medicgirl05

I am glad you addressed this as I didn't know how to get my point across. You did a great job and I agree. BLS skills will be in your tool box as a paramedic.

I have never seen a cot such as this in person. We have Fernos and I like them compared to regular Stryker stretchers. We have crappy stair chairs that have angles that are not good for lifting mechanics. We usually take the cot into the house or to the doorway and move the patient with it. I would rather use a kitchen chair than our stairchairs.

I also used JB learning as a study aid. I agree that it is worth the money as the questions are close to the same as national registry. My biggest help, I think, was John Puryear(sp?). He has a CD that goes over pretty much everything. It was so great for me. I put it in my car and listened to it for months before the test. He uses little stories to help you remember things and that worked really well for me. He also does in person classes with a high passing rate on the NR though I can't tell you anything about that. Edited for grammar.

Dwayne-The patient was transported via ambulance because he told someone(not me) that he took more than his prescribed metformin. The bottle had been filled over 6 months ago and was missing 12. He told me he took the med for two weeks but stopped because it made him sick. He never told me he took any pils and when I asked he denied. Ambulance transport was necessary in my opinion because sometimes you just never know. DFIB- No apology necessary. I had already run that scenario and several like it in my head. The deputy on this occasion gave his weapon to another deputy on scene before climbing aboard. Policy states that we lock it in our narc box if they choose that route. The actual charge was something like "interfering with my duties." I'm not sure what that means but it came as a result of me refusing to file sexual harrassment charges as I was afraid of the label that may be forever attached to the patient. The laws in my area change depending on who the current sheriff is. I have never had them force a suicidal patient into going to the hospital, so the whole experience was new to me. We don't have any psych facilities in our area so all psych patients are difficult. They have someone come and evaluate the patient and determine the need for a hold. This takes time and the ER usually gets stuck holding the patient until someone shows up. Usually this takes 24-48 hours so the ER is careful about who they deem may need an evaluation. After they declare that a patient may need psych care a transfer must be lined up as the closest facility is at least 100 miles away. All these factors contribute to the local ER's not wanting to deal with these types of patients.

Yes I did. I didn't know what the right thing was. I am OK with people not agreeing, as I still don't know what I should have done. I knew I did not want to live with feeling like it was my fault that he killed himself. This was a few weeks ago and since it still heavily weighs on me I'm guessing I didn't do the right thing. Thanks for everyones input.

Dwayne-I didn't necessarily expect the deputies to correct the mans language, however I find it ironic that at the time it was occuring they didn't have a problem with it and then I was asked to press charges for it. I have been in many similiar situations where charges were not ever considered. This very same night I had a dementia patient who came onto me even stronger, to the point of stroking my leg as I was trying to get a line. I wasn't offended by him and didn't press charges. I realize that there are patients who aren't exactly in control of themselves. The charges were dropped the next day as they were just intended to help him sleep off the alcohol.

The hospital wouldn't keep him because he wouldn't tell them that he wanted to kill himself. They were releaseing him. One of our deputies had stayed with him and ws bringing him back to the county. They didn't want to take him home because he was drunk and we just made his problems about $8000 worse(ER trip and ambulance ride) and he was still drunk. The desicion that was presented to me was either file charges and keep him safe or don't and if he kills himself it is your fault. I was afraid of the guilt associated with not filing charges. I didn't feel it was the right thing but I was afraid of having to live with not filing. I am still unsure if the right thing was done.

They didn't intend for the charges to stick. They wanted to be able to keep him overnight to let him sleep it off. The deputy accompanied us to the ER and we had to wait on scene for an "emergency comittal" form. I later found out that the form had not been signed by a judge so it was not exactly helpful. They told me they could not find a judge, we have 3 so that is rather hard to believe as it was the middle of the day. Thanks for your input. This is something that has really been bugging me.

The first time I took the NR I failed. Anyway, they sent me a sheet stating how I did. There are 6 categories and I got above passing on 2, near passing on 2, and below passing on 2. A fellow classmate got below passing in all categories. The next time I passed and did not recieve a sheet stating how I did in any subject. At the time of the failure I searched to find exactly what below passing and near passing meant but was unable to. However, this was pretty soon after the computer test was put into place so there may be more info out now.

