Chief1C

I stock bags of NACL for irrigation, because you can fit more of them than large bottles; and then a few small bottles for the hell of it. Going by a picture and catalog number, I accidentally ordered sterile water in 250ml bags.. Instead of 250ml bottles. Came with red lettering for dilution of drugs. Returned it and got what I wanted, not what I ordered. Ha ha. If you pay attention to the bags, there are two types of "IV" type bags, which contain sterile water. I believe infusing someone with sterile water can cause them serious harm. However the bags for "injection" are meant for diluting drugs. Then there are other bags marked as a solution to be used for inhalation. Instead of a common in-line humidifier for oxygen masks or positive pressure devices; there is a device that self feeds by attaching a tube similar to a drip set to said bag.

Someone could write a very long book, if a psychologist studied the way we (EMS folks of any size, experience or certs) handle grief. One of the folks who trained me, probably exceeding my age by fifty years, once said nothing should bother you, you'll learn not to feel anything. Thankfully, he's retired. Worst advice in the world. It's human to feel and to grieve for those we care for, after all; whether it's a career or not, our duty is to provide care. I don't think that can be done without being compassionate to a degree. Granted I'm not empathetic toward every patient. But kids, whether they have a start on life, or they're just born. Hey, blank slate man, no time to wrong anyone that anybody believes in. I always second guess and rethink my actions, and if I have any question, I become a blithering mess - when it comes to kids or babies. No matter if anything could be done, or not - even if it was obvious that nothing could be done. I feel guilty, just a little. I have a speech I give to new folks who have something shitty happen, but I don't share it often, and I won't on here. I can say - Just because it's raining today, doesn't mean it will be stormy tomorrow. Apply that as one sees fit.

Ohhh.. I so know that smell. Back in September we had really bad flooding, killed the power for over 30hrs. But the water got so high BEFORE the outage, that it threw the breakers in part of the station. Well, a member donated large freezers, and provided things were stored neat and clean, people could keep stuff in there when not in use for our festivals. I know exactly the smell you're talking about. The main freezer, I guess you'd call it a chest freezer, about 8' long, was actually moved by the water, and stuff was knocked on top of it. Well, to clean the sludge off the floor, shit got stacked on top more. Finally at the end of the month, everything was put back to where it should be. The freezer was locked, b/c it had an "excessively large" amount of Bison and Venison meat. Probably damn near 500lbs. I slid the key in, and the lock didn't want to give. Suddenly the lid popped open by itself, like a burp. Or I guess a fart would be a better description. The guys out in the bay heard a "sweet baby jesus..followed by me vomiting all over the place, profusely. I had to lay down, I just kept puking till my throat was spouting off thin stripes of blood in my spit. I started to breathe really fast, total embarrassing nightmare. Hell, I could have inhaled some sort of fatal bacteria for all I knew. I just ate, and the thought makes me feel sick still. Living in an area w/ a lot of old folks who live alone w/ no family, I've seen some really DEAD, smelly people. But this outdid all of them. It was utterly horrible. They tried to give me oxygen for some reason, which just made it worse. I totally stripped naked and put on a jumpsuit to wear home, washed my hair with dish soap and the garden hose. I tried rubbing my nose with wet shop towels, inside, I tried an ammonia inhalant and Vapo-Rub which made me sick again. It was suggested to spray lysol on a cloth, rub it in my nose, and breath out; then rub it with just water (pick it). It actually worked. I used a prolly pretty damn expensive hazmat suit and SCBA to clean it out, and they still use it. Smelled better when I was done, than when we first put it in there. Lots of clorox, Spray9, Baking Soda in 5lb boxes (Sams Club) and Citrus II. But taking it all out was a nightmare, we put the stuff in these HazMat barrells, big plastic totes with screw on lids. They're meant to seal up leaking 55gal drums. I pitty the person that was around them at the dump when the sun baked and exploded the seals.

