spenac

And a small steady bleed becomes a gusher if you push to much fluids. It is important to treat eac patient based on what you see happening. If the doctor disagrees, listens to his points, but then still make the best decision based on what you see on your next patient. In fact had this patient had a liter or 2 pushed and had died he would have said they should have just titrated fluids to maintain 90 systolic. So either way I think in this case doctor would say it was handled wrong. And conversly had the patient lived he might have said good call guys on not giving to fluid.

Biggest advice is try and learn something from every patient whether serious or complete BS. That way you will always keep improving rather than stagnating like sadly so many do.

These are the fun ones. The chest pain, the stroke symptoms, the possible overdose, which to treat first what fun. Then as mentioned this could be related to some infection. Really need an accurate temperature on her as well. Was urine cloudy? Close to the hospital might just do all the prep work such as 2 large bore IV's and a blood draw. Oxygen. Further out you might have to decide which way to start treating her understanding that treatments for one thing could cause more harm in the other. Such as treating the cardiac could make the stroke worse if she has a bleed. In my part time job 90 miles from the hospital we run into having to make the hard choice on patients that have multiple events happening. Sure glad you guys didn't walk her to the ambulance.

Explain to him that if he lies to you he will die when you start treatment. Then ask him again about meds including viagra, etc, and recreation drugs including xtasy. Any change in his response?

Decompression kits usually come with a 3"+ cath. Heres one with 3.25". http://www.narescue.com/Needle-Decompression-Kit-P18C2.aspx

Order of draw and basic info about each color. 1.) Blood cultures (yellow) SPS (sterile) 2.) Light blue (buffered sodium citrate tube) 3.) Red (plain), or Tiger-Top mottled red , Gold(gel separator tube) 4.) Green heparin and light green (sodium or lithium with or without separators) 5.) Lavender (EDTA) 6.) Pink, white, or royal blue (EDTA) 7.) Gray (Na flouride/potassium oxalate)(transport on ice) 8.) Dark blue (FDP)

The practice and policy of many services (but not a law or regulation at least no one provided such) that I think is utterly stupid is the you call we haul. It is time people get educated enough to make a few decisions on their own. It is time we deny transport to those that do not have a real need for ambulance transport.

Also sometime while one person is typing a response another person or two submits comments first. W/o the qoutes no one knows what the heck then the person w/o qoutes is addressing.

Actually if they do strike what better ammo at budget time to ask for a bigger piece of the pie by the fire department. Honestly they would be stupid not to use it in their budget negotions. Get the public concerned with misleading info- just look AMR left you with no one to save your loved ones, but we pulled extra shifts(fail to mention all the extra overtime made) to ensure you were safe. All the blue hairs would demand the leaders to pay fire more so that the ambulance would come. It works, and continues to work. Mislead the public and the money will come. I did not start this as a bash to fire I just stated a fact of how it will be used if the strike happens. Heck if another large private EMS is in the area they would be dumb not to play it up as well. But as fire has the bigger more powerful unions they will benefit the most.

Wow did you just blow a gasket? :shock: EMS as a whole does suck. As a whole it needs rebuilt, but the largest groups being Fire and AMR, refuse to allow it to progress. There are a few services insisting on people being truly competent, but most just want a warm body at a low price. Honestly if fire with it's all powerful unions pushed for improvements it would happen. I would still have a problem being forced to be a firefighter in order to be a healthcare professional. It makes no sense to me that two so very different professions are lumped together.

Now the fire departments will just use this to even get a larger piece of the pie.

Leave it, gift taxes would cost to much just for a penny. Leave my hole filled socks only worn last week.

Good job old man.

At my part time service we draw up the 4 tubes mentioned above. Then place in a lab bag that we have placed patient info on. Bag is then taped to IV bag unless we expect to have to change bags. Now some lab techs do not use our blood draws as they say the 90 mile trip is to long a delay. Other lab techs say no as long as agitated only the tube w/o additive might go bad. Hospital expects us to have a blood draw on any patient that we start a line on. A problem I have seen is some do not realize that you need to draw blood tubes in a certain order.

Suck it up and pay for proper medical care for the tax payers. http://www.politickernj.com/bguhl/25379/do...ostly-mandate-l By bguhl DOHERTY EXPRESSES CONCERNS THAT BILL PROPOSING EMT STANDARDS WILL BE ANOTHER COSTLY MANDATE FOR LOCAL COMMUNITIES Assemblyman Michael Doherty today said he is concerned that new legislation to be considered early next year proposing uniform standards for training and credentialing of New Jersey volunteer EMT’s will result in costly new mandates that will be borne by taxpayers in small communities across the state. “There is no question that we must ensure our Emergency Medical Services are being provided by properly trained individuals,” said Doherty, R-Warren and Hunterdon. “My concern is that this legislation will create a new level of bureaucracy and red tape for local EMS providers resulting in higher costs and that this will eventually be a cost that local communities cannot afford.” After a report issue last year raised concerns about the quality of services being provided by the state’s largely volunteer EMS system, the State Emergency Medical Services Council formed a committee to study the issue and that panel has sent draft legislation to the state Health Department aimed creating new training standards. No legislation has been introduced, and State Senator Joseph Vitale, the chairman of the Senate Health, Human Services and Senior Citizens Committee, told the Star-Ledger that legislative hearings will take place early next year to reach a “consensus” on the issue before a formal bill is introduced. “We need to make sure that we are not doing more harm than good by creating a new series of mandates so onerous that towns will no longer be able to provide these services,” Doherty said. “Rural and suburban New Jersey communities are already facing too many costly mandates from the state which ultimately hurt our taxpayers. We must be mindful that good intentions sometimes result in negative consequences.”

I wish Doc Bledsoe would arrange one of these here in Texas. Hint Hint, Paging Doctor Bledsoe.

Silenced by ERDoc is more like it. Catch you later admin.

Guess I like a real rare adrenalin pumper, of course been there so long I've forgotten how that feels. But I'm just as happy sitting back getting my paycheck not turning a wheel.

Wow this still exists. Thought I loc......................................

Why do all good educational experiences end up with everyone worshipping at the porcelain throne?

Why do you have such an item? That is just scary.

There was talk a couple years ago about changing the law. Don't know if it passed or not. Hey Arizona, I hear you. We used to take around 200 active labors a year the 90 miles to the hospital and 90% plus were illegals. I saw more vaginas in the back of the ambulance than if I went to ever strip club in Texas, of course they're all slimy and gross with aliens popping out so nothing appealing about that. I hate delivering in the back of the ambulance, when I delivered at the hospital much nicer, mainly because I left and let the nurses do the clean up. I do not miss that part of my old full time job. Of course now that I say that tomorrow when I'm there working part time I'll probably deliver another slimy creature, childbirths nasty gross, I don't know what people are watching when they say its a beautiful thing.

About 2 years ago we had a night where it sounded like the ambulance was getting pelted by large hail, but it was birds. We also hit 2 deer, a bunch of rabbits. By the end of that transport our amblance looked like it had been parked in a slaughter house, blood, fur, feathers, and even meat chunks. Never had a night like that before or since, was really like the animals and birds had decided to commit mass suicide.