firedoc5

There had been some long lists of song titles.

"When love fails, make sure you get ALL your stuff."

I have lived in worse then some of them. :-({|=

I know it's been used many times before, but..."Comfortably Numb" - Pink Floyd

Valium and MS was ALL we carried as far as pain management went. I know of at least 12 yrs. it was argued that we needed more, such as Demerol , Versed and Antivan for those freaking out. We did finally get Thorazine about 1991

Apathy goes hand-in-hand with burn out. I know that for a fact. I could go on and on regarding have and have not's back in the early days compared to now. I can't decide to write them down first then post them later, or just do a few at a time wasting posting space. I'd say up to '89 we were finally getting up to 1985 standards in some areas.

We didn't carry Demerol, but I think they do now. They use it more for trauma, such as extremity fx. I wish we did have Fentanyl in my day, I would have used it, but not necessarily as the first drug of choice for MI. I might be wrong, but I don't think Demerol effected BP that much.

Hate to see her reaction if she hit a bunny wabbit. :sad2:

I was referring to Demerol only if NTG and MS had little or no effect. Unfortunately I've seen some docs "rule out cardiac" just because the NTG and MS didn't eluviate pain. #-o Between what I've seen over the years and what has been adm. to me, the next thing used was Demerol if the NTG and the MS did not work. Sure it might not last as long as Fentanyl, but for the time that it is effective it can be beneficial for the pain, any anxiety, especially if the chest pain is not cardiac and relieve stress better than MS, IMHO. If I read, and remember right, the OP went straight to the Fentanyl, by passing NTG and MS. Why go straight to Fentanyl when NTG or MS may have worked, and Demerol (even though not always considered or used as often as in the past) could still be a possibility. I might be wrong, but could it be said that too many Medics rely on Fentanyl too much, or have faith in it only? I by no means against the use of Fentanyl, but there are other options that may take care of it just as well. I've been tested for chest pain since April and as early as this last weekend. All cardiac problems ruled out. I even kept telling the doc that it was not cardiac pain. But I was already in a doc's office for a nero conduction test. He asked if I was having any pain and I said I was having some chest pain and that it was not cardiac. He insisted that I went to the ER. I told them it was not cardiac. But they started me on a NTG drip, no SL Nitro. and gave me MS. None of it helped. Of course they put me in over night. Still all cardiac tests negative. Did an upper GI, negative other then slight GURGE which was old.. They finally gave me Demerol and I did better. I still hurt but it relieved it some. But what I'm trying to say, that in my book O2, ASA, SL NTG, MS, then choice of Demerol and Fentanyl. I'm not saying the Medic was wrong, it's just suprising to me he went straight to the Fentanyl

You have to remember that this is not a typical workplace. It's like comparing apples to avocadoes. I can see no porn, or even TV for that matter during what would be considered "business hours". But you are there for a much longer time. You are actually living there. So I can't see where anything should be said about what is being read or watched after those business hours. At the sub-stations you could have the TV on, but only news or weather. But if you were at the main station, no TV at all. I believe that unless a "hard nose" Chief or City Manager can ban any such material after business hours. I know of some guys, usually rookies that first came on, would complain to the Chief that they didn't like porn in their work area at anytime. The Chief would usually tell them to just not look at it and ignore it.

Of course we all know that this happens way too much. It's the same principle where people think they can use the ER as a free clinic. Or they think that 911 is their only way of getting help, even if it's just something done around the house. To them it is an emergency, especially the elderly. Whish there was an easy/ easier way to educate the public of when to call or not call 911. Yes, it can clog the system, and I wish I had better answer to help elevate that. But education of the public plus may be have another agency that an be dispatched to go to help out. And if EMS is needed they can call to have a unit respond.

Why do you think Demerol is such a terrible thing? It lasts longer then MS. It releives pain and from my experience is more effective. Anxiety tends to be less, unless the patient is for some reason fightng the effects for some reason. Sure, It might not be the first or second drug of choice, but at least it is an option. Also if someone is given NTG. especially a drip, the headace that can/ will be brought on by it may need the Demerol to releive it.

The reason I hadn't been around for the last few days was due to a doc throwing my butt back into the hosp. for chest pain. I was in his office getting ready to have an upper buddy nerve conduction test. When asked if there were any certain areas that were bothering me at that time I told him I was having chest pain. A new doc for me, of course he hit the panic button. I explained to him several times that my chest pain is NOT cardiac. Ever since April they have determined that. He mentioned me to go to the hosp., preferably by ambulance. The only reason I finally agreed to go was because I had been feeling very lousy all day. And when they took my BP it was 88/60, Pulse upper 50's -60's. Couldn't find an immediate ride so they called 911, Both agencies that showed up, a private ambulance serv. and the FD showed up. I don't remember being so embarrassed. They attempted twice for an hep-lock, unsuccessful. I warned them I ha rotten veins. Again, never listen to the patient. But got to the hospital. They immediately put me on a NTG drip, no NTG SL or anything. They did give me MS after about being there 30 minutes, which lasted all of10-15 min. NTG never helped. I kept telling them "It's NOT cardiac". Since April I had every kind of cardiac test they could without cracking my chest open. They did do an Upper GI which I told them I had a problem with Chronic Acid Reflex, but that hasn't bothered me for a long time. Eventually he did see some GURD so they put me on Prilosec. Again, no one listens. From the time they did the UGI it took about seven hours for them to get back to me. Now I've been in the hospitals a lot and have learned a LOT of patients and how to spend the passing lonely hours. But this time I was ready to hit the streets running, at least as fast as my crutches would allow me. Their conclusion. C/P non -cardiac. One of the biggest DuH's you can imagine. My next appointment, probably for the rescheduled for my original test, he's going to get an earful. You'd think that between my telling them that it's not cardiac and that any NTG does not give any relief, IT'S CARDIACPAIN. Like my dad said, "If there's pain, then there is something wrong. The doc's need to look outside the box. Which I had a doc like that in LA, but he left to Canada for a Firbromyalgia study. Of course others have been trying to help out. My grandmother came across on the web where falls and stumbles Like I've been having shows advanced stages of severe fibromyalgia, of which I've already been diagnosed of. So Iamb still doing my best at taking one day at a time. Enough of my pity party. I was just explaining what I've been doing through since my later

