ptemt

I am not going to argue the point with you guys, just looking for your opinion. In my opinion a t-shirt is not a professional substitute for a uniform shirt. I know many will disagree, but I cant imagine my neurosurgeon examining me in his office while wearing a t-shirt that has "Surgeon" printed on the back in 6inch letters.

What are your thoughts ?

You have failed your original post by arguing "the point" on pages three and four of the thread. Can I trust anything you say?

Thanks for sharing! I note that the confusion of Le France is not missed.

I don't suggest it if there is an alternative route. I had to reprimand an employee as it is not a routine route of D50w. If they are able to eat, drink, why not give oral glucose or high protein food?

R/r 911

Indeed! My original question though was which would increase BGL quicker, oral paste or D50?

Because if someone is breaking the law they need to live with their choices.

Have you ever slowed down to the speed limit or below it in response to someone flashing their lights, or if you are speeding and someone flashes their lights do you just continue to speed and live with your choice?

Shock

Shock breeds shock. Without oxygen delivery to the cells and CO2 being removed, they go from aerobic to anaerobic metabolism resulting in lactic acid build up. The sodium/potassium pump fails leading to potassium moving out of the cell and sodium moving in. Excess sodium in the cell leads to cellular swelling and lysing of the cell. Potassium moving out leads to hyperkalemia and cardiac dysrhythmias.

As I recall anyway.

Here is another thread on this topic from a year ago.

http://www.emtcity.com/phpBB2/viewtopic.ph...&highlight=

Dennis Edgerly, the author of the article, runs the HealthOne EMS paramedic education program in Denver. HealthOne is associated with Swedish Medical center in Englewood, CO. The program is accredited and can lead to an associates degree through Arapahoe Community College (local), those are the objective facts. Subjectively, Dennis is an excellent, motivated educator. Look for him at regional EMS conferences as a speaker. I have just completed his didactic program and am now in the field internship phase, and looking forward to a late June completion and NREMT exam.

I had a medic school clinical at the "home" today, now I can't get this Little Feat classic out of my head!

Paul Barrere, Gabriel Paul Barrere

Off our rockers, actin' crazy

With the right medication we won't be lazy

Doin' the old folks boogie

Down on the farm

Wheelchairs, they was locked arm in arm

Paired off pacemakers with matchin' alarms

Gives us jus' one more chance

To spin one more yarn

And you know that you're over the hill

When your mind makes a promise that your body can't fill

Doin' the old folks boogie

And boogie we will

'Cause to us the thought's as good as a thrill

Back at the home,

No time is your own,

Facillities there, they're all out on loan

The bank forclose, and your bankruptcy shows

And your credit creeps to an all-time low

So you know, that you're over the hill

When your mind makes a promise that your body can't fill

Try and get a rise from an atrophied muscle,

And the nerves in your thigh just quivers and fizzles

So you know, that you're over the hill

When your mind makes a promise that your body can't

Her original post says that the partner gave the pt a spray of nitro and off they went, with no IV access established.

I wouldn't give nitro with a BP that low and a patient looking utterly like crap... perhaps I need some more education as to nitro use however.

Would you give nitro in an unstable MI with a systolic BP above 100 for pain relief? Or would you give something else, like morphine? Why?

Wendy

CO EMT-B

With right ventricle MI, giving nitro could be detrimental due to the vasoldilation reducing preload and making the heart more ischemic. Better have an IV first and be ready to challenge with volume.

I trust a member of the COE will slap me straight.

I took my NAEMT tie clip and cut off the "NAEMT" part leaving just the star of life and then pinned it to the back portion of the soft top on my heep. You have to be standing behind the jeep and looking close to see it.

Mosbys's text says 0.5 mg IVP every 3-5 min for desired response with a max total of 3 mg. It is what they are teaching us for symptomatic bradycardia.

You could try making it more interesting by challenging her to palpate your bilateral femoral pulses when you wink at her..........could be an http in it if you use your imaginations.

I think that question meant to imply the author knows you do not carry it in the ambulance for sure, but still wants you to ask about tetanus vaccination (so you can give a better report at the ER and save nurse time?) or for cases where patient does not want transport, you can inform him of the need for the vaccination or a booster.

