Crisis Tech Solutions Ltd

20/07/2025

Title: Rescue Operation of a Trauma Patient (Construction Worker)
Author: Dimitar Nenchev | Crisis Tech Solutions | Medical Practice | Prehospital Care | Emergency Medicine

🆘 1. Dispatch and Initial Information:
Emergency call received for a construction worker who fell approximately 5 meters from scaffolding. Reported unconscious with irregular breathing. Team dispatched immediately under “life-threatening” priority.

📍 2. Scene Arrival and Safety Assessment:
Location: active construction site with restricted access and unstable terrain. The patient is found lying on a concrete surface surrounded by tools and building materials. Immediate priority: secure the scene with site safety officers and fire services to ensure safe access.

👷 3. Primary Survey:
🔹 Consciousness: Responds only to painful stimuli (GCS ~8)
🔹 Airway: Partially obstructed by blood/debris
🔹 Breathing: Shallow, rapid, asymmetric chest movement, decreased air entry on one side
🔹 Circulation: Tachycardic, pale, cold extremities, suspected internal bleeding
🔹 Obvious Injuries: Suspected chest trauma, possible pelvic/long bone fractures, head injury (visible laceration, hematoma)

💉 4. Immediate Interventions on Site:
🔸 Airway secured with basic maneuvers, suction applied, OPA inserted
🔸 High-flow oxygen via non-rebreather mask
🔸 Immobilization: cervical collar, spine board with head blocks
🔸 Pelvic binder applied due to mechanism and findings
🔸 IV access x2 with fluid resuscitation (permissive hypotension due to suspected internal bleeding)
🔸 Monitoring: ECG, SpO₂, BP, glucose, temperature
🔸 Pain management initiated (as per protocol and hemodynamic stability)

🚑 5. Extrication and Transport:
Due to difficult terrain and scaffolding remains, fire rescue assisted with technical extrication using basket stretcher and vertical lift. Transport initiated under high priority to Level I Trauma Centre with pre-alert to receiving ED.

🏥 6. Handover and Continuity of Care:
MIST report delivered:
• Mechanism: fall from ~5m
• Injuries: suspected chest, pelvic, head trauma
• Signs: GCS 8, BP 90/60, HR 130, RR 28, SpO₂ 89%
• Treatment: airway support, immobilization, fluids, oxygen, pain relief

🔑 Key Takeaways:
• Rapid scene assessment and safety coordination are essential in construction site incidents.
• Early suspicion and management of life-threatening injuries (e.g., tension pneumothorax, pelvic fractures) save lives.
• Effective team communication with rescue services and ED ensures continuity of care and optimal outcomes.

13/07/2025

Differences Between Cardioversion and Defibrillation – When, How, and Why
Author: Dimitar Nenchev | Crisis Tech Solutions | Medical Practice | Prehospital Care | Emergency Medicine

🔹 1. Definition and Purpose
📌 Cardioversion is the controlled delivery of an electric shock synchronized with the R-wave of the cardiac cycle. It aims to restore normal sinus rhythm in patients with certain tachyarrhythmias.
⚡ Defibrillation is the unsynchronized delivery of high-energy shocks used in life-threatening arrhythmias such as ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT).

🔹 2. Synchronization – Why It Matters
📍 In cardioversion, the shock is synchronized with the R-wave to avoid delivering energy during the vulnerable T-wave, which could trigger ventricular fibrillation.
📍 In defibrillation, no synchronization is needed — immediate shock delivery is critical.

🔹 3. When to Use Each
🩺 Cardioversion – Indications:
• Symptomatic atrial fibrillation (AF)
• Atrial flutter
• Stable wide or narrow complex tachycardia with a pulse
• Rhythms with a pulse causing significant hemodynamic instability

🆘 Defibrillation – Indications:
• Ventricular fibrillation (VF)
• Pulseless ventricular tachycardia (VT)
• As part of the ALS algorithm during cardiac arrest

🔹 4. Energy Settings and Equipment
🔌 Cardioversion: typically starts with lower energy levels (e.g., 50–100 J for AF), and uses the synchronized mode on the defibrillator.
🔌 Defibrillation: delivers higher energy (usually 200 J biphasic) in unsynchronized mode — “SHOCK NOW!”

