funkytomtom

I'm not really sure what the controversy is, apparently something to do with these forums? Either way, you've been awesome towards me and helped me out, and extrapolating that out I'm sure your a great medic too. I concur with your observation that for an internet forum, this place is surprisingly supportive. Best of luck!

Great intervention and congrats on the practical! If your patient has shallow respirations, he/she is unlikely to be properly oxygenating...I know that it seems weird to be bagging a tachypneic pt, but if the respirations are shallow, it is appropriate. As you can see, some very simple questions end up with more complex questions than before, and very little resembling a solid answer. It is a dynamic field and I hope it excites you.

Awesome! Good luck man. I bet it will be a fun, as well as a long, year.

Couldn't agree more...I didn't go through my medic yet without credit but I have my basic and intermediate all with no credit hours. I'd be that much farther ahead for the same work had I been smarter. I think its excellent to have other options left open. Even if you end up head over heels for ems, it's hard on your body, and a tough profession to make real money in. GET CREDIT where credit is due.

I've honestly found most of my calls to work very conveniently for me. IE-just finished eating, pooping, or showering. Generally most of our calls are at night, especially if there is inclement weather. Most roll-overs seem to happen between 0300 and 0500. Last weekend was terribly slow, and I actually said "it sure is quiet," to no affect. I have yet to find any one thing that guarantees calls.

*insert chuck norris joke here* I have to tell at least ONE...when chuck norris falls into a pool, he doesn't get wet, the pool get chuck norrised.

These are all good! Take pride in yourself, your service, and providing the best patient care to every patient.

How far along they were is indeed in question, it's hard to know, but I do think they were probably well short of 7 months. I would love to talk it over with an ob specialist...I did discuss it with a nicu rn who is a close family friend. Essentially I keep hearing the same thing; they were likely not viable and nothing else could have been done. The word from the pathologist is that the first infant was simply premature, the second "substantially deformed." Things I would do differently: 1) inspect the placenta, 2) work more aggressively on a and b of the first child...it was tough, the smallest bvm out of our broselow went over the entire face (tips?)!

I just finished my intermediate class, and I'm just barely hearing many of these concepts for the first time. Why aren't they addressed?!?!? Now I feel like the idiot. Anyways, its been great reading through all this. Question for chbare, or anyone really; I understand the difference in definitions between hypoxia and hypoxemia, but how is this actually going to play out on a patient?...in the field?

AMEN! If you can't give ALL your patients the best of your care...move on.

Ok...so if anyone even cares anymore, I think I feel alright discussing some specifics. Maybe you can learn from my mistake. My medic, myself, and our driver (we run crews of three) got paged out in the wee hours of the morning to a premature birth, approximately seven months along, in full arrest. So...after I scooped the crap out of my pants, we responded to the scene. Sure enough, the smallest baby I have ever imagined. First responders are doing half-assed compressions. We cut the cord, bring the baby out to the rig, fire carries out mom. We begin our attempt at multi-tasking. Mom still hasn't delivered the placenta (but is fairly stable, minimal hemorrhage), so I'm trying to keep a close eye on her, while also trying to do compressions so my medic can attempt to intubate. We worked on this poor kid forever, we had the smallest stuff out of our broselow bag and everything was still too big. We were unable to intubate, unable to start an umbilical IV, and when we attempted an eazy-IO, the drill barely touched before it blew all the way through. This kid weighed maybe 1 kg. Somewhere in here, I deliver the rest of the placenta, bag it, and set it down for the hospital. Bear in mind, I had watched the placenta come out, not constantly, but as maybe 8-9 stages during its delivery. With medical control on-line, we have to call the kid. We clean up mom as best we could and deliver her to the hospital. So...still reeling from all this, I receive a call from my manager a couple days later: they found a second baby tangled up with the placenta. Unless it's not clear, I never saw a second child, and while I never did an inspection of the placenta, I did have an eye on it from its first presentation until delivery. Hence...why I felt awful. Realistically this pt was not viable and would had to have been even smaller than the first for me to miss it. There was also no pre-natal care, so no way of knowing we had to expect another patient. I've moved on from it and learned a few things: I will be inspecting placentas in the future. I've also learned to work even harder on airway because full arrest in kids is usually secondary to respiratory arrest. Any other thoughts?

Hey Kaisu...I'm just a lowly basic, but I can tell you what has helped me. I had a tough call about a month ago, and what really got me through it was my ems family. I think that ability to understand a bit more of what you are probably going through is quite valuable. As to the "why," I don't know that I can fully put that together. Sometimes it's a terrible, thankless job, full of either unappreciative patients, patients we can't save, or patients with issues we can't address. At these times it feels pretty futile. On patients dealing with depression it helps me to try to be maybe the only person to really care and try to help, for however long I'm with them...I like to think that can be powerful. But alas, sometimes you really do help someone who has never needed help more in their life, and sometimes they even THANK you for it! I think that's just about the coolest thing in the world. I hope my rambling has helped (?), and moreover wish you the best of luck!

We use it as well in just such a manner.

Great to hear! I'll send some good wishes your way!

I can't offer any wisdom, but I'm definitely listening.

Does pumpkin beer come out the other end?

I have nothing but the utmost respect for the men and women of our armed forces BUT I have nothing but the most intense hatred of Creed, which kind of ruins it for me

Attention to detail, sense of pride, teamwork...these are all things I think my service could benefit hugely from (myself included). I try to incorporate a mindset like this into the way I approach my job. I think a lot of it gets back to self-respect and respect for the work you do. You should have both to be effective as possible in the field...I'm gona go pump some iron now

100% of my calls on Halloween involved alcohol. Although I don't know if you could really peg that as unusual...being that most of my calls involve alcohol anyways. Treating people in costumes is something new anyways!

Definitely a troll!

Acid flashback?

I'm actually just about to take my CPR instructor through my local chapter of the Red Cross. It seems really hard to get in touch with anyone at the Red Cross too, but I finally made contact. Maybe this is an option.