Just Plain Ruff

you are getting close medic26 think outside the box What might the physician have ordered to correct some underlying problem.

unremarkable long term medical history Cardiac history - none no implanted devices No surgery scars

trauma - nope Breath sounds are wonderful after you Azcep intubated the guy Pulses are generated with compressions Temperature 102.2 Co2 in capnography show a wonderfully excellent waveform

They did not do a 12 lead - they considered this to be a case of simple nausea and vomiting. The cardiac monitor showed Normal Sinus Rythm the labs came back after he got to the Radiology department. What might have happened to this patient in the Radiology department that may have caused this guy to arrest. This actually happened to a friend of mine several years ago.

I just ordered one of the tactical units and also a exact duplicate of the mt. Horeb truck Can we say OCD to extreme?

Blood sugar - 145 Electrolytes: sodium - 150 Potassium - 2.8 chloride - within normal limits c02 - 26 Calcium and phosphorous - within normal limits this is all you can get for lab values right now, due to the lab tech drawing a critical patient in the ICU. The lab tech called you with the above values though. no-one really blew off any complaints

You are able to secure an airway and continue compressions. Both iv's are established but remember you already have one started. It's a 18 ga. in the right hand Relatively healthy male patient a little overweight Meds - unremarkable other than ibuprofen and immodium for the diarrhea labs: which ones do you want?

I had this exact same situation about 10 years ago. Picked up a 20 year old woman who fell and sprained her ankle(whine factor of 10/10). Put her in the unit with my emt attending to her We drove up on a terrible wreck. Full size pickup into a small toyota cellica at Highway speeds. the celica was crossing the NB highway to get to the SB part of the divided highway. 1 doa in the passenger seat of the toyota(massive open head trauma). 1 critical in the drivers seat In the truck there was a unconscious male who had suffered massive trauma by not being seat belted. We radioed dispatch and requested an additional ambulance and fire for extrication as well as a helicopter. I triaged the passenger and the driver of the truck as black and began to work on the only live guy there. Our protocols never addressed this type of incident because our unit was the only unit on in the county until a back up crew could be called in and to get the 2nd unit to the scene could take 20-50 minuted due to the winding roads and distance from the station for some calls. So our mandate was to stop and render assistance as long as the patient in the back was being cared for. We really didn't have much choice in the matter. So before we all say that you are negligent in stopping, put yourself in my shoes at the time of the accident we stopped at. Sure we could have stopped but we were there and it's damned if you stop and damned if you don't Just for reference, where we were at the first ambulance to get to me after the initial call was 42 minutes. The helicopter was already landed at the time the ambulance got there.

You are the on duty EMS Crew for a hospital based EMS System. You are asleep in your bed and you get paged out to Radiology department for a cardiac arrest. There is a physician, a nurse and a radiology Tech in the midst of working a 42 year old male patient in cardiac arrest. Background - patient is being evaluated for dehydration and nausea and vomiting. Patient was in radiology for a chest x-ray (PA and lateral) Patient has an IV of D5NS at 125 per hour, cardiac monitor shows Asystole with good cpr spikes. Patient has been down for 8 minutes. Patient was found by the rad tech in arrest. What do you want to know and what do you want to do. All appropriate ACLS guidelines are being followed for the current rhythm of asystole

thats just like you Dust, strike first, strike hard and strike often.

good post and question 1. if I have a critical patient and they want me to stop I'll call dispatch and ask them to call the department trying to stop me and ask what they are stopping for. Asking dispatch to advise them I have a critical patient. If the LEO still wants me to stop then I will have my driver or if I am driving I will stop. 2. if it is my driving or my drivers driving at issue then we have a bigger deal than just stopping for a LEO. They are stopping you for a reason and you better have a good excuse as to why they stopped you for what you did. 3. If it is mechanical, then heck yes I want them to stop me. If the vehicle has become unsafe then better to get another ambulance for transport than risk my and my partners/patients life. 4. If you caused an accident or cut off someone then they should actually follow you till you get to the hospital and then discuss it with them. but the long and the short of it is this - You probably should stop regardless of the criticality of the patient. You have to obey the traffic laws of your state critical patient or not and in any jurisdiction, if a LEO wants you to stop and you do not, then you could face tickets and much much trouble. Great question though.

I saw them at walmart the other day. If you cannot get one I'd be happy to procure one at our local walmartacopia and send it off to you.