I have a tube of anti-inflammatory gel with that diclofenac sodium, maybe I'll try that.

I'm going to go out on a limb, and assume that every question is in regard to motor vehicle accidents. We have a lot of crashes, for such a small area, and I'd say about 29 out of 30 are preventable. I always tell people, I've killed X number of deer in my life, and I've never been hunting. That's almost true, but I've never shot an animal with a gun. I've conducted "drives", while hunting. Anyhow, I think only one accident in the past year couldn't have been prevented. A tree fell directly in the cars path, and they struck it, like instantly both happened. Winter - Speed; Summer - Speed. We have a lot of DUI crashes, obviously that's a personal choice, and highly preventable. Almost every DUI crash, the driver claims a deer or bear came out in front of them. See, if you hit the animal, most insurance companies won't make you pay anything. But if you swerve and nail a telephone pole, it's all you, and you get fined. I try not to judge a drunk driver, that's what the courts are for; but I tend to have little sympathy for them. I can't really help but look at a call, and think how many ways it could have gone differently, if someone would have been either thinking clearly - or just plain thinking. Our EMStat Data suggests the most common age for MVA victims is 23 to 45; and of them, the majority have "Patient admits to ETOH" or "Odor of ETOH on Patient". Granted I can't select just drivers, so that's every accident victim. They come in all ages, but I can print out bar and pie charts/graphs, and it has information like that. They use it in statistical data for rural health and trauma. I've seen so many accidents, where you just flat out observe that the person had a 50/50 shot. Adults and children, one crash the car went down an embankment, through the guide wire. See, they use wire rope in some places, instead of a rail. This $#!t doesn't break apart like the rails. It cut the A posts clean through on both sides, and came to rest against the drivers seat. The driver had been thrown around, and was in the back. Severely injured, but alive, and not decapitated. The policeman had the nerve to lecture (the patient) on seatbelt use. Like, man, clearly not wearing one saved a life, the person would have been either crushed, or had their head torn off. Then there was one call that happened a while ago, a teenager lost control on a slick road, and gracefully bumped a rock outcrop. The driver WAS belted. The hard part for me, is that I know entirely too many of the people I treat, and I knew this person; I worked with them every day. Not a scratch, not a contusion, nothing. Unresponsive, staring into space, somehow likely from striking of the head backward, the base of the skull was injured. I don't know the specifics, but the cause of death was swelling of and eventual death of the brain. Happened to a family member too, that call changed me for life. I'd suggest wrapping children in bubble paper, with helmets, and transporting them at no more than 10mph.. No, back seat, well restrained. That's something I can't answer. Make sure people know how to properly install their child seats. Safety seat clinics are a good way to do that.

Obviously, this is in the personal section, and has nothing to do with EMS. I could Google this, and get a bunch of crap that says what a product could do.. So, I bought this Prid Black Salve today - at the farm & feed store. The clerk assured me it could be used on humans too. So, I was fighting a fire a couple weeks ago with my water supply on my back. I climbed over a wooden fence, and got poked by a sliver, dangerously close to my boys. Not all of it pulled back out, took some "pale & sweaty" digging to get the rest out. Today, I noticed it's healed but not in a good way. Has anyone used drawing salve, and actually had a foreign object come back to the surface? Not looking for medical advice, in theory, I can handle that end. MacGyver Surgery, ha ha. Ideas? My grandma suggested adhesive tape, but I think that's an old wives tale for drawing metal out. This is just old wood.

