Just Plain Ruff

and one of the reporters is from kansas city and his cameraman falls in the last segment. All you see is the camera turning on it's side and the reporter luaghing. I'm wondering what happened to the guy who got hit by the plane.

http://boortz.com/more/video/danger_news_reporters.html

isn't it about time to let this thread ride off into the sunset and retire?

for once in my life I was speechless for just a minute. But all I can say is HOLY SH......................................

ok thanks Mateo I was thinking it was something like that. I have also been on the receiving end of a patient who I took their high away. With my first narcan use on a opium addict I woke him up and he started breathing again and then he started to pummel me up one way and down the other. Thank goodness for a huge partner and two burly sheriff's deputies we got him secured down and the most that was damaged was my pride. note to self from that day forward - slowly slowly slowly said the sloth. Give it slowly.

so why do you think that management is the problem? What I'm asking is why do you think management is so much worse on the east versus west. Is it difficulty to get people to go to the east coast versus the sunny west coast? Or is there some other underlying cause that makes the east coast more difficult to find quality or qualified managers?

wendy wendy wendy, the voice of reason. I posted this scenario and after about the third or fourth reply I remembered that thread.

I'm not so concerned with the 162 as that could be due to her extreme pain and Spenac's driving habits. What I'm concerned about is the bp of 162/148. Original bp was 142/120 its the narrow distance between the top and bottom number that has me really worried. What's her 12 lead look like? Gotta ask her about drugs, any drug use while using the outhouse? What are her pulses in her arms and legs like? ARe they equal in the arms and equal in the legs or are they different. Does she relate any history of a tearing sensation to her scapula?

Hello Mr. Run on Sentence. But seriously, AMR is not a bad company to work for you just have to know who you are working for. If you know you are working for a company that will find a way to replace you with cheaper newer medics and you know that you are expected to follow the company line in regards to how you do things, then no it's not a bad company to work for. I have several friends in the AMR Independence system and they love it. They all understand that they will do more transfers on a given day than emergency calls. they also know that they will be required to do other duties taht they don't want to like standby's and the like which takes them away from emergency calls. if you are a new gung ho medic who all they want to do is run emergency calls then this is probably the wrong system to work for. If you understand that you can get fired for being in a wreck even if it is not your fault just because you were the driver and that your partner can also be fired for being in the same rig as you because they can say that you both were at fault because you should have seen it coming and you are idealist enough to know this and still work there then no AMR is not a bad company. But to bitch and moan about AMR making a profit then you are barking and complaining to the wrong person here. There is nothing wrong with a company making a profit. AMR is publicly held, they have stockholders and actually they are not there to make you happy. The only people that they have to make happy are their share holders because believe it or not the shareholders are the owners and if they don't make money then AMR begins to lose money by people selling their shares. This is business 101 here. If you don't like the fact that your company is making money then quit and don't say "I can't quit cause I can't go somewhere else" So as long as you understand all I've said and more and you still wish to work for AMR then more power to you. In most of the AMR services, it's not a bad place to work. It all depends on the managers at that area. If the managers don't care about the employees then there is nothing you can do about it but quit or grin and bear it. You do have choices. It's what you decide to do with those choices that is the key.

is that blood pressure right? did you take it manually or are you relying on that piece of crap automatic bp machine? If it is then we are gonna be in for a long long ride. How old is this lady? does she admit to any history of trauma What does her chest look like other than exactly like it should on a swimsuit model.

I have a new reality show MER 911 (mobile emergency room)

I think you have enough resources to work both patients. Transport them both to the hospital. Work on getting the one in the bus out. But you have to work both the other kids though.

12 kids, 3 drivers. Driver of SUV, bus, and truck are out of thier vehicles and standing with 9 kids on the side of the road. You can see a young womal lying on the side of the road beside the "Tear" in the bus, a young man directly behind the bus, moving his arms in a disorganized fasion, and one still on the bus sitting up. Your 3rd ambulance and rescue truck are arriving staffed with 2 EMT's and 2 FF (first aid so you really have three actual patients and 9 walking wounded You have enough equipment then. Put the young woman near the tear in the 2nd arriving ambulance - your first in ambulance is your triage ambulance put the 2nd patietn who is moving his disorganizedly in the 3rd ambulance which just got there. both those ambos go on to the hosptial You are now responsible for the kid in the bus and the walking wounded. Since it's only a 10 minute run from the scene to the ER you can work on getting patient 3 out of the bus, packaged and initial treatment started while that first ambulance is on the way back to you. Once that ambulance gets there you put them in and they go You then put the walking wounded on the bus that just arrived and you and any other emt's available can go with taht bus to the hospital. Which of the three ended up dying the girl on the ground next to the tear the guy with disorganized movement or the one still in the bus (was she even alive?)

Here's my random answer 37

I would also do the same spenac. It's the old adage "the needs of the many outweigh the needs of the few,,, or the one" It's a lose lose situation but I'd like to hear from others.

You also did not say that there was a third vehicle involved. What was the condition of the driver and occupants of the car. so we know we have at least the driver of the truck The driver of the suv and possibly more in it. The school bus about 15 kids and 1 driver. So a total of 20 potential victims One is still critical and one dead (theres the 5% for black) Any further?

holy crapola that was bad. I can see the fog that precludes helicopters. it also doesn't appear extrication needed, the truck did all the work for the heavy rescue crew.

