crotchitymedic1986

CBEMT, thats why you should carry two pillows and two blankets (there is room in the main O2 compartment). You never know when one will become lost, stolen, used, or soiled.

I have no doubt that the parents of these children have been guests on the Jerry Springer show more than once, but at the same time, in today's cutthroat media world, if there was any inkling of physical or sexual abuse, that would have been the headline, or would have least made the first paragraph. If not on day one of the story, it would surely be out by now. So the reality is that these rednecks are nazis', and have named their kids after their idol. I dont see anyone getting offended when they encounter a child named Mohammed or Jesus (hasuz). How many kids in the late 60s weere named Martin (king), John (JFK), or Robert (RFK) ? Isnt freedom of speech about protecting the things you DO NOT want to hear ? P.S. : If we hadnt won the war, and the whole world spoke german now, would Hitler still be viewed as evil, or as the greatest military mind and leader ever ? Think about it, if he had won, you would have never known of the other atrocities, you would only know what the government wanted you to know.

I worked in a pediatric hospital parttime for a few years, and watched kids die from a variety of ailments and injuries. It never gets easier. I think the biggest problem with kids is that 99% of the time they are INNOCENT, and did not contribute to their death. If you are working an adult who has been smoking for 20 years, or is 200lbs overweight, or decided to see if their car could do 150mph, we can sort of minimize the death (privately in our minds) by saying they did it to themselves. But with a kid, you can rarely say that. I think it is a good idea to talk about it with your coworkers who were on the scene, if things are not better in a week's time, see a professional. The day Pediatric death no longer bothers you, is the day you should get out of EMS. Private message me if you need to talk.

Anybody doing anything new to make your ambulance safer or more functional ? Please share what your service does, in case anyone is about to order a new truck in their new budget year: My suggestions are primarily for the box: 1. No sharp corners or edges. 2. No cabinetry above the bench seat (head safety). 3. Place padding on the wall above the bench seat where your head would hit (usually only has a back cushion), if you do not have captains seats on that bench. 4. Three point seat belts in box. 5. Have atleast two ceiling lights that are moveable/directional so that you can move the light where you want it, instead of having to move to where the light is. 6. Make the ALS compartment big enough that you do not have to bust your knuckles to get an IV or drug box out of the cabinet. 7. Finally, when you install that tattletale squak-box, instead of having it make a sound when you drive poorly, have it deliver an electrical shock to the driver's seat.

Maybe I am misreading the quote, and maybe you are referring to California LAW, but not all EMS agencies have standing orders or protocols (especially when you step into the volley or private ambulance world). I think a good set of standing orders is the answer to this person's complaint, unless this Nurse also acts as the "traffic cop" and tells ambulances where to transport to. I have not worked in such an arrangement, but I know that some cities have set up a "centralized call center" where all ambulances call in report, and then they are directed to certain hospitals to try and ease or eliminate "diversion".

A good strategy (but you have to be mindful of HIPPA) is for "the fire officer" to have a folder that lists everyone's "normal vitals" in his/her vehicle. By the time you are doing rehab, the officer should be on scene. You can then know what is normal, and not allow the firefighter to return until he is close to his normal again. If anyone is concerned about their HIPPA rights, you can use something like first name and radio ID# or unit #, or last 4 of SS number, or just use thier initials, in the folder. This also helps to keep the FF in the rehab area, when they want to go back, but shouldnt. If the officer knows that the person's normal B/P is 110/60, and it is now 140/90, he/she would be less likely to send that person back in. Although it takes a little work to compile that info, I have never met a Chief who refused to order it to be done. P.S. We only listed vital signs, no personal or history info. And this was usually smaller departments, for larger departments the folder could be kept in each apparatus' driver's door pocket.

I dont know that I would question his motives just yet, it will probably be the biggest "event" in DC history (or any other city/state for that matter), so I dont think it is so wrong to wonder about what kind of planning has to occur. Can you imagine how difficult it is going to be to get an ambulance "close" to the patients, or to pluck a patient out of that crowd ? The population of this event will probably outnumber the population of some entire States. Glad its not me.

