Eydawn

Found what I was looking for. Benzos can be more effective in treating the pain caused by muscle cramping secondary to envenomation, and are preferred over muscle relaxants or opioids. So I'd definitely get some Versed on board. Also, these kind of enevenomations can lead to rhabdomyelosis... which is countered by administration of sodium bicarbonate. So since your transport time is so long... I might be considering that. I knew there was something in there... Wendy CO EMT-B

Per an article on emedicine.com: "Calcium gluconate is no longer recommended for widow spider envenomation." http://www.emedicine.com/EMERG/topic546.htm "In the treatment of black widow spider envenomations, antihistamines are used before antivenom administration to reduce acute adverse reactions to the antivenom." Well, the benadryl is a good idea then... also seeing support for use of benzo's.... ativan, anyone? Hm. Still wondering about the sodium bicarb. Something's telling me that the calcium channels that have been dumped have something to do with sodium bicarb being a good thing. Neutralizing increased pH and halting the nerve firing, reducing muscle cramping? Still having trouble finding resources. Wendy CO EMT-B

That's what the TAPE is for.... duct tape if you must... Let's give her some tylenol and some benadryl? That's about all I can think to do, to be honest... because I'm not a paramedic and don't know all the ramifications of all the meds you've got. Something in my head is jouncing around wondering if sodium bicarb might have some positive effect... let me go JFGI and I'll get back to you on that one. But start with the acetaminophen, and benadryl just in case there is some allergic component and it's not presenting as one might expect. Wendy CO EMT-B

So sue me I didn't see the "no air support" blurb. Lol... So why not? Just outta curiosity... is it a terrain thing? I'd be trying some warm compresses to the muscular areas that are painful. Stick hot packs down w/ tape with a layer of gauze between their bare skin and the hot pack. Got any sedatives that might help calm her? Wendy CO EMT-B

Um... so you're complaining about helping with billing... because it puts shiny coins in the company's hand... Where exactly did you think your paycheck comes from? The money fairy?? Or are you complaining that the company is not paying you adequately from the shiny coin pile? If that's the case, you need to renegotiate fair wages.... or find somewhere else to work. How do you expect to get paid if you don't help get billing info from a patient? Are we gonna have to create a new EMT level for that? I know! We'll call it the EMT-SB... EMT secretary and billing.... they can fill out your trip sheets, and collect billing info for you... ;-) In all seriousness, were you complaining about unfair wage vs. company profit, or about having to do billing period? Wendy CO EMT-B

You are obligated to provide care for the first patient you were assigned to. If you have issues with it after determining the guy's a prick, then call medical control and see what they want you to do. A good doc will tell you to leave the patient with the non-life threatening injury with a cop until another unit can get there... It's no different than running on a call for a "cardiac arrest" in a local convenience store and passing a 3 car accident on the highway on your way in... you go where you were told, you call in the accident, and you wait for further instructions. If dispatch is responsible for telling you where and when to go, then turn it over to dispatch! Advise them that you may be a faster resource for the big hairy mess... and let them make the decisions. Didn't we discuss this under the guise of "do you stop at an accident you see on your way to a call" a couple months ago? Doesn't seem much different to me... just a larger sort of accident. Wendy CO EMT-B

Describe the dark spot. Is it a mole, a freckle, a raised bite, does it have pinprick marks in it, is it a small hematoma, a tick, what? I'm also throwing in brown recluse as a suspect here... dizziness, restlessness, nausea, chills, shock... those little bastards are very nasty. And if she's got a brown recluse bite on her vajayjay, she's in for a long painful deal if she makes it that far... Black widow spider is a good critter to have a high index of suspicion for. I'd be looking for any other potential bite sites, regardless of critter, on her buttocks and lower back as well. Why is her BP so freakin' high? Does she have a history of hypertension? How about meds... she on anything that might complicate this? How's her LOC? Decreasing? Remaining the same? How far are you from the hospital, and do you have flight available to come yoink her outta there if necessary? Wendy CO EMT-B

