firedoc5

"Damn it, Jim. I'm only a doctor" - Star Trek

If you have MySpace go to mine, it's under Firedoc5, and you'll see my playlist. There's several Pink Floyd classics on it. What was your age? I like introducing young'uns to music that is timeless.

Yes, Munchausen was brought up. But she was a real nut ball on a daily basis according to witnesses. A lot of times she would do it because of something stressful, or even out of boredom. I know she "went away" for awhile. But I don't think Munchausen was ever determined, best of my knowledge"

Back when it was only EMT-A, EMT-I, and EMT-P, Those whose main goal was to become and Paramedic from the time they finished EMT-A, at least in our little system we used the EMT-I program to weed out the one's you knew wouldn't make it, or should I say shouldn't make it. That's why some said that their "I" class was harder than the "P" class. And we had a great instructor. He was a licesened physician's assistant (this was pre nursing practitioners) and he was the Medical Services director at a large coal mine, so you know he knew his stuff. And he was very hands on. I think we started with about 18-20 students. Only 11 passed the class. They either flunked out or quit. And working with coal minors he knew how to be aggressive.

Know what you mean, man. It might discourage her, and that is the last thing she needs to do.

Dwayne, how is she doing now? If you think posting too long of a post is a problem, don't worry about it. For her we are all in her corner. Think of her being adopted by all of us concerned. PM me even if need be. Get her a lap top, let her talk to us, huh? Just let her know we are thinking of her.

Have you ever been on a call that was a complete crock. We had one gal we ran on numerous times. She was either "unconscious" or "severe vomiting". We always proved she was faking the unconsciousness and came to the conclusion that she could make great home made puke. We'd even find the various canned vegetables and assorted other food products in the trash. She finally wised up at one point and walked out to the ambulance before we even got out. But you could tell that everything in her puke pan was not ingested or digested even a little. Try calling it in and ask for a "Porcelain Level" to let the ER that it is a crock call.

You must love Pink Floyd then, I assume. :-({|=

"You're burnin' up daylight, boys." - John Wayne

"Renegade" - Styx

Been there, done that. It's not all what it is cracked up to be. :love9:

Exactly, a good accurate report essential, with the unsuccessful and screwups included. Good or bad you have to be accurate. I too check the tube before and after getting out of the rig. Get inside and tell the RT to check the tube immediately. One night brought in a code and did the usual. But moving from the cot to the table they must have moved the tube. When the RT checked the tube it got pulled back a bit. And the doc just rolled his eyes. Now this doc was our new Medical Director. So I didn't know how he would react. But after all was over I pulled him to side and I told him that if I bring a tubed patient in, it will be correct or they won't be tubed, EOA then. He sort of glared at me at first and started laughing saying he knew it was placed right until they moved the guy. He was tentative enough to notice the tube move. He was real cool. But we became the best of friends after that. He ran a program on his own for doctors getting ready to take specialty boards. When there was a seminar for ER docs he had me give the "what's out there" and what we put up with, and sometimes it's not pretty. Even after I was done I stayed for the whole seminar and picked up a lot info. And I was a "gopher" too. It was a lot of fun.

I have noticed since '84 that things have became more lax. I've interviewed a few EMT's and Medics and they seem like the more basic things are being over looked. I'm sorry, but I'm a big "you must first learn the basics". I actually had a few tell me they rarely even opened their first EMS books, like they were bragging about it, like, "I'm so smart I didn't need to learn that". I didn't know to laugh or cry about it. Rarely did I pass on their application on to the office. I haven't fallowed the curriculum in about ten years, but even when talking to the newer Medics, you can tell they didn't get near as much instruction as we did, at all levels.

