emt322632

I probably would have ALSed the patient just for precautions. Some older people tend to be kind of stoic when it comes to pain/discomfort. Just curious, you say the wound was 1" in length, was it more of a slash wound or a stab wound? I just noticed you said "stabbed", so was just wondering to cure my own curiousity...

Unfortunately in EMS classes, psychology is covered very little. It's more of a "see the physical, treat the physical" mentality. So when someone calls EMS, and there is nothing physically wrong, we tend to say, "Oh, they're just doing it for attention..." In reality, we have no idea how to treat this person who may or may not be crying out for help. Burn out may play a factor, but I think education plays an even bigger one. Glad to hear you're doing alright, and welcome to the City!

Interesting presentation...hiccups totally took me by surprise...though I got to thinking afterward about the anticoagulant and ASA use, then the business travel...

What happened before the hiccups started? What did he have to eat? Any ABD pain, distention? Any allergies? Trouble breathing? Does the pain radiate or stay in one place, what does it feel like? Fever? Chills? Did he recently start taking any of the medications? Any over the counter or herbal medications? Can we get a temp? 12 Lead EKG, Lung Sounds, SpO2...IV started as well in preperation for possible fluid bolus... differentials...poss MI, pneumonia, bleed somewhere...

I realized I didn't want to do this as a life long career about a year and a half ago. A few of my friends and I applied to R/M, thought it would be a great experience and we'd make boat loads of money. I was shocked to learn they were starting us off at $9.14/hr. Paramedics weren't far behind at $13.00/hr. I realized then that in order to make any money in this business, I would have to: 1) Be in it for a very long time. 2) Move to a different locale. 3) Subject myself to all the hazards that go with the job. (weather, wackos, and weirdos) I decided nursing school was right for me. More respect, better education, a controlled environment...Like Doczilla, I just didn't want to piddle away my life in some cramped supervisor's office wondering what the hell happened. I want to have something more to show for my education. I plan on still being on the job, at least part time or per diem, for a few years to help pay off some student loans. Then however, I don't know. It makes me kind of sad to realize that one day I leave behind something that has been a huge part of my life for nearly 6 years. I can't imagine how those of you who have been in longer felt. At some point though, you have to make the decision that is right for you.

Damn I thought this was going to be more exciting :-) lol.

Has she had the urge to evacuate her bowels any other time than right now? If so color, formed or soft? Current med (prescription, otc, herbal and illicit), med hx. other than pregnancies. What was going on prior to the call to 911? trauma? Can't think of anything else at the moment, eatin my lunch

You will get what you pay for.

"Piss on you, I work for Mel Brooks!!!" -Blazing Saddles "I hate it when I get my Schwartz twisted!!" -Spaceballs "I say, what are those things coming out of her nose?" "Spaceballs!!" "Oh $%^&, there goes the planet!" -Spaceballs

"Punnin on na Witz!!!!" http://www.youtube.com/watch?v=VH2nQHPs4aA

"He's a eunuch....he's a eunuch...he's dead!!" History of the World

Any prescription or OTC drugs? Any drug use besides cigarettes and beer? Family hx of cardiac problems? Lung sounds, heart sounds, any nausea and vomiting? Diahrrea? Stomach pain? Temperature? Agree with Ruff, what was he doing prior to this? Let's get a 12 lead, place on O2

My brother has since moved on, he and I now work at the same company, which is just starting out and is half volley half paid. He did tell them where to stick it when they asked him to rewrite the PCR, and they tried to withhold his paycheck. Luckily he has friends in high places and contacted a member of the local Regional Medical Council, who contacted the owner of the company. He was vacationing in Florida and didn't appreciate the interruption on the 18th hole lol. As for the ALS interface portion, the field providers have all voiced their opposition to this, it's not something we're forced to do, but it's something that many of us will never do. As I said, we are just starting out as a company and many of us have worked hard to form good relations with neighboring squads. It would be a shame to see the relationships ruined so quickly, just because of a little greed.

If and when we do interfacility transports we do bill for them. The agency I currently work for doesn't do interfacility transports, though we have been cleared by the local ER to do them.

