SANDMEDIC

My dad drove around with a one gallon fuel container under his bench seat in an extended cab Chevrolet. He always would make sure it wouldn't leak and never filled it all the way to the top allowing room for expansion. He also added "Stabil" to prolong the life of the fuel in the container. As long as I can remember my dad always had that same ole gas can under the bench seat. To this day he still carries an extra gas can in his truck. To my knowledge it never leaked, but guessing by the cheap junk made overseas these days they all probably leak. I assume no responsibilty in the application of these techniques and are only suggested as past experiences. Use at your own risk. Batteries not included. Objects in mirror closer than they appear. Not responsible for accidents. What else is there. LMAO

Personally I feel it's kind of a waste of time to go trolling down to "Help Out". There are gonna be so many health care providers, FEMA, DMAT teams, state disaster executives etc, etc. everyone will be standing around telling "war stories and beating their chest. 30% of the people didn't come back after the first one, and hopefully those that live there now are planning on evacuating, but like the first time, probably not. I don't think it's gonna be the big show as it was with Katrina. Although those headed down there be safe and take care.

" Troubadour" -George Strait

If you get a transfer call out of town, it's almost guaranteed there will be a working structure fire or MVC with extrication while you are gone. It is all you'll hear for the next three shifts "man you should have seen it, two story house heavy smoke showing"

I am only familiar with the Missouri DMAT which is paid while on deployment as well as training. Something rarely seen is no matter what your rank, EMT, Paramedic, RN everyone is paid the same. Missouri has a pretty impressive DMAT team multiple vehicles and enough equipment to make your jaw drop. Here is a link to most of the DMAT teams across the U.S. The K.C.M.O. team is not included in the list. http://www.dmat.org/teamlinks.html Hope this helps.. Great bunch of highly skilled individuals..

Jonathan Edwards - Sunshine (Go Away Today)

I just feel it would be a good idea not to slather what my location is. BTW how do you like the new protocols? Tell CJ I said hello, he's a great guy. Take care,

I'm approaching the 9 year mark. I never thought I would get burnt but being in a clinical setting has to be the most boring thing I have done in my career. Yes you get to have 110 medications in your formulary but rarely see any acute illnesses. When they do walk through the door, you know it. Immediately you whisk them to higher care or call in MedEvac immediately and are usually out of your hands within a few hours. Although, I never dreaded a day going in to work on a ground ambulance, firetruck or rotary wing. I wouldn't say I'm burnt out, just feel I'm losing grasp on the Critical care & "street smart stuff". I devote at least 2-4 hours a day reviewing "emergency medicine". So when a call for something acute does come in, I'm still on my "A" game. It's great taking care of those supporting the war, don't get me wrong, just overdue for getting back on the street, even if the pay sucks.

"Can't you see"- Marshall Tucker Band Or "I'm one of you"- Hank Williams Jr. (New song I have never heard before)

Yeah my bad.. I was unaware we were speaking of two different devices, Lifepak 5 and the Lifepak 500 two separate devices. My bad...it's good to laugh at yourself every now and then..

I am more curious than anything. I used a lifepak 500 early on my career for about two months, in which it was replaced with a Zoll PD1400 due to having the pacer option. My question for all is did the Lifepak 5 ever come with a pacer as I remember there was no external pacer on the unit I carried. Is there a lot of services still using the Lifepak 500? It would be amazing to know how times the lifepak 500 has saved lives, as it is the "Ole reliable". Anyone know the year it made it's debut?

Alright !! The order was for Glucagon 2 mg slow IV. of all the drugs in my toolbox it was the one everyone make fun of and always wonder why we carry it. Well Glucagon saved the day.. literally! After approximately 10 minutes the gentleman was asking me if he really needed to go into the E.R. as he felt completely fine now. How it was explained to me. The physician explained it as Biphasic/ multiphasic analphylaxis, he stated it usually happens after some initial treatments although can be completely delayed up to 8 or more hours. The delayed reaction was simply a slower release of histamine and other chemical components of analphylaxis, although it potentiates the longer the body is allowed to continue in this state. An alternative drug for treating anaphylaxis in patients taking beta-blockers is glucagon. Glucagon helps to produce the same chemical within the mast cells that epinephrine does, but Glucagon doesn't need the beta-receptor sites to do it. This chemical stops the release of histamine and other chemical mediators that contribute to anaphylaxis. The Glucagon dose used to treat anaphylaxis in patients taking beta-blockers who are unresponsive to epinephrine is 1-2 mg IV. Common side effects of Glucagon administration for anaphylaxis include nausea, vomiting, and hyperglycemia. Things to remember. 1. Take your time and get a complete list of meds. 2. No more making fun of Glucagon. Those that do not carry it, it might be something to suggest. 3. When things are going bad and you are at the end of the Algorhythm, DO NOT have too big of an ego to call your base hospital and ask for guidance. 4. This is a good one to ask around the station, I found that it is such a rare occurance some have forgotten this little tool. 5. Having a little guide book on drugs comes in handy. Not all of us know what Tenormin is, if we don't see that "olol" to know it's a Beta-blocker. Hope you all enjoyed my first little scenario. Any further questions or points I should have made please post.

Exactly!!! The patient is on Tenormin also known as Atenolol. We did not have IV Epi in our protocols, but does anyone have a guess what the order was for.

