CBEMT

My gf has had her meniscusi(?) scoped on both sides, about a year apart. Unfortunately she did not have formal PT after the first one due to an insurance issue, which likely led to the second. The second one did not apparently indicate formal PT. After the first one, she was up and around that day. Turns out she was still getting residual benefits from the morphine given at the hospital- boy did she pay for it the next day! Ultimately she fully expects to need bilateral total knee replacements before she's 60. Who knew high school softball could be such a violent sport. :shock:

Coulda sworn I already wrote a post on this topic....

"No thanks, we're full..." *BURP* :pukeright:

Pretty much what I'm trying to do now- I'm organizing a refresher for my FT job. These kids sit in lectures all week. The last thing they need is me standing in front of them droning on about crap they already heard at least once before. My goal is more of a seminar-style experience. My primary materials are going to be all the protocols that the state updated in 2007 and the research that's come out since they took their initial EMT course.

Well, I hope she followed local protocol. If, like mine, they don't specify a technique, I hope she followed current PHTLS recommendations. And used a tourniquet if direct pressure to the wound failed to tamponade the bleed.

Compared to this? You better believe it.

HPI PE TX (most of which can be referred to the Treatment section of the run form) [HPI] EMS dispatched --> above loc. for "Chest Pain." Pt c/o 5/10 sharp stabbing [L] C/P "all day." (-) radiation, (-) trauma, (+) SOB due to pain. Pt denies n/v/d, h/a, dizziness/lightheadedness, recent travel, or med [changes]. Hx/Rx as noted. Pt compliant w/ meds, took no additional meds prior to EMS arrival. (-)Recent illness, travel, or med [changes]. Last intake- breakfast. [PE] 52 y/o [male] seated in chair, rubbing chest occasionally but otherwise NAD. (-) JVD, trachea midline. Skin warm/dry/pink. Lung sounds- clear bilat. Abd soft/ non-tender. LE's unremarkable, (-) edema. PMS (+) x4. Vitals as noted. ECG- NSR (-) ectopy (-) STEMI. [Tx] Pt -->stairchair-->stretcher--Truck-->ABC ED. Monitor, IV as noted, O2 4 lpm via nc. ASA/NTG as noted. Care/reports t/f -->ABC ED staff [without] incidents. [Changes] as noted. Time HR R BP Treatment Results/Comments 13:45 90 16 150/90 Vitals, Stairchair, ASA x4 @ 81mg S PO2 98% @ RA 13:55 92 16 148/90 O2, ECG, IV, T/P, NTG x1 SL 1/150 Pain 5/10 -->3/10 14:00 86 16 128/80 Monitor Pt, NTG x1 SL 1/150 Pain 3/10 --> 1/10 14:05 86 16 110/76 Monitor Pt Arrival Endotracheal Intubation Intravenous Therapy Tube Size Attempts Gauge Attempts Flow Rate Lines (-) (-) 18g L AC 1 200cc--> KVO 1 Can't really express the format here but hopefully you get the idea.

So.... it's a video version of the paper that we talked about here months ago?

In the urban area nearest me, they're too busy to have posting locations. They'd never make it to them. That said, however, they are fire-based, and therefore have a station to go back to, typically between the hours of 0300-0600. Outside of that, not much chance of ever seeing it.

Massachusetts State Police (Academy only) Mattapoisett, MA Police/EMS

Oral glucose if able, Glucagon if not. Mind you, I haven't had a pregnant woman needing any pharmacological intervention at all save for LR during a transfer *knock on wood,* but that is what we're taught.

I know what you're talking about, and I know that FDNY totally screwed the merger, but I have a hard time believing it's as bad as that guy makes it out to be. You'd think a firefighter stole his wife or something.

And the Northeast. It's not part of their classes but the class and license for ETT in respiratory or cardiorespiratory arrest can be obtained as an add-on after they receive their license to practice. Until 2007 Basics could also obtain "EMT-D" licensure and be allowed to manually defibrillate VF/pulseless VT. EMT-D was more common prior to the advent of AEDs though. I only know of one or two people that got it. Going "all the way" and completing our half-assed, non-Paramedic ALS level of licensure was/is far more common than EMT-D.

We were taught that it should not be administered to pregnant women.

Last year a NJ statie arrested a fire chief for the exact same thing. No lawsuit though. The way the laws are written, he apparently has that right, and state PD policy is the trooper will re-open the road. Period, end of sentence.

Why, because you say so? How delightfully elementary school of you. Withholding pain management from undifferentiated abdominal pain was, formerly, justified by the desire to "not obscure the exam." Then you say "Primarily, you are screwing up the lab results that ALS or the ER is going to be wanting soon..." Your words, not mine.

My first two pairs of pants as an EMT were Dockers. They both ripped down the seat, during a shift, at about the 6-month mark. Haven't had a pair of BDUs fail on me since (I don't get the ones with shear holders).

The point is, are you saying that you routinely give D50 to pregnant women?

Isn't that like withholding pain management from the abdominal pain patient?

The chances of me even getting through the 150 before hitting the hospital is slim, even at the PT job. FT, if I even have time to get it on the pump something is seriously wrong. The ER can hang the rest of it. I need to be carrying 450mg. And since my service doesn't have a pump yet, I can't even do the drip so all I need is 300mg for the arrest IVP dose.

Actually I was thinking that they want to eliminate EMS agencies and give the jobs to firefighters so they can do things like support winning candidates like Christopher Dodd, but ok. :wink:

Agreed. Epic Fail!

You're kidding, right?

That's not necessarily what he's talking about. For example, our Basics have Glucagon on standing order for any hypoglycemic unable to accept oral glucose.

I believe it's open, not closed, chest wound that precludes MAST, but CPR in progress is ABSOLUTELY a contraindication. Congratulations, your post just became Exhibit A. We teach "Vowels in the MIST." Adjunct to CPR Edema (Pulmonary) Isolated extremity fracture without shock Open chest wound "U pregnant?" Myocardial Infarct Shock (Cardiogenic) Tamponade (Cardiac)