Kaisu

I am glad to see that she is suing. This is another example of the law trying to catch up with technology. I hope both sides decide to fight it. I would like to see a precedent set. Nursing is a tough racket - lord knows those of us in EMS have had our run ins with nurses. Nursing and EMS seems to attract diametrically opposed personality types. This girl was an army medic and appears to be of a type that those of us in EMS are very familiar with. Conflict between her and her fellow students was inevitable. Add in a nursing administrative supervisor and the pot will indeed boil over. Interesting indeed. PS - edited to replace "pull over" with "boil over" - Freudian slip :-)

considerate of her to save him the time, hassle and expense of divorce.....

Welcome Tyler. I hope you find the site useful to you. I am a baby medic too!. Graduated in May of 08. Currently working in Western Arizona, doing 48 hour shifts and running an average of 15 - 20 calls per shift. I am getting edumacated fast Love the job!

http://www.wfaa.com/sharedcontent/dws/wfaa...s.92b88044.html At some point, wouldn't you think SOMEONE would go the extra mile and do something about this - call APS, a social worker, something. I know its an issue we all face and I have developed some strategies to deal with these patients. Social services are woefully inadequate in this state, but there are things we can do for the homeless, drug addicted and alcoholic patient. What are some things that we can do?

Kid was weighed at the hospital... 6lbs 8 ounces. I estimated the kid at 6lbs. for total fluid bolus of 50ml. The child had arrested and I did not want him to arrest again. The call came up at run review and the consensus was that it was a good call with things done right. It was the first of my cases to come up for review and it was gratifying. I still run every call through my mental databases and the ones that I need help with I talk to you folks. Thank you for being there.

Thanks so much for the responses. To answer your questions, no on the lido... barbaric I know but in this backwoods part of the country, (Western Arizona) our esteemed medical director ignores standard of care in most parts of the country to go his own way. He pulled lido OUT of our protocols for I/O flush. In all honesty, with how sick that child was, the response I got when I pushed the first 20ml in was welcome. That stimulation did the baby a world of good. Regarding re-aspiration, that might have been an option. I had a very short transport time, and the leg did not begin to get red until seconds before arrival at the ED so I did not consider it. The child was admitted to the regional hospital, stayed 2 days and was released. No NICU at this hospital. Thanks again for the input.

congrats on quitting smoking. It gets easier every day and you will not regret it. Bet your medical problems improve too. All the best to you

Hey there. I have a question for you. First the facts - 2 1/2 week old newborn, born 5 1/2 weeks early in full arrest. Bystander provides effective 2-15 CPR. On our arrival, patient has a heartbeat and is cyanotic. We apply high flow O2, get some info, scoop the kid up and run. In the ambulance, the child improves, now pale centrally, mottled extremities and delayed cap refill. I put in an EZ-I/O into the right tibial plateau and begin administration of fluid. On arrival, the child is pink, spontaneous eye opening and crying. Now the question - When I drilled the I/O, I aspirated marrow. 50ml of NS went in hard. I used a 20ml syringe and really had to push it. There was no effusion to the back of the leg and the kid definitely improved. However, on arrival at the hospital, the leg was turning red. No swelling, just a significant color change different from the rest of the skin color. The I/O was pulled by nursing staff before x-rays to verify positioning. (they spent another 45 minutes getting a line - we didn't have 45 minutes. ) My question - what would have caused this leg to turn red? Any ideas? (PS - the I/O was firm - it did not dislodge.)

awww.. gosh... thank you so much you guys. I haven't been online much... busy renovating.. I miss you all. It means a lot to me that you would post. I'll be back when things settle down a little. All the best to all of you...

underlying is sinus with a sinus pause and an escaoe rythym - possibly junctional....

Yep - Canadian paramedic.... it was ugly for a while... she's back and in action now.

HEY - I do some of my best work on my knees :-P

Hey Phil - I had an ACL recon in 2007 and two meniscus surgeries last year. PM me and we will exchange war stories. I also have some web sites for knees that may be useful. Take care.

I didn't know you were sick Phil. Get better you sick b*****d. We miss your filthy mind.

I don't know who number one is(was), but my paramedic instructor in WI, Jeffery B. Clarke, is #5 nationally registered. He is number 2 in Wisconsin, which still burns his ass because he taught the class that he also graduated from. One of his students has a last name that starts with B - so state gave the student #1 and the instructor was stuck with #2.