Whoa! What a freaky short story! That a Philip K. Dick one? Or Harlan Ellison, perhaps? You gotta tell me who wrote that! You a sci-fi reader, Richard? I cut my teeth at the age of 6 on "The Rolling Stones" by Heinlein.... Wendy CO EMT-B

*Looks longingly at destruct button... settles for "reboot" for Scara and "boots" him furiously across the room* Wendy CO EMT-B

Knew it had to do with P values, just wasn't sure what you were getting at lol! Stats proves that it's all made up. That's the impression I got. But ya gotta believe in something, right? (I know how to actually use statistics wisely and interpret them... but you gotta admit it seems bogus at first!) Wendy CO EMT-B

Huh? Say what? You lost me... Wendy CO EMT-B

Not any parent... a custodial parent for a minor or dependent adult. Those with legal guardianship. The divorced dad who doesn't have legal custody? I don't believe so... that's kind of like an aunt or uncle stepping in saying "do CPR!" when the parent says no... Think it also applies to anyone with legal guardianship/medical power of attorney who signed the DNR for the person they are responsible for and then changed their mind... you were responsible for saying "NO" and now you say "YES" so the most current order stands... Wendy CO EMT-B

Definitely differs by state as far as the high school diploma goes. As far as useful vs. useless.. again, I hate the formula heavy aspects of physics. I love the concepts... but I wouldn't force everyone through a math-heavy physics course. You would be biased! Physics folk usually are ;-). JP, I'll go for 2 semesters of Algebra and a semester of statistics... and I do think epidemiology is a good alternative for those who hate statistics. Even if you hate stats (which I certainly did!) it's a great course to at least sit through. You learn a lot about how research is analyzed... and how figures can be manipulated. Invaluable stuff in my opinion. Wendy CO EMT-B

A basic understanding of physics is good, but I think the high school level suffices. College physics is a royal pain in the arse, and more about plug'n'chug formulae than really grasping the concepts of how things move around and how different forces act. I think a survey course explaining the basic concepts that's focused on improving spatial thinking would be a lot more pertinent than more useless formulae that you never recall when you're looking at an accident scene... Wendy CO EMT-B

Slightly off topic... EMT-B's with IV approval can give IV, IM and IN narcan in the state of Colorado... is this worrying anyone besides me? Since we can't intubate... and we can't give stuff to counter seizures... and we don't have enough pharmacology (most of us) to understand how Narcan works and why... WHY did they give us this tool? :-/ Back to funny stories of Narcan admin... Wendy CO EMT-B

Nope. Calculus is good for learning the higher sciences, but for what we utilize and need to understand, calc is not a necessity. Algebra, however, is. I liked Calculus... but I don't find myself using it very often... and I don't think that it would make someone a better medical provider. (Someone who doesn't dig higher math, that is. Anyone who pursues the study of anything they're interested in or have a yen for makes themselves a more rounded provider... even if it's studying dance theory in depth..) Wendy CO EMT-B

Do whatever you can to make face-to-face contact. The human element is removed when you only communicate via phone and email, and it makes it very hard to make a case for yourself if your resume doesn't necessarily reflect your ability. Have you tried looking up the addresses for their offices? Go in and introduce yourself! Dress professionally! Be honest about where you are and what you're interested in, and be willing to accept that you might not be what they're looking for. Also, if you're stuck in this interim period and there's only a few places you're interested in working for, how about taking some classes to help build your resume? If you can get an Associate's in something, or take pertinent classes like PHTLS, IV (if Ohio allows that), EKG interpretation, medical terminology, healthcare philosophy/ethics... all of those will make you a stronger candidate. Hell... while waiting, how about starting the pre-req's for paramedic? It'll make you a better basic... and start you on the road to paramedic if that's where you decide to go... Wendy CO EMT-B

