shoulder...of which had already been x-rayed and diagnosed at a local ER(because she was a child, she had to go to another hospital for treatment). We on the other hand had a super experience and I would recommend him for someone else until I heard her story.
                          Last edited by AirForceWife; Dec. 21, 2012, 03:17 PM. Reason: clarity

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                          • #73
                            when I broke my leg they wanted to cut off my boots and I had zippers - I just about flipped. Then they wanted to cut off my very expensive custom breeches - I DON'T THINK SO. I sucked it up and got them off - not without a lot of pain - but there was no way they were cutting them off

                            Comment


                            • #74
                              I have been to the ER many times. I have driven myself in twice (a broken finger, which was fine as I don't drive a stick, and because in my fever and dehydration-induced delirium after a round of food poisoning where I did not want to pay for an ambulance, which I do not recommend, though had I waited for transport I'd have been stuck going to the hospital forty minutes away instead of the local as they were diverting patients, but since I walked in they HAD to treat me there), I have been transported for anaphalactic shock, after car accidents (once by my own request, once on a backboard), once after breaking my knee (I fractured the patella and ripped a bunch of tendons) and once after keeling over when an immune disorder had me so anaemic I was close to heart failure.

                              Never once, even when I was on a backboard until the c-spine film came back or when the EMTs had an inflatable splint on my busted knee to keep the leg from rolling, have the ER people felt it necessary to cut my clothes off. I have never had any procedure done just for funsies in the ER, whether it was taking a urine sample, drawing blood, or putting me on IV fluids. I do not ever WANT to be in a situation where they feel conventionally removing my clothes will cause further injury. Especially if it is a riding fall I feel I need to go to the hospital for-no boots are worth shredding a broken leg further, exacerbating a back or hip injury...heck, a badly-broken leg moving before it's stabilized can kill you--nick the femoral artery and it's all over unless you are INSANELY lucky.

                              I don't care if it's my fifteen+ year-old Bond Boots that I have had forever and which are nicely broken in, or my ballroom gown that costs more than most saddles--if I'm in such a bad way the ER docs wants my clothing off NOW and I felt badly enough to be taken in, I am probably not going to argue very hard. Clothes can be fixed or replaced.
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                              • #75
                                I managed to get popped off my young, exuberant horse and rolled my ankle in a very bad way at a show, and by the time the paramedic got there, you could see the ankle part of the boot starting to bulge because of the swelling. I opted to tough out the pain and had my trainer who was on hand pull the boot off. It was excruciating. However, the boots were new, and even though they were the old ariat crownes and nothing custom, there was no way I could afford to get such nice boots again. I am also a die-hard pull-on fan. None of the off the rack zippers have fit my very muscular calves properly; I always get pinched and feel like I can never extend the muscles properly. So would I go through the pain again to preserve the boots? yeah probably. But I also have a staggeringly high pain tolerance (thanks yoga and meditation).

                                Comment


                                • #76
                                  Originally posted by danceronice View Post
                                  if I'm in such a bad way the ER docs wants my clothing off NOW and I felt badly enough to be taken in, I am probably not going to argue very hard. Clothes can be fixed or replaced.
                                  but what a lot of people have said here is that the scissors were pulled out and they weren't in such a bad way. I don't care if it's necssary, cut 'em off. But the scissors have been pulled out for me...and others when it clearly isn't.
                                  Keith: "Now...let's do something normal fathers and daughters do."
                                  Veronica: "Buy me a pony?"

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                                  • #77
                                    Originally posted by RugBug View Post
                                    but what a lot of people have said here is that the scissors were pulled out and they weren't in such a bad way. I don't care if it's necessary, cut 'em off. But the scissors have been pulled out for me...and others when it clearly isn't.
                                    Amen! And thank you!!
                                    Flip a coin. It's not what side lands that matters, but what side you were hoping for when the coin was still in the air.

                                    You call it boxed wine. I call it carboardeaux.

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                                    • Original Poster

                                      #78
                                      Perhaps I need to amend my seam-ripper-in-the-pocket strategy.

                                      I'm going nursery school:

                                      A note pinned to my lapel that reads:

                                      "To whom it may concern,

                                      Please don't cut off the boots. I'll buy you a steak dinner if you use the seam ripper in the pocket.

                                      Thank you,

                                      mvp

                                      PS. The peppermint in there was for a horse. I don't think he deserves it now. You do and are welcome to a little treat."
                                      The armchair saddler
                                      Politically Pro-Cat

                                      Comment


                                      • #79
                                        My post was not meant to offend anybody and was certainly not directed at any individual. Some of you have apparently met individuals who were sour grapes. You are going to find some somewhere but what I'm trying to get across is that for the most part is that we are not all like this as some have implied. I simply tried to explain why some things are done they way they are and was trying erase this preconceived notion that we are all out to take out some sort of vendetta on riders. Believe it or not, people get into medical professions because we want to help others and enjoy it. My attempt to provide some insight into the situation from the other side of the fence so that somebody's next interaction with EMS or the ED may be more positive was apparently not well received as apparently this is just a thread for venting and bashing where the other side is not allowed to defend themselves. It really is no wonder why burnout is the highest in the medical professions over all others.

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                                        • #80
                                          I just had a trip to shock trauma last week. First thing I did (with some help) was remove my show coat, helmet, and tall boots. Luckily they asked if I was able to move enough to assist them with removing my britches. Since my arm was obviously very broken, they informed me that my shirt had to be cut off
                                          All of the staff was very nice. If I wouldn't have been able to remove my boots/clothes myself, there is no way in the world would I have expected them not to cut them off. They have other patients/emergencies to deal with, and no point in wasting critical time trying to pull off boots/clothing without ruining them.
                                          Happy Hour-TB
                                          Cowboy Casanova - Brandenburg

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