Sounds like you are a professional working for a bunch of meatballs. Go to your PMD, or anyone above your boss'. Get the absolute low down from them, taking notes. Go back and talk to your boss', all of them preferably, and ask things pertaining to what they think you should have. If it's not the same, report them. And I'll almost bet that some of the things they have submitted to them, they have been pencil whipped while you didn't get the benefit of orientation or additional training and/ or experience. If you feel a calling there, then don't give anyone the satisfaction of forcing you out or changing your mind to be there. You may have to be aggressive, but just lay it on the line with the boss' and work with the Medical Directors and Coordinator. PM me sometime and I might be able to give you some more advice and encouragement if you want.

I've done that every so often since I was a kid, before the M&M's commercials. "Ballad of the Alamo" - Johnny Cash :usa2:

Actually, we made our own. Plywood with a jig-saw, cutting out the pattern of an older spine board or even experimenting with a new shape.

I agree, if available to with Dermerol before Fentanyl. IMHO

Well, Crotchity, we started at the same time and I'm in total agreement of what we did and didn't have back then. And just think, back then some of those things were considered cutting edge. Look how far EMS has come since then. I look now at what is all there now, and if we had them back them, just think how much easier it could have been for us. Right now I'm just sort of glancing over threads, but later on I may add to your list of have and have nots.

I hope I wasn't off topic...at least not too much. Sorry if I did.

Maybe it will relieve actual ER's from those who use it as a free clinic all the time. That's something that has always been one of my pet peeves. I've seen some who say they'd been sick for two days. When asked why they didn't go to a clinic or their doc's office they just say that going to the ER their "medical card/ insurance" will cover an ER visit while the others may require a co-pay. I like the idea.

The doc maybe somewhat old school and going by what has been done for years. Chest pain= NTG (if hypotensive try a moderate fluid challenge to bring up BP), ASA, MS. If BP allows, repeat NTG and MS. Titrate either to BP. I would only consider the Fentanyl if pain was 9/10. I know I might get jumped on this but...if having a lot of anxiety call med.control for 2-4 mg. Valium. I'd never done it, but have seen it done. Maybe the doc thought that going with Fentanyl was "jumping ahead" a little too much. Ask another doc in the ED and see what he/she says.

Since I'm getting in here late, I'm going to forego reading seven pages of posts and just state my own thoughts. There was always some kind of porn at the FD I was at, especially the substations.Occasionally it was brought up. Now I can see any dept. or agency banning printed porn from like the bathroom magazine racks or where it is visible to any outside visitor. If someone wants to bring their own each shift in their duffle/ gear bag, then so be it, :jerk: as long as it's put away back into their own personal bag. And not just left lying around. But as far as the TV, having HBO, Cinemax, whatever, I would be completely against the ban. It is something that is out there in the public sector anyway. Now if something that was being watched and visitors came in, it would be in good taste to change the channel. I don't know about now, but it use to be almost impossible to get those premium channels anyway. One of our Capt.'s sons worked for the cable co. so he set us up with everything they had to offer...free. The Dept. was only being billed for the most basic service they had to offer. It was that way for several years. Then one day a rookie, not knowing of the "favor" called the cable co. to complain that one of the channels was being real fuzzy. They looked on their computer and found out that they weren't even suppose to be getting that channel. So, BUSTED. But by that time, that Capt. had passed away and his son had move somewhere out of state. I don't know the particulars, but they did get back all the channels eventually. So, to me: No porn laying around or "belonging to everyone". Personal porn, as long as kept out of sight, is OK. TV programs, while being watched responsibly is fine, but change the channel if something that may be seem inappropriate might be on. Same as if there is computer access. If someone is looking at porn, as long as no civilians are exposed from it, to each his own. Just be mindful of those who may come visiting. I'm getting tired of jumping off my little box. :sleepy3:

Black Testicles A male patient is lying in bed in the hospital, wearing an oxygen mask over his mouth and nose. A young student nurse appears to give him a partial sponge bath. 'Nurse,' he mumbles from behind the mask, 'are my testicles black?' Embarrassed, the young nurse replies, 'I don't know, Sir. I'm only here to wash your upper body and feet. He struggles to ask again, 'Nurse, please check. Are my testicles black?' Concerned that he might elevate his blood pressure and heart rate from worrying about his testicles, she overcomes her embarrassment and pulls back the covers. She raises his gown, holds his manhood in one hand and his testicles in the other. Then, she takes a close look and says, 'There's nothing wrong with them, Sir. They look fine.' The man slowly pulls off his oxygen mask, smiles at her, and says very slowly, ' Thank you very much. That was wonderful, but listen very very closely, 'Are - my - test - results - back?'

Now that would get your attention. :shock:

I'm pretty sure I've got some copies of my old clinical forms. I'd have to look for them. When coming to that kind of stuff, I'm a pack rat. Not too long ago I came across my old FFA project books. That was a blast from the past. I'll look around and see what I can find.