crotchitymedic1986

I do appreciate your bleeding heart mike, but I think we need some clarification on what kind of patients we are talking about: Are we discussing those patients who are truly suicidal, or just those who are crying for help (shot herself, but didnt die -- or scratched her wrist with a butter knife) ? I do not judge either, but I have often shown my disapproval through an educational tone, with teen girls who take an OD of tylenol, with the thought that it is a safe way to get attention, not realizing that dialysis could be in their future.

Lets write some rights for those who are domestic abusers: 1. You have the right to beat your wife/child without being labeled dangerous. 2. You have the right to use violence as communication. 3. You have the right to feel good about the tension that you released through violence. Same "Hippie-Feel-Good-Group Hug-Its not your fault bullshit".

The whole liberal pablum-puking suggestion that these patients (or any patients) need "rights" written on paper. You should treat all patients with dignity and respect -- doesnt matter what ailment or injury that they have.

well i guess if you are going to LET THEM arrest in your truck, you might as well withhold care another 5 minutes. No reason to change your standard of care at that point.

someone called it right - Psychology BS. Oh they were talking about the degree, my bad.

Of course not. But no one works an arrest better than EMS (most of the time). Most nurses cant read EKG, and you will be real lucky if the dermatologists who is working parttime in the ER, will remember any of the acls he took 4 years ago.

There isnt an issue here. D50 can be given rectally (using an ETT), so the lack of IV doesnt matter. If you cant get the IV, give glucagon. If that doesnt work (it probably wont on your obese diabetic patient), roll em over and shoot some D50 up their arse.

We are the definitive care in all arrests. Did you ever take an ACLS class with doctors ? The reason no one can fail ACLS now, is because the Physicians failed to often and whined about it.

I dont understand the logic in this question. I am not aware of any circumstance where I would intentionally delay care to a patient, unless the scene was unsafe.

And isnt EMS already under federal control -- yes the DOT has done a fine job ?

Most nursing home patients do present with multiple problems, which is why you treat the patient. This is the best example of cook-book I have seen in awhile: The monitor says she has a rate of 200, lets cardiovert her or give her cardizem -- wait a minute, her mechanical pulse is only 88. She's not hypoxic, because my pulse ox says 98%. Havent seen anyone suggest treating her fever. I know a tylenol suppository or a shot of toradol isnt as sexy as cardizem, but it should be the "FIRST" treatment in this scenario (after O2). I couldnt have written it any better.

Sounds like you guys are promoting communism as the savior of EMS (atleast Federalism). Can you name one program that the feds do well ?

There is nothing wrong with accessing it if you absolutely have to, but too many medics assume dialysis means no veins, which is not always true. I would say I was able to atleast put a 22ga in 95% of the dialysis patients I transported.

Answer: Called to a nursing home for trouble breathing, upon entering the room find the pt, sitting up in bed coughing up green / yellow sputum, AOCx4, answering questions appropriately, full sentences with intermittent coughing up the nasty stuff, also has a low grade fever past few days. Staff states her pulse Ox fluctuating between 85-90% they have her of course on the normal 1.5 Lpm NC. Hx of A-Fib / HTN / recurrent pneumonia. Her O2 sat increased with OXYGEN -- on room air she is satting 80s-low90s, and has atleast one lung full of sputem. The patient does not have a cardiac issue, she has a respiratory issue. If not treated, it could become a cardiac issue, but you should treat the underlying cause first.

not surprised ruff --- professional is as professional does

erdoc completed school in guatamala i guess

wrong, wrong, wrong ---------- know your vein anatomy, you will find a vein

They are all built by the same three kids in China. If you have a main hospital that you transport to, try to get the same one they have to reduce "tubing waste" -- sometimes they will give or sell you their old ones cheap when they upgrade. Those are bulkier than the 3 channel pumps that most ground and air ambulances use, but I find them easier to operate, and they usually have more features (calculate drug dosages for you).

Here is a perfect example of cookbook medicine where rookies treat the monitor instead of the patient (which is the type of medic your preceptor is == it happens). The rate will come down as soon as you get the fever amd hypoxia under control. If you do not have oral antipyretics, I am sure the nursing home had suppositories they could have given you. Treat the fever, treat the dyspnea, give some IV fluid, and the patient will be fine. *** I imagine the ER doctor didnt ask you why you didnt give cardizem, and I imagine he/she didnt administer it either. Kudos for being an exceptional rookie.

I dont like shortcuts when it comes to drugs that can kill your patient or not save them if not given correctly. It is not that hard to be exact, you just need a calculator (which most laptops with windows has an accessory -- If not, you can buy one for less than $3.00) : Remember: Multiply everything together then divide by concentration: administer 5 mcg/kg/min to a 110kg pt with a concentration of 1600 5x110x60 (min)= 26670 / 1600 = 20.62 8.5mcg for 20kg pt with 800 concentration 8.5 x 20 x 60 = 10,200 / 800 = 12.75 Two of the most important, cheap, pieces of equipment that is missing from many ambulances are: A REAL thermometer and a calculator !

Tough to say without knowing if she were febrile and if she was orthostatic. Her underlying problem is pneumonia, so the increased heart rate could be from fever/sepsis, poor oxygenation, and/or dehydration. If her temp is above 102, i would say treat the fever and the dyspnea first, treat the AFib if it doesnt respond (in the ER, not the field). If orthostatic, a small fluid bolus wouldnt hurt. As long as her B/P was good, and you had IV access, I wouldnt be too aggressive with the AFIB, especially without knowing the other 50 meds she was on.

Suggestion: Designing a logo for EMTCITY and converting that to a patch can be very expensive. You might want to see if someone can design something by drawing it on paper, then an embroidery shop could scan the image in and embroider it on the quilt with a machine (much cheaper).

Sorry kitty kat, in my EMT or Paramedic class I was not trained to use: 12-Lead, Pulse Oximeters, Glucometers, Pacing, probably 50-75% of the drugs that are now on ambulances, PPE, IO needles, IV pumps, a computer, a direct connect cell phone or radio with multiple functions, safety needles, sharps containers, one-man stretchers, stair chairs, a broselowe tape, CPAP, or a portable ventilator. Why, cause it was over 20 years ago, and these things had not been developed or were not common in EMS yet. Just because it wasnt taught in your class, doesnt mean you wont need it one day. Our society continues to grow more and more violent, with little regard for human life. I didnt get the chance to use the MARK-I kit or the escape hood that was on my ambulance, but it was there if I needed it.

snores, you can wear ear plugs, or throw pennies at them till they roll over. Would you rather burn to death quickly, or freeze to death slowly

Just wondering, since I have never been to Oklahoma: Why arent volunteer EMS agencies used in these areas that cant afford ambulance service ? Why hasn't the legislature created some kind of new tax to help fund these areas (could tax alcohol, cigs, increase user fees for drivers/hunting/fishing/professional/ or business licenses) ? Do these areas that dont have ambulance service, also not have police and fire coverage -- can those personnel not be cross-trained to be dual providers ?