Just Plain Ruff

As for the ped's patients overwhelming the system We have a level 1 ped trauma center 140 miles away A level 1 ped center 55 miles away Another peds center 80 miles away. With 2 other centers who can handle peds very well both 75 miles away. These hospitals will not be overburdened by 9 peds. The 5 helicopters are here waiting to tkae the patients There are 4 other helicopters within striking distance

He texted me and told me that he got his first tube and then got a rhythm back. Woot nothing further though.

I proudly report that AnthonyM83 had his first intubation!!!!!!!!!!!!!!!!!!!!!!!!!!! which was successful.

schmegma

This was sent to me by a friend. Bald Eagle Named 'Challenger' (Read this text first before you open the link to the video) This is an awesome music video featuring a special free-flying Bald Eagle named 'Challenger' (in honor of the lost space shuttle crew) cared for by the non-profit American Eagle Foundation (AEF). He's a 'human socialized' bird acci dentally raised by the people who rescued him - after being blown from a wild Louisiana nest in a storm as a baby in the late 1980's. Declared 'non-releasable' by federal and state wildlife authorities, he was trained by the AEF to perform educational free-flight demonstrations at high profile public events. He's the first Bald Eagle in U.S. history that learned to free-fly into stadiums, arenas and ballrooms during the singing of the Star Spangled Banner. The celebrity eagle has appeared at numerous major sporting events like the World Series, Pro-Bowl, All-Star game, BCS National Championship, Fiesta Bowl and Men's Final Four, etc. Challenger has also flown before 4 U.S. Presidents! His life story is told=2 0in a children's storybook titled 'Challenger, America 's Favorite Eagle.' Click here: YouTube - Amazing Free-Flying Bald Eagle "Challenger" (AEF) <

ChBare, that answer corresponds with another answer I got via PM. I would think that the patient could still see but I wasn't sure.

I have a question that I can't seem to get answered so here goes you administer the paralytic medication to a patient you are going to want to intubate. The question I have is is that patient able to see? Can they see or focus on anything? I had a colleague ask me this after they ran a call the other night. He was wondering if once he gave the Sux was the patient able to see? Theories are acceptable here too. But fact would be better.

Ok, well the only bus available at this moments notice is the oats bus which with 6 rows and 4 person per row you get 24 patients that can go via this bus. So this bus will suffice I have the logistics set but this isn't for me to decide it's your call. how would you transport these patients. Remember 9 ambulances which will arrive within the next 30-60 minutes. you already have two ambulances there - so they are booked so you have 7 additional ambulances and you have 5 helicopters already committed to this incident and an additional about 4 or so that are within a 100 mile radius. You have a heli base at the hospital which has a ready supply of aviation fuel so if the 100mile or so away helicopters need fuel there is plenty of fuel available. So it's your responsibility to get the patients out. Not mine. The total number of patients you have are 35. 9 of which are kids which are in bad shape That leaves 26 patients left that are not in bad shape.

Yes the winner is the Amanita mushroom. Those woods loving people brought a large ziplock bag of sliced mushrooms that they found in the woods. They thought they were morels. Once the children became unconscious it is a very ominous sign. I've treated one victim of amanita poisoning in my career and by the time he made it to the ER he was already in fulminant liver failure and ended dying while on a liver transplant waiting list. He didn't last long. The children are in BIG BIG BIG BIG trouble Fly everyone of those kids to regional childrens hospitals. Transport everyone who is sick to hospitals that can stabilize them and then get them to a higher level of care than a small rural hospital. Amanita mushrooms are the deadliest of the mushrooms. Once symptoms start you need to be agressive in treatment and get them to a facility who can handle their care. Here is the reference for the article I used as reference. Some say the fatality rate for untreated or late treated amanita runs 50-60%. It's close to Marburg in fatality rates. http://emedicine.medscape.com/article/167398-overview

Kudos for these guys. I probably would do the same thing but who knows. I do have a good rapport with a vet that would drop most anything to come out to a scene like this. He came right out when I responded to a horse hit by a car. He was there in 10 minutes and the horse suffered little. I would like to think that he would come out for this too.

you are not incorrect. The kids ate the salad and the fish sticks but there are 8 other kids who did not eat the salad and who ate the fish sticks and they are fine. Everyone who ate the salad are sick, anyone who did not eat the salad is not sick. There are a few people who left on their own who ate the salad. What do you do about those people?

ok, remember this you are in a small town community. There is a total of 2 fire trucks in town. There are only 3-5 people who have actually went thru MCI training. You can only get 8 total ambulances based on the surrounding services won't send their last ambulance to you because that would drop their coverage in their county to ZERO. They just won't do it. You have 2 ambulances from your service area 1 amb from the next nearest service 2 ambulances from the north county, none from the south, 2 from the west county and 2 from the East. That's all you get. Plus all 5 helicopters have been ordered. If you need more you can ask for helicopters from 100 miles away. So you have 9 ambulances and 5 helicopters and a city bus which turns out to be a Oats bus with 6 rows of seats. Jeep you are right on. So what kind of poisioning are we dealing with based on signs and symptoms and time of onset.

