ccmedoc

What is PEARL?? :?: To convert mmol/L to mg/dl....multiply mmol/L times 18..FYI for the Americans:lol:

Every 5 min by page. After 3 pages and no acknowledgement, a whole lot of police appear. Can be a pain in the butt. If we foresee extended time without contacting dispatch, we just radio we'll check and advise...Next contact must be initiated by us within 20 minutes or..... a whole lot of police appear...Not a bad system unless you forget to check back :oops:

Not a big fan of bustin hiney with a dead person in the back..We work for 20-25 minutes and only transport if ROSC or scene is dangerous. Do not transport L&S. We have fire first response and PD on all dead or presumed DOA. No waiting for coroner, only PD SGT. , and the body snatchers (body removal). I believe that this protocol of working in the field and pronouncing if dead does free up some needed resources, and keeps us onscene less than 40 minutes if no joy with the resuscitation.. If no ROSC in the field..I cannot see it in the ED.. Its never easy for the family, and often having the police and everybody else working hard for the person helps the family. They also can see the effort being put forth. All things help with the closure if they feel slightly involved..every little bit helps.

Not simply on the complaints...depends heavily on the assessment...there's that crazy word again..The most important of your job. :wink:

Its been my experience to have counselors (whether nurses, social workers, grief counselors, or psychologist) work with a psychiatrist in order to get more complete coverage. The patient case would be discussed between these parties for an effective plan of care. I would agree that most psychiatrists are not proficient in the "art" of talk therapy..and it is an art. They are, indeed, very medically oriented as a profession. But this need not be a bad thing.The extent of most of the interviews by psychiatrists I have been associated with are in depth and therapeutic enough to get a better eye on pharmacy. Both prescripton and maintenance. Just an opinion...Another is to stay away from so called CISD. Not very effective in my experience...IMHO :wink:

Without proper physical exam..not necessarily cutting the clothes off, but visualizing the areas of complaint in addition to other possible injury sites, PMS, LOC, etc...the need for c-collar, LBB, and full CID immobilization cannot be assertained. I agree that I do not haul the LBB and assorted toys for every fall, especially from standing, but the lack of proper assessment is reason for concern. Not so obvious without the aforementioned assessment. Cutting all the clothes are a bit much, maybe the hip area perhaps. This could have been done maintaining privacy.

There are a multitude of ways to expose areas of the body while maintaining modest privacy. Blankets, towels, etc. There is no good excuse for listening through clothes, or missing wounds from not visualizing. There is also no good reason for having a totally naked patient in the back of an ambulance. Nearly correct... Inspection, auscultation, percussion, palpation for abdominal assessment. All others should be inspection, palpation, percussion, and then auscultation. The reason for the abdominal alteration is to minimize the increase in peristalsis due to the palpation. This could give a false increase in bowel sounds, thus a false assessment. And, again, always palpate the area that is noted as painful last. Minimize guarding and such.

Yep, thats what we use...we have some latitude though and can skip the 0.5 mg part if we believe it necessary.

Same old same old..... =; ](*,)

I may be confusing paramedic for paramedic specialist..In my area specialist is below paramedic. If so..my bad.. :oops:

Thats like one attempt per medic..for a YEAR? This study sucks. Money spent on remediation or mandatory airway classes every six months would be better spent. edit: I just read the "study" details again..all these failures on a mannequin..wow. This keeps getting worse. I would surely look into remediation...

I was being somewhat facetious..sounds like I hit a nerve.. I don't think 15-30 seconds to intubate is unreasonable though..By then the medic should know if they need to back out and use this airway or not.. 70 seconds needs to be remediated, I would think. :?: :shock:

fifteen seconds they should be intubated with an ET tube..almost the same lift,swoop,inflate.. but yeah, they are a very nice peice of ALS backup equipment. The "gold standard" for bls should still be OPA and BVM... :evil:

This is my thoughts on the basic thing...more or less a formality. Its no that we need to do away with the basic license, only use them for what they are best at...advanced first aid and first response... Make the paramedic license an entry level option with the necessary educational requirements to make it a degree. No amount valuable experience can be gained from practicing as a basic before paramedic. If an adequate field training program is in place, there is no valid argument against dual medic emergency ambulances..IMHO. The whole basic vs medic thing is ludicrous..not worth the fight...it is what it is!! :shock:

Pretty judgemental.. he is expected to accept your beliefs...Not showing the best part of YOUR faith with that statement!!

