Eydawn

Beg pardon. I wasn't in the middle of a lecture about proper grammar and spelling when I made one of my remarkably infrequent typos. As I am a phonetic person, I simply forgot about the "t" at the end of that word since it is seldom pronounced. Touche indeed. Dwayne, I have no pecker, so your comparison doesn't apply to me... As far as the actual topic goes, it seems only prudent that one would move a patient from an environment with limited resources to a hospital, where they presumably have greater resources and are better able to serve the patient. Also, it must be kept in mind that time is tissue... so I wouldn't decline to provide care in favor of wheeling the individual into the hospital (as it is always nice to give the ED a heads up when you're bringing a code in) but I also wouldn't dally past the first cycle of interventions in the back of my truck. Start CPR, analyze rhythm, control airway, call hospital and tell them that status has just changed, deliver shocks if warranted, and get moving. Wendy CO EMT-B

Sure, grammar and spelling are not the focus of this thread. Simply pointing out that those who wish to slam others for spelling or grammar errors should first examine their own writing carefully. Presentation is everything, and a misspelled word can be so distracting that one can literally become completely sidetracked from an argument that is otherwise well constructed and thought out. Wendy CO EMT-B

Someone is apparently wandering through a woman's hair... Never heard of walking into a forest and being lost for the TRESS before. When offering a grammar p3wn, it really helps if you edit for your own grammar/spelling/usage mistakes first... Just sayin'. Wendy CO EMT-B (EMTCity Apprentice Grammar-Nazi)

Michael- I believe Anthony is saying that one can validate the feelings that a patient is having without condoning SI as a valid, beneficial or otherwise GOOD mechanism for coping with those feelings. Unfortunately, expressing that SI is not a valid mechanism or a good mechanism may alienate your rappor with your patient and not do anyone any good... but at the same time, you can't say "good, sure, cut your wrists instead of taking that overdose" because it's positively reinforcing a behavior that is less negative than the alternative but surely still a negative. You don't say "you're overreacting, you shouldn't be depressed"... you ask "how are you doing now? Is there anything I can do for you right now?" But you still have to indicate that SI is bad in some way... It's tricky. Wendy CO EMT-B

You can find it. Can you get patent access with it? Not always. It's always dependent on the individual patient. For example, I just ran a call for end stage liver disease where the Pt had a power-port... tried 2 different peripherals (with my medic assisting and watching like a hawk) and couldn't get either. Neither could he. *shrugs* Wendy CO EMT-B

Did you guys read all the way through? Definitely some valuable material in there that provides insight into self-harm vs suicide intent. Wendy CO EMT-B

We check every drug box the last day of the month. Anything with that month's expiry gets chucked and replaced that day. Even so, I found an expired terbutaline the other day... Wendy CO EMT-B

JP, we're referencing coworker behavior at work I believe. Did the older Scouts try to make passes? Only every so often. Once you make it clear what's going on and where the line is, it usually stops. And besides, I worked the cub side of the road mostly, so I was more "mommy surrogate" than "MILF" material. Wendy CO EMT-B

Agreed! The point Mateo is trying to raise here is the presence of irregularity in all rhythms (for the sake of debate, I'm sure...) and to illustrate WHY people will mistakenly term a ventricular artifact "PVC" when it isn't. No need to be a dick. No need to use some vulgar metaphor and insinuate things about people's personalities. ~_~... not sure why you did that. Then again, I should have given up trying to figure out why you do anything by now... Wendy CO EMT-B

If it offended you, you call "harassment" on her and get rid of her. She touched you in a physically inappropriate, uninvited manner and intimated sexual intent (even jokingly...) Wendy CO EMT-B

Dunno. I'm not unattractive according to some... maybe it's the fact that I bring up my fiance when people ask me about myself. That seems to shut down a lot of passes. Wendy CO EMT-B

I have not been on the receiving or giving end of any "hitting on" at work. Lucky me. Wendy CO EMT-B

One clicks play and gets "embedding disabled by request" instead of the cool video, Michael... Not cool! Wendy CO EMT-B

Eclampsia: Seizures and dangerous illness including decreased organ function. Occurs in pregnancy after the development of pre-eclampsia (hypertension). Pathophysiology in a nutshell... basically the body whacks itself out because it's not tolerating the placenta well, becoming more sensitive to pressure regulating agents due to hypoperfusion of the placenta and a bad... hm... how to put it... bad relationship between placenta and mother's body? Not sure how to phrase it. Placenta previa: the placenta is sitting lower than it should be and may be covering the cervix. Can cause bleeding during later pregnancy, and may necessitate delivery by C-section. Is not necessarily an emergency by itself, but can be dangerous if bleeding occurs... women usually end up not being able to work or lift or have any intimate relationships until they deliver. Women with this have to be really careful and vigilant about watching for bleeding, and if they are bleeding, it is an emergency. Placenta abruptio: The placenta has become detached, either fully or partially. May cause blood loss and hypoperfusion to both mother and fetus. It is a true emergency, requiring ultrasound, blood transfusion, and often emergency C-section. Can happen due to a variety of factors including trauma, dehydration, and high blood pressure. What are the signs and symptoms of a pulmonary embolism patient and how would you treat for it? Wendy CO EMT-B