If this is wrong, then it is wrong for celebrities to name their kids stupid names like "moonunit": http://www.cracked.com/article_15765_p2.html

Well I would admit that my anti-stance on this is driven more by laziness than ethics, but what if you looked at it from this view: When it come to interraction between fire, PD, and EMS, we in EMS take alot more than we give from our brothers in the other two services. They help us on calls alot more than we help them (statistically). So, is it wrong to give a little back, and help PD on some of their calls ?

I would NOT hire a babysitter this way, but I wouldnt totally discount the method. You can learn alot from just one question, if it is the right question. For instance, how do the answers to these questions help you judge EMS personnel: 1. What certifications do you have above CPR and ACLS ? 2. How often were you tardy for work or absent from work in 2008 ? 3. If I looked in your ambulance right now, would I find a pillow and a blanket ? 4. If we inventory your ambulance right now, what object is closest to it's expiration date ? Less than 3 minutes, and I would know alot about how that medic performs.

A few problems to overcome, which can be done: 1. Figure out before you start, how far you want to take this. If you goal is to get your study published, contact the people who would publish it, and ask about their standards. Then look at the links you have been given about the scientific method, and make sure you understand how it needs to be done. You dont want to do all of that work, just to have it thrown out because you omitted one step in the process. 2. You have to convince your coworkers that it is ok to document and admit the truth on every call that you are studying. Then you have to educate them to the study, how you are gathering data, and how they can help you. For instance, if you are studying ASA administration in MI, then it is important that your medics document the truth when they "forget" to give ASA, give the wrong dosage, or dont give it because of allergy or because the patient already took it but fail to document why they didnt give it. If they are dishonest in their documentation because they know a "study" is going on, and they dont want to get in trouble for messing up your study, then the data gathered is worthless. 3. You have to leave the blinders off. Often times when you start a study, you have a belief about what you think the study will show you, which may steer you to or away from a certain idea or direction, which could jeopardize your study. You have to enter the study as if you are a layperson who has never run an EMS call. For instance: When I studied "refusals" as a CQI project, it was suggested that we should look to see if minorities were not transported more often than whites. Everyone said, "thats a bunch of BS, no one here is racist." But the initial statistics did show a higher refusal rate among minorities for the same complaint, so we had to dig deeper. When it was all said and done, we found that the issue was economic, not necessarily racial. When you broke the groups down economically, the gap was smaller when you compared poor whites to poor minorities. But still, there was a gap, and the gap improved when medics were made aware of the stats (doesnt mean anyone was a racist). The same was true when day trucks suggested that the 24-hour crews had more refusals after midnight, which was driving up the numbers. It was true, refusals increased 40+% after midnight. But it would have been easy to just say, "nah, i know these guys, thats not the problem. I wish you luck, we need alot more "studies". It can only bring "good" to your service and yourself. Nothing would make me happier then to know that the people of this forum launched "5" good EMS studies this year (and them shared them with everyone), even if they are very small scale studies.

You are right in that your treatment will not hurt the patient, but if it is CHF or MI, an aerosol treatment will not do alot of good. If it is COPD, then an aerosol treatment migh help alot. This patient could have any of the diagnosis' listed above. Anybody else got a suggestion for how you would differentiate ?

Who the hell wants a virgin ? I remember the virgins I had back when i was a teen, wasnt that good. Give me a marlboro smokin, beer drinkin, whore any day of the week. Thats what I dont get about being a muslim -- I get to heaven, then i have to teach 72 women (hope its female virgins) how to have sex ??????????? P.S. Dont think Ive ever had any that was worth 3.5 million, but then again after you add up all I have spent on houses, cars, jewelry, clothes, groceries, I have probably spent close to 1 million. Guess we all pay for it one way or another.

The good news is that the treatment for both is essentially the same, antibiotics. This is why so many were assumed to be spider bites, because the wound healed, and there was no culture of the wound. Since it healed with first round antibiotics, there was no follow-up. But as we are aware, we have many superbugs that are becoming more and more resistant to antibiotics, which led to more cultures being performed, and the discovery that many spider bites are not spider bites at all. Most the people that I triaged in the ER DID NOT remember a spider bite, they assumed that it occured in their sleep. Obviously, the concern for you is PPE, and proper clean up (dont taste the spider bite).

