paramedicmike

In my area prescriptions drugs have gotten to be more expensive than heroin. We're seeing a lot more heroin ODs than we were seeing just a few months ago. That being said I fully expect that we'll see the price of heroin start to go up locally now that demand is increasing. Doc, have you seen krokodil in your area yet?

My insurance is provided by my employer. I have no idea how policies or plans will change. I do know management is evaluating benefit packages and looking at possible changes. What those changes may be, however, remains to be seen.

"May I call you Pat or do you prefer something else?" Sometimes, though, you just gotta ask.

My colleagues write for a lot of percocet and quite a bit of vicodin. I think ibuprofen would take third on the list. Tramadol is common, too. Legally I can only write for 48 hours worth of narcotic pain medication at a time. I'd like to think this encourages primary care follow up for ongoing pain control but that's probably a bit naive. Of course, there's always the folks who will come back in two days saying they're out and need more. What I choose to write varies. If you have a fracture you'll get some good pain meds. Usually that's percocet. Otherwise, I try to evaluate on a case by case basis and what I'll write for will depend on what's going on. What's hard is that there's a fine line between being compassionate in pain control and being a hard nose about it. As my experience improves I think I'm getting better at ED based pain control. At least, for the sake of my patients, I hope I'm getting better.

For migraines I'll usually use 10 mg reglan, 30 mg toradol, 25-50mg benadryl and a liter of fluid. Turn off the lights and let them sit for a bit. Absolutely no narcotics for migraines. None. Zippo. Zilch.

Good idea! Please report to the wiki thread.

I think it's Pennsylvania that has a law on the books that says nurses cannot be mandated to work overtime. MTA: Here's the link: click me. There are some exceptions as would be expected.

Personally, I like it when people claim they've never been on prescription narcotics before and I can present them with a list of all their recent medication refills. "Let's see. You got 140 15/325 percocets three days ago. You got 120 8mg dilaudid four days ago. Both of these are refilled on a monthly basis for the past 19 months. What did you do with it all?" Among my most recent was a guy on 60mg morphine ER twice a day along with 8mg dilaudid ER twice a day. He said he was in so much pain he was crying. He was in so much pain that every time I walked into the exam room I had to physically wake him up to talk to him.

This article is by Bryan Bledsoe from the beginning of August of this year. It provides more support to the overuse and harm caused by backboards and spinal immobilization. Of course, I don't think this is new information to our regular contributors. However, it's good to get the word out to those still working with an outdated thought process drilled into their heads.

Got this through work. I thought it was interesting. For those of you based in the US it might be good info to know. Click me.

There's usually some time, several days to a couple weeks, in between her appearances.

ETA: I laughed out loud. Well played, Doc.

This is a day late but it's still important and relevant. There's a lot of weight to this web page. Please consider it accordingly.

NREMT has a page with a link to state EMS agencies. Given the international flavour of our community how about broadening that concept to include the regulatory agencies of our international friends?

I thought I saw a post from CHBARE about using this as a case study for publication. I agree and think that if you can get some good follow up it might be a good idea.

I think you'd recognize the names. Of course, I've got nothing solid to base this on other than writing style and attitude. But there have been discussions with others off-forum and I know I'm not the only one who's noticed the similarities.

I think it's interesting. I'm seeing some striking similarities between the content, structure and presentation in some of the posts within this thread that are consistent with that of a former poster who made an appearance under at least two other user names. I find it more interesting that our new colleague started posting after AK left. Scuba and ERDoc have both made valid points especially where it concerns the question surrounding the OP having already been pretty thoroughly answered in the subsequent discussion and professionalism demonstrated throughout. Other than that, I've got no dog in this fight. Just thought I'd think out loud for a moment.

You might be a firefighter if you... ... do CPR without gloves... ... get mad at, and verbally attack and blame, the medic for not having an extra pair of gloves for you for doing CPR... ... have a pair of gloves in your back pocket but can't be bothered to take off your turnout gear to get them in order to do CPR... ... show up in the ER complaining about an exposure because you did CPR without gloves... ... cannot document or describe what kind of exposure might have happened while doing compressions without gloves... ... cannot document or describe what kind of bodily fluids you might have been exposed to while doing compressions without gloves... ... cannot demonstrate any open wound or broken skin that may have proven to be an exposure risk while doing CPR without gloves... ... belittle the attending ER physician while screaming obscenities because he won't do immediate BBP testing after doing CPR without gloves... ... fail to understand that despite the blatant stupidity demonstrated by doing CPR without gloves there was no exposure and therefore no exposure risk... ... document on your workers comp/exposure paperwork "I did CPR without gloves and was exposed." with no further description and turn it in to your boss... ... have any combination, or all, of the above happen to you. The above is all true. He was not my patient.

Actually, the very first link, the same link that I provided in an earlier post, is a site with a title that fits what you're looking for. It also appears to have content that would be consistent with what you're looking for. Yet you couldn't be bothered to answer two direct questions regarding if that was what you were looking for choosing instead to focus on unrelated points. Look, Grasshopper, you've asked for something without providing any info about it. Hell, you didn't even know what you were looking for as you didn't have the name right in your OP. It looks like those who've bothered to reply to your post have no idea what you are looking for, either. Then you went on to say there wasn't any info on Google. I provided not only a link to something that might be what you're looking for, but I also provided a link to a whole page full of hits disproving you supposition that there's no info on it out there. Admittedly, what you're looking for might not be included in anything I linked. You haven't addressed it despite, as I mentioned previously, being asked about it. Twice. You chose, instead, to be passive aggressive in your replies. You also failed to take this opportunity to both help the community at large help you by expanding on what it is, exactly, you're looking for and also to provide some education for the masses. You asked for links. You got them. You were lucky to even get that considering you had no idea what you were even looking for.

Really? What's this? And what about the page I linked above? Is that not what you're looking for?

Or, another possibility is that like so many others, he was looking for someone to do his work for him. If that is, in fact, what he was doing. It's a fine line to walk, I guess, between disregard and enabling.

I've not heard of Random Thoughts or Rambling Thoughts. I have, however, heard of Ramblin' Guy: Or, for those of you with taste in music http://www.youtube.com/watch?v=HWH1bdm83ZI Perhaps if you were more specific with what you're looking for we could help. Author (probably most helpful), when it was published, publisher (harder to know but potentially useful) would all be beneficial in helping you on your quest. Interestingly enough I googled "Florida Paramedic Rambling Thoughts" and came up with this page. Is that what you're looking for?

Ok. I laughed.

Welcome, Robin. I'm of a similar opinion that a non-bridge program would be better. If you already have a bachelor's degree there are several programs out there that offer a one year BSN option where you spend 11-13 months, depending on your program, completing the nursing requirements. At the end you're awarded a BSN and are eligible to sit for NCLEX. I know a few people who've done this type of program. From their reports it is pretty intense. However, it is doable. Searching for "BS to BSN" or "accelerated second degree BSN" will give you a bunch of information about programs out there.