Scaramedic

Ummm I agree with AK on this one. I have never heard the "death scream" from a patient with real injuries, that tends to be the domain of the drama Queen or King. Patients with truly severe/critical injuries like an open Femur fracture tend to be too weak or in too much pain for a nice big dramatic television scream. People in severe pain tend to grunt and moan not scream at the top of their lungs. Which brings me to another point, Firefighter dude you say your patients are in pain and need traction to ease the pain. Do you not carry analgesics on your unit? I have multiple forms of pain control available to me. My patients should never be in extreme pain unless they are shocky and I am unable to provide analgesics, even then their LOC tends to be down and they are not registering pain to the degree you specify. As far as traction on an open femur goes I tend to agree that if their is good distal PMS I would leave it as is. There IS a risk of further infection if you drag "dirty" bone ends back into the body. The same theory applies to eviscerations, do you jam the bowel back into the body or do you cover it with moist sterile dressings? Once again this is a common sense issue to me, common sense what a concept. Let me continue with a point someone else made, the issue of would you even treat a open femur fracture in the face of other injuries? The femurs are some of the strongest bones in the body, to actually fracture a femur requires a ton of kinetic energy. That does not even take into account the energy required to push those bones thru the muscles of the thighs and cause an open fracture. So if you are dealing with an open femur you probably have even more severe injuries to deal with, such as a pelvic fracture which would rule out traction anyway. Finally, what is with all the anger Firefighter? DO NOT make me quote Master Yoda again, you know how he feels about anger. :wink:

I can't believe someone actually proved the point Kerry was trying to make. :roll:

Ummm I seem to remember that Belfast was the first city to put Emergency Care providers in the field and that some cities in the U.S. copied that idea. Oh and just for the record Seattle and Portland were two of those cities, see wes aint that dumb in the Pacifik Norfwest. :wink: OK, Scara has been MIA from these boards for the last couple of weeks so please allow me to catch up on this thread. Doctors in the field is a very good idea, most ER Docs are not General Practioner's and think along the same lines as Paramedics so scene times are not an issue. I also have had ER Residents ride with me and found it to be a very positive experience, I never had an issue with getting orders from a Doc who rode out with me. To our Aussie brothers, you are not that different than us. We also have surgical teams that can respond to the field in the situations you mentioned. Having said all that when it comes to Docs on ambulances in the US... (In my best Kim Il Jong accent) HEEEWWWWOOOOO!!!! With the ever present gloom and doom of the Medicare system doling out less and less money some communities are going to have a hard time keeping Docs in the Hospitals not to mention in the field. Look I hate to play chicken little here but damn, we are looking at some hard times in the next twenty years. With the boomer generation getting ready to retire Medicare is quickly going to be shelling out more money than it's bringing in. So the trend is going to be less and less Medicare reimbursements, which means less money for everyone in Medicine including EMS. I love the idea of Doc's working with us in the field but in reality I think the model of the future is going to be less care in the field not more. Sad but true. Take that Hans Blix!!

Radiation pagers/detectors???!!!!! :shock: That's it I quit!!!! I'm going to culinary school it will be safer.

Anthony ask and ye' shall receive... Stryker Accessories EMP Storage Net

Hey Riblett I searched multiple suppliers and had no luck finding EMS uniform jackets that small. My suggestion is to find a jacket from a civilian supplier, i.e Columbia Sportswear, that looks like an EMS jacket. I don't believe the public will care if your jacket isn't an "official" EMS jacket.

The same can be said for most ALS "skills" as well. :wink:

Awesome quote. :thumbleft: Having said that, why is this thread not DEAD!!! For the love of God would someone please lock this thread. :angryfire: August 27th 2005!!!!! This thread is older than the mental age of some of the people posting on this site. :roll:

I had to Gizoogle something so I did the Gettysburg address, I like it kind of catchy yo yo yo. [sub:596a4f5102]"Fourscore n seven years ago our playa brought forth on this continent a new nation, conceived in liberty n dedicated ta tha proposizzles tizzle all men is created equal spittin' that real shit. Now we is engaged in a bootylicious civil war, test'n bitch tizzy nation or any nation so conceived n so dedicated can long endure . Nigga get shut up or get wet up. We is met on a bootylicious battlefield of that war. We have come ta dedicate a portion of that field as a final rest'n-place fo` those who hizzle gizzy they lives thiznat tizzy nation might live fo' rizeal. It is drug deala fitt'n n poser that we should do this. But in a brotha sense, we cannot dedicizzles we cannot consecrizzle we cannot hallow this ground. The brave men, liv'n n dead who struggled here have consecrated it far above our pizzle brotha ta add or detract. The world wizzill shawty note nor long rememba W-H-to-tha-izzat we say here, but it can drug deala forget whizzay tizzle did here and yo momma. It is fo` us tha liv'n hustla ta be dedicated here ta tha unfinished wizzay which tizzle who fought here have thus far so nobly advanced. It is ratha fo` us ta be hizzy dedicated ta tha bootylicious tizzy ho-slappin' before us--that from these honored dead we takes increazed devotion ta T-H-to-tha-izzat cause fo` whizzich they gave tha last fizzull measure of devotizzles we hizzy highly resolve that these dead shall not hizzle died in vain, tizzle this nation unda God shall have a new birth of freedom, n that government of tha people, by tha people, fo` tha thugz shizzall not perish from tha earth."[/sub:596a4f5102] I always wondered what it would have sounded like if Lincoln was down with da homeys.

