DFIB

I wanna be your personal EMT! But you get my general idea, we EMT are the low echelon folks.

That is very rare but way cool. I stop for just about everything. Posted the article to help the guys that were saying it is our "duty' or "obligation" to stop and render aid when it is obviously a personal descision.

I already agreed to your dose in a prior post Doxicycline is the drug of choice for the gram negatives I suspect he has. I would continue the course of treatment till labs come back. Patient is to return for consult if condition changes or worsens. I am way, way outside my scope of practice on this one and I am pretty incomfortable taking the court with you guys. Please be gentle.

Actually Afghanistan is the orifice I am hoping it came from and not one closer to home. Typhus is pretty common in the third world. Especially in rural areas in less than ideal living conditions. Head ache for several days, general malaise, mild respiratory symptoms along with the living conditions and geography just seems like the right conditions. There is a lot of unpasteurized milk over there as well (brucellosis). The febrile antibodies panel and CBC should clear the air. They should have it. It is not a very complicated test. Even third world labs should have it. The military should definitely have it on hand. If it turrns out to be brucelosis we would have to add an entire battery of antibiotics. Salmonnella will give similar symptoms to the indigenous people but an american would be a permanent fixture in the head so i am kinda ruling that one out but not all together.

I looked up my doxicicline dose and am going to have to roll with you on the dosages as opposed to the ones I posted before. I pulled those from my ear, or some other orifice. I am thinking that our culprit here is a Rickettsia. The best part is that the treatment would be the same as you propose for LRTI. cbare - you are killing me with suspense.

My brain got caught up in the playing paramedic scenario, the goat cheese gave be a brain cramp with the fever. I would add paracetamol 500 mg q 4-6 hours to the doxicicline.

Are you kidding? No way Jose. Everyone can forget stuff. I just know that if that particular point isn't highlighted during EMT training it would be easy to overlook. A medic would have had multiple opportunities to go over pregnancy and it's complications. My assumption would be that an EMT would be more likely to forget, but hey, Thanks for the "EMTs save medics" endorsement. We both know that medics are the bomb in the ambulance. We just carry your bags. I took a lady to the ER today with compensated hypovolemic shock from a upper GI bleed. Hematemesis that produced between 600ml - 800ml in one hurl. The ER doc made me feel like a rock star! Thanks to all the doctors that take the time to give a pat on the back to the little people.

Sitting fat and waiting on lab results while I eat a big piece of toast and fresh goat cheese.

What is the quality, quantity and odor of his poop? Has he eaten any local cheese or milk? Does he have a headache, if so for how long? When was the onset of his symptoms? Are there any lice, flea or rat infestations in the area? I would like to order a CBC, IgG and IgM by IFA if available. If it is not available then a Febrile Antibodies Panel will suffice.What is the turn around time for the labs? If the lab turn around is long. Start doxicycline 500mg qid. if patient is non alergic. Should I write what I suspect or let the suspense build? I am way out on a limb here, hope it isn’t a strike.

What about the male nurses? Spanking for all?

The flock is gooood, the flock is wise. It would help if you tell us you are playing the "devil’s advocate". This would cue the rest of us less psychic participants that you are still serious and not just pulling our chain.

Here is a long shot. As Kiwi progresses with his head to toe assessment he finds Carbon monoxide poisoning or smoke inhalation from burning cow dung or the kerosene heater that the nice soldier gave him last week.

Ummm, I don't think so but it might have more Mexicans than the "home land"

Welcome to the City amigo. Jump right in and enjoy the chats.

Once again you are correct Dwayne. I should have resisted the initial impulse and wrote a three paragraph post about how it seemed ironic to start a thread about spelling and grammar and well.... you know. But I would have missed the chuckle. Being honest I spell like crap. I spell especially poor when writing medical terminology because I learned it all in Spanish first. I use technology to make up for my deficiencies in writing skills. I use spell check because I see guys I respect write long post about spelling, and how people view you because of the lack of proper spelling and how everyone will think you are an idiot for not spell checking and so on and so forth, as if running things through Microsoft Word requires any special skill. HLPP - Please accept my most sincere apology for taking a stab at your post. I am sure it was a slight of hand on your part. But you have to admit it was pretty funny, howbeit at your expense. The negative was not given by me. Dwayne does have a point about the rationale for giving this particular negative. Was it for content? The content seems fine. Was it for the idea? I think it is a good idea. Is it useful and have the potential of being the longest thread in the history of the City? It probably does and possibly will. juxtaglomerular apparatus: is a microscopic structure in the kidney, which regulates the function of each nephron. Texas Rangers just lost. Bummer. Bummer. (Noun. slang) Any unpleasant or disappointing experience.

ERDoc - Your showing your age with your avatrs. I know you dont like the music.

EMT dies off duty while stopping at an MVA. http://www.jems.com/article/news/ohio-emt-struck-car-killed

What did they have against big butts?

Till death do you part? My wife slays me every day. After 23 years she still takes my breath away! You guys are a beautiful couple. Congratulations!

I have video of a beating knife in the heart. It was kind of cool to watch the heart rate in the knife handle. Only in my video the knife is stuck in a hog. Around here most suicides are hangings. I have seen one pneumothorax but no tamponades or hemothorax. You might want to Google Beck's Triad.

You mean a lot and grammar? grammar (noun) = The study of the way the sentences of a language are constructed; morphology and sintax

chbare - Masterfully said. Simply a great post.

I know that my third world situation is vastly different from any of yours. More than a serious contribution this is going to be a little rant. My service is led by an absent leadership and run by a bunch of small minded people that could screw up a wet dream. Med direction is a joke that spends his time sharking the service to line his practice with patients. No online directives. Horrible supply replacement. Very little accountability. A good worker is someone who doesn't steal stuff, shag a coworker while on duty or show up with ETOH on his/her breath and there aren't very many of them. When I pull call I show up with my entire crew because none of the other people are trustworthy. I love EMS but hate my service administrators. What can I do? They are the only show in town. That said I have several very significant structural changes in mind that would be very productive and revenue producing. They would also cost a lot of folks their job. I am waiting for the annual leadership changes before I even bring up the ideas for change. If I can get onto the board I will be set for some really good things. Attempting change in my current set up is a waste of time. So no matter how difficult your situation seems, it can always be worse. Edited for spelling As soon as I posted the above a lady called that said she was a "friend" of the service president to "buy" a CPR card for her husband without taking the class. Yea, your situation could definitely be worse.

We had a guy that recorded our call tone and used it for a ringtone. He would giggle when we would all jump to his incoming calls. It was kind of funny once or twice. We convinced him that his tone was not conducive to the wellbeing of EMS workers, him in particular. He changed it.

You just cant beat a glass door in the crapper. Pros. You don't have to wait for a commercial to go. Cons. You can't have your friends over after taco night.