I love that word! My high school English teacher used it often and it just stuck. She also used xanthopsia-referring to a yellow tinge to vision.(She wore the same yellow dress three days in a row to make that one stick, it worked!) I later learned that this can be a side effect of digoxin toxicity.

You are dispatched to a suicidal patient where deputies are already on scene. You and your partner arrive and are assured the scene is safe. You enter the house of a late 50's male who is seated on his living room floor surrounded by empty beer cans, he is obviously intoxicated. He tells you he is OK, he wants to get drunk and shoot himself with his 357 which is secured by a trooper who is already on scene. Patient isn't exactly thrilled by the presence of any of us but agrees to let us check his vitals. Everything is normal. Blood sugar included. Patient has no medical complaints. Officers advise the patient that he is going to the ER, either in the ambulance or in the patrol car, patient's choice. As patient is "deciding" he makes several inappropriate sexual comments to me. He asks if a fellow medic(not on scene) has ever tried to get my panties off, this was asked in the presence of two deputies, a trooper, and an investigator; none of which said anything to him. I told the patient he was not going to talk like that to me. He then asked if I'd like to have sex with him, again the deputies remained quiet as I told him he was inappropriate. The patient finally consented to a ride to the hospital, a deputy rode along in the back. On the trip I was asked another time if I'd like to have sex with him with no remark from the deputy. I advised the patient that I was not going to tolerate this behaviour from him. So we take him to the ER without further incident. The call is now over, we are back at the station all snug in our beds and a deputy calls and tells me she needs me to file charges on the patient. If charges aren't filed they have nothing to hold the patient on and they are afraid he will go home and kill himself. Now I have had many drunks come onto me, some much worse than this one. I have never been asked to file charges on anyone before, and the deputies who witnessed the mans behaviour didn't seem to think it was inappropriate at the time that it was happening. I know nothing about law enforcement or filing charges. I am curious what others would do in a similar situation. I felt like I was put in a really tough spot. If there is something I left out please inquire. I am really curious what y'all think the "right" thing to do is? Thanks!

I actually think it may be of benefit to some people to know they aren't alone. Personal experience has taught me that this type of thing happens way more often than anyone would think to men AND women. I think it is easier to deal with such an experience knowing that others have been thru similar experiences. If people were able to talk about such things without fear of being judged it may be easier for them to process their feelings and move on, and yes I realize everyone doesn't work the same way. JMO.

Precisely.

It depends where you go in TX as to what the protocols are. We do not use MAST at any of the three services i work at. Protocols differ from place to place. For example, one place I work Zofran is a paramedic only medication where you must obtain a 12Ld after administering the med and another place I work basics can give it without much thought. If you look at the NREMT skills that is a good place to start. Good luck to you.

Occasionally a high level of cortisol, as a reslt of hydrocortisone, can cause symptoms of Cushings disease consistant with a blueish skin pigmentation? This also meets the declining mental status.

I have an idea for the reason for the blueness that is unrelated to hypoxia...Don't want to completely blow it for everyone playing until we get a little more fun out of it...IF I am even on the right track!

Are you able to obtain any info from him? Headache? Erectile Dysfunction? Perhaps a cortisol level is in the lab report? Has he been given any other meds at the hospital? How much hydrocortisone did he receive and has he had that med before? If so, did he have any reactions? Good post! You have me thinking. I am eager to see if I am on the right track....

Why would you want to be enhanced anyway? Haven't you ever heard the old saying "It's not the size of the ship but the motion of the ocean?" "Everything is bigger in Texas."

Just relax. At this point that is the best thing to do. Try to get a good nights sleep, eat a healthy breakfast, and give yourself plenty of time to get to the testing center. That's my advice.

I'd be happy to help you out if I can. A little review is never bad, plus the semester will be over shortly and I will be looking for something to do. Let me know if I can be of assistance to you.

I haven't had much sleep so I'm loving the role play story. At first I had a hard time concentrating but then I got caught up in it. Will there be a sequel? I think CM cares too much. Sometimes people are mean and ugly and theres just nothing you can do to change that. Let it roll off like water on a ducks back. Easier said than done I know.