🔹 5. Practical Tips for Prehospital Providers
✅ Always assess rhythm and pulse carefully before acting
✅ Confirm the defibrillator is in SYNC mode for cardioversion
✅ In cases of unstable tachycardia, be ready to escalate rapidly
✅ For VF/VT, defibrillation is the priority — time is myocardium

🔚 Key takeaway:
Cardioversion and defibrillation may appear similar but are fundamentally different in timing, indications, and ex*****on. Knowing which to apply — and when — can be the difference between life and death in the field.

https://crisissolutions.info

12/07/2025

Снощи събрахме средства за благородна кауза – закупуване на външен дефибрилатор ⚡❤️. Всеки живот бе поставен на първо място, защото всяка подкрепа може да спаси нечие бъдеще 👏👨‍⚕️👩‍⚕️.

03/07/2025

Orthopedic Templating for Total Hip Replacement: Precision in Preoperative Planning
Author: Dimitar Nenchev | Crisis Tech Solutions | Medical Practice | Prehospital Care | Emergency Medicine

🦴 1. What Is a Total Hip Replacement?
Total Hip Replacement (THR) is one of the most common orthopedic procedures, aimed at relieving pain and restoring mobility in cases of advanced osteoarthritis or severe hip trauma. A crucial part of its success lies in accurate preoperative templating—the process of measuring and planning implant size, positioning, and leg length before surgery.

🖼️ 2. Imaging – The Foundation of Measurement
Proper templating begins with high-quality imaging:
• AP Pelvis X-ray – ideally weight-bearing, centered, and symmetrical, showing both hips clearly.
• Lateral Hip X-ray – provides a side view for assessing the sagittal profile of the femur and acetabulum.
• CT Scan of the pelvis/hip – used in complex cases or for 3D navigation-based surgery.

📏 3. Key Measurements in Templating
Templating ensures restoration of:
• Center of rotation of the hip joint
• Leg length
• Femoral offset (lateral distance from the femoral axis to the center of the femoral head)
• Neck-shaft angle of the femur

Anatomic landmarks used include:
• Teardrop line – to guide acetabular cup placement
• Lesser trochanter – for leg length comparison
• Femoral axis and neck axis – to choose correct stem size and angle

💻 4. Digital Templating and Software Solutions
Modern orthopedic planning often uses software such as TraumaCad, OrthoView, or MediCAD to:
• Overlay implant templates directly on X-rays
• Auto-calculate key dimensions
• Simulate component positioning in 3D based on CT data

🔍 5. Why Accuracy Matters
Poor templating can result in:
• Leg length discrepancy
• Improper implant fit
• Increased risk of dislocation
• Persistent postoperative pain or reduced function

✅ 6. Intraoperative Verification
During surgery, surgeons:
• Use trial components to verify fit and leg length
• Adjust implant positioning for optimal biomechanics
• Employ intraoperative navigation or fluoroscopy when available

📌 Conclusion
Orthopedic templating is not a formality—it is a critical step in achieving long-term surgical success and rapid patient recovery. It brings together anatomy, engineering precision, and digital technology, all working in harmony to support modern orthopedic care.

01/07/2025

Collateral Circulation – The Hidden Protective Mechanism of the Human Body
Author: Dimitar Nenchev | Crisis Tech Solutions | Medical Practice | Prehospital Care | Emergency Medicine

🔬 What are collaterals?
Collaterals are alternative blood vessels that provide a bypass route for blood supply in cases of partial or complete blockage of major arteries or veins. They can be congenital or adaptively formed in response to chronic ischemia. Although often unnoticed under normal conditions, these vessels play a key role in maintaining tissue perfusion and organ viability.

