Just Plain Ruff

But even though the south lost, they did get nascar.

this is the EXACT reason that PD will get called by me to come and take over this situation. I'll handle the medical issues, the people with badges will handle the other crap.

she just as easily could have died. Ruptured uterus is a bad bad thing, bad mojo mr juju.

ok, so they perforated her uterus or her abdominal wall and shes in a world of hurt I'd be looking for profound shock soon. I'd be prepping for intubation and a trauma code if she doesn't get to surgical intervention soon. The guys have some explaining to do.

oh good lord no, cardiac arrest ACLS Guidelines, then go with the d-50 later if suspicion warrants.

did you clarify what they meant by messing around?

Hold the phone, with the statement of messing around was there any chance this wasn't vaginal bleeding but Rectal bleeding?

I have also taken several courses by Bob and to say the least he is definately one of the most qualified instructors out there. I am humbled by knowing him.

I always have 25 extra sets of hands so intubation can be done with nary a thought by some fireman or paramedic who hasn't gotten his required number of tubes. It all can be done at one time, IV, ET, drugs, Defib and cpr all at the same time at least in my perfect world.

I guess this one's a good law. Unlike the law that allows a male to enter a female restroom, that was an emergency measure that was passed last year.

watch it buddy or I'm gonna report ya and then boot you the next time I see ya in chat. but I'm glad you are back buddy.

See Spenac, that wasn't so hard to do a quality first post back.

I think he's pissed at the firemen. Or he might think that some tissue or products of conception are in there. That's all I can figure out.

I like the way you think Christopher collins, make fire get the sample But .... She's in trouble, I don't think I'd wait around for a sample though. Get her out to the ambulance and get goin to the hospital. I still say she's pregnant and she's having a miscarriage. Only thing to fix this is surgical intervention after an ultrasound. How's her abdomen? Soft non tender or hard or rigid? Does she have any history of heavy periods? What meds is she on? What are her vitals after you get her supine on the cot, legs up and the two iv's goin? I'd get a couple of tubes of blood just in case the ER decides to use those tubes you got. They probably won't though unless you are hospital based. What is her heart rhythm and pulse ox? and the other requisite question and answers.

you are correct. I guess maybe not a butt whoopin but history really doesn't care who won the majority of the battles, history only cares about who won the overall war. It was definately not a war to be proud of on our side. But then again, when is war something to be proud of unless you are playing the game Risk or the nation simulation game called Cybernations. War is good there. But not in real life

Asys, I agree, I've worked with partners who were horrible providers but instead of doing what should be done the management put them on the transfer truck or the resource vehicle to go get the backboards and equipment that was left at the various hospitals. As long as they fulfilled a job no-one wanted to do they were not properly re-trained. I think that if the worst case scenario which would be the guy had great intentions, to expose a bad emt's care but he went about it all wrong. Best case scenario he did it to expose a bad provider. I bet the guy had good intentions but the result of good intentions is usually a bad outcome. I would have hoped that this person had tried to go the other routes in his quest to expose to management that the emt in question was a poor emt. If those didn't work then I guess you have to resort to the not so above board ways of getting things done. I still think the service really didn't have much choice especially if he took the pictures without the patient nor his partner having any idea they were being taken. Cell phone pictures have a tendency to get sent to anyone and even with the best of intentions of this emt trying to do the right thing, management can't really take him at his word that he did not send them on. Plus if the patient was in an sense undressed or unresponsive this makes for great youtube video or picture sharing. You send it to someone 1000 miles away and the possibility of that person getting the picture knowing that patient is nearly non-existent. Now that person sends it off to 10 of his friends and you get my thought process. What would have been a better idea for this guy is to take pictures with a polaroid that the department provides for accident scenes and ambulance involved accidents. That would have been the right way to go about it. Not sure what story he would use to tell his partner but he could have thought of something. I feel for the guy but a bad decision has consequences, he thought he was doing the right thing and it bit him in the rear. That's sometimes what happens. Hopefully the department did something to the bad emt in terms of retraining or remediation. But my guess is that they might not have done anything.

yeah but in the end we beat em so I look at the overall big picture and not just temporary setbacks. Don't you? Plus the White house needed a facelift anyway. It was so Last century, it hadn't been renovated since 1789. (tongue in cheek)

I suspect that the real reason he was fired was that the patient was Ultrahot and she was in some state of undress.

She's still pregnant until ruled out. what is 110K's?

Yes, who can forget the War of 1812. Another butt whoopin.

I believe that lack of sex won the war for us. They were really pissed and they took it out on those poor english regulars. So don't knock us. Our colonial ancestors whooped your ancestors butts. And I believe you have smarted from that ass whoopin ever since. You all still think we are a colony of yours. Just what do you ahve to do with EMS? Your blog gives no satisfactory answer.

Let's take it a different way. You are the patient, you are being cared for by mr I don't have a clue emt in the back.(Not the guy who got fired). The guys partner takes pictures on his cell phone of the care received. Do you care? Do you have a problem with being photographed by an EMT with his camera phone and do you have a problem with the EMT Taking your picture without your permission? I can honestly say I have a real big problem with it and if I found out that this was occurring I'd be really pissed. I can also say if I saw him taking my picture on his cell phone I'd probably take it from him and after I got out of the ER I'd drive right over to his place of employment with the phone and lodge a formal complaint? Or I'd just destroy the camera.

i had a patient one day in the ER when I went to go give her toradol I told her I was giving her Ketorolac and she said "I'm allergic to that" When I asked her how she knew what ketorolac was she said she knew it was aspirin and that since she was allergic to aspirin she couldn't take it because she was allergic to aspirin. When I asked her if she was allergic to Toradol she said no I'm not allergic to that, I had that for my headache a week ago and it worked great. I told her it was the same thing. She then said "Nothing but demerol ever works for my headaches" You had to know this person and their history to find it funny.

ok, if they have a history of hypoglycemia I would give it but only after all my first line drugs were given. If you have time you could give it earlier. I think the prime indication for this was if they patient was confirmed prior to the arrest to have low blood sugar. What I mean is if the wife took his sugar prior to his arrest and it was low or in the 40's then I'd give d-50 sooner than later. But I'd make sure at least the first round drugs were in, and the pt was tubed and all that. If there is no documentable history that the patient is hypoglycemic, no evidence of insulin or glucophage or byetta or any diabetic meds then giving sugar goes to the bottom of my list. Just like narcan goes to the bottom of my list for arrest if the patient has no evidence of having taken any narcotics or heroin. But if I'm in a nasty dirty apartment with the trappings of a heroin user, syringes, needles, and spoons and all that crap then Narcan pops to the top of my list probably even before I tube the guy. But that's just me.

unfortunately Timmy, the most common time we as EMS providers will witness an arrest is when the patient is in the back of the ambulance or we are already there. The majority of arrests are already happening when we get the call. Put the AED on but don't turn it on, do your 2 minutes of cpr and then turn it on. That will fix your desire to put the AED on and get it ready and it will allow you to do 2 minutes of CPR. But Julian, the answer you gave was spot on. As a matter of fact I have a physician I'm working with today and I showed him your answer and he as an ER doc would not offer any more than that. He was impressed.