Kaisu

... if you run out of a burning structure and grab a puppy ... for the photo op

Great pic squint. I have a rott/pitt mix that was my brothers dog. He almost got himself shot by the cops when he refused to leave my brother's body. He is my dog now. Loyal, smart and great protector. He is 80 lbs of muscle. The vet nearly fell off his chair when he weighed him cause he don't look that big. I have a 50 lb female staffordshire/pit mix. She was found starving and shivering in a corner, her tail broken in 3 places. Sweetest tempered dog I have ever known. Happy and joyful. I wonder daily how she can be so loving after what people did to her. I have a purebred doberman. She's a tool :-) I have a half mastiff mix. He is a wonderful otteman. I have a shepherd/malemute mix. Also a rescue dog, he is a tad neurotic, but also smart and loving. It sounds like a lot of dogs, and I guess it is. I am undisputed ruler of the pack and rarely have to raise my voice. I love them all very much.

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The EMS Gods smile on those that consistently do their job at as high a level of proficiency, caring and effort as possible. The outcome was good - the sphincter constriction on what might have happened will help you keep your edge. Great story - thanks for sharing.

On one of my first calls, I slammed a guy with 2.0 of narcan. I didn't mean to... I put it slowly into the lock, then flushed fast. I know - dumb dumb dumb. I was new and out of my depth - thrown to the wolves fresh out of school. The patient was a male in his 50s with a combination narc OD and a lot of alcohol. The mountain of puke that ensued just wouldn't stop. It bought the patient a tube in the ER and a doctor that took a strip off my hide. I felt so terrible. I had caused that patient a horribly invasive procedure. (The outcome was good - he was extubated with no complications about 3 hours later.) I never forgot it and learned my lesson about narcan.

Squint I am soooo elated to see you. Man - sounds like you've run into a shit storm my friend. My brother offed himself 2 years ago. It certainly shakes us out of our ruts doesn't it? After he died, I just couldn't do it anymore. Every dead body I ever saw started running through my feeble little mind. Everybody I loved became a dead body in my brain. The joy of the job went out of me. My husband is a Vietnam combat vet. He was in Hue during Tet at the end of an impossible to believe people could survive tour. I have a PTSD diagnosis from childhood. Guess what? You learn to cope. You heal. My credo is that grass grows through concrete. Life is about growth and reaching for the sun. Even if you do nothing but just keep breathing from one day to the next, if a person gets some space and light, they heal. I am in school again and loving it. Once again, it is great to see you again

I was absolutely shocked when I read the first few responses to this post. It's not warm and fuzzy and PC to avoid defamation and insults. It's human decency, empathy and emotional maturity. I challenge anyone of us to spend a few hours in this woman's wheels.

Every time the protocol police lost their minds and made a fuss, the medical director backed me. It did nothing to improve my popularity. I felt more and more isolated. I figured it was only a matter of time before I made a mistake and the sharks swarmed in for the kill. I guess I am still hurting.

I went back to school because I love to learn things. I know that there is so much about medicine that we don't know. I lost interest in EMS when the really cool things I was learning about medicine either were of no use to me in the field (protocols, short transport times, etc.) or painted a target on my back because I didn't fit in with the herd. Room temperature IQs that had memorized the protocols advanced in the ranks and perpetuated the stupidity. Refusing to backboard kyophotic geriatrics for their slip and falls on the carpet had me dodging bullets. I loved the field. The field did not love me back.

As usual Chbear... nice scenario and interesting info...

It's the first thing to check with altered mental status given that vitals and ECG are off the table. The only beta blocker OD I have run on was an adult. Initially alert with stable vitals she dumped fast - hypotensive, bradycardic and then lethargic and finally comatose. Are you educating us to the fact that kids are different? Is hypoglycemia something that happens to kids in beta blocker OD?

Blood glucose?

In this teaching scenario In my tiny little brain - beta blocker OD is treated with glucagon. Altered mental status has to be caused by something and if it is a beta blocker OD then it stands to reason there are changes in the ECG and related vital signs. What does the ECG look like? and the vitals? and the kid? how does the kid look?

I guess stupid people that lack pediatric assessment skills would find the helicopter necessary

Good to see you and congrats on the excellent ACP result. You worked hard and your patients will benefit. Fresh out of school I was cast to the wilds of Western Arizona to sink or swim. I don't know what I would have done without the wonderful people on this site. They would pat me on the back or kick me in the ass as I earned it. There was nowhere else I could turn to for good clinical advise (and terrible personal - jk). I look forward to your postings.