Eydawn

I get to graduate from nursing school this Saturday! That's what's eaten my life recently... and why I haven't been around to post much. Hoping very much to change that!!! NCLEX, here I come... Oh, by the way, y'all? Mike's a fantastic, wonderful individual. ;-) I think we've recruited him to the Colorado is Awesome club. Wendy CO EMT-B RN-ADN Student

If I was a lawyer, I'd eat your reports for breakfast. The fact that you passed "documentation" in your class doesn't mean anything. Do you want to improve your English language skills? Or do you honestly not care? There's lots of *great* and I mean *GREAT* medics here trying to give you a bigger picture... you yourself admit you're in your teens (that's when I started as well, by the way) so you should realize that your job is to be a giant sponge and absorb all the wonderful information thrown your way. Once you've been a provider for a while you can decide which bits to chuck aside as unimportant... I'll give you several instances in which English mastery is important: -Resume. You hand me a resume with no capitalization, word misuse, spelling errors? I'm going to round file it. It's my first impression of you. -Documentation. As I said above, if I were a lawyer, I'd eat your reports for breakfast. You can learn to do better, and you should- not just for your own professionalism, but to contribute to our profession as a whole. -Professional communication in the workplace. There are many who will miss the message for the mistakes in your communication. Email is your friend, both CYA and rapid communication wise... if you can't learn to write one quickly and correctly, it'll hold you back. Welcome to the City! You're going to do great. Ask lots of questions, and put your all into it. Wendy CO EMT-B RN-ADN Student (21 days and counting) Dude. Mobey uses Canadian English. He's in CANADA. Ergo, British English spellings... extra vowels here and there... c's instead of s's... you get my drift... Just saying...

Dwayne. I'm going to BEAT YOU. And I'm close enough to do it, too! If you don't get yourself in to get a cardiac workup and holter monitor, I will drive to where you are and kick your ass. You know how I said you're too hard on yourself sometimes? This ain't one of those times. You are, in fact, being an idiot. You know something's wrong. Don't tell me you don't. Especially if it WOKE YOU UP. You know it's probably your heart. And you're willing to risk Dylan's future on a "well what if it ain't nothing and I spent all that money" moment? I'm gonna turn this around and ask you, what if Babs or Dylan came up to you and described the exact same thing (and had it happen three times with no provocation)? Would you hesitate to spend the money? Of course not. Take care of this, BEFORE YOU FLY BACK TO THE BOONIES. Wendy CO EMT-B RN-ADN Student (21 days and counting)

AK- I find it interesting that you feel you have to disappear, rather than pulling back and lurking. Is there really NOTHING left of value here for you? I also am busy and don't have time to post much, but I do still lurk and pop in occasionally. Why the huge, final, whammo move? Just my thoughts... Wendy CO EMT-B RN-ADN Student

That's funny as hell!! I like it. That was a good laugh. A little too much distraction... but the message was pretty simple... Wendy CO EMT-B RN ADN Student

Personally, with the weakness and whacked out affect, I was thinking he ate dear old departed Mom's lithium caps. Whoops! Look! A zebra! Isn't it purdy? ;-) Sometimes it's the darndest things, and there's no way to tell until the right person goes 'waitaminute...' on something. News flash- even after we get them in the hospital, sometimes we can't figure out WTF caused XYZ- period. Not with all the labs in the world, not with the greatest workup, and 5-6 different sets of MD eyes plus countless RNs and CNAs... sometimes, it remains in the great unknown. I wonder, with the brainstem compromise, if active warming would have helped because he was already in a hot environment and profoundly cold despite that. Hm. Any thoughts? Wendy CO EMT-B RN-ADN Student

I miss the forum... nursing school has eaten my brain, time and almost soul at this point... I'm at that stage of "oh God, I hope this ends eventually, because I'm about done with playing this game..." As much as women help pre-hospital, men are invaluable on the nursing floor. The strengths and different wiring of each gender makes an inter-gender team highly valuable when it comes to critical thinking, problem solving, relating to certain patients... the days where my male friends are working makes the day go so much smoother for some reason. Maybe it's the dilution of the estrogen, maybe it's just that everyone relaxes a little bit, or maybe they're just the people I dig working with so my attitude is better- who knows? I think the biggest thing, regardless of gender, is good communication. I don't care what parts you have, if you can't communicate with the team or your patients, you need to fix something... Wendy CO EMT-B

