island emt

please don't feed the short little being that lives under the bridge :-}

Ethics is a dilemma . it seems to me that younger generations learned them differently than folks of my age group. Right & wrong have different meanings to some. the instructors have a need to make sure that all are playing the game by the same rules. Considering that most classes are usually held in close quarters, we used to give out the same test with the questions in different order just to weed out those that might be sharing the answers to the multiple choice or matching questions. It was always fun to let them know they got the correct answers:: only to the wrong questions. That usually put a stop to sharing after the prima donnas bombed a quiz or test. Even had a couple that were texting answers to each other.

He's just baiting you Hertz He's a wanker from nowhere that like to get a rise

point :::: SET ::::: & Match to the Brit in the corner. KIWI goes down in flames again

This was just this past tuesday. I do have a copy of the twelve lead at the station . I'll scan it and see if I can post it. Whenever we get dug out. :-}

I actually got to see a case of pericarditus the other day trevor. Wasn't my patient , but the ER doc had us all look at the 12 lead to see if we picked up on it..

Well the snow is finally slowing down a little. Right now everywhere is 3 feet deep with a lot of blowing and drifting. My driveway took 4 hours to remove the 4 feet with my big commercial snowblower. The road up to the main road is ass deep on a tall camel. Have put out calls to a couple folks to get a payloader to come dig it out.

Well the world is still out there this AM. Snow is still coming down hard and winds are blowing @ 50 + . Looking out in the yard it appears to be between 2 & 3 feet with drifts to 7 feet high. our young lab went out to P this morning stepped off the deck and was in over her head. Power is still on and the weather guessers are saying the snow will stop by dark tonight. official total from the national weather service office as of 7 AM is 29" in the past 24 hours. Looks like blizzard conditions for at least another 12 hours and then we can start digging out. Some places will have to be done with a payloader as the drifts are house roof high.

Pt HX , eval , vitals, orthostatic BP, quick 12 lead while stretcher/ stair chair is being brought in 325 mg ASA if no contraindications , O2, IV access, NTG if indicated,& not taking the magic blue boner pill, put his butt on the stretcher, get in the office and start heading towards definitive care while doing all the above. We have a thirty minute ride to small hospital and hour plus to cath lab if determined by diagnostic review and evaluation. Today with the weather might take a couple hours due to whiteout conditions just to get to the local hospital. If your in the big city with a cardiac center on almost every street corner. stay in the house and play with all the toys as your transport time is only three minutes.

If you jump on it right now you could probably get here by mid April trevor. Just in time for the lobsters to start running. :-}

Jeeeez young whippersnappers :-}

No surprises there . Mass OEMS is always a few years behind the rest of the world.

A little over a foot of fluffy powder so far today, with the real beef of the storm expected to arrive here in the next 4 hours and rage all night & into tomorrow afternoon. Been sitting right at 10 degrees F all day.

Another dinosaur here: Started in 1971 as an ambulance attendant. worked my way up the food chain and am now at the top of the pile with all the headaches. Shit does flow uphill. I Hate paperwork and committees. looking forward to retirement years. Then you young whippersnappers can come pick me up off the floor or help me get to the toilet.

Or you might find yourself sitting in a dark room with a bottle and a gun in your mouth wondering if you;ll see the sun come up! happens far too often.

Thank you. The joys of small town rural EMS. We know the majority of our customers as neighbors and acquaintances. Even the summercators get to know us after a few years visits. towards the end of her fight , we held her hands & told her it was okay to let go and join her husband. It was hard to do and it was also the right thing to do.

As a rule reciprocity is not automatic. Many states recognize national registry certification. Some don't. Most will require some remedial ed for transferring even NR.

Defib: I have worked for upwards of three hours on a code where we did get return of pulses, then lost them , then got them back a total of 8 different times. We shocked over a dozen rounds of V-Fib over the course of the code. We did transport and worked alongside the hospital code team for an 1 1/2 hrs in the ER. Finally the decision was made that she had been down long enough without good perfusion to have suffered life ending brain activity. We stopped and she held on for thirty minutes more then finally her heart gave up. She Was a good friend who's husband had died 6 months earlier from cancer. We believe she died of a broken heart , and just wanted to be with him.

I still have a set of mast trousers in my museum Doc. Back in the day every trauma pt got them put on and half of them got inflated. Why??? because the current science from Vietnam showed they worked.

Funny thing about that: We all will die someday. We can make a determination of death here by several methods. Obvious injuries incompatible with life, Rigor, dependent lividity, Pulseless and asystole in 3 leads for more than 20 minutes after resus attempts or not. They do not want us to transport a "working code" to the hospital. The current protocol is to work a fresh arrest for 20 minutes and 3 rounds of acls protocol. If no ROSC then call it and notify Medical control Dr that you have ceased efforts and time of death. We can get approval on the phone from Pt's physician to have them sign the death certificate. We do have the ability to transport any pt that is hypothermic and children, or anyone with near drownings.

In 42 years in the business, [ I guess that makes me a rookie} I have seen many times where we arrive and bystanders or family members have started CPR and all of their breaths went directly into the stomach.Put your hand on the distended belly and the fountain starts gushing. I've also worked many codes with no vomit produced. Working a couple of whales at a buffet restaurant , I would expect lots of vomit by the fact that they are lying supine with a full gut. Nothing earth shattering in the news department there. No one is arguing whether an ETT will give control of the airway. The argument is based on whether or not an advanced airway is having a positive outcome with Cardiac arrest patients. The AHA guidelines are moving respirations and airway way down the algorithm for a reason. Because the science is being tested and found to not be all that beneficial in resuscitation & survival with a positive outcome. You can argue all you want that it should be done this way because thats how it's always been done. It won't make it right and may be detrimental to our patients.

when I took statistics, we used an abacus

They sell a very nice 12 volt plug in cooler at most auto stores or camper places that will keep your food @ 38f . not much bigger than a 12 pack of canned beverages. They cost in the neighborhood of $35.00. Ought to be able to find room to store that in the ambulance. Unless your sitting in a parking lot in a type II van. We have one in our ambulance for chilling fluids.

Other than the empire: not many folks call the 7-11 parking lot our ambulance base station. We use the grill and lobster cooker at the station for meals most of the time.

A lot of the copious vomiting is caused by providers blowing air into the stomach and insuflating it. Hence when compressions are done it burps up all the contents with the air pushing out the load. Yes I have worked codes where there was no vomit.