Just Plain Ruff

Holy Post resurrection batman - But this paper is one I found. https://cms.galenos.com.tr/Uploads/Article_22451/EAJEM-6-7-En.pdf A 10 minute search of Google produced no other results of battery acid injection. I think this thread should be closed.

For anyone needing something like this - this is not the first time I've had to do this. https://www.amazon.com/3M-Littmann-Stethoscope-Classic-40005/dp/B00KS993II/ref=sr_1_3?gclid=CjwKCAjwg5uZBhATEiwAhhRLHowMAj211bB0m6o1mEFm3cTycy6hmjQu1T7G7WCmdEO4GiWiaEVeUhoCQw0QAvD_BwE&hvadid=508991332735&hvdev=c&hvlocphy=9023408&hvnetw=g&hvqmt=e&hvrand=15330268509225918082&hvtargid=kwd-1209005458467&hydadcr=7465_9611853&keywords=classic+ii+stethoscope+parts&qid=1663523286&sr=8-3 Amazon has everything. Let me know if you need anything else.

So many familiar faces - so many great friends from long ago. many have come and gone. many have gone forever - gone to the EMS systems in the sky. Good to see you all come back to say hello.

You will not get an email notifying you of this - the unfortunate thing is that they don't notify any of us of anything like this, we have to be proactive and read up on this on our own. I'm against this - plain and simple. The new emt's and medics that are coming out of school and getting licenced are a hodge podge of quality over quantity. I had a brand new EMT get hired at my agency. She had no idea how to put a regulator on a oxygen bottle. She didn't know really what the heck a Long spine board was or what it might or might not have been used for. Traction splint - yeah that is a long metal splint that you use if you have time. These people are being taught to the test and the test only. Ask em to think critically and they fall apart. I'm not saying they all do this but the majority of those I've seen are ill prepared to face a critical situation until they are hired and have a strong preceptor to hold their hand and tell em what to do. They rely on just enough to get by. If we allow this change to happen and it WILL happen if not enough of us step up and make our voices heard, people are going to suffer and they will die. Not to be a doom sayer and negative nelly but remember back to when you were a brand new medic. Remember how much you didn't know, now take away the degree aspect of the learning and put the licensure in the hands of an already strapped overworked state bureau of EMS to oversee dozens if not hundreds of new fresh emt's and medics taking their classes and learning and just how can an already strapped and overworked and underfunded and understaffed agency like the bureau of EMS (Yes I know you like to bash your state bureau of ems because i do to) and expect them to take on even more responsibility in overseeing all these education programs and ushering in these new undereducated students - soon to be new providers. Do you see the problems here??? This is an awful rule proposal and it's going to get your grandmother injured or killed. maybe not yours but someones.

ok, first off, there are about 2 regular members looking at this site and I'm one of the two. Maybe there's more but this site is pretty dead. No offense to the admin/owner here but everyonce in a while we get a new member. This is probably not the site for you to ask these types of things because you won't often get a response until 1 or two months later and I assume this is too late for you. the insulin medication is incorrect - I'm almost 100% sure that insulin is not given orally but I don't know about outside the US but I'm pretty sure. This patient needs a endocrinology consult STAT and there is much left out of the scenario to give much better answers. If her sugar was 500 or was it 900+, that makes a difference as well as if she was throwing ketones or not. I would slowly decrease her blood sugar by not more than 200 per hour. Watch for hyperkalemia She needs and ICU bed at a facility that can handle her, not a icu bed in a small hospital like some of the ones I take patients to. 4 bed ccu or icu's dont' really cut it. She needs probably a cardiac consult, gi consult, nutrition consult, wound care if she has wounds (diabetics often have unhealed wounds) etc etc etc. A facebook group I can recommend is Master Your Medic you can join, and post this question there and it will get you faster and better answers from some of the smartest minds in EMS today.

Things are good here on my side, had a stroke post patient assault in September of last year. That totally sucked. I'm back to normal but it was a long road. Moved from a urban setting to a rural setting (much safer and I can actually let my kids ride their bikes without me being outside watching their every move). Things are good. Thanks Scuba - so the patient blind sided me and hit me in the side of the head. I was unable to defend against it because I didn't see it coming. She hit me full force. Had terrible neck pain after the assault. Nobody expected me to have a significant injury. Fast forward 9 days, I collapsed outside a Massage therapy place (hadn't gone in for the massage and there was no happy ending). Called EMS, transported to the big major stroke center in KC MO had a series of 5 cerebellar strokes. Turns out the assault caused dissections of my middle vertebral arteries - and over that 9 days, clots built up until the stroke occurred. Heparin therapy, oral coumadin, 2 1/2 months of physical therapy and I went back to work 3 monts after the assault. Believe it or not - work comp was spot on and paid for everything and they are sending me a check for 7k for disposition of case. I need the 7k to buy a car that my son totalled. Lifes been interesting.

Things are good here on my side, had a stroke post patient assault in September of last year. That totally sucked. I'm back to normal but it was a long road. Moved from a urban setting to a rural setting (much safer and I can actually let my kids ride their bikes without me being outside watching their every move). Things are good.

