Eydawn

Congratulations, Zilla and Mrs (and little tiny bundle, too!) Welcome to your new life! Good luck! Wendy CO EMT-B

Wintergreen berries for muscle soreness on a hike in the Midwest... Sassafras root peeled and chewed for wisdom tooth pain... mullein leaf (Indian toilet paper) steeped in hot water for loss of voice or sore throat... wild sage chewed for a few minutes to open up clogged sinuses... I've done all of these and they all worked remarkably well. Wintergreen berries taste wonderful and contain a methylsalicylate similar to ASA. Sassafras has a deliciously spicy taste similar to root beer, and it numbs your mouth really well when you're aching or have canker sores or encapsulated wisdom teeth. Don't swallow it... just chew a small piece about the size of a chiclet until it loses its flavor. My Mennonite friend who's good with plants turned me on to this one. Mullein tea was a godsend my first summer on camp staff. Plenty of it growing all around us... pick the younger leaves if possible, rinse well. Place into a thermos cup, pour hot water over the leaves, close cup and let steep for 10 minutes. Open drinking port on thermos, drink hot liquid. Don't eat the leaves at the bottom. I went from literally NO voice to being able to teach three first aid classes (to over 80 kids a pop) in a row. I love that stuff. It smells like ass, but it really just tastes like weak green tea. We also had a lot of wild sage growing in with the mullein... pick a sprig, crush it and smell it first to make sure you know it's sage, then chew the sprig for a few minutes. Pretty bitter but it will open you up pretty quickly... and it doesn't leave you jittery like Sudafed does. And of course, there's always wild green onions... MMM..... that's not an herbal remedy, unless you count supplanting a Sodexho camp diet with fresh greens as a remedy... Wendy CO EMT-B

You can purchase shirts like that at pretty much any surplus store around. It's not illegal to just wear one, as far as I'm aware... I want to know the other half of the story though. I wonder if he was being an asshat at the party. That might account for someone tipping off a police friend to get this guy harassed... Wendy CO EMT-B

KED: used for patients requiring spinal immobilization, often as an extrication aid for people involved in motor vehicle collisions. First: Apply c-collar to patient and ensure that someone is using manual stabilization throughout this entire process. If in a car, try to lean the seat back away from the seated patient, instructing the patient not to move. Assess CMS on patient's extremities. Bring KED into the car and place it behind the patient with the head-stabilization portion up and the ischial straps down by the patient's tush. Pull the abdominal/thoracic sections around the patient's midriff, seating firmly under the patient's armpits. Fasten the three straps. There are two methods I have been taught for these three straps and reassured are correct, and the book seemed to have no preference when I learned, so either fasten MIDDLE, BOTTOM, TOP or TOP, MIDDLE, BOTTOM depending on your local flavor. Then, maneuver the ischial straps under the patient's thighs, using a see-saw motion to move them as far back towards the patient's butt as possible. Bring the straps up and around from in between the patient's legs, and fasten each to its appropriate clip. Use feed-and-pull to tighten the straps, but try not to pinch anyone's testicles. Tension the thoracic straps using feed and pull method. Tell women it's about to get a little uncomfortable, but make sure you're not limiting anyone's ability to breathe. Then, using your assistant who has been holding manual stabilization this entire time as help, bring the head-stabilization portion of the KED around the patient's head, having the helper transfer his/her stabilizing force to the outside of the KED until you can get it firmly taped/fastened and the patient's head. Then your patient is ready to be moved to a backboard. Reassess CMS. Transfer patient to backboard. For the Love of GOD... release the ischial straps.... fasten patient to backboard, and continue with care as necessary. Next scenario: Describe in detail the initial medical assessment you would do on a suspected Tylenol overdose in a 14 year old patient. You can go ahead and assume the patient is female, conscious, breathing, and the parents have given consent. Wendy CO EMT-B

Sidetrack... can someone explain the benefits/risks of using dopamine vs using epi? I only recently realized what dopamine is and why we use it... Just curious. Wendy CO EMT-B

Crucial part of D50... draw back multiple times during the push to make sure you still have vein patency. Everything else you nailed, Terr! Kaisu, we don't discriminate... go ahead and play. And I have never used an air splint (changing altitudes make em kinda problematic) so I'll pass and let someone else do this one. Wendy CO EMT-B