I used to be of the opinion that if any patient had questions about billing policies, they could contact our billing department. This was when I was fairly new, didn't know how billing happened or how much rates were. Now however, I can ballpark an estimate for them on the spot, and if they ask I will tell them what the costs may be. I have had several rather unpleasant experiences when it comes to billing. Recently the head of the BOD where I work suggested that when we do ALS interfaces with neighboring agencies, we should advocate that we should transport so we can bill for mileage (something I refuse to do, I'm not playing musical stretchers on the side of the road) My brother also had an experience at his previous place of employment where he was asked to rewrite a PCR because he said the pt ambulated under her own power to the stretcher. He was asked to rewrite it so it read that she was placed on the stretcher, in order to be more certain that Medicaid would cover it. Fraud at its best.

IV saline lock. Don't need to get too excited at this point. Locally I only have access to toradol or morphine for pain. With the unknown etiology of this pain (bleeder or not a bleeder) I'd opt for morphine rather than toradol. Does the community hospital have a CT? If not I'd say the closest hospital that does. If the community hospital does indeed have CT, the patient is stable enough to go there.

Let's consider a brain bleed. Any recent falls? How long ago was the accident? Any neck stiffness? Nausea/vomiting? Cardiac monitor, IV, O2, nice easy transport to the hospital, pain management enroute.

I don't even know locally of any degree programs the likes of which are being mentioned here. I'm in my last year of an Associate's program (thank god!!) and plan to head on to a Bachelor's in the very near future. The school I currently attend is looking to add a Bachelor's program for nursing, if that's any indication of where the profession is heading.

Well we went back to see the doctor...the ventricle size has decreased, brain to skull ratio has remained the same or decreased as well.. All in all, the doctor says this is what he wants to see happen. :-) It's still a wait and see scenario, and we won't know if anything is effected until after she is born, but this is good news. Thank you all so much for the prayers and well wishes. I'll post pictures when she's born...:-)

With the new onset of a-fib I'm more inclined to lean toward a cardiac condition than a heat related one. What is his normal BP? (If he knew it that is?) Any improvment in his condition after ASA, O2 and the fluid bolus?

As others have mentioned, make sure this is something that you really and truly want to do. Research it thoroughly before you jump into it. I at one point wanted to make EMS a permanent career, but after being in it for only 5 years I've seen that this isn't really something I want to do full time for the rest of my life. I decided on nursing school due to the availability of work , and also decent pay and benefits. Keep in mind, whatever decision you make it is your and yours alone. Do what is best for you and your family, and you won't go wrong.

It's like any rule or policy, enforce it all the time for everyone, or do away with it. It does no good for little kids, (white, black, or mauve) to hear someone say "You can't say this word." Just to hear it uttered by people who are supposed to advocate tolerance.

My wife and I are expecting our first child in November. We're very excited, but recently were told we were to go see a perinatologist due to a finding of ventriculomegaly (enlargement of the ventricles in the baby's brain) on our most recent ultrasound. I've done some research into this, found many instances of good and bad, and just was wondering if anyone has personal experience with this finding. What type of outcome was experienced? What complications? The perinatologist we spoke to didn't impress me much, he didn't even bother to read the prior U/S report from our doctor, and seemed to insist to us that the baby may have Down's Syndrome, though he did no karotyping or other tests to back this up. At this point it is a wait and see scenario, and only serial ultrasounds will tell us if anything gets better or worse. But I guess I'm just looking for others who, like I mentioned, have experienced this type of thing before.

I wouldn't get a medic alert bracelet unless you suffer from seizures, diabetes, or in some cases asthma. I would however carry around a list of your medications, with your pertinent medical history written on it. For your home, there is an excellent program called the Vial of Life project. This program provides you, free of charge, with a prefab medication list to place on your refrigerator, and a decal to place on your front door. EMS providers responding to your home will see the decal, and know a med list is on your refrigerator in case you are unresponsive and alone. You can check out their website to see if there is an affiliate near you, if there isn't you can print out the forms from their website. www.vialoflife.com

Was she wearing a seatbelt? Airbag deployment? How fast was she going and what did she hit? Don't know if I would have been so keen to backboard her, accident happened prior and she's obviously agitated already. Any LOC? Suspect rib/sternal fx, aneurysm...Any hx of hypertension with a BP that high?