My father was on a Rescue Squad on the IL River, 1970-72 and was on over 75 drownings in that area. He wasn't a diver but piloted the boats. Unfortunately most were recoveries. And I think I took too many water rescue classes that now I don't have any fun swimming. Always wanted to become a diver but never did, but was certified for dive surface support. One thing I learned was that if you are not a trained swimmer for a rescue, don't try it. Too many have tried and failed, sometimes loosing their own lives.
More truth than fiction.
One couple at the age of 95 yrs. young decided to get divorced after 77 yrs. of marriage. When the judge asked why now they said that they stayed together for the children. And since they all died of old age there was no longer any reason to be together.
You need to know your vehicle and your own limitations, strength, and weaknesses and respect them. That's one thing I learned. You need to keep in mind of the weight of the vehicle and how well or not so well how the vehicle handles. It's not just you and your crew whose lives are in your hands.
Tell me about it. That was in the mid '80's so I know a lot of people's priorities tend to have got screwed up, especially with the older docs at the time. They just didn't understand trauma system. Sitting steadfast in their own ways I think they wanted to mess with what they didn't want to.
Palpating a BP is just a preliminary reading. But you do need to auscultate one at first chance and go from there. Maybe I'm just too old school but I just couldn't get use to the idea of trusting machines to do things that can be done manually. For monitoring purposes it's fine, but if for your base-line readings it's best to do it yourself. IMHO
It does take a bit of practice to hear a BP in a setting where you are bouncing around, kind of like getting your sea legs. I can't remember exactly who it was, I think it was an MICN on one of my very first transfers that gave me the advice of having a shorter stethoscope to hear better. So that's what I did. I just had a Sprague-Rappaport and I shortened it and by golly it worked.
Unfortunately, for a time, the Trauma Centers seemed to get mad or annoyed that we had brought in a major trauma, like it was our fault the pt. got hurt in the first place. At one point we had the priority center in our area tell us to take them to the other lower level center across town. About 1-2 hrs. later we would have to transfer the same pt. to them anyway. It was very frustrating. We did finally get all that ironed out. But I think some of the staff were called on it and a few were "sent to other depts." From what I later found out it was based by one doc's stance, and he was the County Coroner. But still never found out what his stance exactly was.
It depends of what kind of source the infection is coming from. Is it air-born, or from contact with something, or both?
I have a 12 yr. old niece with cystic fibrosis and she contracted MRSA. At first it was all protection when visiting her. After a year of battling it, she is now free and clear. MRSA is serious but don't freak out about it.
Always glove and mask as basics. Go from there with what you think is appropriate.
I found out that interpretation is so easy it's hard. You might find it difficult then one day something will click and you'll have it figured out. When looking at a strip remember the basics and work your way up until you have identified it. I assume you have sat at an ICU monitoring desk and watched rhythms. If not, try and do it. It will help. The generated strips are for basic learning. After that go over every strip you can find.
You'll do fine. Confusion just leads to knowledge.
That's about what I was going to say. When in doubt, contact Med. Control. If not possible go by ACLS protocols, which is standard.
Establish allergies before ASA! Get as much hx. as possible. I know it's passe', and maybe not even taught anymore, even frowned upon, but MAST is another option for hypotension and brady. Doesn't hurt.
If you still haven't talked with your Preceptor, go to your Med. Director.
I swear I had a post on here. Someone messing with my mind?
Watch, listen, learn, jump in when you can when you should. Don't puke or pass out, that could be frowned upon. Relax, roll with it. Have fun, but not too much fun. Plus what the others have said.
I think that's it.
Much of the time we as EMS was Rescue. It was John Wayne time and we had to pony up. Actually I liked it. I think if anyone has the chance to take an ERT class, do it. At least have the knowledge and understanding of what is going on. If you can't/won't do it and there is somebody else, by all means stay back until the pt. is brought to you. But just think what you can do as a Medic while they are doing Rescue/ Extrication/ Extraction.
Seen it before, too KEWL, LMAO. Cardiogenic and Neurologic shock due to massive CVA. Needless to say, even though we did have a pulse back three times for very short intervals, the guy didn't make it. Our Medical Dir. presented it at a convention in St.Louis but I don't know what was thought of it there. He never told me.
I might be wrong, but I remember (way back) an Epi drip was easier to adm. if no pump was available. Back then very rarely did we have a pump on board. And with Dopamine, anything less than 7-8mcg/kg/min. just produced renal dilation and frequently had to be increased. That's per another ACLS Inst. I taught with, who learned me a lot while teaching with him.
Like I said, I could be wrong. Too many brain cells have gone bye-bye I guess.
I've had experience with this one. Had a pt. PEA (EMD for you old farts) showing 2nd degree block type one (Wenke-bach). At first Gene and I looked at each other and shrugged our shoulders. Both Epi and Atropine did work, but for very shortly. Medical control couldn't believe the rhythm we were getting so when we got to the hosp. we showed them the strip and said "told you so". Even a pulmo. doc said he'd never seen it. The pt. had a CVA hence the neurogenic shock. Would I do it again? Don't know. Ask your medical director what he/she thinks.