I'm mixed on this. On one hand, the amount of people getting sick with Covid just boggles my mind. Around 50% of the patients who come in the our emergency room and that we go get in the ambulance are either covid symptomatic or actually have covid. For that reason I'd like to see everyone vaccinated but on the other hand....... I totally understand the mentality that people have who do not want the shot. I'm not sure that I agree with it but I'm not going to push a vaccine mandate on them. I am hearing of hospitals who are mandating for continued employment the vaccination and they are losing about 25% on average staff. I' m sure the hospital or EMS system have taken into consideration how many people they may lose and are ok with that. For my EMS Agency (about 18 total people) we have at least 3 if not 4 that will quit if the vaccine becomes mandatory for continued employment and that would cripple our ability to fully staff/respond to the community. As for the hospital itself, I'm thinking that around 25% of the staff will refuse the vaccination which would again, damage badly our ability to provide care to patients in need. yesterday case in point, we had a transfer to a hospital about 200 miles away(the only hospital in a 400 mile radius that could take care of this patient) and I'm not sure if they got the patient transferred or not due to staffing levels. Having one ambulance on a transfer of that distance and length of time leaves us with one ambulance in the entire county of around 20000 people/900 square miles. We only average about 5 calls a week that put both our ambulances on the road at the same time (not including transfers) but you can see how having even a small number of staff down can really cause havoc. So I don't know the answer and I don't think there is. I am not anti vax like some people say, I'm antimandate.

Hypothetical or not - this is a terrible idea - plain and simple. No matter how many times we run the same addict, we still took an oath and it's part of the job - we go to help the person. We don't put the same parameters on the person who is 400 pounds (due to very poor diet) who we go get every week or 3 x a week at home and transport to the hospital We don't put the same parameters on the elderly person who is living at home who pushes the button on their medic alert device We don't put the same parameters on the drunk who continues to fall down and passes out do we We don't put the same parameters on the diabetic who refuses to take their insulin or medication but still continues to eat mcdonalds or every time you go to their house you find a huge bag of Haribo gold gummi bears and a case of coca cola. I learned long ago that "It's not my emergency, I'm not paid to get my panties in a bunch because I B Bangin" overdosed again for the 36th time in Heroin alley and I've got to put on my "Supermedic" hat to go save his life again. My service pays me to go and put a IV catheter in his vein, dump a little bit of narcan in his body and wake him up again and have him sign the refusal so he can go do this again for the next crew. A good friend of mine in sunday school was teaching and he had a wonderful class topic called "My response is my responsibility" and in the end, how I respond to this situation dictates how I deal with I B Bangin's condition and I choose to treat him like I would treat my own family member who overdosed on heroin - Im going to do everything in my power to bring him back from the dead and let him see his next fix. I'm not here to pass judgement, I'm here to work. If anyone reading this falls into the "3 strikes and your out" mentality that seems to be slowly pervasively moving into EMS, then honestly, get the Fuck out of EMS, you don't belong here, your thinking SUCKS Big donkey balls. And if your service is beginning to think like that then as a very very valued member of this forum (DustDevil god rest his soul) used to say "Your service Sucks" and that I agree with.

Yeah, I think you dodged a bulllet on this one. Keep on keeping on.

Seems like they are trying to get a batch of people into their network without having to get the required items required for FEMA. You would think they would do it the other way around but what do I know, seems strange. I don't think I would want to work for a group that I don't know when I'm going to get the call for a job and then have such a short window of time to get the req's complete. What if I get a job notice that I could accept but don't have the time on that specific date to get all that stuff done. I'd be skeptical of this group.

Hey, good research topic. our service does not do hypothermia because we are so far away from a STEMI/Cardiac center that there is a real possibility that the patient will begin the re-warming process before they get there. The only thing we even remotely do is cold packs to the axilla, groin, small of the back and behind the neck. Any further and we feel that we run the risk of doing more harm than good. Now if we have ROSC and put them in a helicopter from the scene, then we very often put cold packs in those places but thats only if the paramedic thinks of it. So to make a long story short - we do not have a permissive hypothermia protocol/guideline - it's more of a paramedic remember guideline. Does that make sense? By the way, you probably won't get much more of a response out of here, we have a very limited number of people who still post, heck I might be one of the single handful of people who come here and actively review the forum. YOu might have better luck on the facebook sites.

So question, in your next service, if they practice lax infection control will you quit that service again? Not to be the negative nelly, but did you bring up your concerns to management and if you did where did it go? I have a co-worker at my other service that believes that because he is in great health he won't get Covid regardless of whether he practices infection control or not. I care if he gets it but it's on him and not me. if you practice good Infection control habits you should be ok, honestly, screw your partners, in the end, you have to go home to your family and if they don't then they don't. I would not have quit, I would have brought it to managements attention and let them deal with it, because in the end, you are the one out of a job and they still are working. But honestly, the choice was yours to make and I'm hoping you made the right decision and you have or had a job waiting for you before you quit. I wish you nothing but the best. Sometimes we have to fall on our swords to make a point.

