ERDoc

Our trauma service likes trauma pts to receive normasol or LR. Even in our sepsis guidelines, the max NS is 2L, after that we switch to LR or start pressors.

Welcome!

On a positive note, the crew was referred to as EMTs and not ambulance drivers.

Even if it does nothing for your career, but it is something you want to do just because you can, go for it. I would love to have enough free time to take some college courses that I avoided back in the day.

Welcome!

I vote for skipping the project and let them study.

What?

Whoa, wait a second guys. I think some of the women on here are saying something. We should try to listen.

I have to disagree that this is abandonment. It sounds like this medic was driving a pt back to a nursing home. I would assume their pt was stable if they were being sent to a NH. I believe he left his partner in the ambulance with the pt. I think we could come up with a scenario where the medic would have to transport with the 911 crew also. What if the 911 unit that responded was BLS only and the next available ALS is over 5 minutes away? Should he stay and play or grab his equipment from his ambulance and transport in the 911 unit? I think there is a lot of missing information here.

LOL. Those photoshopped patches on their uniforms are horrible. This is a horrible story for both the girl and the medic. I'm curious why they would suspend him. You would think they could spin it and use it for some great PR. I've read in some places that he helped the 911 crew transport the girl. I wonder what was going through his partner's head, just sitting there with the original pt waiting for him to get back from the hospital.

Say what you want about men, but we are the only ones that you should trust with all of your secrets with. We'll never tell anyone because we probably weren't listening in the first place.

Pain may be subjective but there is a limit of what is reasonable.

No offense Rich, but NYC protocols (or Nassau/Suffolk) aren't exactly the most progressive protocols. When I started they were still doing coma cocktails and slamming people with 2mg of IV narcan right off the bat. That is not the proper way to deal with these pts. You don't need to give them enough to wake them up, just enough to keep the breathing and maintaining their airway. It start with 0.2 or 0.4mg depending on the situation. That is about 1/10th the dose that the medics/EMT-CCs I used to ride with would give.

1. Anecdote is not evidence (see bold) 2. Narcan should only be given to get them breathing on their own. They don't need to be awake and conscious. With that being said, I know many devices don't let you select how much you give but a paramedic that is pushing it IV should be able to give it properly and not punitively. I can't count the number of times I have given narcan anymore and I have never had a combative pt. A few puking pts but not combative. Treat the pt properly and it will not be a problem in most cases. EDIT: I wasn't directing that comment at you personally Mazz, just making general statements.

The fact that after 10 years this shit still bothers you is a good sign. It means that you still care and you are doing the right things. When things like this stop bothering you, it is time to step back and figure out why. That may be the time to walk away. Don't take it as a sign of weakness but a sign of being human. As much as it sucks, just know it is good that you still feel. PM me if you feel you need to talk.

You learn to compartmentalize. You look at your life and realize how lucky you are. You feel horrible for that specific patient and their family (some of which will stay in your memory for the rest of your life) but accept you have done everything you can and realize that there are 100s-1000s after that one that will need you to bring your A-game and to not do so is not fair to them. You find people in your life or an internet forum\ who know what you are going through and lean on them and talk/scream until you are ready to bring on the A-game for the next person who needs it. Hugs to you Kate.

Welcome!

Wow, it's like a 20 year high school reunion in here.

Good to hear you are doing well Welch. Despite what my kids and receding hair line tell me, I don't feel old. Sure, I was a PGY-2 in the PICU when I joined on a slow call night and now I am an attending of 9 years but I'm still not old, right? I know I have been out of the field but you guys still use MAST pants, Bretylium, Minitor IIs and VHF radios, right?

It's hard to explain but the rush is different. I hate traumas in the ER, but I miss traumas in the field. Maybe it is the situation surrounding the field trauma, the lights, the noise, the smells, etc, I don't know. Maybe it is just nostalgia from an old guy who misses his younger days. I think it all depends on where you are. Where I came from, if you wanted to carry a central line kit, you could carry it and use it.

It is never a silly question. You will find that people in EMS enjoy talking about themselves so if you ask them a question about it, they will be more than happy to answer.

I think vaxed is the FDNY term for vetting someone.

Where is this utopia where nurses do disimpactions? I can tell you why he did it. Disimpactions reimburse really well. I've probably done 2 peripheral IVs in the last 10 years (yup, my nurses are that good) and one of them was because I wanted to.

Know who is probably the worst person at getting peripheral IVs?

There is a lot missing here. We need to know more about the hospital course.