Eydawn

Perhaps the issue is slated to be addressed at the next CE for kristinaemtb. Perhaps not! Even so, if I were a sup, I'd be handing out print copies of the new protocols- complete with rationale. By the way- wouldn't perusing this forum as well as other EMS resources possibly be considered attempting to further one's education? By keying in to what is debatable, you often figure out which issues to pay attention to and what you still have deficient understanding of. I (after reading some materials- not the AHA but another abstract I'll dig up, it's here somewhere, gotta clean the room first, lol) had been under the impression that the primary focus of increasing the compression ratio was due to the rate of O[sub:46b1a04987]2[/sub:46b1a04987] desaturation from the bloodstream, indicating that the patient was being better oxygenated by moving more of the blood around to get the oxygen already in the system to the major organs. Didn't know it had anything to do with prep for electrical stimulus. Here's a question from someone who hasn't had a lot of cardiology yet but has a basic grasp of metabolism... how does the buildup of ATP affect the efficacy of the shock in "rebooting" the heart? I assume it has something to do with the H+ gradient and the electrochemical nerve receptors that are involved in muscle contraction... anyone care to take a shot at it, or should I move this into its own thread? Wendy NREMT-B

I've definitely run through scenes again in my dreams... not always bad.. sometimes just noticing things I hadn't before... sometimes I'll dream about things I'm worried about, like one of my sick friends having to go to the hospital and how all that would work. Sometimes I'll go back to before I was an EMT and things that I saw or that happened that I would have responded to differently now. Definitely have recurring dreams about my dorm catching on fire. Think it's because of the smokers below me- somehow their cig smoke gets vented into my bathroom (we're not supposed to smoke in this buidling). Anyway, I definitely have dreams about waking up to the fire alarm and trying to wake up all my roommates- even though it's never happened... and what I would do while doing that- like grabbing my cell phone etc. Definitely that dream feels like I'm on duty. Wendy NREMT-B

When I was a small child I wanted to be a police officer. I was homeschooled and pretty sheltered. Went to an inner city public high school, met the people I'd be arresting and developed asthma and decided cop was not what I should head for. Played around with the idea of becoming a microbiologist for a while, and then got into a venturing crew where I got my First Responder... the first time they let me on the ambo for a 3rd ride, that was it. Help! It's got me and it won't let go! I hear sirens in my sleep! (the EMS bug) Wendy NREMT-B CO State EMT-B MI State EMT-B

Vitals. How far did he fall? I'm assuming C-spine is an issue- so grab the backboard and c-collar. Pertinent history of similar/other injury? Medical conditions? Why'd he fall? What hurts most now? Allergies? Meds? Last oral intake? Pupils? Any signs of head injury? Respiratory distress? That'll do for starters. Wendy NREMT-B

Well, I just found out today that my stagecraft professor has survived 2 (count em, TWO) blunt trauma cardiac arrests. One MVA, one fall. Statistical anomaly for sure! Wendy NREMT-B

You're damn right I'd stay in it. If I wanted to wear a uniform I'd join the postal service. Echoing what others have said, this is a calling- not just a job, because lord knows you don't subject yourself to all sorts of abuse/stress/wierd hours just for a paycheck. There has to be something else in there to make it worthwhile. It's got me and it won't let go! (The EMS bug) Wendy NREMT-B

I have to agree- more, more! That was amusing and wonderful! Wendy NREMT-B

You can explain to your coworkers that it doesn't matter where he works- if you want to help put his rig back together, it's not because you have loyalty to his company, but because it gives you a minute or two with him in the middle of your day. Remind them that it's not a given that you will see someone when you get home at night because you never know what can happen, so one of these days it might actually be the last time you get to see him. (Not saying this is likely- just going with the appreciate the moment thing). Also ask them to put themselves in his and your shoes- what if they had had paperwork snags that had prevented them from working as they wanted to? Wouldn't they have pursued other options? What if one of the girls instead of you had been dating him- how would she feel? Unless talking brings more conflict, sometimes people just need to have the simple stuff pointed out again, whether they listen or not. Wendy NREMT-B