You know I was thinking about this a little bit more and I think the chances of this happening are so remote unless you work in a small rural area that this might be a moot point But it could happen so it's good to discuss but I think it's statistically insignificant.

Jess, my son and I played with those nerf guns over the weekend. I wonder if he got his inspiration from the nerf gun.

actually, if you get dispatched to your house for a violent call, then I can guarantee you that everyone here would advise their dispatch that they are responding to their own home. I think that if the medic or emt notified dispatch then a 2nd unit should and could be dispatched. I for one have had to treat two of my own family members and it is not fun. It wasn't an immediate relative but it was my aunt. She suffered a stroke and it was not a good call nor a good outcome. I did all that was expected of me and more. I also took care of the wife of my uncle(great) and it was a transfer from our ICU to a cardiac center 75 miles away. She was very very sick. She arrested in the ambulance and we shocked her, we brought her back and made it to the cardiac center. She received immediate open heart which is what she was being brought up to have anyway. She survived and lived another 8 years. So taking care of family members are a definate possibility but a higher probablility in a small rural area than a large urban area. The possibility of taking care of someone who hurt your family member is a distinct possiblity if you live in a rural area and if you are the highest level of provider and the patient needs your level of skill then you will need to take care of the scumbag if there's no-one else available. Usually in every service there is someone available to spell you but sometimes not.

that's just not a good thing. Who'd have thunk it.

I believe I answered the question - I asked if they gave her any dye???? I didn't see any response unless chbare was replying to my post?

take the pre-emptive action you need to. you need to first discuss this with him. Tell him you were discouraged by the lack of work he did as well as the non-lack of personal work he did. Tell him that he either needs to shape up or you'll go to management Next you need to write this all down in a narrative or whatever detailing what he did and didn't do. Date this and seal it. That way when this yahoo goes to managment first, which he will, over some little thing that you did and made him do then you have the ability to fight back and say, whoa wait a minute, here is what happened If you are not into confrontation which most people are not, then you need to go to your supervisor or management and discuss it with them. Often times in EMS the person who complains first is the one who keeps out of trouble. Many ems workers will stab you in the back to further their career goals or they will run you over in the ambulance if it will keep them from getting in trouble. Good luck.

well this argument is pointless, the hospital can hire anyone they want. If they only want to hire non-smokers then so be it. They are a place that takes health and healthy living seriously so if they don't want to hire smokers then that's their right. If I was a business I would not want to hire a smoker either. And if I did hire the smoker then they would have to be smoke free while they worked there. That would be a requirement of employment. Smokers rights smokers rights - well in my business there are no smokers rights just like this hospital. Yes it's a choice and you can make that choice, but it's also a choice I have as well as the hospital has to not hire you. If you don't like it TOUGH Cookies. It's my company.

with no post bite care, probably about a week or two

I had a heat exhaustion illness about 8 weeks ago. Mowed the lawn in 95 degree heat, didn't drink any water for the entire time. spent the entire afternoon before my wife got home lying on the couch. Wife started to pour water down me and it wasn't till the next day that I felt back to normal. I believe I started to cease sweating but by that time I was done with the lawn. Ever since, I can only go out in the heat for about an hour or so before I begin to feel sick.

like I said, brown recluse bite. Had a patient with the exact same wound post brown recluse bite

my understanding is that Yes you are more susceptible.

sorry guys, but I agree with Terri. These threads are in the funny stuff section. We all know what they are about so just don't open them. There are posts from certain people who I don't read because I don't like them or their posts. That's all you have to do is not read them. It's all in good fun. There are other things to worry about besides getting upset over these threads. I won't post on anymore of the bashing threads and we can let these threads die a quiet death. If we're gonna get technical, some people may find offense at the jokes posted in funny stuff but I have not seen anyone call those who post those types of jokes. The bashing threads according to some may show our forum in a bad light but the jokes do too. Brit, do not think I am singling you out on the jokes because that is not my intention, I am making a global statement about the jokes. I like some of your jokes. I for one do not really read many of the funny stuff forum here, I just move on to the next post.

ok, I've seen an injury like this before There could be a couple of reasons 1. Brown recluse bite 2. Electrical burn but this guy would be toast if that's the exit wound. He'd more than likely be dead 3. Cigarette burn that got infected 4. Septic joint or a laceration that got infected and they split the skin to take care of the pressure 5. He's the brother of the guy on the comcast digital voice commercial who got the snake bite and the foot is black. It's a snake bite that's gone bad Too many things could be going on with him but I suspect number 1 or number 5