crotchitymedic1986

I remember responding to a call for a child with fever. Upon arrival, i found that my patient had a large red mark on her neck. When I asked what happened to her neck, the parents explained that they were treating her fever by coining her. Then they put a penny to her neck and started scrubbing. Apparantly it is a common asian custom, that I had never heard of: http://www.ehow.com/how_2228235_use-coining-treat-fever.html What is the most unusual home or cultural remedy that you have witnessed on your calls ?

Well i doubt that we can stop all crashes nation-wide from this one forum, but generally when you want to solve a problem, you must first study it, gather statistics/data, analyze the data, then draw some conclusions. I didnt know that many people had been killed in ambulance crashes in one month. And no, I doubt the numbers are any better when it comes to firetrucks or police cars, but that does not reduce the significance of the situation. That is alot of "needless" death and injury, some of which was probably preventable.

yes, do you understand the difference between moteling and lividity ? Apparantly the poster did.

some of us like to prevent death.

OK, answer this then: Why isnt there any lividity in the leg/foot that is hanging off the bed ? If blood has started pooling in one spot in the patient's back, why isnt it pooling in the lowest hanging part of the body as well ---- Oh i know, right after he arrested, all the blood in that leg rushed to that one spot in the back. DDDDUUUUUUUUUUUUUUUUHHHHHHHHHHHHHHH !!!!!!!!!!!!

Yes, i am familiar with warm and dead, which is usually due the patient being covered up. But can you answer this batman: If the patient has been dead long enough for the blood to pool in the patient's back, why did all the blood decide to pool in one small spot between the shoulder blades ?

you dont know that it was lividity, it might have been a bruise. pt still warm, down time unknown.

As spenac noted, this is not a "complete log", but of those logged, here are the total numbers for just December 2008 (which isnt over yet): Ambulance crashes: 23 Ambulance personnel injured: 24 Ambulance pers. deaths: 0 Patient Injuries: 7 Patient Deaths: 1 Other vehicle injured: 11 Other vehicle deaths: 5

read again: I checked for rigor, there is no rigor. The pt brother arrives on scene and says I don't want anything done for him, Your not going to take him and do cpr. So My partner talks to him. The pt has no dnr and the brother doesn't have power of attorney. I put the monitor on and its asystole in all three leads. The pt is warm to the touch. My partner and I roll the pt to check for lividity, there is a tiny tiny amount starting between his shoulder blades, and some minor mottleing, on his leg that was hanging off his bed.

my bad, it has been corrected.

Here is a link to a site that maintains an ambulance crash log. December's accidents will pop-up with this link, and you can search all previous months. If I get bored today, I might count up all of 2008's crashes to get an injury and death count. Of course, those crashes that are listed are voluntarily emailed to the site, it is not an all-inclusive list: http://www.emsnetwork.org/artman2/publish/...e-crashes.shtml

I would have worked it, you have no legal standing not too. For all you know, brother has been pumping him full of antifreeze for the past several days. You did not mention the patient's age ????

well dont throw out the waffle maker. just go buy you a box of Krusteaz Belgian Waffle Mix (about $2-4.00), add some water and mix -- makes great waffles: http://www.krusteaz.com/brands/krusteaz/pa...e_waffle_mixes/ There are other brands, but this one makes the best belgian waffles in my opinion.

Just to clarify crazy: You respond to a construction site where a worker has accidentally shot a staple into his index finger. Bleeding is under control, and all vitals are stable, he will probably need a tetanus shot, but no stitches. You are on an ALS ambulance. Do you transport him or not ? If he is willing to let a coworker drive him to his doctor or local doc-in-a-box, do you tell him that he shouldnt and beg him to let you transport ? If not, do you still get him to sign AMA ?