You need more ambulances for starters. Is anyone on scene yet to provide sizeup? And the hospital is gonna have to take it in the rear and get ready. They are gonna need to call in everyone they can. They are also going to need to contact the next 2 -3 closest hospitals to them and tell them to expect the minor casualties. the local hospital is gonna have to treat the criticals and the yellows. There being not used to trauma should not have any bearing on whether they get these patients. They will adapt because they are going to have to adapt for this scenario Put all the greens when you round them up in the school bus and send them with ONE emt to one of the neighboring hospitals or send them to the local doctors office unless that doctor is going to be over at the hospital and even then they can go to the doctors office for initial care by their nurses (perish the thought). But like I said, do we have a scene sizeup yet?

taking a cue from a post from spenac You are on the way to a cardiac arrest - 7 mins out A mass casualty incident comes out which is 4 miles behind you. Bus versus dirt truck. 15 potential patients with 2 ejections. You get the idea. You arrive on scene and find a 57 year old male who c/o hurting his ankle but it never was a cardiac arrest, the frantic caller didn't see anything but the guy collapsing in his garage and called before they investigated further. So it was dispatched as an arrest. You explain to the guy that there is a very very bad accident down the road with the 15 patients and some ejected. You even explain to him that it is children involved. The patient tells you "I don't give a damn, you are gonna take me to the hospital to get checked out. You do have other ambulances on don't ya?" Basicallly the guys a prick but that's beside the point. What do you do?

Spenac, I'm in full agreement. If the patient can wait and you can evaluate that wait and explain to the patient that there are 15 patients on the road down a ways who are really hurt the patient may say sure go take care of that and then come back and get me. Then by all means you can do that but if the patient says Hell no, I want you to take me then you don't have much choice do you? I'm not gonna go any further off topic I'll post a new one. Sorry Mobey

Your dispatch center should be mobilizing all the resources they can though. helicopters - all should be utilized that can respond to your area. (is it too foggy for air transport? I think it might be so you may not get them)(edited by poster) Heavy rescue - from wherever you can get them from As many ambulances as you can get from your mutual aid orgainzations. (if helicopters cannot fly then you will need a lot more ambulances than you think you need) If you have a military base near you could request their ambulances and their medevac helicopters Call the local school district to bring a new bus to transport the non-injured. prepare for at least 20% reds, 20% yellows, 55% greens or not hurt and 5% blacks. Mobilize law enforcement to shut down the highway both ways.

well it's a toughie You continue on to the cardiac arrest. They called first. Even though the dude is probably gonna die anyway. But we all want to be involved with the big one so I bet someone will say turn around. But then again, you are 7 minutes out of the arrest - 3 minutes out from the wreck. Your other crew is gonna have to work the wreck until you are done with this call. There is no easy answer. I had a similar incident. We were rolling on a car wreck about 10 miles outside of a small town. We were 2 miles out from the small town with 10 miles left to go to the wreck when our second unit was toned out to a cardiac arrest in the same town we were just about to drive thru on the way to the wreck. We did not divert to the arrest. Our 2nd unit went on it because the wreck call came out first. It was reported to have 3 patients inside with 2 unconscious. We were also going to be first on scene before police and fire due to the distance that we all had to travel. On arrival we realized our decision was right because we had 2 critical patients who were flown out by air and the other one coded quickly after we started to transport to the hospital. The cardiac arrest was indeed Dead right there when the crew got to him - he had been dead for a good long time.(>12 hours) But I'd like to see what others say about this.

I want to see the bite. i also want to remove any restrictive garments and jewelry and the like. If it might cause constriction remove it. Rings, necklaces, bracelets and watches. Bra's and socks too. The rest of her clothes if spenac thinks she's hot!! :twisted: Good thing is if it is a spider bite it usually isn't fatal. What's her underlying heart history and basic health history? how long are we into this transport so far?

well I'd start the iv and keep it open, forego the lock. I'd start with 30 mgs of toradol and then hit the morphine if needed. I'd also if we are going to go down the road of the spider bite, I'd have some epinephrine ready in case of allergic reaction.

oh now you put the outhouse in there. Look for a scorpion sting or a small bite mark from a black widow or other poisonous critter. Go look around the outhouse for the offending scorpion or spider (you probably won't find that though) More than likely she would have felt the scorpion sting but she probably would not have felt the spider bite, rarely is there immediate pain on a black widow spider bite. Black Widow Spider Bite Symptoms The black widow spider produces a protein venom that affects the victim’s nervous system. Some people are slightly affected by the venom, but others may have a severe response. The first symptom is acute pain at the site of the bite though there may only be a minimal local reaction. The local pain may be followed by localized or generalized severe muscle cramps, abdominal pain, weakness, and tremor. In severe cases, nausea, vomiting, faintness, dizziness, chest pain, and respiratory difficulties may follow. The severity of the reaction can depend on the age and physical condition of the person bitten. Children and the elderly are more seriously affected than young adults. In some cases, abdominal pain may mimic such conditions as appendicitis or gallbladder problems. Chest pain may be mistaken for a heart attack. Blood pressure and heart rate may be elevated. People rarely die from a black widow's bite. Life-threatening reactions are generally seen only in small children and the elderly.