If this would have been posted sooner...this thead would most likely be a ton shorter.. :wink: Very well said..

CCU charge nurse, huh?? I would enjoy seeing this list......That must have been one long class.. :shock:

I would say make a list of what you like about ems and what you dislike. Weigh the two. If, indeed, it is the profession that bothers you then you should seek another career direction. I don't think you would excel in this field if you are not highly invested. If it is the school, as Spenac questioned, then maybe you will be ok. Most students that "just take one semester off", never finish as they intended. Life has a tendency to happen. :roll: Just my opinion, I say stick it out till summer. You're young..finishing this school may afford you some enlightening life experience.

Agreed The price per dose of morphine and fentanyl is so small, especially the amount dispensed prehospital, money should never be an issue. Another argument I hear is that it is not our job to feed their habit. This is rediculous, as it is not our job to judge whether they have a habit in the first place. If the patient hurts, fix it..no more to be said. It is becoming not uncommon for litigation in reference to lack of, or inefficient, pain control. Protocols are a safe haven for now, but I doubt that 5 mg of morphine is going to get anyone into trouble. At the same time, judging someone an addict who is not, and withholding pain meds may. If your patient hurts and it is within your scope, treat them...color or socioeconomic status or possibility of addiction plays no part initially. Leave the rehab to the counselors and those trained to do so.

Yeah, I was told PA school acceptance is somewhere in the area of 1 in every 17 qualified applicants, where medical school could be in the 1 in 7 range. Most likely related to the number of medical schools compared to PA programs. Its been a few years, but I doubt the ratio has changed much.

Do you know what courses are included? Just curious how much credit they are giving to the paramedic license. Does he have to be NR. I have been researching this for the medics in our area. We have a program, but I would like a comparison...Thanks!

Something else to consider may be..It has been communicated to me that in the years preceding 2010, an MSN program will be next to impossible to find. It is my understanding that by the year 2015, all new NP practitioners will have to attain doctorates. A clinical doctorate of nursing practice would potentially put nurses in a better position for extending their scope and provide more complete care. Depending on the timeframe you are talking about with your education, PA may be a better choice. I know a few individuals in a physical therapy program previously a masters. When the programs switched to doctorate, they were forced to extend their scholastic plans..kind of disrupts one's life. Even if you attain a masters NP, in the future with the mandate towards doctorate, it may be a bit more difficult to find a practice. Just a thought and, if I am wrong, I welcome correction.

Thinking something very similar myself. I've never been the "emotional" type, though. I think you have to be concerned about the person described as the stone heart for their entire career. Bottling the emotions that are bound to be experienced in this field is a dangerous practice, both emotionally and physically. I believe that it is incumbant on us, the professionals that have the experience in the field, to recognize the signs of this showing in our coworkers and let them know these potential dangers. I have referred many friends, and some individuals I met through these friends, to seek counseling (not to be construed with CISD) by qualified persons. We are lucky to have social workers and counselors around here with nursing experience and can relate. It has been explained to me often that it is seen as expected for public safety to provide a stoic, hard demeanor. This, with no healthy emotional release, leads to the abuse, suicide, and addictions, we are all aware of. We have experienced this personally in the last couple of years multiple times in our area. So, for the original poster, this relesase is healthy and necessary for continued mental health and shame on anyone who belittles you for it.

I respect them as human beings. I may not agree with their belief, I don't agree with many things, but I respect their (the adults) right to have and act on these beliefs, within the law. I do think, any rational parent presented with the facts in a respectful way will make the right choice. Most times anyway. The changing of the interpretation of the "no blood" rule is fact of this. "...when it comes to fractions of any of the primary components, each Christian, after careful and prayerful meditation, must conscientiously decide for himself."* *Watch Tower Bible and Tract Society. Questions From Readers. The Watchtower 2000; June 15:29-31.

From what I've been privi to...a ton of adults don't have this ability........