JakeEMTP

There is a difference between 19 and 16. Do you answer the tones while you are sitting in High school? I would hope not.

We had our Medical Director update on Wed. He was discussing the pain control protocol which has 50-100mcg Fentanyl and 12.5mg of Phenergan. I asked the question as to why Phenergan? It was explained to me that back in the day, we had Demerol for pain control on the ambulance which as you are aware causes N/V. That is where the Phenergan came from. Phenergan is still on the ambulance, but is a second choice. Because of the analgesic effect of Phenergan the primary medication of choice for N/V is now Zofran. Apparently, it has a much better chance of being tolerated by the pt. The MD mentioned that in his 19+ years in Emergency Medicine, he has only seen 5 people have an allergic reaction to Zofran.

I will be taking the NR CBT test. There is a Pearson VUE testing site in town. There is a rumour that there will be a skills test at the college here as well, so that would be sweet. However, one in Vegas would be nice too! I haven't decided when to take the NR test yet, but it won't be to long. I will be taking the NC EMT-P exam on Jan. 18th though. Spenac, I'll have to make copies of my notes. That may take some time!

First, I would like to express me gratitude to all the posters here for their continuous contributions to the forum. Their knowledge and experience was extremely helpful to me during the last two years. Secondly, I would like to apoligise for not being an active member of EmtCity the last month or so. I have been extremely busy studying and finishing clinicals. Please forgive me. Monday night I had my final exam. I don't have the results as yet but left the room feeling good about it. I passed my other classes so I'm just waiting on the results of this last one. It has been a long two years and at the same time, it seemed to go by rather quickly. I hope that makes sense. My advice ( that a $2.00 might get you a coffee somewhere ) to all the other students and future medic students is to get your pre-requisite courses, study hard and ask as many questions as possible. The time to make mistakes and ask questions is now. Not when there is no one to ask in the back of your ambulance. Once again, thanks to all of you and continue the good work! Let's be careful out there.

Dwayne, yes I do, but I like to double check and for some reason, it shouldn't be that easy. The formula will get to a midpoint as Dustdevil suggests. From there we usually tritrate to effect as again, the rate will change according to how the patient responds.

I agree dust and wouldn't use this method on the truck. For testing purposes though, it gets you close and then pick the appropriate closest answer. In real life, I much prefer the clock method for Dopamine rates.

I'm sure this isn't new to the more experienced members of this forum, but I recently came across a very easy way to calculate dopamine drip rates. Take the pt's weight in pounds. Drop the last number and subtract the first number from the number remaining, multiply by 2. For example, you have a 100 kg pt. Convert to pounds = 220. Remove the zero and you are left with 22. Subtract 2 from 22 and you are left with 20. multiply that by 2 and you have the drip rate. 22 -2 =20 20 x2 =40 gtt.

Yeah but, when you were a medic student the protocol's were " load pt. on cot" and " drive fast to the hospital".

Sesame Street will never be the same for me. :kermit:

I do it routinely. I'm just about done with classes, so I'm not a medic yet. That being said, I will pick up the protocol book en route to a call just to review. I'm also not opposed to looking at them in the back of the ambulance, just to check to see if I have overlooked something, or perhaps there is something else I could try. I have witnessed experienced medics do this and I hope this is a practice I can continue once I gain some field experience. I don't want to become to complacent or to cocky ( can I say cocky here? ) that I think I know it all and don't need to review.

Gotta have my station. I need a place to study Dust! Wait, are you now advocating SSM? :?

As I stated in the other post, our Medical Director is extremely approachable. I can call his office and ask a question or receive clarification on anything. I have talked to him many times in the ED on various subjects and he answers e-mail quickly. Changes to protocols have come about through this type of communication. Just lucky I guess. Or, is this how all Medical Directors should be? I understand were not NY or LA. However, we're not exactly Podunk USA either.

With 64 trucks though Shannon, that's only 10-12 calls over a 24 hour period on average, per truck. Pretty normal around here.

I rode in a few of the Int'l Navistar ambulances were I used to work. They were used for precisely the situation you describe.They were capable of handling 2 stretchers if needed. They provided a comfortable ride for patients as far as ambulances go, the nurses and medics loved the room they had to work. I never found the power of the DT466 to be lacking. They are a BIG truck. This is as you are aware not a vanbulance. It requires some advanced planning when operating it through traffic and not just anybody can drive it. Here is a link to some of Duke University Medical Centre's fleet of critical care transport units. http://lifeflight.dukehealth.org/modules/s...x.php?albumID=5 Disclaimer: I never worked for Duke. The service I worked for had similar units.

That, my young friend, would be Angie Harmon. Just a side note to ponder. Why does Jack McCoy always have the smokin' Assistant?

I'm working now. We have wireless internet. I just bring my laptop.

Or they give a crap about.

So do I. After I posted, I had to go on a call and the alloted time to edit had passed. I realised you were probably joking ( albeit in bad taste ) on the way back. Sorry for jumping you like that. The Maple Leaf tattooed in my chest took exception.

Happened just the other day. I was in the EMS room finishing my narrative, when one of the ED nurses I precepted with ask If I could do a stick for her. I went into the room and saw what looked like the mommy due to all the 2 x 2's on her arm. Located my site and was about to stick when I asked the nurse if she would be so kind as to shake the bed for me.

As a Canadian, I take exception to that remark. My little remark was based on the fact I'm 47 y/o. Dating 24 y/o is fine. I do not condone what goes on in Podunk USA.

Ok, so maybe I exaggerated the price somewhat :wink: , but would you be willing to be responsible for leaving a $13,000.00 piece of equipment behind? It's not like it's a backboard.

Geez, I hope so.

Except for the fact it is $25,000.00 and I might need it before I get back to the ED to retrieve it, I would agree with that.

I agree. However, when you get to be my age, it's fashionable.

I respectively disagree CB. Then whole point of what we do is pre-hospital medicine. If we can get them there providing better compressions via the Auto-Pulse, then we have done our job, as has the device. If better compressions help to get a patient with better perfusion to the trauma bay or Cath Lab, the Auto-Pulse has done what it is supposed to do. Remember. it is just a tool that provides better compressions than you or I could ever dream of providing. That is the sole purpose of the device.