tcripp

My two cents along with the photos...is to get a journal and WRITE everything down; things that you would want to put in Twitter or FB. Do one every day even if it is just a one liner and how you felt that day holding your new child; include your senses. Then, as he ages, you'll be able to write down the things he does and says. I wish I had done it because my memories are now fleeting ones...

Dfib - it's the lucidity combined with the tick I am questioning...

Most recent patient of mine...got called out for chest pain and left sided weakness. Get there and the guy has moved to his upstairs bedroom so that he can have the seizures he feels coming on...and to protect himself because he usually falls and hurts himself. (Thank you sir for your consideration.) Oddest thing I have ever seen, but this guys was having what I would call "ticks" and saying that his is seizure activity. He also says that he's got that feeling that a grand-mal is coming and had taken two of his dilantin to stave it off; FYI, he's not compliant with his meds, so he has no level built up at this time. When we go to start an IV, he asks us not to. I explain that if things progress as he thinks they will, we need access so he agrees. Is there seizure activity/convulsions that would ever present in this manner - small ticks while he is fully lucid? Part of me wanted to call BS but he's obviously been diagnosed with something else he wouldn't have the script in the first place.

It's about time you posted a pic!

Happy New Year, Craig! And, Crap...I go in in the morning...

I have never seen this before, so thanks for bringing it to my attention. However, the first box does include "LOC" whether you look at it as "loss" or "level". This page seems very simplistic and I'm glad our local protocols vary as much as they do.

To start with, go do a ride out with each service and talk to the medics you ride with. Be current with national standards. Search the forums for other interview tips...they will hold true for both of these services.

Please, every one...there was sarcasm in those posts. Just want to make sure we are all on the same page here...

I guess it depends on how cute your patient is...

Fireman...obviously, you've been doing this for awhile!

I'm assuming you mean your own protocols. So, have you asked your command about that? Also, what is your level?

I typically do wish them well and ask if there is anything else I can do. Usually, the response is, "no, but thank you for your care". Other times it is something simple such as, "can I get a drink/blanket/etc". If I can get it, I do, if not, I refer them to the nurse and pass on the message. For the patients in our county, each one will receive a survey asking about their care, so this just increases their memory of me at the event.

While I've never done wilderness rescue, they teach you to use "what you have". So, take in the bare necessities and keep your mind sharp on things you can do with what you don't have. The more you carry, the slower you will be. Example, carrying cravats, you can find something to splint with...so no splints needed. Just you and a kid...won't need a backboard. Other information needed will include time of day...was this early enough in the day that you think you can make it in and out with the existing daylight? If not, that camping gear may be more helpful as night falls. And, then you will need some food for the both of you. What is the size of the missing boy? Will you and a kid be able to help him out or should you plan to stay where you are until better help can come.

I've often thought of this myself! Other than power/protein bars, fruit/nuts, and peanuts butter...really can't think of too much that won't get old and fast. Each year, I do a 40+ hour gig in an ambulance (that follows runners for 200 miles) which is the only time I'm totally without heating devices for an extended period of time. I'm thinking an MRE or two might be a good addition to the standard "cold fare" I carry. Toni

Welcome to the City! Jump right on in. The water is fine! Might I suggest you lose the word "hopefully" in your post? A list of goals can't be accomplished with "hopefully" in the mix. And, if you miss the goal, you just reset! Congrats on the engagement and baby. Looks like you have your hands full! Toni aka - 45 when I got my Paramedic...so let's talk about "a little later in life" grin...

Dwayne, where do you come up with this crap? Just kidding...this is a great question. I've been using the back of my hand, wrist or inner forearm for years to assess temperature, whether it was for a body temp of my child or a patient or bath water or testing the heat of formula. I recognize that this is only a relative temp and I understand that I don't use my lips or fingers because they can more quickly change with the ambient temperature. (Apparently, using one's lips to check your pt's temp is frowned upon. Who knew?) In doing a little research (online), I did find a site that read you should check the temp of your own forehead first, then compare that to your patient. Apparently "everyone does it" but I have yet to find anything that reads "why".

23yof - her tiny car kissed a tree...there is no more front end. Driver's side windshield shattered with a hole in it; no evidence of anything going thru it. She's got some scratches on her left arm and a busted lip. That's when a pic helps the ER. So, no, you aren't the only one.

Educational purposes and ONLY if there are enough hands to take a picture of the necessary information. Example, the other night we had a car vs. tree...tree won. Easier to convey to the ER doc what the damage was via one or two pics. We had 2 paramedics and an EMT on scene...while loading the patient in the truck, the captain on scene took a quick pic. And, in a number of years or so, I'll be able to use that picture in some DWI course. I think it should make a point...

Ditto to what CM said. Of course, I'll be going back and asking for details on why we changed it tomorrow. I'll let you know if it's anything other than mfg recommendation. Toni

I'm okay if it fizzled out as I am about done with the news broadcasts anyway but just as long as we do not treat our men and women who served in the same manner.

We had this conversation at our service last year when we didn't carry D5W on board. I'm not sure what sparked the conversation, but I believe the decision came down to the fact that it was recommended by the manufacturer. We now carry D5W (100 mL) and have specific instructions for mixing/running so that we are all on the same page.

This starts out with, "So...this one time...in band camp..." Just kidding. However, we were teaching a group of high school students (15-18 yo) CPR. And, my partner begins to tell them about the "Staying Alive" song to help them keep the beat. Talk about your deer in the headlight look. But, wait...it gets better. I'm now trying to give them the connection. "You know, The Bee Gees." --> Crickets "Saturday Night Live?" "John Travolta" You really would have thought I was speaking Greek.

Unfortunately, no link to send. Here is the excerpt. Eclamptic seizures – 10%; 2 to 4 grams slow IV push, at no greater than 1 gram per minute, until seizure stops or a maximum dose of 4 grams has been given. Hypomagnesemia (TdP) – 10%; 1 to 2 grams slow IV push (at 1 gram per minute), if SBP > 90 mm Hg. May repeat same dose every 5 minutes until a maximum of 4 grams has been reached. Large doses (i.e., up to 8-10 grams) of magnesium may be required to suppress arrhythmia; 
contact OLMC for further magnesium therapy. [*]Reactive airway disease – 2 grams IV added to 50 ml NS infused 
over 10-15 minutes if SBP is > 100 mm Hg. [*]Pulseless V-Tach (TdP) – 10%; For torsades de pointes (irregular polymorphic VT) associated with a long QT interval: Magnesium sulfate, 1 to 2 g diluted in 10 mL D5W IV/IO. (If torsade de pointes is not terminated by defibrillation, administer magnesium sulfate as soon as rhythm is recognized.) Hope this helps the cause some...

Who actually has time...on the job?

Our protocols don't fall within your nice survey. I can send you the drug formulary if you'd like...