Was the throat pain present before beginning the course of zithromax? Did it worsen after taking the antibiotic? Has he ever been placed on antibiotics before? What is his occupation- is he a singer that undergoes a lot of vocal stress, or does he work in an area with volatile chemicals that he could possibly be inhaling, for example? Any unusual exertion, exercise, shouting, excessive screaming/talking etc? Has he ever had throat pain like this before? Any history of heartburn, vomiting associated with the infection, etc? That'll do for starters! Wendy NREMT-B

So some people have had bad experiences with FF's, fire based EMS specifically... doesn't mean all FF's suck. Just keep that in mind; yes, they may be terrible where you are, but there's terrible paramedics and EMT's too, and we've got too much to do to keep wasting time yelling about how evil the FF's are. If the fire based EMS is screwing up/trying to take over your system, I understand a need to vent, but remember you have to try to do something about it other than just badmouth FFs. I'll say it again; two of the best EMT's I know are also FF's. They don't operate in both functions simultaneously and I owe a lot to them. They've taught me a lot, and the level of care that I have received from them (as a pt) has yet to be matched by any other care experience I've had. Wendy NREMT-B

Alright... my first mentors have to be the EMTS who taught my First Responder class for my venturing crew. They incorporated a much deeper level of understanding as to why we were doing what skills we were doing, and they watched us and helped us learn what we wanted to do. I wouldn't be an EMT if I hadn't done 3rd rides and hospital shifts with them, and I certainly wouldn't be as good a medical provider I am now if I had only gone through my EMT class. One's now an RN and the other is the person I would trust my life to over anyone else in an emergency. The second set of mentors has to be my two older buddies, both excellent Boy Scouts and both excellent FF/EMT's. (No, they don't combine the two unless they're out at the camp working with Elbert Fire...) Mojo and Justin have taught me far more than I ever thought they would, and they have led by example ever since I've met them. They're really my role models. They nurture the younger kids and help teach each other (including folks like me) everything they can get their hands on. Then there's the forum mentors. I've learned tons from ParamedicMike, RidRyder, Dustdevil and LoneStar to name a few (I can't type everyone, I'd get worse carpal tunnel!) I can't wait to learn even more. Bring on the challenges! Wendy NREMT-B

Catcher's Mitt! I wonder why? I don't get it. This must be another part of my education that is lacking... I'm sure it'll get explained to me before long... Wendy NREMT-B

You Are a Frappacino At your best, you are: fun loving, sweet, and modern At your worst, you are: childish and over indulgent You drink coffee when: you're craving something sweet Your caffeine addiction level: low What Kind of Coffee Are You? http://www.blogthings.com/whatkindofcoffeeareyouquiz/ Not surprised at all.. I love those things. They're one of my guilty pleasures! Wendy NREMT-B

Vomiting kids, lots of dehydration, too much to drink (unless Cedar point is a dry zone, I can't remember), cuts and bruises, SUNBURN, and people with pre-existing medical problems who went on one too many roller coasters. Not to mention "I stayed up all night driving to get here, didn't drink any water and have only eaten doughnuts in the past 24 hours".... Out at Bandimere we had a kid that stayed on a ride for 15 minutes (the goof running it was too stupid to check his timer)... kid turned pretty green. Also have seen lots of sprained ankles. Dust, I don't think it matters too much; most of the people who're too sick just to chill and drink water need to get shipped out of the park anyway. Notable exceptions would proably be diabetics... ate too much cotton candy, need to chill out and re regulate their blood sugar... etc. Wendy NREMT-B

It reminds me that we all have a job to do, each with its own difficulties. I owe my life to two firefighters who cared for me as EMS professionals over a year ago.. they're also now primarily EMS and my best friends. No likee, no readee! Although if we start talking about the best way to attack certain fires, I will shoot someone :twisted: Wendy NREMT-B

Estrogen induced stupidity, huh? You wanna hear about the injuries I've treated in my male friends? From sheer stupidity? Guess they must have excess estrogen! Wendy NREMT-B