This is a dead topic, the original poster never came back and gave us more info. Cell phones on a call are a NO NO. Don't even pull em out unless they are provided by your service. Here are my reasons and I only have a couple 1. They make you look stupid - like you cannot even stay off your phone for the length of a EMS Call. 2. Your EMS Agency should be providing equipment for you to communicate to the hospitals and other agencies, NOT you. Your phone is your property not your companies - unless they want to pay part of your cell phone bill. 3. If you are on any type of crime scene call or call that could be a law enforcement issue call and you pull out your phone - the officers on scene can suspect that you are taking pictures and confiscate your phone to pull evidence even if you are NOT taking photos. The minute they do that you have effectively lost your phone until they determine it has no evidence. 4. it's just bad form to use your phone on a call unless it's for work and the public doesn't have a clue and will think you are making personal phone calls and not concentrating on the patient. JUST DON'T DO IT.

So this scenario just reeks of a national registry scenario from years gone by that hasn't kept up with the times. Evidence based practice dictates that patients with Oxygen saturation of 95% and no significant LOC changes do not require supplemental oxygen therapy but the scenario says the passing criteria is applicaiton of oxygen and in the competency they even suggest Non-rebreather. You are on the right track by not wanting to put oxygen on this guy but again like any other education that we go through these days, we are taught to the test not taught to think independently. So your state examples are still being taught to the National Registry test which is honestly a dinosaur but we all have or have had to take it so until some group gets a backbone and says "NO MORE TO COOKIE CUTTER TEST SCENARIOS" we will still have emt's and medic test takers giving oxygen to patients with O2 sats of 100%. Until you pass the test, my best advice would be to study and practice to the test scenario papers you have and not try to use that beautiful 6 pound piece of gel in your head called your brain, you might just fail if you use your brain. Good luck

Yes, time off, vacation, sick time, holidays all banked in one bucket.

Well I hate to sound like an old crotchety medic but every one of us knows what we signed up for. We are exposed to all sorts of pathogens, we take precautions, and if you don't then it's not on your service, it's on you. These days you have to protect yourself because no-one else is going to do so. Go in on every call with the mindset that they have COVID, Sepsis, EBOLA and every other communicable disease and protect yourself. You have to protect yourself first. If you are not protected, then DO NOT GO IN TO the scene. You would not go in a fire scene if you didn't have bunker gear on right? You would not go in a TB patients room without an N95 mask on right? Today, it's on you to protect yourself because in the END, you have to go home to your family and no one is going to provide for your family other than you.

Huh?

When I went out due to developing a fever and was told to stay home for 14 days which was shortened to 7 days due to not having further symptoms, I was told that I could either use PHO's or not get paid. How's that for fun times.

our agency has put out a "every respiratory patient has covid until proven otherwise so we better see you wearing your PPE's" I had a exposure last monday, got a fever thursday and was sent home for 2 weeks of quarantine. got called yesterday and asked if I had any symptoms after 3 days of being home, said no. was told if still no symptoms after 7 days they will put me back on the schedule this friday so I get to go back to work. This is based on CDC guidelines for exposure and return to work but when I return to work I get to wear a mask for the remainder of the 2 weeks of my quarantine time which they are determining if it's based on date of exposure or date of symptom presentation. That's where the disconnect is. I work 24 hour shifts so I will only have to wear the mask for a maximum of 3 shifts but maybe only 2. I was not tested on the day I had symptoms because they said I was "LOW" risk. I got a week off for having a fever for 8 hours. not sure if that's overkill or if it's doing the right thing. I'd rather be working. but I'd rather do the right thing than not and infect other people. thank god for Doordash food delivery and a great friend at work who delivered some food staples (milk, bread, diet pepsi and trash bags to us yesterday).

You need a sit down with your supervisor to find out just what he means by "being compassionate". if he thinks that you are spending too much time talking to them and being their buddy or does he think you are being too compassionate to the drunks? Either or you need more clarification.

Hey Macktheknife, Do not let the number of members fool ya, there are about 10 if not less active members on this site now. We used to have more, a lot more. Maybe we will get a influx of new blood but with facebook and all it's groups, this site is not very popular anymore. I'm one of the old guard, been here a very long time.

Hi Emma, I'd be happy to discuss with you what questions you have. Email me at ruffems@gmail.com and we can set up a time to discuss. I've been a paramedic for nearly 30 years and I am happy to answer your questions. I'll be at work tomorrow for a 24 hour shift so if you want to do the call tomorrow that would be fine. Michael

look up a EMS group on face book called the EMS Experience and ask there. I know the owner of the group. If you still cannot find a buddy, let me know. I'm a medic but I'll help you out if you want. You can study and bounce questions off me and I'll help ya out.

One more thing, our new ambulance we are getting is gonna cost 235K, if you want to put an X-ray on that new ambulance the cost just went up to maybe 300K, no hospital or ambulance service will justify that cost.