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Your computer must be broken then.

AO x 4 would be good. I don't know why MCI tugs at the heartstrings. That is a good question. Many of the decisions I make outside of EMS are oriented around doing "The greater good for the most people". I guess this sentiment bleeds through while on the truck as well. I can't deny the disparity between the rules and what I think is best. I think Dwayne said it more eloquently in one of his post. Possibly it is the human suffering I know is out there. Possibly somewhere inside I want to be a hero. Possibly because in my dreams I am always Batman and never Robin. I simply don’t know. .

Yeah..though I know beyond a shadow of a doubt that you are all right... I'm thinking that the school bus would be the end, or likely end of my EMS career. I can't imagine any way that I'm not going to stop and try and render what aid I can...30 minute response to that type of scene is going to cause all sorts of unnecessary morbidity/mortality likely, much of which can be easily mitigated... It's not the same as choosing whether or not to stop in my car. I've got an ambulance full of shit, the MOI makes it likely that I can make a difference here for many... I know the right anwer, but I also knew it in the last job that got me fired when the right answer conflicted with what I believed to be the right treatment. I just always have this silly awareness that I can find another job, but I can't ever go back and undo a terrible thing, when I could have avoided it, to the best of my ability to see such things, from a human point of view as well. I've had to triage...and I hate it worse than anything in the world when lives are possibly at stake...but I can and will do it...I'm thinking that this would become a triage situation for me...not the car possibly, but the bus. And I will move on, after they jerk my cert, to something else.. Yeah, stupid answer I know...but it's as honest as I know, at this point in my life and career. Dwayne

Pro's: A site owner thats not afraid to let the conversations flow A great place to blow off steam, Meet fellow providers from all places of the world Interaction with some really bright minds in the business . Meeting some really smart youngsters , who might be caring for me in my old age { like next year] :=} Cons: Whacker wannnabe's and poser's

A significant consideration is the fact that we need to determine the extent, damages and processes that led to and resulted from the error. This is the reason we report errors and perform investigations and a root cause analysis. Going to a patient immediately following an error does no good as we often cannot provide the patient/family detailed information about the situation. Often, details and implications are not fully realised until the investigation phase. This is also why we have QI/QA processes in place, to identify issues and manage issues. In addition, many errors occur that are often unnoticed or unrecognised until the QI/QA process occurs and somebody identifies a potential issues. Also, how do we define an error and implications of said error? Technically, you could error by placing your chest pain patient on a non-rebreather at 15 LPM when said patient lacks dyspnea and have no signs or symptoms of hypoxaemia or hypoxia. Yet, many people are doing this. Should all of these "errors" be reported? Certain members of this site appear to lack basic understanding of the investigative process. it is less about "CYA" as some have put it and more about performing a good investigation in order to uncover as much information as possible, allow people to analyse and process said information, enable people to make plans of corrective action and allow people to assess the extent of damages. Often, this process leads to the identification of system wide issues that can be improved to prevent future problems. A medical error is not typically associated with a single event, but rather associated with a series of issues that all played a role in causing the error.

What in the bloody hell are you talking about we don't talk funny; I tell you its you blokes who have the nunngered vocabulary Although this one time in rural New York .... Me: Yeah this is Tom, wicked allergic to bee stings, stung twice, reckons no SOB but his chest sounds a bit buggered, wheezy, doesn't seem crook like cardiovascular, bit perkier on some salbutamol, you blokes got adrenaline eh like if he goes to poo? Upstate rural New York volunteer EMT: <blank state like he's being beamed up by aliens> .... what? Dramitisation - may not have happened

That sucky feeling changed something in you and you changed your practice. That's why these things happen, so that we can learn from them.

If they code on the ground we'll accompany ground medics to the closest hospital on the ground. If they code in the air we'll code them in the air. Strokes are one of those things that can truly benefit from a rapid transport to a center that can effectively treat the patient. Locally, there are many changes being implemented to facilitate air transport of stroke patients. Keep in mind that every time you call out a helicopter you are putting the lives of the flight crew at risk. If you've paid attention to the news over the past few years you'll have seen/heard about the increasing number of HEMS crashes resulting in the loss of life of crews and patients alike. Make sure you're calling for the right reasons and not because you think it's cool. As a flight crew member, I am willing to accept the risks of the job if truly warranted. However, it is a *HUGE* disservice to call out a helicopter for someone who doesn't really need it because you think it's cool. Aside from the risks involved in HEMS transports there are substantial costs involved. Do you really want to add a $12K to $15K helicopter bill to your patient who may or may not be able to pay even part of that? All because you think it's cool? Yes. Helicopters are cool. I can't deny you that. I think they are, too. But use your head when calling for one. Your patient, the flight crew and the families and friends of everyone involved will thank you.

Pros: I keep coming back Cons: I keep coming back This site is a good tool to kill a few minutes, learn something new, teach a little, shoot the bull and generally engage the neurons in something collectively constructive. And I've met a few interesting people here. But the best thing is you blokes over this side aren't as queer as those neo-Nazi bastards who run that other site

Excellent topic. It is worth checking this site on a regular basis for the things that I learn. I was not aware of ACE inhibitor induced angioedema. Had I run on this patient, I would have been loath to take any aggressive measures. The key here is the history - 3 hours to develop a swollen tongue does not in my way of thinking, an airway emergency make. I would certainly provide oxygen (nc 4 lpm at this point). Being ignorant of the pathophysiology before reading this post, 25mg of diphenhydramine would probably find its way into this patient, as would a corticosteroid. Other than that, rapid transport to the ER. It is wonderful to have ERDoc chime in with the statement that prehospital, really nothing to be done. I am probably a day late and a sandwich short coming in at this point, but I wanted to express my deep appreciation to the OP and the other posters. I have once again learned something.

Guess we need to change the name of this site to C.Y.A.CITY