🫀 When are collaterals activated?
Collateral circulation is activated in cases of:
• Atherosclerosis and stenosis of coronary arteries
• Chronic peripheral arterial disease
• Strokes (especially with occlusion of a major cerebral vessel)
• Pulmonary embolism (in the pulmonary circulation)
• Liver cirrhosis (portocaval collaterals)

🧠 Physiological mechanism
When normal blood flow is disrupted, the body responds with vasodilation of existing small vessels and stimulates angiogenesis – the formation of new vessels. Collaterals compensate for the lack of blood flow by taking over part of the blood redirected from the compromised vessel.

🚑 Importance for prehospital and emergency medicine
In emergency practice, collateral circulation is often a key factor for survival. For example, in acute myocardial infarction, a patient with well-developed collaterals may experience milder symptoms and a smaller area of necrosis. Similarly, in stroke, a good collateral network can delay irreversible brain tissue damage, providing a “therapeutic window” for intervention.

🔍 Diagnostic methods
• Angiography (coronary, cerebral, peripheral)
• CT or MR angiography
• Doppler ultrasound (for peripheral vessels)

🩺 Collaterals and prognosis
The presence of well-developed collateral vessels is a favorable prognostic factor. They not only reduce the extent of injury but often make the difference between life and death in the acute phases of vascular incidents.

⚠️ Important for practice
• Symptoms in acute conditions may be atypical with active collateral circulation.
• Patients with chronic vascular pathology often “survive” thanks to it.
• Development of collaterals requires time – in acute occlusion without collaterals, the outcome is often fatal.

Collaterals are not a panacea but are an amazing example of the adaptability of the human body – a silent network of vessels that can be decisive in a critical moment.

Led by CEO and medical trainer Dimitar Nenchev, our commitment to excellence ensures top-tier instruction for critical safety and medical practices in the UK and Nor

28/06/2025

Hornet Sting: What You Need to Know
Author: Dimitar Nenchev | Crisis Tech Solutions | Medical Practice | Prehospital Care | Emergency Medicine

🪰 What Is a Hornet Sting?
Hornets are among the largest and most aggressive members of the wasp family. A sting from a hornet injects venom that can cause intense pain, swelling, and in some cases, systemic reactions. Unlike bees, hornets can sting multiple times.

⚠️ Signs and Symptoms
Most hornet stings result in localized reactions such as:
• Sharp, burning pain at the site
• Redness and swelling
• Warmth and itching
In some cases, more severe symptoms may appear, including:
• Nausea or vomiting
• Dizziness or fainting
• Difficulty breathing
• Rapid heartbeat
• Anaphylaxis (a life-threatening allergic reaction)

🚑 When to Seek Emergency Help
Call emergency services immediately if the person stung shows:
• Trouble breathing or swallowing
• Swelling of the face, lips, or throat
• Confusion or loss of consciousness
• Hives spreading over the body
• History of severe allergic reactions

🧰 First Aid for a Hornet Sting
1. Move to a safe area to avoid additional stings.
2. Clean the area with soap and water to prevent infection.
3. Apply a cold pack or ice wrapped in cloth to reduce swelling and pain.
4. Take oral antihistamines like cetirizine or loratadine for itching.
5. Use a topical corticosteroid cream to relieve inflammation.
6. Pain relief with paracetamol or ibuprofen as needed.

💉 Important Note on Allergies
If the person carries an epinephrine auto-injector (EpiPen), use it at the first sign of a severe allergic reaction. Even if symptoms improve after using it, emergency evaluation is still required.

📌 Prevention Tips
• Avoid wearing bright colors or perfumes outdoors.
• Stay away from nests and garbage bins.
• Keep food and drinks covered when eating outside.
• Wear long sleeves and pants in high-risk areas.

Hornet stings are painful but usually manageable with prompt first aid. However, they can be dangerous for allergic individuals, so always assess for signs of systemic involvement.

https://crisissolutions.info/

Led by CEO and medical trainer Dimitar Nenchev, our commitment to excellence ensures top-tier instruction for critical safety and medical practices in the UK and Nor

23/06/2025

🚁💉 Driven by the urgency to save lives in the most critical moments, a flight paramedic rises above every obstacle—literally and figuratively—to deliver advanced care where it’s needed most.