Can you do that out step by step for me, MedicRN? I was trying to figure it out myself (even though I'm not a medic) but I'm not sure how to make the conversions all work right. A 60 gtt set is 60 gtts per mL per min, correct? Without being able to look up references, I'm having issues. Wendy CO EMT-B

Combitube, specifically? Small syringe first, 15cc's if I remember correctly- large syringe next, 80-90 cc's (basically inflate it until you meet good resistance and pop the tube off the syringe.) Small syringe is distal balloon, large syringe is proximal balloon. But you listen after the small one- put the BVM on the white connector, ventilate and listen... if you hear breath sounds AND no abdominal gurgling, you're in the trachea so you leave the large syringe alone. If you hear gurgling and no breath sounds, use the large syringe and then confirm for breath sounds. Since we seem to be looking at more advanced type BLS, I'll continue the trend... List in step-by-step order how you would gain venous access on a patient needing D50 and the administration thereof. Don't miss anything... each tiny detail is important. Wendy CO EMT-B

Hot cooked onion poultice on the chest for coughing/being sick... fortunately, they were smart enough to put a towel between the greasy, steaming poultice and the person's chest so the person didn't get burned... Wendy CO EMT-B

I got to sit with my billing folks as part of my orientation. Guess what Medicare paid out on a $1700 chest pain bill? $375. Yep, that's it. What they do is minimize cost wherever possible... that's why this little form called the Advance Beneficiary Notice (ABN) exists for us to have patients sign if we feel that Medicare may not pay for their transport. You want to go to the hospital that's 20 miles further out when the one right here meets your "level of medical need"? Sign the ABN- Medicare doesn't pay for extra mileage. Medicaid is even worse... they tend to pay out less, and if you have a patient who qualifies for both Medicare and Medicaid, you CANNOT legally bill them for the balance. Surprise! Every little thing you check on your PCR, from pulse ox to nasal cannulas to IV starts... equates to a billing code with a set cost for that service. And yes, if your patient is WALKING to the ambulance, according to Medicare, they could have WALKED to a taxicab and therefore it was a superfluous transport so they don't have to pay out for it. That's the logic. Does it suck? You bet it does. I put "assisted patient to cot/pram/ambulance" because you bet I'm assisting them to walk, sit down, get comfortable, climb into the ambulance, etc. because I don't want them to fall while in my care. It sucks. But it's what we have to do to ensure we stay around to provide treatment to people. Wendy CO EMT-B

ROFL! I can has hotdog? :wink: I prefer teh goggies ovr teh kittez... (Ok, I'll stop now. My brother got me hooked on lolcats, icanhazhotdog, and FAILblog. It's a great way to waste time during boring lectures...) Wendy CO EMT-B

Of course, Michael... you put that and what do I do? Google it. Wow... didn't know the lolcat folks had THAT project going! Wendy CO EMT-B

There is a difference between training and education. Yes, one gets out what one puts in, but the quality of program and the content of education offered also has an effect on how good a provider will be. Not everyone is a good self-study on ethics, sociology, psychology, pathophysiology, pharmacology, and the like. Unfortunately, those who are self-motivated to exceed the expectations of the minimum training are few and far between... there's a few of us who are vocal on this site, but the attitude of "screw the thinking, you need to develop the gut instinct and the skills" is still prevalent in EMS, which is why we struggle as a MEDICAL profession. Without moving to a degree as the minimum requirement to be a professional pre-hospital provider, we allow the "skills before brains" crowd to remain in power, which helps neither us nor our patients. Degrees weed out those who have no desire to perform good medical care. Or at least, they certainly help. Degrees also help people develop broader understanding of the world and the intricacies of humanity... which leads to more ethical awareness and allows people to more easily bridge cultural gaps. That background can certainly be a plus at 3am when you're trying to negotiate with a patient who has concerns other than that massive MI they're having... Just saying. I know what it is to feel that you've put in, and it's unfair to judge all providers in your level in a lump... but the skills folks still reign supreme and our medicine suffers. I'm a well educated Basic with a biology background... and I self-study a lot of what we do and can't wait to go for medic. But not all Basics are like me... many are content to just be the paramedic's bitch. That's not what we need in medicine. Wendy CO EMT-B