Never utter the phrase "I know that." Nothing irritates me more than a new Basic doing something wrong, I correct them and they utter that phrase. If you knew it why did you do it wrong in the first place!!! :angryfire:

Hand cramp. Nuff said.

My most awkward and irritating call of all time, it's a long story so get a cup of coffee before you start. We get a call for a trauma at a concrete company on the outskirts of the city. We arrive on scene first and are directed to the rotary kiln area of the plant. For those of you who do not know what a rotary kiln looks like here is a picture for you. So we arrive at the base of this thing, its about three stories high and there is about 8 inches of lime and concrete dust on the ground we have to walk through. We are told that an employee was in one of the kilns servicing it and a big chunk of hardened lime fell from the top, smacked the patient in the head and knocked him out. He is conscious now and the site EMT Basic is with the patient. Fire has still not arrived on scene so I grab my equipment and head up the stairs with the plant supervisor. My partner is going to wait for Fire and come up with them. I head up multiple flights of narrow metal stairs with the plant supervisor, after a few minutes we arrive on a platform at the end of the kiln. The patient is in one of three kilns, the two kilns right next to it are still running. Lime dust is everywhere, its about 95F that day and on this platform its about 110F. My patient is lying on the bottom of the kiln, which is a long steel tube about 150+ feet long full of more lime with very little light from a few lightbulbs strung about. I have to crawl through this little hatch, slide down a 2X6 and crawl through more lime dust. The plant EMT has the patient boarded and is providing excellent care. I get to the patient and go ahead with my assessment, he is A&O, C/O head and neck pain with no obvious bleeding or trauma. As I am assessing I keep looking out towards the hatch and still do not see anyone but workers from the plant, no Fire and no partner. :dontknow: We get the patient out thru the little hatch door and I get out onto the platform. As I get out I notice that there is no one but plant employees on the platform and lining the stairs. I ask the supervisor if Fire has arrived, he says they have but his employees will not let them come up. I asked him why and he stated his employees will handle everything. So here is the situation I am covered head to to in lime dust, I am alone, I have a patient I need to get down to the rig and I have about 15-20 plant employees all around me. I tell the plant supervisor he is responsible if anything goes wrong when we take the patient down, he assumes responsiblilty for the situation and down we go. In my opinion as far as the handling the patient the employees did an amazing job, they brought the patient down the stairs safely and they were not confrontational to me and were more than willing to do anything I said, except allowing Fire to assist. We slowly brought the patient down to ground level, as we exited the building I found an amazing site. There were two fire trucks, multiple fire Chief vehicles, multiple Sheriff's department vehicles and a whole bunch of pissed off people on both sides with SO keeping them separate. Apparently what I missed was that when FD arrived the plant employees physically stopped them from coming up the stairs. The FD guys were told that the employees would handle the patient, needless to say this pissed off fire who called more units and the Sheriffs Department. It quickly turned into a giant clusterf*#k that I am very glad I missed. As I exit the building I am immediately hit with a FD Chief and a Deputy who want to know if the situation endangered my patient. I told them honestly it did not and that the employees did fine. Once outside we clean as much of the lime off the patient as we can with dry towels, it was pointless trying to do it anywhere else. I wish I would have done the same. We load up and take the patient to the hospital without any further complications. Oh wait there was the problem of the lime (diluted though it was) starting to burn on my skin because I was sweating so much. We get in the ER and turn over the patient, the ER Doc grabs me and takes me to the ER doc locker room and orders me to strip so he can brush the lime off me and then has me take a shower. I put on scrubs, the Doc checks me out real quick for burns and I am released to return to cooperate. Once back at cooperate we turn over the unit for decontamination, everything I took up was covered in lime as well as the back of the unit. We then had to write incident reports on what happened and statements for the Sheriff's office. So lets run down what happened on this call. 1. Lime/concrete dust in every aspect of my body. 2. A war between FD and the concrete company was initiated. 3. I am afraid of heights, sorry I failed to mention that above. 4. Ungodly heat and cramped spaces, both of which I hate. 5. A Doc I work with had me get naked and helped brush me off. :oops: 6. A ton of paperwork which I hate most of all. The situation actually resulted in several meetings between all the agencies involved but no charges were brought against the plant employees. A policy was written that any calls at this plant will be dispatched with the Sheriff's office. I ended up with some really minor burns on my arms and legs. Overall a pain in the ass and very awkward call.

