firedoc5

I know I'm guilty. When working around the clock for six days straight and almost everyone you've had conversations with are your co-workers and medical professionals, you can by habit keep using medical terminology, radio codes, etc. You can get some weird stares on your day off. After I had to get out of the field I had taken a job at a local sporting gear type of place. There was an accident on the highway out front. I called 911 and out of habit I told the dispatcher that there was a 10-50 in front of the store. She had no idea what I meant. I apologized and told her a motor vehicle accident. Then she got snotty and said that they don't use those old kind of codes anymore.

Yeah, Anthony, we had quite a character show up. That's why his topics are now locked. Good move. I know this is really extreme, but...Had call to the jail of someone having a seizure. Sure enough guy laying on the floor flaying about. We knew him. When my partner Bill went to take his BP he told him, "Stop shaking so I can do this." The guy stops moving his arm, but still keeps the rest of his body moving. We all started laughing so hard it was hard to get him out of the cell. Have you noticed that a lot of your regular jail call subjects are on meds for seizures? I brought this up to our PMD at the time and he said that so many have had seizures in the past, either from DT's or that they fried so many brain cells that they are at risk for them. And of course, many do fake seizures in hopes of getting Valium or other meds. As someone else mentioned, always be careful of your "regular" fakers. One day they might not be faking, sort of like calling wolf.

One morning a little boy asked his parents when they got a bird in their bedroom. They were puzzled because they didn't have a bird. When asked the little boy said he heard them through the door say, "Should we catch it in a towel or just let it fly this time". I know, I can hear the moans already... :roll:

You're right, Sleepy, there are no absolutes. You can never say never, and you can't always say always. Each situation is different. Sometimes you have to go with the flow, over come, adapt, compromise. Common sense comes into play. What worked one time may not work all the time. Use experience and training together. That's what I try to emphasize when I'm teaching.

We're people too. And in this job you gotta keep a sense of humor. If they don't get the humor, that's their problem.

KEWL

Good call.

Last bowel movement in AM and normal, may rule out impacted bowel, but not completely. How has her BM's been over the last week? How has her fluid intake been? Any gastric reflux? Passing gas? What is her normal diet? Cause of UTI? I know, I'm reaching.

One thing we come across is the hysterical patient. They are not combative. But they can be inconsolable and "freaking out" in a non-violent way. On a four lane street a driver slowed and motioned for an elderly pedestrian to go ahead. The lady did, but when she go into the other lane of traffic she was hit. The woman that motioned her to go was the typical hysterical person, who wouldn't be. I wasn't at the scene but was in the ER when both ladies were brought in. This lady was literally tearing her clothes off. We put her in a room way down the hall from the cardiac room where they were treating the woman who was hit. One of the guys I worked with and I tended to her. Two nurses, a social worker, and even a Nun came in to help her. They gave her valium and I believe Versaid. It was a good hour before she calmed down enough to talk. Her husband came in and she started to panic again while trying to explain to him what happened. But he got her talked down quickly.

Closed head injury is probably what I saw most with being combative due to trauma. There are a few MVA's I had that really stand out in my mind that we knew it was not behavioral. Those can be difficult because you can't lay them prone. I never said that all combative patients need to be prone, like I think a few has assumed. If you do have them prone and they stop breathing, it's no big effort to turn them back over.

Shock

"Brain Damage" - Pink Floyd

That's exactly what I was going to say. If I had someone on the scene dressed like that I'd tell them step back. Later it would be discussed in length, and not in a good way. There are no excuses. If you don't have overalls and at foot attire, then don't bother showing up.

Never said it never happened or that it could not ever happen. And no, I don't think any of this crap is made up. But if someone is yelling and screaming, you pretty much know that they have a good airway. If they stop yelling and screaming then you can ascertain whether or not their airway is compromised or not. I've never seen someone that has respirations of 12 and shallow being able to screech at the top of their lungs. Have you, CB? And if they are not getting enough air, then they are not going to be able to use up a lot of energy for very long fighting you. It's when they do stop fighting then, like I said, evaluate their resp. status. Any questions? I'm sure there are. :homework:

I have a feeling we won't be hearing anything from "Shane" anytime soon. :dontknow:

Nice shot in the dark, LA.

I know that area of Tx. My heart goes out to the family and department.

"God's Gonna Cut You Down" - Johnny Cash

Unfortunately it happens all too often. I just don't get it. How can people do that? I'm not going to get on a rant about it right now. Being a foster parent we have to be advocates in these types of cases. During our classes I've had instructors ask me to give more insight when these things occurs. Sometimes I think I gave them more than they expected.

When it come to the term "base line vitals" it's not referring to what is normal. It's referring to what your first set of vitals are, no matter their value. It's what you compare with future readings.

At first I learned the "LEAN" acronym, later to be told the NAVEL one. But I was always sceptical about Valium. I think I've given all of them but Valium that way at one time or another. Actually, I was hesitant to give anything (other than O2) nasally, only when ordered to. I think Oxygen is a given. I don't think anyone would forget it so it didn't need to be included in an acronym to remember. :wink:

Eh, too S & M. :?

One med that I'm sure no one carries is Stadol. Between migraines and kidney stones, I'd used Stadol NS for a while. Now I don't even want to see the box it come in. I personally have never adm. anything IN before. It was once discussed when someone asked if you could administer the N.A.V.E.L. drugs IN. instead of down the ET. I really wasn't for sure, but I argued, Why? If you had them intubated, why go nasally? Plus, unless it's a mist form, that's a lot of fluid going into the sinus's and down the back of the throat. Refresher: N- Narcan A- Atropine V- Valium E- Epi. L- Lidocaine

I would highly not recommend a pillow case for spitters. Air would be diminished, but also could agitate them more. At least no one recommended a gag, even though at times it was tempting. The NRB with air flow has been what I've found the most effective. I hate spit. I'd rather someone puke on me than spit. Guys, this one's for you: One thing I'll mention is, what about having to physically restrain a woman? You really have to watch it. They can, and will, come back claiming something like, "Someone grabbed my boob!" or "He had his hand on my butt!" These claims are usually unfounded. I've heard the City Attorney and Judges state that in a combative fit, the woman wouldn't have paid enough attention to know whether someone had touched her inappropriately. Other view? Gals, chime in if you want.

Once the main thing for ERT was much more extrication training, fire rescue, scene safety, sometimes repelling, cave-in response. You had to be at least a Basic to take the course. Training could also include farm machinery extrication, heavy equipment, construction rescue. Some classes, depending on what agency you were taking it through could branch out in any or all these areas. But no matter what was included it was the same cert.