How about we focus not "equally on all cancers" but aggressively on the most deadly and costly of them? On those holding the most promise for potential treatment modalities, or genetic information that allows attack on other similar cancers? We used to focus on curing cancer. Right now we focus on treating it. Bit of a weird thing, eh? Wendy CO EMT-B RN-ADN Student

The NIBP can be a good time saver. However, if you don't verify significant changes manually, you are a fool... the machine is limited, so make sure you double check to see if your ears hear what the machine hears. Trust your own BP over the machine's. If you're not sure either, then have someone else check it. If you're going to be basing interventions off of your pressures, you better be sure of those pressures! Heaven forbid you get a false high and give more narcs, or a false low and give pressors... @_@ that could really be bad! Wendy CO EMT-B RN ADN Student

Well hell. Foley? Removed? Sweating? High pressure? Autonomic dysreflexia. Sit his ass upright! Get the Foley back in! Urinary retention is probably the issue... OR, it could just be from the sexual stimulation. Regardless, elevate the head and let's get moving to the hospital. Also, why is this gent using an indwelling Foley instead of intermittent clean-cathing self? Just curious. Good scenario (dragged out WAY too long) challenging our assumptions... everyone assumed the husband was the war vet, that the alcohol and guns indicated a PTSD exacerbation. Moral of the story? Ask more questions. Direct questioning is important! Wendy CO EMT-B RN-ADN Student

My hospital has its own storage room for gear left by EMS crews. I know, because I had to go looking for my SAR team's backboard recently (surprise!). They not only clean them, but they sort stuff by type, and if they know where it came from they'll try to mail it to you instead of letting it fester forever in the storage room... I would say this policy is short-focused and not good patient care... and it will result in negative outcomes if people follow it without good judgment. I understand wanting to minimize losses from gear... but you gotta take care of the patient first. Wendy CO EMT-B

It interests me that many particle physicists acknowledge a higher power, or are agnostic. Many I've read are not atheist. Just says a lot to me about that which we don't fully understand in the universe. I particularly like the quote "Quit looking at the electron like it's a phucking particle!" I don't do well with the math, but I do love the conceptual aspect of physics (which my physics inclined friends say is impossible to truly understand without getting into the math... but then again, they live in another dimension I think...) Good thread, Dwayne! Wendy CO EMT-B RN-ADN Student

How's this for ya? (Warning, NSFW! Graphic.) Went viral a few weeks back. Wendy CO EMT-B RN-ADN Student

Man, I wondered if I should say that... lol... *Sighs* Wendy CO EMT-B RN-ADN Student

Alas, I will be stuck taking HESI exams and going to pinning rehearsal (oh joy!) on those days. As one of the scholarship recipients from last year, I can say this was well worth attending. I loved it. One of the best educational experiences in my life. Not to mention the cute Canadian doctor with the artfully sculpted facial hair... ;-) (just kidding.) Great chance to do some deeper thinking, practice some skills, get thrown into a pediatric "oh noesies" simulation with a team you've never worked with before... it was fantastic. Wish I could go this year- maybe next year! Wendy CO EMT-B RN-ADN Student

I have to pipe up as well... I have not seen continued paralysis in our ICUs. As a matter of fact, I have seen as part of early ICU mobility, people still receiving ventilator support (still intubated) standing at the bedside or marching in place. Those people often get weaned not long after that, but they are not kept totally sedated and certainly not paralyzed. I could definitely understand keeping them paralyzed for flight, but what is the difference really between keeping them at a high level of medication induced sedation and keeping them paralyzed with sedation (as we all agree that paralyzing without sedation is a big mess)? Either way, they're not fighting you or the tube... Wendy CO EMT-B RN-ADN Student

