Katiebug

I just read an acronym to help remember the drugs for fluid overload. I'd never heard it before and thought it might help some of you students. Remember LMNO to make them Pee. Lasix, morphine, nitro and oxygen.

Lol, it's all good. I've got more books than time to read them. I'm just a book whore. Congrats to the winner!

You misread it??? I spent over an hour searching the net for that. You turd, lol.

Lol, Dust. I wish I could afford to. Mike, around here (Mid south) 411 gets you the phone directory.

I carry a plastic O2 key on my keyring and it has come in handy many times. O2 keys often get misplaced and it makes you feel like a moron when you're looking for something to turn the valve with.

Lol, I was waiting for your retort, and prepared for the debate, but that is a valid point. There should be more options than calling 911. I never considered that. What are you doing to fix it? I'll be glad to help. Let me know.

I agree 100% Mike, but I'm certainly not anti-protocol. I even reference them as a study aid. Most patients fit nicely within them. I also think you should exercise your critical thinking skills because protocols will never cover everything you will see and do. Maybe a patient doesn't respond to the treatment in your protocols or maybe the protocol doesn't exist. If I deviate from a protocol, it's because I can justify it. If I dont believe the protocol fits the patient, I'm not embarrassed to get recorded on line direction if I need it. It's about being a patient advocate. My pride has no place in my unit. I'm not trying to start a debate, that's just my approach. I know from years of reading your posts that you are an excellent medic. You answered some difficult questions for me when I was new. I specifically remember one where I had a patient bleeding from the eyes. That was about six years ago I think. My point is that protocols are good and useful. I reference them often and recommend a working knowledge of them. I do agree with you that they are guidelines, not hard and fast rules.

Two cowboys are riding their horses together on the prairie. They come upon a big pile of manure. The first cowboy goes to the second, "I will bet you a $1000 that I can eat all of this crap." The second cowboy agrees, so the first cowboy eats the entire pile and wins $1000. The two cowboys ride on and after some time come across another pile of manure. This time the second cowboy bets the first that he too can eat the whole pile for $1000. The first cowboy agrees and the second cowboy eats the entire pile and wins the bet. They ride on again. After a while the first cowboy says to the second, "Do you realize that we just ate a whole pile of manure for nothing?"

Congratulations! Now to be thrown to the wolves! Lol. It's all good. Most every scene fits inside your protocols. Just be prepared to think outside the box when it doesn't. Don't hesitate to call medical direction if you're unsure. I've done it several times. Remember to be a patient advocate and good luck to you!

Dust, it was a blatant 911 abuse call. The point of my story is valid.

Thanks for the info. Thats good stuff.

At my rural post, if the helicopter can't fly, we are 1.5 to 2 hrs from the level 1 hospital. There is a band aid hospital down the street from the station and two level 3 hospitals within 30 to 45 minutes.

Had a lady that had an allergic reaction to her sex toy. Her husband had gone out of town and bought it for her before he left. She refused to go to the hospital. A little epi, benny and wash off and out the hoo hoo, and she signed the refusal AMA. Had another guy that inhaled a small screwdriver. He was holding it in his mouth when he inhaled to cough. The guy was in no distress whatsoever. I literally did nothing for him en route. He was joking about it.

And this is another case for an IO drill in every protocol. That way your not screwing around trying to get an IV for ten minutes when there's probably more pertinent issues at hand. Again, my humble opinion.

There's about a one in one thousand chance of bringing back a traumatic arrest. Some protocols give the option of not working them at all. If you're asking if more should have been done by the medics? I don't know. Wasn't there. Was there tracheal deviation? Lung sounds? Skull depression? Posturing? Pupils? Can basics combitube where you are? Too much info missing. I'm fairly certain that if the medics thought it was workable, they would have worked it. My opinion is based on information given only. Without the whole story, opinions don't mean much.

Now that's more like what I'm talking about. How's that working out over there?

Kaisu, your name is on your profile.

