Arizonaffcep

Ya...AZ has the BEST sunsets around. Ya, as a minor, if you have CONSUMED ETOH, even though you may not have a drink around you, you are still MIP.

Bring your ETOH prep pads!

Standing orders cannot be deviated from, without SUBSTANTIAL reason (ie allergy to certain med). In reference to the last sentence, at least in Southern AZ, you still have to notify Meds Control (who relays to the receiving hospital) what standing order you are following, age of Pt, stable/unstable, transporting code 2/3, etc.). The good thing is, that's the extent of the communication.

This guy filming should be shot. No questions asked. I can't stand educated stupidity. I hope that's civil enough :twisted:

To go along with this...any nuchal rigidity? Fever? Could be a meningitis thing...

Yes, and no. I will usually unwrap my present to visualize, unless there is a bleeding control issue. If there is, then I leave it alone, perhaps even add to the wrapping (if needed).

For underage drinkers though, it IS an ILLEGAL substance. Free invitation for you to come out to UMC/Southern AZ and watch how many people get "tagged" for underage drinking. No joke...if UofA PD catches any UofA students with ANY amount of ETOH in their system (AZ state law says the hospital is allowed to reveal contents of a tox screen, including BAL to PD without breaking HIPAA, but only that info), they can (and occasionally do) get kicked out of the University (if they are in the dorms, they at least loose their student housing) and a few times I've seen them revoke full scholarships for it. The UofA has a ZERO tolerance for ETOH in underage drinkers. PD doesn't have the authority to actually revoke the scholarships themselves, but if they (the ETOH + student) falls under a certain category of offence in relation to ETOH, once the arrest is forwarded to the UofA then it's revoked by the financial aid people at the UofA (built into the "contract" for financial aid). Also, just FYI, because the legal drinking age of Mexico is 18 (I think, I know it's lower than AZ), AZ DPS (AKA Highway Patrol) actually does set up check points for people returning from Mexico to bust underage drinkers (regardless if they are driving or not). God help them if they are driving...that's a LOT of charges (according to DPS, can be minor in possession of controlled substance, reckless endangerment, DUI [even if their BAL is 0.01 or less, because it's illegal for them to be consuming ANY ETOH], plus any speeding, or MVC related charges, if applicable)! For people 21 or older, if you have some ETOH but are still "competent" to make a decision (A&O X 4, without OBVIOUS signs of intoxication), then by all means, refuse. But for minors (under 21) who have consumed ETOH, they have lost the right to refuse, because for them, ETOH is an illegal substance, whose abilities to alter mentation have been well documented throughout time (at least several thousand years).

That's totally going to be my kid in a couple of years.

I agree, but then you run into the whole "its not legal for them to have ETOH, so by that token, they can't refuse." Much as if a person has cocaine/meth/pot etc. My mearly using those, they (at least in Southern AZ) have lost the ability to refuse because the law has described it as "mind altering substances" or (insert favorite saying), which of course means they don't have the mental capacity for a refusal.

This can lead to problems. If you transport a person against their will, then you run the risk of a kidnapping charge against you and your company. Now...that assumes that the "intoxicated" person is A&O x4, and is able to answer questions appropriately. If they aren't then maybe. If they are totally inebriated, so be it.

I would wonder maybe septic? Maybe chemical exposure?

That's stupid. They turn into "social" transports which needlessly clog the ED. Now...if the Pt legitimately needs to go, nuf said. But if they are alert (maybe not A&O X 4) but able to maintain...and they aren't driving and going home with SOBER family/friends, then why not? Happens all the time in the ED. Send the patient out with a responsible person who WILL be with them until sober. Now...if they are unconscious, etc. then it kinda rules that situation out. But you get the picture. You could even go so far as to write in the narrative that "XYZ, Pt's friend, has stated he will take responsiblity for Pt's welfare, and will be with him/her throughout the night" and have that person sign the form after the statement. Does it take away YOUR liability? I doubt it, but it at least off sets it to a degree.

Who likes cats anyway? :twisted:

See if they can find what the cause of it was. At THIS point, acidosis sounds respiratory in nature...84% RA? I'd be curious as to the cause.

If at first you don't succeed, so much for skydiving.

How does the inside of her mouth look? Are we sure that the bloody sputum isn't pulminary edema?

Vitals, Hx, Meds, Alergies for starters, SAMPLE, etc. Heart rythm (from monitor), 12 lead if available. FSBS.

Do you often use this term in your patient reports? If so, what exactly does it mean? And, if asked to demonstrate from only that information you have charted, have you charted enough information to clearly show that your patient (and/or his/her vital signs) are "stable"?

That's crap. I've never seen the "life-saving" IV before. Who told you that? If you're a 1/2 mile from the ED and there are other priorities...then tough. Those folks in the ED know how to start an IV. Sorry, not irritated at you...just that stupid mindset about wasting time o/s to get an IV. Now...if you need it for something like RSI or what not, then that's a different story. But then again IF you are 1/2 a mile from a trauma center/hospital, then who cares about RSI anyway. Just get them there. Suction the airway...BVM and/or dual lumen airway (way underused in MHO).

where and who do you work for?

Don't know specifically, but in AZ they are using LP12's. I would think there might be a tendancy it to be the same company wide. Hope this helps.

Wow. This would NOT have happened in Southern AZ. Too many problems with HIPAA for one...no one likes a 6 figure lawsuit against the attending AND the service. I agree with taking equipment from hospitals. NEVER do it unless you have had training on it. If the patient on that monitor codes and you can't figure it out...its your butt in a sling. Sorry about the harassment issues. He just needs to go away. Maybe play with the polar bears? Also, with the agitation, it is most prudent to assume hypoxia until ruled out (ie. O2 via mask with a pulse ox over 95% with a good wave form). Once that is done, then move on to chemical restraints. It could be something like a CVA which would not alter the PO, so O2 is always good.

Perhaps those kids should appologize and ask for the ball back. Then...be more careful. Good for the old lady!

The FD I was working for was using Motorola XTS 5000 VHF. I'm not sure what mobile, but those were the handhelds.