Maybe they'll be able to fix some of those damn syntax errors in the questions while they're at it. The version I took was possibly the worst written test I've ever seen! Wendy NREMT-B

So how does one treat methemoglobinemia? I assume that it needs some sort of chemical intervention because the problem lies in having too high a ratio of inactive hemoglobin (methemoglobin) and subsequent hypoxia; how would one reverse that? Wendy NREMT-B

I hail from Midrealm, the barony of Andelcrag, Three Hills Canton. I have not yet chosen a name, but intend to enter heavy fighting as soon as possible! Wendy NREMT-B

Plug the holes, treat the symptoms... you don't have to know which direction the holes came from, because only a surgeon can fix the internal damage. Plug, load and go, trauma is a surgical disease! Wendy NREMT-B

Knock 'em dead! You guys have got the wherewithal, hope you remember all the textbook stuff! Can't wait to see you enter the field. Let us know how it goes, and start slinging medical questions at us! Wendy NREMT-B

Few more questions... How drunk was she? Remember that ETOH can mask symptoms; she might have neck pain that she's too goofy to be aware of at the moment. Everyone responds differently to alcohol. Was she compliant with you, were you able to explain things to her? Was she ETOH+ to the point that she would have been unable to refuse treatment? Were there deformities present? Kind of unclear from the way you wrote it, I couldn't tell if she was negative both on pain and deformity, or just on pain. Any LOC? She might be AAOx4 now, but if she had a loss of consciousness before you arrived on scene, that's another good indicator that she needs to be collared. Given the location of the scapula, I'd say it's safe to assume that she might have a spinal injury as well. Remember that pain from other injuries can also mask pain, especially in something close by. Any other injuries noted? Any other individuals in the vehicle, and if so, what were their injuries? (More clues to the severity of the impact). Remember, also, when in doubt, C-spine it. If you're not sure, then assume yes. Worst that can happen to her, she gets a little stiff from hanging out on a backboard for a while, whereas if you don't collar her and she has a spinal injury, she can end up paralyzed or dead. You're not an X-ray machine (although that would be cool! Who doesn't want super powers!) and you have some qualifiers I would have C-spined her for. So what did you end up doing? Eydawn NREMT-B

You Are a Warrior Soul You're a strong person and sometimes seen as intimidating. You don't give up. You're committed and brave. Truly adventuresome, you are not afraid of going to battle. Extremely protective of loved ones, you root for the underdog. You are picky about details and rigorous in your methods. You also value honesty and fairness a great deal. You can be outspoken, intimidating, headstrong, and demanding. You're a hardliner who demands the best from themselves and others. Souls you are most compatible with: Old Soul and Peacemaker Soul What Kind of Soul Are You? http://www.blogthings.com/whatkindofsoulareyouquiz/

You're kidding me right? CPR on someone with a pulse? If you can palp it, you don't compress it! Isn't that what all the AHA/ARC guidelines are about? Airway Breathing Circulation... under Circulation, you only begin compressions if the patient is *pulseless* and apneic!!!! Or did I miss something here? Eydawn NREMT-B

Isn't that why a lot of rigs carry gatorade? For the FF's/Tactical/PD that get dehydrated at scenes? I know when I did one of my 3rd rides I was the gatorade flunky, set with cups and a huge gallon jug to get the FF's re-hydrated.... What about ice chips- it's such a small amount of water that it can't complicate things but still gives the patient a feeling of something wet in the mouth, thus making them feel better. Would that be enough fluid to mess up someone with restricted fluids/possibly on the way to the OR? There was a study done a few years back on dogs and thirst, where they re-hydrated the pooches either IV or with a direct gastric tube, but the dogs went ahead and drank anyway because the psychological need of thirst had not been satisfied- wouldn't that hold true with the patient with the really dry mouth? You can pump their system full of fluids, but feeling something in your mouth curbs that thirst impulse... Unless of course the patient was unable to protect their own airway, in which case a piece of ice might just not be the best thing, but then again, neither would water be at that point! Eydawn NREMT-B