Katiebug

I don't know where you have moved from, but I live right down the street from collierville in Cordova. The county part. I worked in Memphis for 3 1/2 years as an IV. I now work as a paramedic at Horn Lake FD. If you want/need to know about the multiple private services around here, PM me. You don't have to get your IV right away to get a job, as long as your reciprocity comes through. You've got a lot of options. You don't have to resort to a McJob.

Well, I've pretty much told you all I know about it. I'd have to google to do much more. We would have to test the blood Fe content. The only other assessment questions I can think of have already been listed. If Fe was elevated, yeah, I'd get him out of there and hope it was the right thing to do.

All basics in my state are IV certified. I have no idea how many other states are like that. Basics can also assist with prescribed meds. They can't give the insulin, but they can assist. If basics where you are can't start IVs, it's time to weigh txpt time vs intercept time.

What options? Either she gets help with insulin she has on her and/or you bolus fluids and transport. There's nothing ALS can do with this that BLS can't do. That is as long as BLS can do IVs in your area. Also take into account txpt time vs intercept time. While her BGL is high, at 226 she's not approaching DKA. She shouldn't be huffing of CO2 at this point. If BGL was 400+, then it's time to scoop and run with a wide open IV. 262 needs to be immediately dealt with, but it's nothing to panic over. Keep it basic and go to the ER with it.

Does she hve insulin? Sliding scale? Help her administer it. If not, all you can do is bolus some fluids to bring down the BGL and txpt.

I don't know. I only know about hemochromatosis because I read about it while looking up something else. I remember that it is a liver disorder, it causes abdominal pain, joint pain, bowel problems and decreased sexual function. Oh, and it runs in families, so if his brother has it too, it's a good indicator. It sticks out in my mind because the remedy is blood letting and replacing fluids until the Fe is back to normal levels. I suppose I would ask the pt if he has had a loss of sexual function/desire since the onset. Also if he remembers any of his brother's tx. Has he had any testicular issues? Is he jaudiced? Is his stool abnormaly dark? What else will excess iron cause? What about the whites of his eyes? Are they white?

You can. It used to be taught not to because of risk of infection secondary to pulling an exposed bone back in the body. It is now taught that it is not a concern and to traction it. At least that's what we're taught here.

Guess #1) Hemochromatosis. A build up of iron causing the S/S the pt has. Is he jaundiced?

I don't see any evidence that this was racially motivated. The evidence I see shows abuse of power. While prejudice shouldn't be ruled out, in the grand scheme of things it should make zero difference in the outcome of this. It doesn't matter what race of people this happened to. The outcome should be the same.

Ventmedic, You read too much into my post. I do not suggest retribution against a "downed" officer. My point was that these officers seemed to have forgotten who's on their team. While I wouldn't refuse care to the person I hate most, I would be terrified to know my life was in the hands of someone I had assaulted. As far as LEOs go, they are indespensable in our line of work. This guy though seems to have serious control issues. Whatever call he was on (if any) was obviously not so serious he couldn't divert from it to pull over the ambulance, then follow it to the hospital. I know a lot of good cops, but we've all seen the ones that think they can do anything they want too. This is a cop that will likely need a medic at some point if he doesn't get his rage and control issues resolved. The point is that he should remember that when dealing with the medics.

If the ambulance was running L/S, it is perfectly understandable why the driver never heard the police cruiser. It's hard enough sometimes to hear a siren when you just have the radio on until the EV is upon you. Either way, no matter who was at fault, it was foolish of the officer to not let the ambulance get the pt to the hospital before dealing with this. Some additional training is warranted for both parties. As a side note, the officer needs to remember who will be standing over him when a meth head puts some bullet holes in him at that "routine" traffic stop. I bet he'd hate to see that same paramedic then.

