Leaderboard

My father went threw 6 weeks in CICU after a unsuccessful bypass surgery and I can sympathize with your problem. I think once the nurses get use to the idea of you being there they will be a good allies. They were for me.

Obama like his predecessor is a liar, you can tell cause his lips are moving. The real shame is you thought it would be different.

As usual, I'm trolling the Interwebs trying to stay awake while on my shift and giving myself a break from some microbiology homework. I found this really interesting article on MSNBC titled When The Elephant in the Room Isn't Really There and thought it would be something interesting to bring up, especially for those of us who work with the elderly population with any sort of frequency. I had never heard of of Bonnet syndrome before reading this article; brings up some good food for thought. So, what if your patient is oriented, totally there mentally, but insisting that the giant pink elephant is in the ambulance with you? Are they really hallucinating? Is there something pathological going on in their brain? Or is it merely their visual cortex substituting imagery in the absence of readable visual input? Will it change how you interact with this patient at all, now that you have read this article? Wendy CO EMT-B

it's been in my experience that administering IV fluids ( normal saline ) at a t.k.v.o rate is not harmful and infact , if they need to admin T.P.A ( clot buster ) well they then have an IV access already established with your line and fluid running. I believe that as long as doing the line isnt delaying transport then its an acceptable practice and usually the nurses are thankful a line is running for them upon handover in the ER. An intravenous line is inserted to provide drugs and fluids when needed at the hospital anyhow.

Do not judge an EMT class on how far the spread the EMT hours out (over a matter of weeks or months). I went to community college EMT. Two quarters. Instructors were great people. CRAP education and preparation. Cookbook to core. Waste of time spreading that out. One only studied right before the exams, anyway (or not at all and still passed), because cookbook is easy. I continuously get ride-along students from a local accelerated program here with students who have really impressed me. I can pick out the ones who went to that school. They can explain nitro in terms of basic pre-load and do basic critical thinking better than most EMTs. They know their academics and their skills. It's still basic, since it's EMT, but it's a 3-week program, and if I had to choose, I would prefer to be treated by students from that program, whether traumatic or medical (if it had to be at EMT level). This might be the exception, not the rule. But even then, recognize there are exceptions. Also, told they have much much higher NREMT pass rates. So, that's increased academics, field performance, and testing rates (whereas some only have quality in one of them). Before knowing about this program, I was against shorter programs.

Lots of love and prayers coming your way dear lady. I'm so sorry to hear about what a giant mess this has all been. Please, if there's *anything* I can do to help you out (and you know it's not idle talk from me) you just email me and let me know. Stay strong, dear woman! God doesn't give us anything we can't handle. Love, Wendy

Hello, Really, if your transport time is short the prudent option would supportive care until you get to the ED. Just be ready if things go down hill during the 15-20 minute transport. I am not saying 'scoop' and 'run' with everything and let the ED sort it out. But, EMS should be an extension of the ED. In the ED he would get supportive care and a work up to see what is going on. Why should the EMS standard be different? He has signs if right sided failure (edema and JVD) and signs of left sided failure (rales and pulmonary edema). Signs of a infectious process (general malaise x 5 days with a fever). Cardiac issues as well (1st degree block/bigeminy with an elevated DBP). Plus, a solid list of unknows..... Renal...what is going on? Any failure? Urine output? Lytes? K+ Mg+ Phos? et al.... Fluid status? In he dry intavascular? CBC? Hgb? LFT? Tn-I Blah...blah.... =) So, Kiwimedic.....what is going on here? Cheers, David

Pretty much says it all, doesn't it?

Hey gal - Well wishes and prayers being sent your way for healing, protection, and comfort. Hang in there and vent whenever you need to !

This is not a new trend for emergency services. Many county services both down south and out west use a three tiered system with Police that work as Medics and in some cases as firefighters. They are sworn officers that have also completed fire and EMS training and are required to change hats on a call to call basis. This is primarily done when the counties run Police Fire EMS. I think it is a great idea to be able to change hats at a drop of a dime because it keeps the job interesting and utilizes its employees the best possible way for each situation. Many Virginia State Troopers are also paramedics and dual role as well as many SWAT team country wide. In my home town the entire town highway department crew are trained as firefighters and are automatically dispatched to extrications and structure fires so help with staffing issues. They are covered under the same town insurance, lowers the ISO for the town residents, and really reduces response times. I think if more towns got on board with cross training it would help the budgets, prevent layoffs and better our comunities. .....Just my two cents

I later found it as a 'repost', so if I'm gonna get a -5 from Dust, well, I guess I'll just have to wear it.

I'm going to say no as well due to the fact that the patient was at a hospital with a legally designated emergency department. The problem in this case falls on the hospital staff for not recognizing and treating the problem as it should have been. EMTALA certainly plays a role in this kind of scenario. It's unfortunate, but we have no control over the hospitals treatment of a patient. Shane NREMT-P

It seems about 1o days to long to me. All they really need is a good EVOC coarse.

Oh sure.. cause it only takes about 120 hours to provide emergency medical care and we all know getting cross trained fire/police dudes there in 5 minutes is much better than getting ACLS there in 8. I mean, all those guys do is start IVs right? And as police and fire stuff requires ongoing education, training and practice, its a good thing that EMS crap is so easy.

I'm not against cross training - there are areas where it works to their advantage. There are a few areas in ohio that I'm aware of that the cops also function as paramedics. Many of the troopers here are also cross trained with all being trained to a minimum of a first responder (certified) as well as all of fire being basic so they can perform their own rehab and an ambulance is no longer needed to stand by. Many have their own "fire buggy" which responds solely to the fire scenes for treatment. However - here's where the lines get blurred - when you are on a scene and both duties are required which one takes priority? If you are both a trooper and paramedic you don't treat the patient or have to leave the patient- that's abandonment, you don't keep the scene safe and you potentially get yourself killed. Needs to be a clear line as to when you are what. I'm not advocating against it, but I am playing devil's advocate. As to the SVU episode - I was referencing the fact it was overly dramatic. Most of the time, I'm actually quite the fan of the show as it's well written. Yes I understand real SVU cops probably hate it and sit and perform much of the same griping we did with "trauma", but it is well written and probably much of the reason it's lasted so long. I really just didn't see the justification for having her perform the skills when truthfully they could have. It might not have made such an interesting story line, but all well. Richard - I do stand corrected on the flight part - thank you. I was halfway listening while doing something else and heard the helicopter discussion and then looked up to see them delivering her baby and was like WTF ? Ironically though, I've not seen them drawing blood - every time I've seen the episode they have them at a clinic or the hospital getting it done. Perhaps I've just missed those episodes? Fair enough - just thought it rather absurd at the moment and fired something off. I'll return to putting my foot in my mouth and shut up now.

About two weeks before Obama won the presidency, a friend of mine shared a story of a mental patient who was being admitted against her will. She had freaked out about the possibility of Obama's election, was seeing apocalyptic visions, started reading her bible 24/7, and had contemplated murdering her kids to save them from the horrific future she saw. You can dedide with the knowledge you have now, whether or not she was crazy or visionary. Realize the one of the most common causes of hallucinations is medication related, especially the phenothiazines.