spenac

Never heard of any place with more wrecks than just plain BS calls.

epilepsy

entropy ( reposted because it was ignored earlier )

We did use SECURE IV, they suck. http://www.spanamerica.com/siv/instruction.html We had them in all sizes so not just a bad box. You actually could see the catheter tube bunching up on the needle as you inserted IV. Thankfully we switched. I sure miss the old no safety IV's.

entropy

Where J&J are talking about all the areas nurses touch lives. Nurse in ambulance was if remember was going to intubate. Also nurse at motorcyle wreck.

At least its not as stupid as the nurse in the J&J commercial working in the ambulance.

That sucks. Fire has no business in EMS. The facts to back that have been discussed way to often for me to rehash.

In a court of law the question asked will be what is the standard of care. If you answer I do it based on what I feel is appropriate you will lose. The lawyer will show you were not acting in accord with the accepted standard which will be PHTLS or equal for trauma. Now if you are accused and asked why you removed clothes and you produce the book to back your reason, you have proven that you have done what is standard care. Obviously we want to protect peoples privacy, but we must do a complete professional exam to avoid risk of negligent care.

Welcome to the city thats always off track. :wink:

empathy

The 1999 PHTLS book page 44 talking about trauma says "At some time during the evaluation of the patient, all the patient's clothes must be removed and the patient rolled to examine the entire body." " Critical to finding all the injuries". " The EMT should not be afraid to remove clothing" Page 46 says "See, don't just look. Hear, don't just listen. Feel, don't just touch."

concavity

Me thinks that Richard either watches lots of movies several times or has a photographic memory.

This is where you need a reputation of always using the same method. Use the same steps with all patients and document each step. I had one OB patient ask the nurse if I was supposed to have examined her and the nurse said yes all OB patients require an exam. The nurse new my routine. That was as far as it went. Had I had a rep of sometimes checking sometimes not would have been easier to have had the nurse say no and perhaps I would have faced an investigation. So main point do not neglect a complete exam. Verbalize what you are doing and document it.

I've been called for stubbed toe. I've been called to give them a ride to the store 90 miles away. Denied transport to both.

With that info I would feel they were unable to protect their airway and so a basic would not administer anything orally.

Extremely true. It also helps in case you are sued or accused of wrong doing. What gets people in trouble they always get to hospital with the hot girl exposed but given same trauma the ugly chick is still clothed. If you do something by a methodical method you don't get distracted by anything and you complete a proper exam on all patients. Your work mates and the people at the hospital become used to the fact that you are consistent and complete in your exams. People trust you because they know that if something happened they would hope you would be the one to examine and treat them.

Having always been rural and your doing good if you can get 1 cop to help it just shocks me the thought of so many resources at one spot.

Dang Richard thats a lot of equipment tied up for 1 patient. Me thinks maybe overkill happens in New York.

Perhaps your description of what you feel might give the doctor the clue that something serious is up. Don't be bashful and never doubt the input you might give even as a basic. I have had a female complaining of pain to a breast. In palpating compared to the other found a hot spot. Doctor met me as I wheeled patient in and patient started getting immediate treatment. Had I just said patient complains of breast pain/ non cardiac related she would have waited hours to be seen. I do not know full details but she was admitted to the hospital. So that little tid bit that causes no changes in my care can get patients much needed care quicker.

I guess I owe a lot to the vollys that taught me my FR and Basic. First night of class we started doing hands on. I have never had a problem checking a patient. If in doubt I remove more or even fully expose to make sure I miss nothing obvious. I palpate, auscultate. etc. There is nothing to fear about skin. If you chose healthcare embrace it.

Ruff and ERDoc we need your insite on this topic: http://www.emtcity.com/phpBB2/viewtopic.ph...&highlight=

episiotomy