firedoc5

Had that problem for an early morning T-time for a golf tournament a buddy of mine signed me up for. Suppose to be at the golf course at 8:00, got a call to deliver a baby at 6:30. I slid under the wire.

Guilty. I remember quite well.

"Ewww, Yek, Gross!" "That stinks!"

Anytime. 8) Have fun this weekend. I'd say you're having a combination of the fun bug and getting married jitters. It's natural. Now, do we need to discuss advice for the wedding night?

Does that go along with Underwater Basket Weaving and Beer Can Crushing?

Invisibility with super human strength. If you had the chance of a free car, either a '69 Camero, '72 Shelby Cobra Mustang, or a brand new vehicle, what would it be?

I live close enough to have gone as a member of Fellowship of Christian Firefighters, but I don't have any dress blues that fit right. Guess I'll have to work on that, and hope that it won't be called for again. Staying with the loved one the entire time is an old southern tradition in many families. Some funeral homes are fine with it, but I've known some that didn't allow it. It's a tradition I've always supported.

I think I know where some of this is going. It sounds like UMBC offers a Critical Care Paramedic course, and recognizes it and the Medics that took the class in their system. So to me, outside their system they really can't use the term of CCEMTP. It's not an official level. So, the question is, can a Medic in any system that offers any additional classes and inservices as a recognized level? I can see someone use EMT-P, CCT (Critical Care Transport) or any variation of it. Perhaps they can use it on documentation on forms for their system, but not for State or National documents, unless the State recognizes it. Clear as mud?

I don't think you can say never start a line in the burned area. But I don't think you'll find a vein very easily. May have to "hunt & fish" for one. The 3rd degree burn, especially deep will damage whatever vein is there. But if there is even just one other place, go for it. It would be hard to say to with hold at least an attempt, but I don't think you'll have much luck. It might have to wait until a doc could put in a central line or do a cut down in the ER. I know some of us have been trained to do a cut down, but it's not usually practiced pre-hosp., at least around here at that time. Also, I would think that if you did get a line started it will more than likely infiltrate causing even more tissue damage, and like you said, Ruff, increase the risk of infection. I hope this helps, Ruff.

"Geeez, I'm so drunk/ hung over." :puke:

"I use to be not able to spell Parmedeck, now I are one.

I was very tempted to go for a carotid stick. But due to space in the rig and doing what dressings we could, I just didn't get the chance. I was lucky to get the antecubital in one stick. I always thought back that I should have used a 14g instead of the 16g. :roll: As far as starting an IV in a 3rd degree burned area is not acceptable. Plus I don't think you'd find any veins usable. An IV in the area of a 2nd degree burn should be avoided but can be done if necessary. All burn patients are very prone to infection, even by their own skin. As human skin burns it gives off a poisonous toxin which is also absorbed into the skin. For the life of me I can't remember what it is called. :? Keep all clothing and foot ware. The burn center will need to know what materials were used to make the clothing. Probably 80% of her rubber boots were melted onto her. She did lose both feet eventually. AZCEP is right about the airway. Rapid fluid replacement can be detrimental if not monitored. Between that and possible inhalation burns, you can lose the airway very quickly. Airway needs to be watched at all times, especially if not intubated yet. If need be sedate and intubate. Luckily this lady did not have any noticeable inhalation burns. Unfortunately, even after a total of 10mg. MS, she remained C & A X 3. At that time all we had was MS and Valium. I didn't want to use the Valium due to concern of knocking out her breathing and knew the difficulty of trying to intubate while en-route due to lack of moving space. Once in the ER, found out that she was the aunt of one of the nurses on duty. So we had that going on too. Due to weather, ARCH helo. out of St. Louis was grounded. So I got to do the transport by ground. It was two nurses, an RT, and myself in back. I made sure we had our best driver go, who happened to be my partner. Later I asked Brad how fast he was going. He said that sometimes he didn't know, the speedometer only went to 85. But he made sure he only went that fast of the completely straight sections of the Interstate. I was very impressed with the burn unit at Barnes Hosp. (Now Barnes/ Jewish). Luckily Brad and I went. The doc. at the burn unit wanted to know everything from the time we first saw her until she arrived in the burn unit. I would highly suggest that if you do tend to a burn patient and they are transferred by ground, if at all possible go on the transfer. You might be the best source of info.