Vomit's my weak point... here's the thing. As long as I look away and clench my jaw a bit, I can help someone throw up into a basin. I still want to gag, but my focus is changed. It's cleaning warm puke off the floor that gets me... *URP!* That warm feeling through your gloves... eeew... Vick's vapo-rub is good, also, breathing through your mouth helps. Wendy CO EMT-B

And that sort of led other people to look for other antibacterial/antibiotic type agents and revolutionized medicine. It *does* make a difference if you can take something from "quack" status and elevate it to "medicine".... Wendy CO EMT-B

Alexander Fleming... he actually had some Petri dishes with staph that he was culturing and he found some plates with this mold on them and almost hucked them, but then he took a closer look and realized that the mold spots were surrounded by clear areas with no staphlycocci. And he went "Gee... that's funny" as most scientific moments of genius go... Wendy CO EMT-B

You hear what you want to hear in posts... so far, it's a 50/50 split on how that post's been received as far as reactions to it... I don't hear condescension in it. I hear good ideas.... but that's me. Even so... it's a post. Untwist the boxers and sally forth! Now, you know you need a grain of salt with Vent's posts to make them more to your taste. Wendy CO EMT-B

Dude. Relax. Seriously! You are indicating indignation because in your initial post you implied that this patient might be better served by transfer to a facility with a lard-ass capable cath table. Vent is merely saying that in some places, catheterization may not be appropriate... hence, the same rule-book (cookbook) is not followed for every MI patient, even though that's pretty much how we as EMS providers learn to approach it... She's not insulting you. She's not even implying that you're a cookbook medic. She's simply stating the facts of the case... that it is not necessary for you to feel indignation about this patient due to not everyone needing the treatment that your mind jumps to... not that you're a flawed provider or thinker. Seriously. Really. Re-read it, go take a walk, then re-read it again. Wendy CO EMT-B

That's AFTER the baby is completely out of the birth canal and the cord isn't being squished by the baby and mama's vagina and all those contractions. After the baby is completely out, then the cord is basically a large hose through which blood passes... Make sense? Cord + baby inside vagina = squished cord and no flow. Cord + baby outside vagina = no squish on cord. Wendy CO EMT-B

Easy tiger! Vent wasn't trying to be condescending... she's just expounding from her own experience and education. She's right... there's only so much that can be done and you may not have all the clues necessary to the situation. I don't think she's trying to imply that you're stupid, a cookbook medic, or otherwise... Remember that both sides here aren't playing with the full deck of info... Peace.... Wendy CO EMT-B

Baby's head out of the womb? Can you suction and ensure open airway? Baby no longer needs cord blood for survival. Try to slip the cord over the baby's head. If unsuccessful, clamp the cord in 2 places and cut between the clamps. I gotta agree with Doc on this one. Cord around the neck can become very dangerous, very quickly. Wendy CO EMT-B

Matt- I'll be an editor. Let me know what all you want me to do. I'll also write and research questions if needed. But you'll have to edit me in that happenstance. Wendy CO EMT-B

Accommodation: The process by which your eye adjusts to focusing on an object that is close or far away. AKA: We test for accommodation by bringing something like our finger or penlight (not lit) in towards the patient's face, watching their pupillary response to the changing distance of the object. As I always forget which order is which, R's in PERRLA mean Round and Reactive (not sure which order.) Round: To be circular or ball shaped. Reactive: To display some sort of change or difference in response to stimuli. Ok Doc... How does the NURSE administer that neb setup? And what is the difference between a Beta 1 and Beta 2 agonist, and why do we use Beta 2 agonists for bronchoconstriction? EDIT: For TREATMENT of bronchoconstriction... Other folks: Describe, in detail, how you would handle a combative patient who may or may not be ETOH involved. You see a large head laceration and a very large drunk reeling around a circle of onlookers. Ready? Go. Wendy CO EMT-B

Agreed. AK, spenac, I'm requesting that the BS stop until warranted by further idiotic posts. Find another really idiotic post, feel free to lambast said poster... but can we continue with the actual procedures run-through? Wendy CO EMT-B