thank you sir duke, and I will return the favor to you. Yes, many ER docs get bent out of shape, because in the end of the day, they do have liability for their care or lack of care, but most hospitals couldn't care less about the ER patient volumes, or how holding admitted patients in the ER for 8 hours, compromises their ability to treat patients well. They get pissed, they have no one to vent too, so they take it out on who they can -- emts, medics, nurses, and techs. But before we criticize, lets take a look in the mirror. You are on your 20th hour of a 24 hour shift in which you have been slammed. You barely got one meal in your body, you have had no sleep, and you are on your 4th BS drunk call in a row. Is your tone over the radio to the dispatcher as pleasant as it was at 8am ? Is your tone and body language to your patients, FFs, EMTs, volunteers, patient's families, and nursing home staff, as professional as it was at the start of your shift ? Being an ER doc is like being the only BLS truck in an ALS service. You get dumped on all day long. Other doctors dump their patients on you that they dont want to deal with, and you basically run a non-emergent clinic for drug-seekers all night long in the ER. Also realize that many docs have never had a job in the corporate world or employment world period. They went from high school to college and medical school, where they were treated like crap and yelled at the whole time. They may not know any better, we do.

richardb. bible, baseball, and southern ---- what are you talking about ?

ding-ding-ding for scuba. Upon exposing the legs you find a "nitroglycerin patch" on top of the patients boo-boo. She went to the bathroom and got one of "grandma's bandaids".

scuba is getting warm. it is on her right knee, but you cant see it because it is under her pants leg.

pupils are normal and equal, a bit sluggish to light.

Lung sounds are clear and equal -- respirations are shallow, most likely due to current condition. If all you did was the treatment that you first stated kaisu, you would probably improve the patient's condition, but would be embarrased upon arrival at the ER. Keep thinking about the cause. It is not obvious, but this was a real call, and could happen again very easily.

Good treatment so far, but if that didnt work or atleast improve the situation, what would be your next course of treatment ? What are your thoughts as to why the patient is in this condition ?

It's approximately 17:30 hours, and you respond to "unresponsive child". Upon arrival at the scene, you find an 8 year old girl, unconscious, unresponsive, and diaphoretic. She got off the school bus at grandma's house around 16:30, and was feeling fine. She told grandma that she had fallen on the playground at school earlier that date, and asked grandma if she could have a band-aid, then went out into the backyard to play. Vitals: Pt unconscious/unresponisve on ground in back yard. No radials - B/P 50 palp Monitor - Sinus Tach at 140 - no ectopy D-Stick - 112 RR 18, pulse ox 94%, lungs clear Skin pale and diaphoretic No hx, no meds, no allergies -- perfectly healthy child. There is no evidence of trauma, fall, insect sting, or overdose --- playmates state she just passed out. Go for it ......................................

NO matter how many calls you run, and how much experience you gain, you will always find that one call that bitch-slaps you from time to time. You probably did fine, as long as you were treating the most critical patient, since you were the first transport unit on the scene. As a senior medic, I always made a point of walking the entire scene first, before I got lasered into one patient, to look for missed patients, scene hazards, the most critical patient, and making sure the dead patients were dead. I would then make sure we had adequate resourses enroute, then I would start treating the most critical patient. I would say the biggest thing is to make sure you identify all hazards -- there is only so much you can do for patients, but you cant do that if you are dead OR injured. I remember one cluster, where a large utility truck struck a power pole, flipped upside down. The driver was dead, and seatbelted in. Diesel fuel was leaking everywhere, but since the driver was dead, no one was in any panic mode. When one of the cops reached in to get dead guys ID, he hit some button somewhere, and something on the truck started arching electrical sparks all over the place (into the spilled diesel fuel). The hose monkeys hadnt pulled a line yet, so the scene went from peaceful to immediately chaotic, and everyone realized that if this were a gasoline powered vehicle, we would have all burnt up. LESSON LEARNED.

I hate to break the news to you, but your state is probably going to be the first one to be hit, if you are in california (medi-cal). California has sunk deep into a spending deficit, and now no longer has the bond rating to be able to borrow money. Medicare will have to cut benefits, as there is no way to sustain the current system, with current tax revenues, as the baby-boomers start making claims. I think it will hurt the non-emergent companies first, but that means your 911 service will have to do granny-totes.

The other tactic for him or her to try, is if the owner goes through with making them pay, he/she could say you know what ? My back has been hurting every since the accident, since we didnt get her insurance information, I guess I will have to file a work-comp claim.