THAT I can testify to. What size of ER was it? Do they get a lot of codes? We had code in the field that we revived. Got to the ER and the pt. crashes. The main ER staff were busy on a critical MVA pt. that got there about 5 minutes before we did. So it was a few ICU nurses and some floor nurses. Here I am doing compressions (great for the abs.) and no Doc. in site at that time. My partner and I ran the code. Since I was an ACLS Inst. I was "elected in charge" until either the DON or Doc showed up. So do I'm doing compression and giving out orders. No one else there had ever defib'd. a pt. other than my partner so he was watching the monitor, ready at the paddles. Finally one of the docs making his rounds shows up asking if we needed help. I whispered loudly "Help'. He took over and got on the phone for more help. Evidently all the floor nurses were LPN's. Guess that's why so many were very timid on doing stuff. And the RN's (two I believe), one would do nothing but adm. drugs and the other was just making sure everything the LPN's were doing things right. They wound up putting in a pacer and got him up to ICU. That was a save for us. Even under normal circumstances we don't call it a "save" until the get to ICU. If they didn't make while still in the ER we didn't call it a save. They eventually flew him out so we didn't know how he turned out. Fortunately at the next ACLS class practically every one of those nurses were in that class. On the note of long term partnerships, when you are with the same service, sometimes at first there is a lot of trial and error. I learned how each EMT and Medic did their "own stuff" and quirks and I could adjust myself to where we met in the middle. There is just one time that stands out in my mind of a "fumble". Had a taxi driver coded. He was laying on the road way under the opened door of the taxi. We moved him to where we thought we had enough room to work with. I just got the guy tubed and I turned to move the monitor so I could see the screen better in the sunlight. At that time Jimmy was flushing a epi needle. And wham, I got jabbed to the bone in my finger. Rookies take note We came to the conclusion that we faulted by not making enough room, Be sure to have more than enough room to work. Should of had the monitor already where it could be seen. And don't have a needle up where it can be hit. It's just little stuff like that can not be overlooked. Even though Jimmy is now Fire Chief we still tease each other about it. We just said that he zigged when I zagged.

This is pretty much what I noticed, too.

L-6: " Uh, we're in line at the McDonald's drive through, but we will get right on it." Dispatch: "You drive over the curb and go NOW!" L-6: "But we already paid."

I try to keep things as simple as possible. You could have key words of, EMS, Paramedic, Fire, Rescue, Emergency Workers. Or something like that. I don't know, I just loiter here.

It IS funny, true but funny. Some of the funniest jokes ever used were from first hand experience.

BUMMER! I too have seen places we frequented a lot.

HHMM, The first words that come to mine is, "DUH". Back in my day we didn't have meetings or debriefings or any kind of support. Now there is. It was recognized about ten years ago when they realized this was creeping up on guys/ gals. I can't think how many times I would be having a down point and nothing to fall back on. Who knows, if it wasn't for my body giving out, I might still be in the field.

We always had Ambulance on the sides and front of course, but have MICU or whatever level they are on there too. Of course nobody is going to 911 asking for a MICU. It's up to the dispatchers to screen calls and get as much info as possible and assign what level of care is needed. That may take more learnin' for dispatchers, but....oh well. But one way or another, it's not going to change anytime soon.

I just had a thought. If EMS hash out a few things (like, right), the calls can be screened better. Basics and Intermediates can run on the less serious situations. But an MICU then they know will know it is a serious situation. But to run MICU you must be a P or higher AND take additional advanced classes. I know that is asking a lot, almost impossible. Get it out to the general public and the dispatchers will need to revamp their screening procedures. If a call comes in and there is a B or I unit can be respond and start everything until the MICU get's there. Clear as mud?

I thought that the words "Intensive Care Unit' along with "Mobile" would differentiate more and carry more weight an importance than just "Ambulance". But maybe not the entire world, but especially in the US, Canada, Australia, UK,etc. But what do I know?

I've had a JV line inserted while still awake. Had pneumonia with asthma attack. I'm a very poor candidate for a periphereal IV.They needed my blood in a big hurry. They had tray tray out to ET. me.Come to find out one doc had argued that he would have done. But being awake during an JV is nothing compared to a femoral stick, small or largo bore, it hursts the same if not. Apologies to the ladies out there, but if felt like my right nut was trying was to remove it with a rusty WWII surplus knife sucking through a 14-16g. I just don't panic until they "Cut down''. In matter of fact I had to have blood drawn today for a pre-op on a heart test/surgery on the 15th. The phlebotomist who drew my blood had been my parents neighbor for years, in matter of fact one of her sons may have been in my little sister's class. And she knew how bad my veins were she missed the first time. She seemed a little upset. I told her not to be. On average I'd say it's three sticks. I usually tell anybody and it took more than once, not to worry about, it's just payback for all the people I had stuck in the past.She asked me if it was alright to draw from ABG's. I was a leary of it because one time I had an ABG drawn by a young little gal, and it hit a nerve or tendon or some thin and and I had wrist/hand/numbness for about a month. But today Yaddi did good.

I believe that tunnel vision is a human response that everyone has, but in most jobs, especially EMS it's something you have to condition yourself to overcome. And I've seen those that has years of experience that still tend to do it. But to me, FOUR attempts in one area? Sounds like he was bound and determined to get the stick probably in the same place he's always gotten it before of other patients. Maybe if he looked else where he's feel out of his comfort zone. I've seen medics that would not try anywhere else but AC. I'd explain to them that there are other sites available, and sometimes those are easier. But they were "taught" in class that the AC was had the highest percentage rate of success. The lab tech hated it, that was their spot.