The Hook

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Got called the "Flashy light bus guy" by a drunk once. Been called all the classics! Had said to me "Are you the ambalance boy gonna take me to see the doc at thu doc at that big white hospital?" (some words pheonetically spelled) The names from the Narcan recipients seem to be slightly more harsh. Why is that?

Oh, definately talk to the crew. You never know, maybe this responsible individual chose to drink his beer BEFORE he came on the clock! I'd hate to accuse someone of consuming alcohol on duty, that would be irresponsible!

I own a Littman Master Cardiology and love it. First because it was a gift from my wife for graduating Paramedic school, secondly because I like the dual tone bell. Light pressure and you can detect the tiniest Sub-Q Emphysema, mild pressure and you can hear the heart tones of the person sitting next to your pt, and with heavy pressure you can hear GI noises from the pts shoulder! Ha! kidding a little, but still a great tool!

1. Why do the pt's that are begging for O2 asap when you walk in the door are speaking to you in 10 to 15 word spurts with elaborate and detailed descriptions of their breathing difficulty? They usually have 99% O2 sats and 1 second CRT's. :? 2. Why is it when walking into a Dr's office with a serious or critical pt they are surrounded by 1/2 dozen nurses and 2 doctors who all want to tell you what's wrong with the pt yet there is no IV, O2, ECG, face sheet, or enough room to get to the pt themselves? :shock: 3. Why is it when you get onto your ambulance at the begining of a shift and you've just made it on time you get a call the second you punch in and the unit is missing half the stuff you need and is completely out of PCR's? :x 4. Why is it when you are in a good mood you get great pt's and when you are in a bad mood you get jerks all day long?

Handing over the responsibility of these drugs is a much bigger deal than many may realize. I am sure it is exciting to say "hey I can do this and give that!". Though unfortunately without a paramedic level of training or higher seeing the big picture is very difficult. Cookie cutter medicine without understanding is like putting a gun in someones hand and saying go out and hunt bad guys. You've seen it on tv and have maybe read up on it a little but have no professional training and clinical experience with it's use and the expertise required to determine it's use. We recently had a paramedic student overstep his authority and placed a pt in danger. Not because he was wrong in his evaluation but because he had not yet had the training or practice with a seasoned paramedic to make that decision on his own. Everything turned out fine thank God. Though he made a crucial mistake in the process in handling the delivery of the drug. He did not take a BP before giving nitro in an almost unconscious pt. If it had been too low we all know he could have dropped the BP right out the the bottom. If it was a right heart MI the preload could have all but disappeared. Fact is these meds are (even in a simple setting with classic findings) too much to deal with only having an extra 1/4 in a college setting. The picture the instructor would have to paint would be limited due to time constraints. Dustdevil's passion for knowing your own education before attempting someone elses is going to prove prophetic with these EMT-J's. Be careful if you are a "J". The education itself may be setting you up for failure and disaster in the field. The Hook

Loved it! Definately going to use this one. Great advice for teenage guys thinking about sex! The Hook

Haven't seen it yet, thought it came out on the 12th of June. Is there a web site it is being held at or was there a screening of the first episode that I missed? The Hook :wink:

Greetings All! I have found and met several new friends and am grateful for this site! I am looking for any really good cardiology books that may improve my understanding on our (paramedic's) primary advanced skill. It has become obvious to me that EMT-Is are getting closer to us than we realize. Cardiology is the biggest subjectskill that sets us apart. I am looking to master my trade skill. Any downloads that can help would be great as well. Thanks again all! The Hook, Kevin firefighterkjhook@comcast.net

Back to business. The person below me (the one on this site you pervs) can't stand the color of his ambulance, his boss, or the expansion of his wasteline! The Hook

That is fantastic! I have actually printed it off at work. The Hook

One addition to my comments, the gash on his neck, how deep-long is it? Another concern would be Sub_Q Emphysema and the resuliting edema in the neck. It could potentially occlude the airway if left unchecked. The Hook, Kevin

I agree with the decompression. Check and recheck often vitals and mental status. Check the pupils and talk to any witnesses. The blood coming from his nose is there only blood? Have you done a Halo test to check for CSF? Question, how long was he trapped? How much of the body was trapped and to what degree? Is compartment syndrome a concern here and what would you do in that case? And personally I would go with NS opposed to LR for the drip. If compartment syndrome is a concern LR could throw his electrolytes off even more. Apply a C-Collar, confirm strapping to the backboard is complete and adequate. Pad the voids and check for additional broken bones. If pt can only be moved on stomach then a stokes basket would come in handy here. Stabilize the flail chest with a trauma dressing. I agree with notifying a helicopter and having them en route for transport (obviously as long as location of accident is further away than you could transport in the same time by ambulance). Start one IV at kvo rate and start one INT. Check the BP to see if the pt actually needs fluids. The kvo rate will not hurt if the BP is within safe limits. Automatically flooding the pt with fluids could cause it's own problems. Let me know what you all think! The Hook, Kevin

Not certain of the list of approved abbreviations. I will look. Thanks everyone for getting back to me. The help is appreciated. Kevin "The Hook"

Greetings! I am looking to drastically improve my PCR narrative writing skills. Is there a web site, download-able outline, advice, a book, or any other source of info floating around on the subject out there? Please let me know! Thanks to all! The Hook