Be really assertive and bring one of your largest buddies with you to help be a bouncer. Tell them that you'll report them for child endangerment if they don't let you get to the underage riders in a timely fashion, and insist that your tent gets set up in a locale that facilitates good care. In other words, tell them that if you're going to be there, you're going to do your job and if they don't want you to do your job properly, they can fark off. Be pushy. Be aggressive. Let the good ol' boys know you're not going to get shouldered aside because they don't understand the mechanics of trauma. Wendy CO EMT-B

If the vehicle still runs in top form, and has been well maintained and kept stocked correctly, then there's no issue as far as I see it. Hell, it's probably in better shape than some of the rural FD vehicles that are newer in my area... simply because it's used more often. As far as looking... left, right, left, ask partner if I'm clear while still looking left, pull out, look right, look left again, and proceed through if I'm totally sure I'm clear. I hate driving the giant flashy billboard... people want to HIT it! Scares the hell out of me. Wendy CO EMT-B

I completely sympathize with your plight. And I would severely disagree with whoever says you are not respecting the individuals who have passed on by being creeped out by this. Some of us are more sensitive to certain things than others, and that's not a failing, it's just who you are. I think that what you need to do is learn to associate that room in your station with your closure. It's no different than the morgue in the hospital... in the hospital, you probably have a crew room where you can sit and rest for a minute and catch up on paperwork, and the morgue is somewhere in that same building... so learn to associate your holding room with that same kind of separation. Once they go in the room, tell yourself that they are no longer in there (because as far as you're concerned they're not, and you shouldn't have to deal with the body again). Realize that that room is not really a part of your station... that it is a resting place for these bodies to go, a place full of respect and proper treatment. Then walk outside your station and take a minute to let your mind relax and let go of the call. Don't go straight from this extra room to your bedroom or your common space... make stepping outside yet another break with what has happened on the shift that resulted in the body ending up in the holding room. Don't even think of it as part of the same space... because it really isn't. That's how I would deal with it if I had no choice, which it sounds like you don't. It's kind of like how I dealt with the cadaver lab... don't get me wrong, I absolutely loved the lab and the learning experience I got from it... but being in there 2-4 times a week for 8 solid weeks during the summer was very difficult for me, as the room was very cold and the smell very pervasive. How did I survive? What I would do before going in was change in my previous class building into scrubs, walk to the building with the lab, sit outside in the sun (or at least in the hallway if weather sucked) and prepare myself for dealing with the dead. It allowed me to tolerate being in the room full of bodies and students much better... then, afterwards, changing out of the scrubs into my street clothes and walking out of the locker room and straight outside to get warm again. It put the lab in its proper space in my mind. Nail polish on cadaver hands always makes me start to tear up... and I get a very strange feeling from seeing it. I also hate cadaver smell, and really kind of shudder every time I go back through the notes that went into that room, because the smell has clung to the paper. Does that mean I am weak, or that I disrespect the bodies? Not in the slightest. I actually said a quiet prayer and thank-you to every body I had touched that day in lab, in gratitude for the opportunity to learn. It's not that you need to "man up"... you just need to figure out your own way of coping. I think my suggestion above might help you get that mental break you're looking for and help you feel at home again in your station. It's all I can really think of at the moment... PM me if you want to talk more about this (with someone who shares your sentiment and would also feel slightly creeped out until she learned to adapt to it). Wendy CO EMT-B

I would also take into consideration that you guys just moved to AZ... moving cross-country can also produce a lot of stress. Have you guys had a long sit-down talk, honest about what's bothering you or why things feel different? I had one of those with my fellow last night... and just hearing that there's reasoning behind the irritation helps a great deal. Also... how is he adjusting health-wise? That can also be a stressor. I would also advocate seeing a counselor. A good counselor facilitates communication and teaches you to find the solution within yourself... a good counselor doesn't TELL you how to solve issues in any relationship, but helps to guide you through your own process of finding the solution. Good luck to you, Lady... I know it's not easy. Wendy CO EMT-B

Single tube construction is the biggest one for me. As long as there aren't dual tubes chattering with each other, I can figure out what I'm supposed to be hearing... I have a cheap single tube that I've had for years (which resurrected this morning as I lost an earpiece to my nice Littman that the future mother in law gave me... and it worked fine.) Wendy CO EMT-B