I put a sincere effort into the survey; answered each question. When asked why I chose each answer, I explained why in the box provided, rather than clicking a dot. I found, however, at the end I could only remember "highlight details" from each case. Where as on a call, I depend on my memory of it to write up my tripsheet. As I only take a few notes and basic info; along with vitals on a notepad while actually "ON" the call. Even if we stack up calls, I never have a problem remembering; nor have I ever had a problem studying then taking tests. The format of the survey, essentially is set up the same way as our Online-Con Ed courses. You watch some objective and subjective info for 28 minutes; then take the test. It will have a scenario, and three or four questions that go with it. Now if I had to answer a question later in the process, about the scenario that I had just read and tested on, I probably wouldn't recall. I've always supported those courses, but I tend to learn by doing; rather than watching. In a nutshell.. I enjoyed the survey, it was well planned, well written and I appreciate being given the opportunity to participate. I in no way intended to insult or disrespect our new member, Andy Lazar; and if it appeared that way, Andy, I apologize.

Agreed. I will no longer interact. However, I disagree that it's "every thread". I do agree it's bullshit, and I'm not sponsoring bullshit. I input correct information. I get replies that are either so confusing that I feel like an idiot after trying to understand them; or they make not one bit of sense. THAT is what gets posted on nearly every thread. The individual member is supposed to decipher the meaning of said comment, and decide whether it should be taken as - is he serious, b/c he talks like a Physician's Desk Ref. manual is written; or is he joking - or does he just not have a clue? Yeah, I'm not sponsoring that. You can keep the $14.99, or w/e it was, and I won't say anything insulting toward anyone else.. B/c I'm really not exactly pissed at Dwayne, miffed, yes, pissed off - no. All that said, maybe I'll check in after a few months, I'm throwing in the towel.

for every I answered never. We're required by law to carry a copy of the state-wide BLS protocols. However, it is my personal belief, that one should know their protocols before they are providing the care.

I'll take the survey, just out of boredom though. My second cousin is a professor of business at Cornell. Very nice school.

Actually, one of the first things I said was:

I said PID!? Extensive knowledge my white Irish ass. I may "only" be an EMT, but at least I have thirteen-plus damn years of effort behind each one. You're looking this stuff up in books and on websites.

I asked if there was any problems urinating, discharge, or odors - you said no. I may have finished the EMT course, prior to taking hundreds of hours of additional courses, about 159 months ago.. But I do recall that our duty isn't to diagnose. Sure, you can rattle off a definitive diagnosis sometimes and be right on the money. But will I write it down? Absolutely not. B/c if.. IF.. I were to end up in a court room, what do I say, when they ask for my medical background, to base my diagnosis on? It makes for good and inappropriate conversation during dinner, and that's about it. This isn't a scenario, this is a little twenty question mind-fuck-game of yours. And I'm no longer interested. A good scenario has a curve ball, but you're just dropping the ball in the storm sewer, before you even pitch it.

Appendicitis never even crossed my mind, as the history noted: Of course, she could be lying about that too. Maybe a skin infection, hot/tender/red, fever, vomiting, but no GI upset to the lower end. Which is why I thought an abscess; or cellulitis - which can occur anywhere on the skin. And you could be getting there at the start, the fever could spike with worsening symptoms. Monitor the vitals, make a detailed and anal outline of the history and exam of the current condition; treat symptoms. That's basically what you're gonna get in the ambo. Diagnose it, yeah, prolly not.

As a diabetic, myself.. I'd consider the BGL to be perfectly fine.. In fact, 100 would be high for me, since I should practically own stock in Dex4 - the glucose tablet people. "BP 120/80 PR 90 RR 14 " are with in normal limits. The CO2 thing there is supposed to be in the 30's or something, unless I'm mistaken. That's not something we do, none of our equipment can read it, and the only time ALS reads it is in intubated patients. One expects a certain degree of rise of pulse, blood pressure and potentially respiratory rate when an ambulance arrives, as it can be embarrassing, stressful, don't know what to expect. Then of course the pain factor, pain will reflect in vitals. Have we palpated the abdomen yet? What does it feel like? Pain to press, pain when pressure is let off, pain go away when pressing, masses, bulges, how bad is the pain. 1 none 10 child birth - that's what I say when I ask older women about pain. How long has the patient been vomiting? What color is the urine? Are we leaning toward some type of syndrome that leaves the body with excessive amounts of alkali? Did you get your scenario from watching a TV show?