Why is it important to ask about a vaccinate we don't carry.

"I believe the intent was to "think" outside the box. I personally never heard or recommend Tetanus injections in the field as routine care. Again, hopefully to educate and expand on wound care and the possible illnesses associated.

R/r 911"

I think Rid and Anthony drilled it. Thanks everyone for giving this topic a shot.

I think it means that the paramedics should have current tetanus shots. No reason in the field to give them to people.

page 554

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Critical Thinking

Why is it crucial for you to be knowledgeable about and to ask the patient about tetanus vaccination if the vaccine is not carried on your ambulance?

----------------------------------------------------------------------------------------------------------------

It just got me wondering if anyone has it in their protocol.

Mosby's third edition revised paramedic text seems to suggest that some ems systems have tetanus shots in their protocol. Mine does not, does your's? Please post yes or no and where you are located if the answer is yes before delving into any controversy.

Thanks

I feel that being in a class uniform puts you in a more appropriate mindset when running scenarios.

You want to elect someone for something and don't even know what the topic is?

I must say on this one, I believe I agree with vs-eh, I'm going to go back and re-read everything again, then I will post my opinion for certian, but as it stands now, I agree with VS.

My point was to get the thread back on track as it seems to have drifted quite a bit. I want to thank you though for the good chuckle this morning.

"I must say on this one, I believe I agree with vs-eh, I'm going to go back and re-read everything again, then I will post my opinion for certian, but as it stands now, I agree with VS."

I nominate fellow Coloradan and EMT-B, Wendy "Eydawn" for a seat on the Council of Elders!

well, none of these really answered my question, this has become a place for shameless bickering. well, nevermind I will ask someone else this question

Give it a year as a basic to see if you like it. If in that time you realize that "hey, I want to be a medic too," then go for it. In the Denver area we have programs that require both one year emt experience and A&P I and II. We also have programs that require neither. I just took entry exams for a local school that requires one year of work, A&P I&II, IV and EKG basic. I have a year and a half in as a basic and know that I want to commit to the next step.

Or as Master Po said;

"When you can snatch the pebble......then you are ready."

Master Po also said;

"When you can walk the rice paper and leave no mark..........then you are ready."

Try not to get frustrated by the COE on this board, just sift out the chaff and find your own path.

He is the "council" in the "Council of Elders".............. errr he is the elder in the "Council of Elders"

AZCEP,

Thanks for staying on topic.

Lots of other more or less interesting, informative and entertaining replies as to be expected.

The patient was at BGL of 27. On scene drank an amp, ate part of a swiss and roast beef sandwich, some OJ and a pepsi with no significant improvement up to BGL 35. On the way one tube oral plus one amp IVP and another amp in the ER. Full recovery with mention of some "bad insulin."

I am really just wondering if drinking D50 is quicker than the paste inside the cheek or swallowed.

First off, I did use the search feature and quickly found that "drinking" is found in numerous threads unrelated to my question.

For a patient with BGL < 40, able to follow commands and swallow, currently without venous access, which will boost blood sugar levels quicker, oral glucose or drinking an ampule of D50?

Thanks

In

Advance

Hi Wendy,

You might try recruiting at HealthONE in Englewood for recent EMT-B graduates or medics. Six out of seven days for two months could be a hard sell for someone currently employed with a family. There were lots of young folk in the program when I went through two years ago that I suspect would have jumped at the chance. Put the job in the EMT jobs link above.

Good luck!

Thanks everyone! My practicals have been delayed due to a snowstorm, but this Wednesday they are on again!

Its funny you mention it, but yes, I have CEUs lined up already for this month and am looking into intermediate or paramedic class for 2008... my age still concerns me there so we will see.

Thanks again,

SARgal

Good luck to you on Wednesday. From reports I hear all of the youngsters in my emt class of two years ago have washed out to other occupations. After completing A&P I intend to be in a paramedic program in January of '08. I'll be 49 when I sit for the NR.

Well done! Now get a job and start collecting CE's as two years rolls around quicker than it used to.