I am on the second half of a 48 hour shift. Our crew of 3 (1 EMT/1 Paramedic on each of 3 rigs) ran 30 calls the first 24 and are well on our way to another 30 today. I am still new enough that I LOVE the experience. I'm not a fan of recliner time - I get paid to run calls and I like them. I converted a patient from vtach to sinus, diagnosed a DVT, overruled fire when they wanted to take a refusal (they wanted to get back to the superbowl) and transported the patient, was the only person on scene (with my partner) able to talk a drunken rape victim to accompany us to the hospital, and 14 other calls of various severity. I also found out that a 17 year medic with the company is walking away from his 3 years to go to get 20 because he just can't take the meat grinder anymore. I was shocked and saddened because he is my goto guy on this shift. The input I would appreciate from all of you is: 1- what kind of career longevity can I expect if I continue this? 2- what is the value of the experience I am gaining with tons of calls vs. the risks of running with this kind of volume? 3- should I start planning an exit strategy? 4- I love this job - what else can I do if you think the answer to 3 is yes? Any of your comments would be greatly appreciated.

I use Informed Emergency and Critical Care ACLS version. PS .. I also like it for Hemodynamics and blood labs for my long distance transfer patients.

I use mine to look up patient meds that are unfamiliar. I find that is super useful.

I ran in a hospital based EMS system. We were the only paramedic service in the two largest counties - one in Wisconsin, the other in Michigan. We were a dual medic system that ran in transporting rigs UNLESS BLS services in either of the counties requested a paramedic intercept. We jumped into the intercept car, which was a souped up station wagon. Our gear was kit based, and the wagon had the peds bag, trauma bag, airway bag, drug box, monitor/defib and an infusion pump. We would haul towards the BLS rig. When we met up with them, each paramedic would grab some gear and we would hop into the back of the BLS rig. One of the EMTs would jump into our intercept vehicle. The other EMT would drive the ambulance. The system worked great. Two paramedics in the back of the rig working on the critical patient, and an EMT driving the ambulance and the intercept vehicle. I currently work in a EMT/paramedic rig in Arizona. Supervisors will respond with us on calls that sound like an extra pair of hands will be useful. I will always prefer dual paramedic rigs, but this is the best we can provide in this area at this time.

I don't know about other states, but here in Arizona, as a paramedic, I am obligated to report abuse or neglect if I suspect it. If I don't report it, it is a felony. The answer to your question is yes, I have reported, and no, I did not do it anonymously. (as a matter of fact, it took about 6 phone calls to make sure the report was taken and acted on.)

I remember a 6th grade broom ball game. Our small rural school (Jumbo Gardens ) played an even smaller rural school (5 Mile). I was a shy, alienated kid who was teacher's pet but humiliated on a daily basis by my classmates. We were not an athletic school. A few days before the match, we had our first practice. To my and everyone else s utter surprise, the game brought out reserves of aggression, speed and strength that no-one else, including me, knew were in me. I scored the only goal in practice and got some of the first kind words from peers in my elementary school career. On the day of the game, I was on fire. I scored 4 goals in the first quarter. The other team had none. I was a little embarrassed when I realized I had cross checked a very nice girl right into the spectators. I helped her up. I wasn't penalized because the other team was hacking at my ankles with their broomsticks in a futile effort to bring me down. After the 4th goal, the coach pulled me out of the game. I couldn't figure out what I had done wrong but I was partially relieved that I no longer had to make such heroic efforts. The game ended 4-0. It remains one of the few bright spots in my childhood. I was walking on air. The coach prevented a blowout. The other school had some solace in the fact that they were as good (or as bad) as the others on the team. It wasn't until I read these postings that I finally understand, 30 plus years later, why I was pulled out of the game. PS - I'm old - I'm allowed to tell long boring stories from back in the day. :wink:

My very first PNB was 3 1/2 months old. I took a great deal of comfort in knowing that everything that could have been done for the child was done and done right. I don't believe anyone of us deals with the loss of a pediatric patient easily. If you had not been affected, there would be something seriously wrong with you. You are not having a moment of weakness. You are responding in a normal way to the event. It is very common to have images, dreams, thoughts, etc. coming back to you. It is also common to have an "avoidance reaction" whereby you avoid things that remind you of the incident. After my first autopsies, I did not want to watch Dr. G medical examiner for example. Our western society does not have effective cultural ways of dealing with death. The vast majority of people get a ritualized, antiseptic experience. Those of us in EMS see it in all it's dirty, messy detail. I have some specific strategies for dealing with it. First and foremost, I take care of myself. I use the HALT mnemonic. I ask myself if I am Hungry, Angry, Lonely or Tired. Often, if I am having difficulty, I will answer in the affirmative to at least one and usually more of these. I take care of hunger by eating, anger with physical exercise, loneliness by reaching out to loved ones and tiredness by resting. This effectively deals with 90% of the situation. I do know that if I don't take care of these things first, nothing else will be effective in coping. I also rely on the triad of physical, emotional and spiritual. Take care of the body, the mind and the spirit. The foregoing notwithstanding, I will never forget that little baby, but I can think of him now with acceptance and peace. Good luck to you. I hope you are feeling better.

Definitely will not be shown in the US

as I've stated before crotch... I really like your style. I would miss you if you weren't here and I always enjoy your posts.

a woman with a prolapsed uterus after childbirth will bleed to death... we were taught in paramedic school to push it back in.....