Arctickat

CYA Healthcare at its worst.

Kaisu, why no benzos? It may improve compliance. What we need to remember is the cause of her decompensation. She's septic and in respiratory compromise. We can fix the respiratory compromise definitively with a complete MFI. hmmmmm...is the reason you guys are trying to avoid intubation because you don't want to use a BVM for a couple of hours?

My backup tube would be a King.

Fine, then I'll say it. The kid is an idiot.

I would agree triemal, but only because I serve a relatively small service area with a low call volume and can send another ambulance if another call comes in. Also, I can be ready to respond from this scene should the need arise, and return once all is done. I've done it before. It's only gonna be a couple of hours before his wife arrives to take him in, and who knows, if he's going the same direction that we are we could still follow them, just in case she needs us. However, I will not take my ambulance and crew out of service just in case this guy crashes when there are others calling for help. I'll go to where I'm wanted and needed rather than hover over someone who doesn't want me there.

lol, they needed a pointer so we wouldn't have difficulty locating it on the image?

Document the crap out of it no matter what, but you can't leave Why can't he leave? Do you sit and babysit every competent and informed refusal you get?

Whoops, sorry, should have included that. http://www.sciencedirect.com/science/article/pii/S0196070911000755 http://www.ncbi.nlm.nih.gov/pubmed/21715048 I was actually looking for that this of the NG tube curled up in the cranial vault and found that one instead.

My wife makes me watch Grey's Anatomy with her...you should have tried what Carev did in the last episode. Fake Cry. Beg him until you're bawling like a pathetic little wisp of a man. Women's tears might get attention, but a man's tears will get anything. Hell, I could just sit with him and tell him stories of all the useless death I've seen and easily bring myself to tears...then tell him how I don't want him to be the next body I cry over...

Do meds actually become toxic as they age? My understanding is that one of two things happen, they either become less potent or, since no sterilisation process is 100%, the bacteria in the solution increases to a state whereby the drug is no longer sterile...and at that point you can see a visible discolouration.

Or in my case, measure twice, cut once, cut again but just a little, measure once more, trim of a smidge, measure again, trim off a blade width, then thump it into place with a big hammer.

Hmmmm, did you ask him why? When I get a refusal I'm not comfortable leaving I usually ask the patient why. Sometimes I have to ask why 5 or 6 times. Everytime I shoot down their reason why with a sound argument until they eventually have no more reasons. As for Mike's determination, was he knowingly being a threat to himself? I mean we know that the Sympathetic response to trauma is to constrict blood vessels, but once the adrenaline wears off he's gonna start gushing blood...but does he know that? From Dwayne's explanation it would seem that he does know if he didn't before, but still....it's his choice, and no doubt Dwayne did the best anyone could to convince him and inform him of the danger associated with his choice, so, my thoughts, hate it as I might, turn my back and walk away. Did you ask him if he'd like to record a message for his wife since he'll be dead before she arrives? Hey Ed, wouldn't the leg still be viable for up to 6 hours? I know in cases of a dislocation with circulatory compromise, we have 6 hours to get the flow returned.

Yeah, Kate is in the same school as I am. Snow her and intubate. CPAP if she's breathing on her own or PPV with PEEP if she's not, and monitor for pneumothorax development. I can fix a pneumo, but I can't fix her shock without proper ventilation.

Not sure about the NYC EMS system, but maybe your website needs an update? https://npiregistry.cms.hhs.gov/NPPESRegistry/DisplayProviderDetails.do?searchNpi=&city=&firstName=&orgName=ny*&searchType=org&state=NY&npi=1023364957&orgDba=&lastName=&zip=

Too late Mike, you missed all the fun.

Sweet dreams buddy!!!

Naw, I'm thinking more of a teenager with an attitude.

I'm pretty sure that Kiwi was being facetious.

I always envisioned Mike as a fluffy little bunny.