Nope. Just a year or two before that, if there was a shortage of LP 5's, for transfers we had to lug a huge LP 4 with the bouncy scope that didn't trace and everything. :tard:

These are all good posts. Take them all into consideration. But one thing you can do is sort of run around with the Medics. Listen to what terminology they use. When they are filling out their paper work, have them take you through it. Most are very willing to tudor you through it. Ask all the questions you can. If someone seems to be bothered by questions, find someone who won't be. But don't get ahead of yourself. There's a lot of things that you need to take time to learn. Try to have a balance between knowledge and experience. Don't worry, you'll do fine. You sound just like me when I first started out. Keep up the good work.

Well put, Dwayne. I'm glad you said to keep calm. Do not to panic no matter the circumstances. 8)

CDIC- "Chief Dude/ Dudette In Charge" HSDS- "High Speed Driver Specialist" ABCD- "Advanced Basic Care Dispenser"

Well put. Better than I did. In my book if you are at the Paramedic level and certified in at least ACLS and BTLS (or the equivalent in your state), then you should already be considered "critical care" IMHO

There's many of us that would have so many initials behind our names that if you had to write them all out that it would take up three pages. You just need one set, your actual level of certification/ licensure. I actually debated about starting a thread for everyone to list their "accomplishments" for just kicks & giggles. But I thought, "Naw". Some may try to dazzle everyone with BS, and not impress with their knowledge.

"Dixie" - Traditional

The PMS I can handle. I know many can relate to this. Would you rather work outside when it's 95 out, or work in an office at a desk when it's 85 inside?

I understand. There are in-laws and out-laws. But anyway, KEWL!

I know every state has their own levels of EMT. There are so many initials now that you can't keep track. One set of initials may be used in one state, and another state have different initials for the exact same level or certification. I might be wrong, but those guys in MA might have been using the initials in the wrong text. They might have needed to say that they were EMT-P, Critical Care Transport, or something like that. It use to be in IL that you use your initials of EMT-(what ever) followed by additional certs. and training. i.e. EMT-P, ACLS Inst., BTLS, ERT, FF II,.....and so on. Like I said, I know things have changed a lot in the last 5-10 yrs. and it's different from state to state. I might be wrong. But I do know of many who tries to add additional initials that don't exist to try to impress. Some think that just because they have had experience in some areas that are not specifically certifications that they can make up their own initials that no one have even heard of. And actually, that really cranks my chain.

Or use the ER as a free clinic instead of going to the doc's office. "Man! Not another one of you." "What's your sign?"

Had a large semi-dump truck over turn on a two lane street, narrow in matter of fact. Cars could get around but had an officer directing traffic. One idiot didn't even slow down or obey the cop at first. But the cop did get him stopped. The guy started yelling to just give him a ticket and let him go ASAP. No reason given. Paul, the cop, said he was just going to give him a written warning, but if he wanted a ticket, so be it. Sometimes people just never fail to amaze.

That's one issue I was going to make, especially about wet vs. dry dressings. Actually the rubber from her boots and tissue on her back were still actively burning. That calls for the wet sterile dressings. STERILE, STERILE, STERILE. Can't stress that enough. However, along a fence row in a muddy field, rainy, about 35 degrees out, you can only do the best you can do. When going to lift her onto the cot that had a sterile burn sheet on it, one Medic saw just a smudge of mud on the edge. Since he didn't think it was sterile, he ripped it off exposing nothing but the bare mattress. She was about 80K's. Talk about yelling at the guy. He finally put another one down, but not until we had held her for about two minutes in the air. High flow O2 (15L NRM), only one IV site not burned on arms. Left antecubital. Stuck her with a 16g. NS. Adm. 5mg MS. repeat approx. 10 mins.