Call medical direction. The people who have signed the legal document (DNR) are present and presenting conflicting responses. I was taught that anyone who signs the DNR can rescind that decision as long as they are physically present at the scene, and that someone who signs a DNR for themselves can void it if they are talking to you and say "I know I signed that, but I changed my mind. If I code, work me" or some variation thereof. Since the parents appear to *both* be legal guardians, you have a problem! Definitely a tricky scenario! I'd think that there's more precedent for following the wishes of the parent wishing to provide care for the child... consent for care and all that... but the fact that the kid has a terminal illness complicates things. Put it in the doctor's hands. Hopefully he or she has a nice lawyer they can grab real fast to help sort out the mess. Keep working the kid until informed otherwise. Wendy CO EMT-B

I'll agree on everything except the physics.... and you forgot Algebra. Wendy CO EMT-B

Human interaction will hopefully always take precedent over the convenience of an interactive machine. However, if they go far enough and develop AI.... then all bets are off, no? If robots become sentient and gain rights (Asimov, anyone?) then how will robot-human relationships be regulated? Where will they fall in the legal structure? It's a very interesting speculative field! But that secretarybot is creepy. And if she functions anywhere near as annoyingly as the Fujitsu self-check machines at the grocery store, I'll pass. I definitely end up talking back to the self-checker... me: "Just take my cash, you arrogant machine!" Fujitsu: "Please remove the last item from the bag" me: "I didn't put anything in the bag! What are you smoking?" Fujitsu: "Welcome valued customer!" me: "You said that 10 minutes ago! Did you forget?" Fujitsu: "Thank you for shopping with us! Don't forget to take your change and receipt!" me: "You didn't take my money yet! Does that mean my groceries are free? Why don't you inform the security guard over there..." Fujitsu: "Please follow the instructions located on the pinpad." me: "I just fed you a $5 bill. WTF do I need the pinpad for?" Fujitsu: "Thank you for shopping with us! Don't forget to take your change and receipt!" me: "You are welcome you Japanese hunk of electronic junk! Thanks for taking forever!" Now imagine if it had emotions... and looked like a woman... aren't you menfolk complaining always that we're *already* hard to read? Throw in some good ol' Bill Gates-esque technology and THEN see how you feel... Wendy CO EMT-B

I'd work with the PD and your state EMS office to figure out how great the need is and to get protocols for the taser use written if you guys insist on carrying them... that way you're covered. Don't just pack a taser. Have paperwork behind it. It's all a game of dodge the lawyer... Wendy CO EMT-B

The problem with fire and EMS in areas other than yours (where it seems to work ok- the exception and not the rule for most of us in terms of combined experience) is that many firefighters are *forced* to become EMT's or paramedics and do a terrible job because that's not where their yen is. There are also great EMT's or paramedics who are forced to become firefighters who do a terrible or unsafe job because that's not where their yen is. The IAFF supports combining fire and EMS because it means their firefighters will always have a job... and it holds EMS back as a profession because they try to keep educational standards low enough for those who don't give a crap to pass because they have to in order to be able to keep their jobs... You see how resentment could build? Ask me about Aurora Fire and Rural Metro here in CO in PM if you want a first hand look at that system working very badly... Wendy CO EMT-B

Michael! You really are a smart-aleck! Gotta love it though.... man, I'd hate to see someone actually come on and do that... we'd roast them alive ~_~ Lol! Wendy CO EMT-B

I like the photo name badge... that way no one can kipe your ID and impersonate you... Mine hangs from a lanyard (ick), I'd much rather have it as a clip on my shirt. Wendy CO EMT-B

An opinion on hiring someone or not hiring them must be based upon verifiable facts to have credibility. An opinion based on emotion alone invites challenge.... For example, the statement that medics who are on antidepressant medications are inherently "altered" seems pretty naive unless you've got some facts to indicate that depressed medics NOT on antidepressants are *less* altered than their medicated counterparts.... and that both classes are unable to do their jobs effectively... Wendy CO EMT-B