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Mike, I think you and many others would benefit from reading this article. Just because it's past its expiration date doesn't mean it's not good. ETA: There are also programs out there that will take expired medications and send them to charitable medical organizations for use in third world countries. Again, just because it's expired doesn't mean it's not good.

In my area we have no inpatient psych facilities. The closest one is about 100 miles away. As a result of this we have repeat patients with underlying problems that aren't being evaluated. I am at a loss for how to help these patients. One example is one particular patient repeatedly tried to harm himself as a result of a known psych disorder. We would transport this patient sometimes twice a week to an ER and then after being treated for the immediate life threat was sent home to try again. Law enforcement can get an emergency committal but it usually takes about an hour to get the paper signed by a judge, and the paper must be complete before the patient is under a physician's care otherwise it won't work. The issue with that is that in most of these circumstances sitting on scene with the patient that long is unrealistic. After they get to the ER it doesn't matter what we tell the ER doc, as long as the patient says they don't intend to hurt themselves or others they don't get a psych hold. I'm curious if other agencies are having this problem, and if so what is being done?

well this is might be the weirdest place for the first post i'm currently sitting in my hospital room/bed with a massive headache which me and my doctor seem to think is a cluster headache I've been here since Monday and all my symptoms seem to add up pain on 1 side of the head affected side eye feeling like its going to pop out burning pain in my head swelling in the area of the headaches so anyways there giving me 4mg of dilordan every 4hrs and waiting for the neurologist to show up and i'm itchy as hell my nurse just gave me benadryl so if you post to me and i don't answer I'm more then likely pass out (25mg of benadryl) they think the itch is from an adverse reaction anyways feel free to respond back t (also note i pointed all this out to the doctor before thy figured it out but seems me and the doc are on the same page.. please feel free to respond back posted this on another website and dont feel like changing it to a non new member type post

I doubt many people will remember me, but I was a member years ago in '06. I took a long hiatus due to finishing up college and getting my life in order, but after lurking around a bit, I decided to come back. Back then I was an EMT-B for my school's volunteer squad and also for a private transport company in New York. I have since then become a Paramedic and have been working for a large hospital based ems system that does both 911 in New York City and the surrounding Burroughs (I myself work 911 in Queens) and also interfacility bls, als and als critical care transports (including picu and nicu transports). I just celebrated my 8 year anniversary in ems this past December and looking back, I know I've grown so much as a provider. I'm happy to be back here to share in some stories, laughs, scenarios and fun!

Evening Everyone, I have been lurking on different EMT boards for a while and decided to take a shot at gathering additional information by creating an account. Getting to the point, I am considering volunteering with my local Fire Dept to become an EMT. Are there any people that can speak specifically to the Fairfax County area? I am curious about expectations, dos and donts, how to approach the firehouse when requesting information, etc. Any help is appreciated.

Congrats on working to get your basic and I am glad you got your headaches figured out!

Appreciate the feedback from both of you. paramedicmike, perhaps my most important concern is not screwing up and contributing to someone dying. That and dead kids. I am extremely green at this point. Honestly, I am uncertain of what to expect because I know nothing in this field/lifestyle. I just want to contribute to my community in some regard, no hero worship seeking or looking for acceptance (codependency). I am just looking for some helpful advice and perhaps, some insight into local culture (Fairfax County). One of your questions does stand out. How does a volly integrate into a paid system?

They are a good system. I was with Montgomery County in MD just across the river and we would run mutual aid with them every once and a while. Approach with lots of questions and an eagerness to help staff and learn and you'll be great.

Call the attending at the psych clinic yourself for advice. Tell the doc what you're dealing with and if he'd be willing to consult the next time you have this patient. If the psych doc is willing to accept the patient, then transport him to the psych centre next time and bypass the local ER.

I think CPAP is definitely worth a trial, perhaps PEEP in your context. With such a disease process you are always open to issues, however I think that the use of CPAP would be worth the risk. I would definitely hold off on RSI until I have tried a less invasive route. Especially with the patient being elderly, we all know the risk of the patient never coming off the vent. I think we are all guilty of pulling the trigger on RSI a bit faster than we should in some cases, especially the elderly.

ty ty

Feel better, my brother in EMS.