SWA_EMT

Sucks we’ve lost another great provider. Rest easy, brother….we’ve got it from here.

Here's my $0.02. While a BGL is necessary, the next of kin/responsible party is irrelevant. The pt is 18, which means she has to make the decision for herself. That being said, I'm not necessarily concerned about the elevated pulse & respiration rates. She was just biking, of course she's going to be elevated. Along that thought process, chances are she may also be an avid cyclist/athlete, which means she may have a low BP normally. Now, while the lack of memory for the event as well as date/time is concerning, we cycle (see what I did there? ) back to the necessity for a BGL. Now for the heart of the matter: Do we allow this pt to refuse tx & xport? This is where you need to do a really good focused H&P on the pt. Find out if those vitals are normal, if she has any known medical issues, etc. After performing that H&P, if everything checks out..we can start down the refusal pathway, whereas if there are issues found, things would need to take a different turn. If after everything we do & find, she still wants to refuse, it is still ultimately her decision. So here's what we do: explain the risks of refusal (possibility of unseen/UNK injuries & explain that the possibility that there is a chance those injuries could lead to more serious events [to coin the phrase: SZ, coma, death]). My next move would be to explain that I work under a MD's license, & I would need to contact him/her to explain the situation, & that I would express to that MD the pt's wishes to refuse tx & xport. If my MD is ok with the pt refusing, then by all means she can, but if not - I would need to xport the pt. Given the above, if the pt is allowed to refuse: I would explain that refusing right now does NOT mean that tx &/or xport can't be sought later. I would HIGHLY encourage the pt to seek further medical tx on her own, or contact EMS if her S/Sx change or worsen. One thing I would explain to the pt is that at the moment, she still has a lot of adrenaline pumping through her system due to the events & that once that adrenaline wears off, she's likely to experience increased pn or other S/Sx, which would then be an indication of the need for further medical tx. After that point, I would ensure that the pt signs my refusal form, as well as grab a witness (non-family, non-EMS) signature if possible. So what do we take away from this? The bigger question in this scenario is: What caused the pt to crash on her bike? Was it an underlying problem such as a low BGL, or did the memory lapse come after the event? The biggest assistance we can provide as EMS professionals is not getting sidetracked by surface level problems; we MUST dig deep, think critically, & be all inclusive in our exams & tx's.

I'm much the fan of King airways over Combitubes as well. If I'm the only medic on a code, I would rather slip the King in & use that as my airway so that I can concentrate on other measures.

I had a 90'sY/O lady once, who happened to have had an AICD placed back in the stone age. We got called for a fall...and I noticed quite a largely swollen area under her L shoulder. Not knowing she had the device, I made the mistake of saying "Ooooooh that's not good."

Wow...this news is sad. I know that she had some really serious health issues over the last few years. Jess was one of the very few that I talked to pretty regularly from here, & we continued that contact in other social media avenues. She will be greatly missed!!

Wait what's that sound? Oh, it's just the sound of the wooden soooo scraping against the pot. Haha.

Here I sit broken hearted.... Yeah, still just kinda hanging out in the shadows. I should probably work on that. I'm not even sure who's around here anymore that I used to talk with.

What helped me was listening to music while I studied. I'm talking light, soft, classical music. It's said to open up your mind & allow you to think clearer. Just my 2 cents.

Honestly, you cope by doing exactly what you did. You go home & hug, kiss, & hold your family members tight. You tell them that you love them & that they mean everything to you. Life is short.....nothing we can do as humans, or providers of any level, will change that. Sometimes bad things happen to good people. Just make sure you're going home knowing that you did your absolute 110% best for that person....so you can look at yourself in a mirror & say these important words: I love you.

I, like a few others I've seen posting, am still on the fence with this. Yes, I see huge benefits to allowing public, LEO, &/or EMT use of Narcan. I also see many of the negatives to that provision. Narcan given IN is great, but based on personal experience alone, I saw no difference in the speed at which it reversed the opioid effects of some poor soul.

I'm not quite sure what this "old" mess is all about.....but I'm still around every now & then.

I'll take that rain!!

Can't take the call. My EPCR died. Hehe.

It's been quite some time since I ventured into the reaches known as emtcity......must say I like some of the changes I see. I've been a medic for just over 2 years now....so that's probably the biggest change for me since I've been away...

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