I've never noticed that liability insurance is any different, based on the age of our drivers. That could just be a fall back excuse? I won't say start somewhere with low standards, b/c that could affect your ability to become employed somewhere else, as well.

Well.. The only time we see a surgeon in the ER, is the trauma surgeon, and I doubt this is Trauma Alert worthy. I'm going to say: This 20 y/o/f, with stable vitals and a low grade temp is having abdominal pain below the naval w/ vomiting. States no possibility of pregnancy, normal bowel habits, normal menstrual cycle. Sign here for transfer of care, have a lovely day. UTI? PID? Cancer? Hell if I know, I covered all the questions. You said she wasn't sexually active, has she been assaulted? Rather when asked, does she clam up, quit talking, avoid answered? Is she currently having her menstrual cycle?

Gives them a reason not to get caught doing it again.

Get some training, then lecture me on limits of knowledge. OK - is not an acceptable answer on last BM.. and just because someone doesn't have a history of an MI, doesn't mean they're not having one. I bet a trauma patient, just in an MVA, doesn't have a history of trauma either. Last BM may have been normal on Saturday. But if it's Sunday, and that last BM was 8 days ago, that may be a problem.

We?

Yes, I had the full certification upon passing the test. It was the same EMT course that everyone else in the state took. The only difference was I was 16, and I only took it because I had interest.. and I got a really good score. The only stipulation, was that under the child labor act, I couldn't be alone in the back until I was 18. However, I still had the full cert, and nothing changed when I turned 18, I re-certified at 19.. and four times since. (or once every three years).

I was an EMT when I was 16, however, I had no intention of being gainfully employed as one at the time. Just happens to be some handy skills for a young, interested person to have, in the sticks.

Normal Menstrual cycle? - Urinating okay? Pain, burning, discharge from anywhere? - Back alley van abortions? - Last BM? Frequency, color, consistency. It matters. I always ask. Any Jaundice? You say lower, but which side, left right, groiny more than belly? Around the naval? Any attempted piercings? Any noticeable foul odors, not necessarily feminine. What has the person been eating lately? Nuts, seeds, etc? Diverticulitis? Blockage? Abscess (internal or under the skin)? Ovarian Cyst? How the hell should I know, that's why she's being taken to the hospital.

I just fill them out before the course, and give them the card when it's finished. They usually copy them for the EMS Region, then peel and fold it to pocket size.

Here's the dirt.. I only know this, because when someone is sentenced to do community service, the individual offender is responsible to find the service he or she will perform. Often, it involves like cleaning up a park, etc. But on occasion, they'll ask the fire companies if they need anything done. In fact a group of them painted our whole station, and did a damn fine job too. I'm usually the person they coordinate with, so I get to hear their stories while I in no uncertain terms, babysit them. In the Commonwealth; if a person under the age of 21 is *convicted* of being in possession of; or under the influence of alcohol; they automatically lose their driving privileges for a period of 90 days. This is a suspension, not a revocation. With each additional conviction, the amount of time increases. Finally, after the third, they just lock you up. If the person is aged 14... When they turn 16, they have that 90 day wait hanging over them. However, if they plead guilty; at age 18, the conviction is expunged from their record. But only for first time offenders. They'll of course also be fined, and slapped with 16 or 24hrs of community service; eg 4-6 four hour days for minors; or 2-3 eight hour days for adults. As child labor laws prohibit them from working a full 8 hours of community service. If the person in question is applying for EMT-B, or MFR, and is under 18, and was convicted; they have to report that when filling out the application for the course. Same if they're over 18. You don't have to report like a traffic violation, only convictions. If it's expunged, then it's not a concern. A drivers license is not required to be an EMT or MFR; as no part of the course requires one to drive the ambulance. However, getting a job as an EMT, will require it, as that's what *most EMT's are paid to do; drive paramedics. Unless it's a service that only staffs two EMT's.