So at this point i'm growing more and more concearned as the miracle Epi & Benadryl is not doing the trick. It is at this point I hop on the radio with our base hospital (Something rarely done) for guidance. You are the base hospital, what are you gonna advise. or You are in my position, what are you gonna do. SaO2 continues to drop and there was no RSI to use.

The patient used his wifes EpiPen which was not expired. She is severely allergic to bees. Pt thought "But thought it would work". The patient denies eating, he stated he drank a soda and took a shower. The patient states he does not feel any better. You load him on the stretcher and begin the journey 30 minutes to the hospital. Pt states his “throat is getting tighter”. Racking your brain you administer an additional dose of Epinephrine 1:1,000 0.5mg SQ. 10-15 min since initial dose. And continue the SVN/ Nebulizer Albuterol/ Atrovent (Ud). Second set of vitals: BP: 90/48 (after 750ml NS IV) P:132 R: 28 irregular SaO2: 88%

The patient was stung multiple times (unknown amount). The bees were still there swarming when the fire department arrived 4 hours later. The patient had no immediate response to the bee stings. He used his EpiPen just prior to you arrival due to his difficulty breathing "getting worse" No changes for better or worse after use of EpiPen. This is gonna be a quick one all. We've all done the Anaphylaxis protocol and it varies some but I was schooled on this early in the career and it something you never forget. I'm going to present this exactly how I treated the patient. Your Partner places the pt on O2 -NRB@ 15lpm Your partner obtains a set of vitals as follows: BP 88/50 Pulse: 122 Resp: 30 irregular. SaO2: 92% on NRB @ 15lpm You place the patient on the ECG monitor: LDII RSR@ 130 /s ectopy. You administer Epinephrine 1:1,000 0.3mg-0.5mg SQ And begin SVN/ nebulizer Albuterol 2.5mg/ Atrovent 0.5mg. You establish an IV NS 1000ml wide open rate You administer 50mg of Benadryl IV. You administer 125mg Solu-Medrol IV.

The patient waited nearly 4 hours before calling 911 as he thought he “was fine”. Pt. c/o rash, difficulty speaking, and difficulty breathing. Pt advises he used his EpiPen without success. As you stage a safe distance the fire department used the old dish soap in the water tank trick and has since made the scene safe. As you enter the home you can hear the wheezes from the patient in the kitchen. Upon arriving at the patient you find a 48 y/o male A/O x 4 speaking short word sentences, profound uticaria over his entire body. Pt /c profound edema to upper and lower lips. Pt in obvious respiratory distress. Pt’s wife states he was just fine and they were waiting for the exterminator to arrive. She states it has been nearly 4-5 hours ago. Pt’s wife advises the pt. used his EpiPen just prior to your arrival. Pt’s wife provides you his complete medical history. Hx: HTN, hyperlipidemia, BPH, Medication: Zocor, Tenormin, Altace, ASA Allergies: PCN, Sulfa Primary assessment as follows: Male A/O x 4 speaking short stridorous sentences. Face: Pale skin color. Eyes: PERRL @ 3mm Chest: (=) rise & fall, labored resp., accessory muscle use Lungs: Inspiratory/ expiratory wheeze bilat x 4, diminished @ bases. Ext: CMS intact x 4, uticaria to upper and lower extremities. Skin: Pale, hot, diaphoretic.

Aspirin comes to mind Vomiting Hemataemesis lethargy Seizures Coma Not good!

HMM 3 y/o pretty active age. Generic Hx/ Meds/ Allergies. Was there any time where the 3 y/o was unattended? Access into areas under the sink or playing with any of the older childrens toys at the babysitter? Legos seem to make their way into some interesting places. Definately load and go. I never did mess around with kids, they can go down hill very quick. Poison ingestion vs Foreign body (toy) The blood streaks kinda keyed me up to this DD.

I have to try my hand at this.. You are EMS unit stationed in the rural Midwest. Approximately 30 minutes from the nearest hospital. It is a sunny summer day. Hanging out at the station the tones drop. “6417, 6410 respond to an EMS call from card 8322 map 4. Difficulty breathing, 13244 County Road 462.” You are dispatched to a residence 10 miles from your station for a 48 y/o male that was mowing his grass when he was “stung” by multiple bees. Dispatch advises fire is also responding due to the high volume of bees still swarming outside the residence. Dispatch also advises you have a "Conscious and alert male c/o difficulty breathing and severe rash".

Welcome to the world of "Sore throat specialist". We get a good mix here in Afghanistan, doing rotations to remote sites in the mountains in small camps with less than 200 people. Guess what? The medic is usually the most popular guy. And definately lives up to the name "Remote Duty Paramedic".

EZ-IO works like a charm. Only used it 4-5 times but when you need it you know it. A lot of services now carry them, although I always enjoyed the look from the ER nurse when they finally see where the IV line goes. Professionally when it comes down to it, if the Sternal IO and the EZ-IO were sitting side by side I would probably choose the sternal IO. This only due to the speed and easy deployment and just feel more comfy using it. I have never used the "Bone Gun" or whatever it was called. (never carried it). I have other talk about false deployment while not in use, but truthfully I do not know. I do feel that over time I will grow to utilize the EZ-IO more often. The EZ-IO is impressive under fluoroscopy. Choose your weapon.. As long as they get the job done, i'm game for either.

^Wow! yeah what he said. :shock:

"Spirit in the sky" Norman Greenbaum (1969)

It's a bad day when you hear of a fallen brother. Rest in peace my brother, may you and our Lord look over us all, and give us guidance.