It's different in the same way that being an NP is different than being a PA. It's bringing a different background to the table. It's advancing a field that has so much more to offer. Imagine Paramedic Practitioners opening their own clinics. I would go to one. I think it's inevitable. You are right about the nurses union trying to shut it down though. All good ideas are ridiculed before they are instituted.

http://www.wakegov.com/ems/staff/app.htm Sounds like a cross between a sprint medic and a home health nurse. Not quite what I had in mind, but maybe a step in the right direction. I just saw this a few minutes ago. The ante has been raised.

Doc, I'm suggesting adding the BS and Masters programs to what we already have. There would be a natural progression just as RNs progress to NP. Paramedics ride the unit, work in hospitals, etc... BS level studies teaching, management and business, along with advanced medical studies. Paramedic Practitioner would be similar to taking the PA course with a focus on emergency medicine and family practice. Of course you could specialize, just like PA and NP. Emergency medicine, ortho, oncology, peds, nephrology... Whatever. Got a link handy? I'd like to see.

It's been awhile since I've been here. I still recognize many of you and have been reading your recent conversations. The last time I was here, around four years ago, I was a paramedic student working for a private service doing mostly dialysis transports. It was either here, or on EMS Village, I was feed a large piece of humble pie. I realized I wasn't so smart and decided to keep my mouth shut and listen until I got some real experience. Since that time I have been working both municipal and rural 911. I have been peed on, pooped on, vomited on and bled on. I have plugged it, pumped it, breathed it, pushed assorted drugs on it, splinted it and scraped it off my boots. I have worked on everyone from the homeless epileptic to prostitutes to business owners to the mayor's parents. Both of them. I listened intently to the old medics and picked up the good tricks. I'm aggressive and I believe in fixing people if it's in my scope of practice. I'm on par with you seasoned medics and I'm a competent medic in my own right. Now I'm getting ready to leave EMS. Why? Look at the most recent thread about unions. In that thread it was noted that we are losing many of our best and brightest because paramedic is the pinnacle of our profession. There's no more room to advance. I propose that we work toward changing that. As of now, I'll be getting my BSN and going to PA school. If there were a Masters level Paramedic Practitioner program, I'd likely do that instead. There's no reason it couldn't be on the same level as NP or PA. There's been a lot of talk about education standards. Here's a way to raise the bar. In addition, paramedic instructors should hold a BS in paramedicine. In my area we are taught by other paramedics. Thats not always a bad thing, but I challenge you to find a nursing instructor with only two years of college. We talk a lot about advancing our field, being understood and taken seriously, unions, salary.... The list goes on and on. What it will take is one of us getting the degree and putting a program together. The rest will follow. Thoughts?

Same here except I also carry a pocket knife, a pen light, iphone, smokes, Snus, and some OTC meds,(Tylenol, ranitadine, Tums) for personal use. My POV is loaded down with enough stuff to survive a natural disaster. Not because I'm a "Whacker", but because I live on a major fault line and I expect there to be a natural disaster. Being over zealous may be a bad thing, but being prepared is not.

I can sympathize with the OP. It's frustrating. We all know the rules, and have to abide by them, but they can be frustrating none the less. I was on a BS call several months ago when tones dropped for a choking victim. We could have been there in under two minutes, but our sister unit had to take it from several minutes out. They said the pt was barely viable by the time they got there. They couldn't get the sausage biscuit out of the guys airway in time to save him. My patient? She couldn't sleep. That was her entire chief complaint. And she owns a car. Coulda, shoulda, woulda... It still can frustrate.

Never heard of an RA before this.

There's a few answers to that. 1. There should be a Knox box that 911 responders have the key to. 2. Most electric gates around here, (Mid south), are supposed to open if you yelp your siren. Interestingly, I've never been able to get one to work. 3. The apartment complexes in my area have given gate keys to the FD to keep in the first responder vehicles. There are a few solutions for you. Hopefully one or more works for you. There's a few answers to that. 1. There should be a Knox box that 911 responders have the key to. 2. Most electric gates around here, (Mid south), are supposed to open if you yelp your siren. Interestingly, I've never been able to get one to work. 3. The apartment complexes in my area have given gate keys to the FD to keep in the first responder vehicles. There are a few solutions for you. Hopefully one or more works for you.