Obama is the president. I'd call that progress. Just in case anyone is saying that individuals of differing skin color never get anywhere... just figured I'd throw that out there. Now... the issue as I see it... The problem with minorities entering fields requiring some higher level of education is not a "white man keepin' me down" problem, as much as many would like to say it is. It is a problem of the culture of poverty and the failure of certain cultures to realize that one must value education in order to advance. I grew up in an inner city neighborhood, rife with drugs, gunfire, poverty and general misery. (Next to the liquor store, so I saw and heard it all.) Whether the individuals in question happened to be Black, Latino/Hispanic, Asian or simply poor White, the problem was the same... education of one's children and one's self was not valued. A certain few individuals realize that education is the way out, and avail themselves of the ample opportunities provided to those of disadvantaged status... but then they find themselves caught in a bind between their own culture of upbringing and the newer, educated culture they have entered. Many become alienated, and in an attempt to find a new niche, abandon their childhood peers and even their own family, because they are ashamed that they cannot convince their compatriots to join them. They are often branded "race traitors" or "you've become White" regardless of ethnicity. It sucks. Individuals who attempt to accuse the White race for oppression fail their colleagues. There is a history of oppression in almost every ethnic, religious, racial, or otherwise categorize-able group's history. Those who continue to blame history only bind themselves further from remedying their own problem. It's not a race issue. It's an education and culture issue.... and until vociferous racists like Jesse Jackson and Al Sharpton among others are removed from the pedestal of "advocacy" the cycle will continue. It will be a long and hard battle to convince undereducated and impoverished people that they must value education for their children if they hope to bring our nation out of the mess it's in... and it needs strong leaders, not knee-jerk reactionaries who like to cloud the issue because they hold a lot of resentment within themselves. I've said my piece. Wendy CO EMT-B

Happy birthday, Dwayne. Here's thinking of you! (always) --Wendy

Apparently, I think too much. I'm thinking too much about the medicine and my skills are suffering for it. :roll: Actually, they do have a point... I'm still pretty clumsy. Working on it though.. and will continue to improve and learn for as long as I breathe... Wendy CO EMT-B

NO... really?! *Facepalm* Wendy CO EMT-B

First of all, I'd be careful with calling people retarded. Just because I disagree with you doesn't make me an imbecile. Your tack on this one, however, DOES make you an asshole. Sorry. Walking into the middle of a scene where a man has just watched his whole family die in a fire and asking him "how do you feel?" is NOT dispassionate observation, it is intrusion. Reading something in a paper and actually being there are two different things, and you're arguing from a ridiculous stance if you argue they are one and the same. Standing over a dying child when you have a bottle of gatorade in your back pocket, waiting for the camera perfect moment that will show suffering to the rest of the world, and failing to provide assistance after capturing that moment is not only cold, but inhuman. Having to ask yourself if you will help a child is ridiculous.. yet it is a thought displayed by a woman in a non-fiction writer's book trying to TEACH other people how to BE journalists. And it was praised as high awareness of the "line"!! So you'll pardon me if I'm a little jaded. And you have *NO IDEA* how many times I have or have not interacted with the media. I treat everyone with as much respect as possible... but you shove a camera in my face and get in my way and scream "media privilege" as I'm trying to do my job, you will piss me off! How dare you presume to know what my personal level of experience is? I have seen it at least six times... including my dealings with the Boy Scouts and care provision in that setting. I have a very founded prejudice, thank you kindly. Keep your character aspersions to yourself. You can disagree with me all you want... but I used to think you were above name-calling like that... guess I was mistaken. Wendy CO EMT-B

Because, unlike the journalist not encumbered by having several other patients to triage in the hopes of preserving as much life as possible, I cannot ethically stay with the 16 y/o who is an obvious black tag. The journalist, however, can take the shot of the year and then intervene... or even better, if time is critical, forego the shot in hopes of preserving a life. It is a job. But I have never agreed with prioritizing some work of your own over human welfare. Maybe that's why I'm not a photojournalist. Wendy CO EMT-B

Yes... I've known about him from before. Thanks for refreshing me, Brent! Being the messenger is important. Being human is more important. Wendy CO EMT-B