There's a good joke in there about eating "cat", but perhaps we should leave it alone. :^)

How much will you appreciate it when the family drags you to court to explain why you didn't try to correct the PEA? How will you justify that when it is your job to do it? Are you going to say that your opinion was that he would have no quality of life if you resusitated? Would you be qualified to make that call on scene? Sometimes, yes you are. In this case, no. You would get lambasted in court. Aside from that, the guy had a chance. Albeit a small one, but a chance none the less. That's enough to work it.

Well put. Conventional medicine is not always the best option. Until now, it has been up to the patient or gaurdian of the patient to decide what they felt was best for them. Now I see that freedom has been stripped away too. While this is about trying to do what's best for a child, it's also about some other things too. It's about a parent's right to make decisions for their child without government interference. It's about religious freedom without fear of persecution. It's about being able to practice your faith to the death without government OR society interfering. Fundamental rights that people seem to willingly be giving away in order to conform to the collective consciousness. Freedom of speech is okay as long as no one is offended. Freedom of religion is okay as long as no one thinks it's weird or cultish. Freedom to parent your children is okay as long as no one reports you to protective services for spanking them. Freedom to choose your own medical care is okay as long as conventional medicine doesn't disagree too much. Frankly, I'm appalled that the court feels it has the right to intervene here. Frankly, I find this whole damn government becoming more and more tyrannical by the day. Is anyone else out there?

Thanks for the clarification. Still would work it. Intubation, Epi, Atropine, possible bi-lat decompression, work him till we get to the hospital. The guy deserves that much of a chance. At least I'm to assume so since I don't personally know him. I'm sure his wife and kids think so. Oh, his mom and dad would probably appreciate it too.

Tasteless. Revolting. Just...wrong on so many levels. Oh, and stupid.

I did not know that was how to defib an infant. That is very good information I hope I never use.

Agreed. As Anthony said, that's very poor form. You would put our whole profession in a very bad light. You probably don't care about that because you seem to need/want the money, but I seriously doubt you would get it that way. If people are afraid to call rescuers for fear of getting sued, then the system is broken. Sue workers comp, heal up, then go earn your money like you should. It's quite likely that the fellow you are considering suing earned what he's got. Man up dude. Or go work in a pillow factory where it's nice and soft.

What is antero lateral? I'm assuming it's left or right recumbant?

Awesome tip Rid.

We were taught not to shock infants. But I believe that in a dire situation, the ends justify the means. I hope that doesn't get my arse in a sling someday, but if I've got a baby coding on me and I've used every option at my disposal, I'll likely begin looking for options that aren't supposed to be at my disposal. I'd just have to take my chances with the EMS board. If you remember an incident a few years back, there was a paramedic that performed a successful c-section on a woman killed in an mvc. The woman was not workable, but the baby was saved. The paramedic lost his license. That was an unfortunate decision from the EMS board of his state. I am aware that the medic was WAY out of scope, but I believe he made the right decision. It was worth losing the license for. I know many here will disagree with me on this, but that's okay. That's what a forum is for. Let me have it.

DTJ=Dispatched to Jesus

I will work all codes unless the patient is so dead it is obvious they will stay dead despite my efforts. I've heard too many stories from people that were expected to die but didn't to not give everyone a fighting chance. It is my responsibility to give injured people every tool at my disposal to allow them the chance to live.

I have the iPhone too. As a matter of fact, I'm typing on it right now. The iPhone is an invaluable resource to me. I use it daily to look up meds and maladies I've never heard of or don't remember. The iPhone also has some really cool apps for health care providers. I highly recomend it.

I saw three drugs on the test. Atropine, Narcan and one I'd never heard of and don't remember. None of them were the correct answer. I saw more questions on the A&P of the cardiovascular system, identification of EKGs, when to defibrilate/cardiovert and trauma than anything. From talking to others, it seems to be a crap shoot as to what you will get. Some say they get a lot of drug calculation questions. I've heard others say they got a lot of operations questions. Based on your previous posts and your appearant level of intelligence, I would say that you will probably do just fine. Just take your time and read and re-read each question carefully.