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20/06/2025

Firefighters Are Our Everyday Heroes 🚒🔥

Every time the alarm sounds, firefighters answer the call—running toward danger when everyone else runs away. Whether it’s battling towering flames, rescuing people trapped in wreckage, responding to road accidents, or delivering life-saving care on scene, they do it all with courage, skill, and heart.

👨‍🚒 They face extreme heat, toxic smoke, collapsing structures, and unpredictable emergencies.
💪 They carry heavy gear, work grueling shifts, and make split-second decisions that can save lives.
❤️ They comfort the scared, help the injured, and protect our homes, our neighborhoods, and our lives.

Firefighters are not just responders—they’re protectors, medics, rescuers, and community leaders. Their bravery, discipline, and sacrifice make them true heroes who deserve our gratitude every day.

To every firefighter out there: Thank you for your service, your strength, and your unwavering commitment.

16/06/2025

High-Fall TraumaAuthor: Dimitar Nenchev | Crisis Tech Solutions | Medical Practice | Prehospital Care | Emergency Medicine📌 What is it?High-fall trauma occurs when a person falls from a significant height—such as a roof, ladder, scaffolding, balcony, or mountain terrain. The main mechanism of injury is vertical acceleration followed by sudden deceleration on impact, transferring kinetic energy throughout the body.⚠️ Common injuries: • 🧠 Head injuries – concussion, intracranial bleeding • 🫁 Chest trauma – rib fractures, lung contusions, hemo-/pneumothorax • 💔 Abdominal trauma – liver or spleen rupture, internal bleeding • 🦴 Orthopedic injuries – fractures of pelvis, spine, limbs • 🦹‍♂️ Polytrauma – simultaneous injuries affecting multiple systems🛑 Scene assessment: • Height of the fall (>3 meters = high risk) • Surface impacted (hard or uneven increases injury severity) • Body position at impact (feet, back, head)🚑 Prehospital management: • Ensure scene and personal safety • Primary survey – ABCDE: • A – Airway with spinal precautions • B – Breathing assessment • C – Circulation and bleeding control • D – Disability: neurological status (AVPU, GCS) • E – Exposure: full body check for hidden injuries • Spinal immobilization – cervical collar, vacuum mattress or spine board • Rapid transport to a trauma-capable facility🧠 Remember:Even with minimal external injuries, internal damage can be life-threatening. A high fall is always considered a high-energy trauma — always suspect hidden injuries!https://crisissolutions.info

15/06/2025

6H / 6T – Reversible Causes of Cardiac Arrest
Author: Dimitar Nenchev | Crisis Tech Solutions | Medical Practice | Prehospital Care | Emergency Medicine

🧠 What does 6H / 6T mean?
This is a systematic approach used during Advanced Life Support (ALS) to identify reversible causes of cardiac arrest. Often, one of these conditions is the actual trigger for the arrest and can be corrected even during resuscitation.

🔹 6H – Six metabolic or hypoxic causes:
1. 🫁 Hypoxia – insufficient oxygen in the bloodstream
2. 💧 Hypovolemia – significant blood or fluid loss
3. ❄️ Hypothermia – low body temperature
4. 🧪 Hypo-/hyperkalemia – electrolyte imbalance (especially potassium)
5. 🩸 Hypoglycemia / hyperglycemia – metabolic derangement (sometimes included)
6. 🧬 Hydrogen ion excess (acidosis) – metabolic or respiratory acidosis

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🔸 6T – Six mechanical or toxicological causes:
1. 💉 Thrombosis (pulmonary embolism) – blockage in the pulmonary artery
2. ❤️ Thrombosis (myocardial infarction) – coronary artery occlusion
3. 💊 Toxins / drugs / poisoning – narcotics, antidepressants, pesticides, etc.
4. 🫀 Cardiac tamponade – fluid or blood in the pericardial sac
5. 🫁 Tension pneumothorax – trapped air compressing the heart and lungs
6. 👊 Trauma – especially massive chest or abdominal trauma

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📌 Why is this important?
Even the most well-performed CPR will not succeed unless the underlying cause is addressed. If one of these reversible causes is identified and corrected in time, return of spontaneous circulation (ROSC) is more likely.