Generic lettuce salads, a couple of dairy based salads but these were hardly touched. The majority ate the salads which had that one ingredient from the one family. Vitals of critical patients Poor vitals - shocky, pale in color, diaphoretic and there is vomit around them also. All patients have most of the same symptoms. Started out as nausea and progressed to vomiting. The symptoms all started around 6pm when the families were supposed to start heading home.

7 unresponsive patients - they are ages 4, 6, (2) 9 year olds, 10, 11 and 14 Others are yellow and green this is a park with one shelter and a small pond. Many of the sick are being comforted by their respective families City bus is available No odors no municipal structures, there is a pool about 1/2 mile away Salads are present. no recent landscaping or chemicals used in past 2 weeks no decon needed on this one. no recent chemical use No respiratory issues here - no dead birds and the pond is quite clear And you have many unresponsive children So far we have one ambulance on the scene. several unresponsive children More history is that several salads shared the same ingredients from the same wood loving family. One bit of history that a male was able to give you is they ate at about 11am and all were done by 11:30. It is now 6pm

Vegetarian family, no meat products except for some fish sticks for the kids. simply salads and other vegetarian dishes.

I think that we as educated medical professionals can decide what we need to respond lights and sirens to and what we don't. The nausea and vomiting call at 3am probably doesn't need a L/S response The chest pain at 3am certainly does unless you have no traffic and you live in a rural area. The fall with ankle injury more than likely does not warrant a emergency response even if the bone is showing. It looks impressive to those who call but seriously, how often do those turn out to be major trauma. personally while working nights I rarely run hot after midnight because there is rarely much traffic and we get there just as fast without L/S

Family reunion in the park 65 family members but only 35 are sick at this time. Venue - park shelter but the group has the park almost to themselves - about 3 acre park, one playground, one small fishing pond. Symptoms vary from nausea to vomiting, unresponsive to agitated.

I have your email you sent via the yahoo email Do you want pictures and the like or just a description of what we do. Maybe if you partnered a specific child up per person who volunteered that would be even better. That child could send a letter to who they are paired to. I would be happy to send a letter to more than one kiddo if you have extra kids.

I'm getting ready to go off shift, but I'll respond to all answers tonight when I get back to work. Called to the scene of a family gathering. On arrival you are met by a male who states that everyone got sick about the same time. Main complaints are Vomiting. You are a small hospital based EMS system, running 2 24 hour ambulances. You have another service in your county with a ALS crew and a BLS crew. You have a helicopter based at your hospital. Closest additional units are 25 minutes (1 unit), 40 minutes(3 units), 45 minutes(2 units) and 5 additional helicopters all within 60 minutes away. Your hospital has a 9 bed ER and works with 3 nurses and one EMT at Triage. It is clear without a cloud in the sky. It is also spring time.

Zilla, if the rat poison is a superanticoagulant and the patient has not started to bleed much then by all means give charcoal but most of the time the time of ingestion is way off and the charcoal may not help at all. Plus, one study I read about showed that the difference between giving charcoal and fluids versus giving just charcoal was as follows 6/110 patients had a increased INR 24-48 hours post ingestion with fluids dilution alone where 1/110 patients had increased INR with charcoal and fluids. In my mind only 7/110 had any benefit to the fluids/charcoal or charcoal only treatment. So charcoal may help in 1% of the cases (extrapolated from this study) but 99% of the patients would not prove beneficial. Here's the link to the article I read http://www.mnpoison.org/index.asp?pageID=150 (scroll down to the Decontamination section) for the magnesium overdose - see this article on emedicine - http://emedicine.medscape.com/article/246489-overview Another form of Rat poison is similar to warfarin overdose. So you'd need some Vitamin K to start off - I'd start with 10mg but may go up to 25mg if severe bleeding is occurring but 99.999999 of all ambulance service carry vitamin K so the ER would be the place to get this treatment going. I'd draw some lab if I was able so they could check the INR of your sample. This might be one of the only times that a anal rententive lab director would allow EMS blood to be used. Once the K is started at 10-25mg SQ continue to monitor the INR and other clotting factors, admit to the ICU and watch the patient. One caveat to remember - giving Vitamin K as a standard treatment to a asymptomatic patient will negate any value to the INR for a specified period of time and we need to remember that Coagulopathies can develop over time and if you don't have a valid INR then you are WAY behind the 8 ball and the patient will suffer. So routine giving of Vitamin K for these overdoses without a initial INR would not be in the patients best interest.

Can you explain what you mean by poisonous gas???? Is this gas gonna knock out the crew in the ambulance? If it is then we need to stop the ambulance and call for a hazmat incident.

The same person who said Life was easy was also the one to tell all the teachers that on the playground it's inappropriate to play tag and have someone be "it" because it might scar them.

My thoughts would be to make the units lighter but that's been said already How about universal connections - that's been said before What I would like would be a keyboard style monitor to enter the patient name and etc. I would also like to see one that can easily be connected to our stretcher - lp12's do not offer good handles for this job. For the 12 lead how bout electrodes that can be used by most commercially available 12 lead (hospital ones) machines A recording feature or an easily used set of buttons for when each med or intervention is done. Right now on the LP12 you have to go to options and then hit a button and then scroll thru the choices Bluetooth/cell capability to fax the 12 lead to the ER And other stuff

Never said you were schizo just the fixation on the fake calls with lights and sirens in England borders on the schizo or obsessive.

she didn't mean what??????