Holy crap, how did I miss THIS thread? EPIC! If someone states that you're not fully comprehending what's being said, there's more to their point than what you appear to be reflecting. Regardless of agreement/disagreement with the points being made by either side. It's not an insult to state that your reading comprehension in this particular thread needs work; it's an observation, made by the individual attempting to communicate something (to no avail, apparently). Too funny. Now, let's get to the meat a bit here. KSL2786, have you ever been bitten by a dog that was either intentionally aggressive or reacting due to fear? Have you ever attempted to calm a dog that was not yours (or not familiar to you) in a high stress situation? While it may be possible to assert control over a familiar animal using physical force, it is much more difficult to do so when the animal does not know you, nor you it. Is it shitty that the cops ended up shooting the dog? Absolutely. Does everyone involved wish it could have ended differently? I bet you'll find so, here on the City. Nobody likes to hear about a dog being killed. Does that mean that the cops are unintelligent, horrible people for making that decision? No. When you have a medically compromised individual, someone who's already been bitten, and an aggressively posturing animal, there's not a lot of time to sit and ponder. They responded to what they perceived to be an imminent life threat, by removing the most threatening element in the situation. If some meth-head had come screaming up holding a knife, yelling "banzai, doggie!" they'd have shot the meth-head. See where I'm going with this? You can Monday morning QB an officer involved shooting all you want, but unless you were actually there you're working off of incomplete data, and should recognize that. Doesn't mean you can't be hacked off that they shot the dog, but it does mean that you're not the end-all-be-all authority on what went down. Oh, by the way? I'm also 26. I'm also in school. Your writing, compared to mine, sucks. That's not an insult, it's an observation. The way your communication comes across in forum-land (which is not the same as face-time or Facebook, even) makes you sound much less mature than one would expect for a 26 year old. You can either whine that I'm mean, or strive to improve so that miscommunication occurs less frequently in your endeavors here. If you don't explicitly state it or spell it out, people are forced to make inferences and assumptions, which, as the "parents vs. roommate car funny" shows, can completely skew an interaction. Wendy CO EMT-B RN-ADN Student

Ok, the whole "don't trust the monitor's interpretation- EVER" aside, this is FUNNY AS HELL. And also a very sad example of why it sucks to be an EMT-B; for all many EMTs know, this is the truth of how it works... "you don't need that book learnin' to be a medic, just do the skills and get them to the hospital..." I gotta admit, I laughed OUT LOUD at work last night when I read this. Witchery, indeed... :-) Wendy CO EMT-B RN-ADN Student

You mean, hey, a rescue like it should be- happy to have helped the folks, no harm no foul, no charge for rescue in accordance with the MRA and NASAR stances... ;-) Wendy CO EMT-B RN-ADN Student

Welcome back to the madhouse (and the 'City!) Wendy CO EMT-B RN-ADN Student

Welcome to the 'City! Wendy CO EMT-B RN-ADN Student

HOLY THREAD RESURRECTION! @_@ 5 years! Wow! Is that a new City record? ;-) In all seriousness, shut'er down if you're stuck, and document it as a delay in your run report. Don't force anyone through a red light. I have to say, in my area, I'm surprised as to who I think drives well going emergent. In order of increasing proficiency, we have local PD, local sheriff tied with local EMS provider, and the best drivers of all are actually the FD. (Shock, I know... but it's true.) My husband and several of our friends/acquaintances have almost been nailed by PD going code (usually without siren) on more than one occasion... PD *would* have been at fault in both of the near misses with my husband. I hate driving emergent. Blech. Wendy CO EMT-B RN-ADN Student

Arctikat, You're right. Sorta. She should have gone for the nadgers. Problem solved. Sounds like these two druggies were cruising for a fight and happened to try to pick on some younger, obviously more naive women (see about them being photographed without permission, above- they did try verbal for cease and desist to no avail). If she had kicked him in the balls, he would not have been able to strike her back, and the rest of the younger male posse would only have had one asshole to contend with. It's never good when a pile of teens/twentysomethings gets shitfaced in a club. Moral of story... Wendy CO EMT-B RN-ADN Student

Well hello! Welcome to the City. Hop on in, the water's frisky and choppy (but fun and informative!) Wendy CO EMT-B RN-ADN Student

I like it, BAYA. And I guess we could treat for the sedation by managing airway, so not as huge a deal here... Now, to dive off into tangent land... as I recall, Reglan is one of the antiemetics that is approved for use in pregnant women. Would your treatment for dystonia change if your patient was pregnant? What extra considerations would you take into account, if any? ;-) Wendy CO EMT-B RN-ADN Student