ERDoc

I have never heard of anyone in EMS taking alcohol straight from the bottle. 8)

I think someone has been watching too much ER. I can't imagine you can build up enough energy to produce a worthwhile shock, but I could be wrong. Either way, good luck defending that in court.

Apparently no one is listening to me. The ER doc didn't use a pen and pocket knife! That is the secret to a successful cric!!!

One of my attendings told a story that happened a few years before I hit residency. Someone at the local community college accidently put methanol in the drinking water line instead of whatever line it was supposed to go in (don't know the details). Luckily it was summer so there were not many students, but 7 ended up needing to be admitted. Imagine the scene in the ICU with 7 college students on alcohol drips. Must have been quite a sight.

Why do you park on a driveway, and drive on a parkway? Answer: The usages are extended from the base meanings of the words, and are consistent with these meanings. A "park" is a place set aside for a specific purpose. The English word way is the equivalent of the Latin word via, meaning "road" or "path." Thus a "parkway" is a road (way) through a park. The road is used by cars, thus you can drive on a parkway, that is you can drive on the road (way) through the park. The term driveway originated as the designation for the place you drive you car into at the house, like from the gate of the farm, or estate, to the house. When you got to the end of the driveway, you would park the car. ("Park," as in the meaning described above, because you are putting the car in the place designated for the car, that is the car park.) The term driveway was thus established and continued to be used, even when people with tract houses had only a short "way" to drive to the house, so the place where you drive the car into by any house is called a driveway. It is still consistent with the base meaning and broader usage of the term in that you "drive" into and onto the "way" designated for the car for that dwelling. Taken from here.

LOL, no the "Happy Little Trees," guy was Bob Ross. Doug Ross was George Clooney's character on ER. About the time the show was jumping the shark they did an episode where he was driving around depressed in a huge rainstorm. Somehow he came across a kid that was in cardiac arrest from drowning. He did a cric with a ball point pen and pocket knife. He then flagged down a passing TV station helicopter (in said monsoon). He had the crew broadcast that he was coming in and what he needed to the ER, who just happened to be watching the right channel at the right time. I may have some of the details wrong, but you get the idea.

I was thinking we should go Doug Ross on this guy. I'd like to break out my ball point pen and pocket knife and proceed with a cric. How about retrograde intubation?

-10000 for hijacking my hijack.

I knew there was a reason I really liked you.

So, what do you all think of the upcoming presidential election? Disclaimer: Yes, this is an attempt to hijack an entirely insulting and inflammatory thread that I find totally offensive. I really think we should only bash people who don't have MD after their name. :wink:

Just to clarify the tamponade point, you may or may not see anything on EKG. Even if there is a contusion, there is nothing to do about it, unless it casues an arrythmia and then you will see it on your rhythm strip. It is not a clinical diagnosis anymore (at least in the ER). We will put a quick ultrasound on the chest to look for tamponade.

Please do not become a nurse if it is not what you want to do. To be a nurse you have to have compassion and be passionate about what you do, otherwise you will not be a very good nurse and you will burn out easily. You also have to be able to deal with doctors, some of who can be pretty rough. If your heart is not into nursing this will wear on you very quickly. Nursing is a career that you need to have your heart into, if you don't you are doing yourself and your pts a disservice. Going from medic to FF is not a promotion, just a career change. One has nothing to do with the other. My opinion, you should not take the EMS position away from someone who truly wants to help people and not use them as a stepping stone. If you are not interested in EMS as a career, don't take the position.

VentMedic, I know I came off as very opinionated, but I think that is what broken was looking for. He was looking for someone's opinion on his care. I was basing my opinion on what I was given. I realize there are always 3 sides to a story (yours, mine and the truth), but I can only base my opinion on what I was told. I stand behind what I said. Those bystanders at the scene should have been removed by law enforcement as they were interfereing and were advocating for substandard care. They obvioulsy have no place at a medical emergency scene. The crew probably felt a little intimidated by the scene. They were grossly outnumbered by a bunch of people, pt included, who thought they had some medical training and were trying to dictate medical care. They were trying to do this in an adrenaline exaggerated state. This was a bad scene all around. The crew screwed up by not taking control of the scene and providing proper care. They also screwed up by not taking the pt to the requested destination. Like I said before, based only on the info given, no one at this scene made any good decisions. Bad case all around. Dust, as usual, is right. We haven't had a good discussion on pt choice of care and desination. I won't hijack this thread to do that, but it would be a good topic.