Wow it sounds like everyone so far has had it real easy when it comes to mouthwash. In Tulsa the Dollar stores would sell a gallon of generic mouthwash for a buck. We would get calls for groups of homeless passed out behind the various dollar stores with the prerequisite bottle of el-cheapo mouthwash laying next to them. A2L be happy that mouthwash is more expensive than real alcohol and they are stealing it, when it gets real cheap it becomes the drink of choice for the "Urban Adventurer." On a side note, I had the situation above with five homeless guys and they all wanted to go to the same hospital. It was a basic friends stick together situation and the other choice was jail for public drunkenness. So rather than call in a second unit we hauled all five to Hillcrest in Tulsa. The Charge Nurse was less than thrilled when I walked in five intoxicated patients, she was on the phone complaining to the supervisor before I even finished the paperwork. The Nurse felt that the patients should have been split among the three hospitals in the neighborhood, not just Hillcrest. In her mind it was acceptable to put three units out of service to haul five guys who were just using a trip to the ER to avoid jail. The supervisor sided with us and the "patients" left the hospital within 30 minutes. Just goes to show the stupidity of the "ER or Jail" situations that go on in some cities. I thought it was funny though, I wasn't a real fan of Hillcrest anyway. The nastiest thing I seen a person drink was carburetor cleaner, he cut the can open with a knife and drank the fluid inside. Also Lysol was popular, they spray the contents into a can of bottle and then drink it. :puke: P.S. For those that ask how can one unit transport five patients? We put 1 on the cot, three on the bench and 1 in the airway seat with me standing and going from patient to patient. Big fun! :wink:

There once was a guy from Nantucket...

Very bottom of the page Dust, I had to mail some stuff to them and took me a while to find it. They are not much more help if you call them either.

Huh, uber liberal Ben Affleck treats a woman like a sex object. Isn't this exactly the kind of crap they have been raking Arnold over the coals for? Where was the outrage over this? Where were the protesters from NOW? Once again hypocrisy in action. :wink:

I found the Ant in question.... I think I understand why it was an emergency now, his music was really BAD!!

Can I get one of those Asys?

I agree NREMT-Basic, start with this post right here... :wink:

I find it interesting that hot water is now the treatment of choice for jellyfish. Correct me if I am wrong but haven't native peoples used human urine for centuries to treat jellyfish stings? Maybe it was simply the temperature of the urine and nothing else in the urine that deactivated the toxins of the jellyfish. Interesting. Oh and for the record if I get hit with a jellyfish please use hot water rather than pee on me. Thanks.

In my experience there is nothing you can do if the patient decides to bolt at the last moment. All patients have the right to refuse treatment at any time during their care and can leave anytime they want unless they are a danger to themselves. It sounds to me like your company has many issues, foremost they hire idiots as supervisors. Just out of curiosity what did you splint the arm with? Maybe the supervisor was being a tight ass and was afraid the company was going to lose a vacuum splint or some other device.

I would like to nominate this thread as the creepiest thread ever on EMT City. Injecting people with battery acid? Good God man. Sounds like a Joseph Mengele experiment.

I bet your talking about the people who feel the need for a pilgrimage to some site in the middle of nowhere. The cooling suggestions above are good but let me throw out some other ideas on cooling the pt and to keep you from getting overheated during the rescue. #1. The first thing to do is get the patient out of the direct sun, I know out in the middle of nowhere that might be an issue. One idea is a small lite weight hiking shelter like this. Granted it's kind of spendy (REI always is) but I am sure you can find a cheaper one on other sites. Once they are out of the direct sun it will be easier to cool them. I would also use ice packs, they last for a while and are not that heavy to carry in. #2. I am sure you know the desert survival stuff but let me throw it out anyway. Dress in lite colored clothing that covers you well. There is a reason you see the photos of the explorers with their Pith helmets and tan clothing. Use a white sheet to cover your patient if they are non-ambulatory, white reflects heat and will help the patient stay cool. Also try to avoid movement in the heat of the day. If the patient is stable enough you might sit with them until it cools and take them out then. Once again I am not sure how far of a hike you are talking. #3. If the patient is non-ambulatory I would suggest a stretcher carrier like this one. It will help you carry you equipment in and the patient out. They work well in rough environments and will save your back. This will also decrease your workload which will keep you from overheating also. Most of all enjoy that wonderful heat.

Any chance you can tell me the winning Keno numbers at the Bellagio for weekend after next?