ANSWERS WITHIN BOX

I think the vote is still out on that one, as online schools are as varied in quality as paramedic schools are. There are probably some degree MILLS out there, as well as some outstanding schools. I think most colleges have come to the conclusion that it is better to pass 80% and keep the money rolling in, instead of flunking 50% in the first year. I hear that Univ. of Phoenix online is very reputable. With that being said, I do not know if I would have to ability to do online, i am a classroom kind of guy.

Not so fast, that wound may be MRSA instead, especially if the patient doesnt remember actually being bitten. You see this more in the ER than in the field, but often times patients present with a wound that looks like a spider bite, but they do not remember getting bit. One study showed that over 70% of "spider bite" wounds cultured out as MRSA instead. http://www.aafp.org/fpr/20041100/10.html http://www.surviveoutdoors.com/emergency/mrsa.asp (this link contains a pic) http://ochealthinfo.com/epi/mrsa/providers.htm

no tenderness, pain, or problem with any extremity.

There is no such think is ADD or ADHD, just KTNTAW (kids that need their ass whipped).

Would never shoot a rookie, it is for you that I am putting this out there. Go ahead, ask any other question you like, that would help you in your efforts. P.S. and you dont have a 5 minute transport time, so you have to treat the patient, one way or another. And for the sake of arguement all phones and radios are inoperable, you can not seek guidance from Medical Control.

Just shaking my head ...................................... http://www.wesh.com/news/18469631/detail.html

Not suggesting you are wrong or right, which specific symptoms or thoughts led you to CHF versus the other possibilities, if you wouldnt mind painting the picture. Thanks.

Heather jean asked what should be on the eval sheet ? Depends on your service, as you may have unique things that other services do not have (more mtn or water rescues than a service in the desert -- maybe you are in the desert). So you have to ask yourself, what are the things we think every new employee should be proficient in before we turn them loose ? At the EMT level, I would say the following is a good start: Proper defensive driving. Map reading or ability to operate GPS. Ability to operate each piece of equipment on the truck that is at his level. IV skills. Immobilization skills Territory knowledge and hospital locations. Restocking of the ambulance and clean-up procedures. Vehicle inspection. Things that are unique to your service or region. Policy / Procedure / Protocol

This is not your typical scenario, as it really isnt a scenario, but instead a common EMS call that may be difficult to diagnose (yes I said the D word). What I am looking for, is what criteria you use to decide what treatment you provide for this patient. Please base your decision on the info provided. This is not a trick scenario, the patient has one of the four conditions listed above. So which direction do you go with the info provided, and why ? You respond to a 50 year old male with onset of dyspnea in the last few hours. The patient has no history other than he has smoked about 2 packs per day over the past 20 years, and he is about 40lbs overweight. He states he was short of breath when he woke up, and it has progressively gotten worse over the past few hours. You find: Meds : None, but pt has not been to a doctor in years. Allergies None Pain: None LOC / head / neck: Alert and oriented x 4, PEARL, NO JVD Skin: warm and dry - no cyanosis. Neuro: No neuro deficits Breathing: He is in obvious distress with insp/exp wheezing noted bilaterally. He is using acc muscles. Pulse Ox: 88% room air B/P: 210/98 Pulse: 94 Monitor: Sinus no ectopy / 12-Lead negative for MI. Extremities: Moves all well, no edema, no pain, no tingling. D-Stick: 102 No cough / No fever No drug or alcohol use No exposure to chemicals or signs of anaphylaxiis.

Taking bets on how many shifts go by before this conversation takes place: Dispatch: Unit 123 respond to 67 Macedonia Church Road for unresponsive patient. Unit 123: Dispatch that road is not on our map. Dispatch: 10-4, take Hwy 53 until you see the big red barn, turn left on Billy Clay Road, go until you get to where the Sardis Church used to be before it burned down, turn right on that dirt road. That road splits at the Crick (creek), turn left at the split, the patient will be in the 3rd trailer on the right, just past the school bus that is up on blocks. Family states they will have all the dogs rounded up by the time you get there.