No, the firemonkeys potentially sentenced you to living your remaining years on a vent (think Christopher Reeve). They should have been arrested for interfering, but if you are ok with them putting you ability to walk and piss on your own at risk, who am I to judge. The EMTs that took care of you were total tools and shouldn't be practicing. That tenting would have resolved with a traction splint had the EMTs done their job properly. You were surround by incompetence and should feel lucky that you made it out as well as you did. It could have been worse.

What are you talking about??? I said we were docking him points. Don't you basics know anything? :wink:

Usually when you hear about a blood shortage, it is of a certain type. As previously stated, the best way to conserve blood is to cancel the elective surgeries, not to deny it to dying pts who will suffer a miserable death without it.

Determining if some one can make their own decisions requires more than just being A&OX3 or 4 or 8. They have to have the capacity to make that decision. This means that they know and UNDERSTAND the consequences of being treated or not treated. You can decide if a patient has the capacity by doing an adequate assesment. It is not a very difficult thing to do. If you are not comfortable with your ability to assess a pts capacity, call medical control and let them get on with the doc. Taking a pt to a hospital that they do not want to go to (assuming they have the capacity), as previously stated, is kidnapping. Good luck defending that in court. To the OP, as screwed up as this crew was, about the only thing they did do correctly was put you on your back and immobilize you. You should have been boarded and collared. You suffered a trauma severe enough to fracture your femur for christ's sake. There is no way to r/o cervical injury. Obviously, you were in a position to refuse this, but they should have leaned on you to go with the proper treatment. I'll let others debate the advice given by firemonkeys. However, it seems they missed the boat by not putting a traction splint on, which would have alleviated a great deal of your pain. Any ER should be able to handle the beginnings of a trauma (assuming they have a real ER doc and not an internist or surgeon there). You come in, get stabilized and get sent on to specialty care. If they have a CT they can handle trauma (even if they are not a designated trauma center). That is not to say that a trauma center wouldn't be a better choice. The way this call should have gone down: 1. Pt fully immobilized 2. Traction splint applied and narcs given 3. Transport to hospital of pt's choice with emphasis made to pt that a trauma center would be the best choice.

-10 for no other reason than to cause a fight.

BLS causes nothing but trouble.

ALS sucks.

Funny, but some people have way too much free time on their hands (guess I'm guilty of that too, since i watched it. Damn).

Back in the day-34% Now-9%, but I don't think my Littman should be held against me. Good think I didn't have to claim all of my drug rep stuff. :wink:

Let's think of the differential of hypoglycemia. Anyone wanna try it? What about the pt that we already know either supports or refutes the things on the ddx?

I will start by saying that I am using one of the computers at work, so clarity is not the best. Are you sure that is a wide complex? It almost looks like a narrow complex with ST elevations. Looking at the 12 lead, it looks like ST elevations in the inferior leads, with depressions in the lateral leads.

Most people that are in a group start as an employee, but after 1-2 years (depending on the group), you become a voting member and have a stake in all financial decisions. Most are very democratic groups that rely on the partners to make the decisions as a group. We do not run an office per se, but we do run our own practice. There are still fee-for-service groups out there where you eat what you kill. Yeah, being in MI is a lot like being in hell (I assume). I miss NY. There is nothing better than a North Shore or Hampton girl (sure they're high maintenance, but they're worth it). I'm not used to a church on every corner, drive through chapels and a conservative press. If this area is conservative lite, I'd rather not venture into the real deal. Guess I should know better than to assume there might be hope for a place where are man can be dragged to his death behind a pickup truck because of his skin color and no one seems to care.