nypamedic43

I was 44 when i started medic school. There are days I wonder why I didn't go into physical therapy or something lol. But I love my job even if it is tough on my body. My thoracic spine is screaming at me as I type this. Good luck

I know that we can't force care on anyone and if they are alert and oriented they have the right to refuse. My question was : How long would you spend on scene trying to convince the patient to in the ambulance?

Well damn....I didnt even notice the misspelling. I was just typing happily away, drinking my first cup of coffee of the day.

I'm never very good at posting new topics but here goes. Yesterday, I went on a call for a person hit by lightening. We had some pretty big storms roll through here yesterday, lasting several hours. Strong winds up to 70 mph, hail, lots of rain and cloud to ground lightening. We got the call about 1400 hours. The location was a farm, way up on top of a hill. When we arrive the fire dept is there and the patient is sitting on the back porch step, alert and oriented x 4 and a little jittery. I ask him what happened and this is the story: When the first storm rolled through, around noon, he was standing in the doorway where he was now sitting. He heard a close lightening strike, flet a tingle and found himself 3 or 4 feet from where he started, up against an upright freezer. He stated he didnt lose consciousness but had a slight headache and upper epigastrum/lower chest pain. About an hour 45 minutes later, he noticed a NYSEG truck up on the corner, checking out the pole that had been struck. He non chalantly told the NYSEG worker that he had gotten hit with lightening from the strike that hit the pole. It apparently hit the pole, ran down the wires to the house and then into the house, where he was touching the door frame on the back porch. The patient then stated that the next thing he knew, he could hear sirens in the distance, coming closer and wondered where they might be going, When the fire dept pulled up in front of his house, he was kind of shocked. The NYSEG guy had called 911, which wasnt a bad thing. I checked his hands and legs, chest and back and found no burns. He stated that the pain was a 3 or 4 on the pain scale but he really didnt want to go the hospital by ambulance, because he has no insurance and really no money to pay for it. We told him that that wasnt important, but he really needed to go to the ED. He kept refusing. SO I asked if it was ok to put the monitor on him just to check to make sure there wasnt a problem. He agreed. The monitor showed a normal sinus rhythm and the 12 lead showed the same with no ectopy. Pulse was strong and regular, with a rate of 82 and respirations were non labored at 18. Blood pressure, considering the circumstances, was normal at 122/84. He still seemed nervous to me and when questioned, he admitted to smoking a bowl before we got there....hence the nervousness when he heard the sirens. We advised him that he really should get checked out but he insisted that he didnt want to go by ambulance and his friend would take him down. He then stated that he was getting ready to go down when he heard the sirens. He kept apologizing for dragging us all the way out into Gods country/ He said he didnt call and he didnt ask the NYSEG guy to call either. We told him it was fine and not to worry about it, but asked him again to come in to the ED with us. He again refused. Against my better judgement I signed him off as a refusal but told him that if anything changed, the pain got worse, he got short of breath, he had any tingling....to call us back. We were on scene for probably 30 minutes, getting the whole story and trying to convince him to come with us. I guess if I had any questions at all, it would be.....How much time would you spend trying to convince a person that going to the ED by ambulance is in their best interest in a case like this?

I've tried Rockies and found them to be very stiff and unfriendly to the feet. Others love them, I guess it just depends on you. I wear Magnum Stealth Tactical boots with a side zipper. LOVE love love them...they were very easy to break in, almost didnt need to. Very foot friendly. I had always gotten black work boots at Walmart for about $50 and walked out of them in about 6 months. I bought the Magnums for $100 and they are still going strong a year later. Bottom line is if you are going to be in them for many hours, get something that is friendly to your feet. But like some of the others have stated, don't worry about boots right now. Concentrate on class

It isn't that they aren't welcome. And if you are going to be in the medical field in any capacity...you need to get a tougher skin. The medic's and Doc's on this board have more cumulative knowledge than you will ever find anywhere else. They like to challenge thought processes, which is a good thing. Just because your ER doc said something offhand that "adenosine wasn't needed" doesnt mean that the medics did anything wrong. Maybe they tried a vagal maneuver and it didnt work. Maybe they considered electricity but opted for the adenosine. You don't know because you didnt talk to them. Maybe thier protocol states that a sustained sinus tach or SVT of 150 or higher gets adenosine. You should probably get familiar with thier protocols or ask the Medical Director. ***note I've said medics..not EMT's...EMT's can't give drugs.**** Have a nice day

How about basic CPR or airway management...course if you aren't an instructor, teaching that might not be a good idea. I'm pretty sure that unless they are going to be water skiing or diving or falling more than a couple of feet, cspine management is going to be a non issue as well as broken bones. Kids are pretty resilient and God willing the only thing you will be doing is handing out the scooby doo band aids for skinned knees and elbows. A camp full of 3-6 yr olds....I would packing some Valium for my nerves. Good luck Edited for spelling

Are you talking about last week tuesday or just this past tuesday...like 2 days ago? Either way being back on an ambulance so soon is a bit fishy to me. Sorry to be suspicious but recent past events on this board has led me to be suspicious of anyone with this kind of story. I gotta throw the BS flag here....if I'm wrong I will wholeheartedly apologize. If not..well......

The company that I work for is under contract to respond to disasters through AMR. They contact UNYAN. United New York Ambulance Network, to activate us. I think your best course of action would be to call the Emergency Management Office, either in the Springs or at the state level. They would probably have the most info for you. I've been out on the injured list for the last 8 weeks so I'm not sure if we have been contacted or not.

It is just a way to honor them, whether they are "hero's" or not. My Mom always told me that funerals are for the living. The dead don't care. It made sense to me then and it still does. We need an outlet to say our goodbyes, to have closure. In some cases this is the way its done...in others, it's more low key. Personally when I kick...I want all my friends to have a huge party. Do not mourn my death but celebrate my life, however insignificant it may be.

A simple google search for NREMT study guides revealed this: http://www.emt-national-training.com/nremt.php and this http://emtprep.com/ and this http://id44.com/ and several others. I will admit that I didnt go through the sites except for the home pages. Good luck.

I'm not so sure I would even look at a bracelet like the ones pictured. This is just my opinion, but if you have serious medical problems. that you really need to make sure that emergency personnel can become aware of quickly...you may want to go with a regular medical ID bracelet. You can be sure that if you are unresponsive, that the info will be found in a timely fashion. I know you want to be cool or pretty or not conspicuous but those bracelets pictured could very easily be disregarded as just goth jewelry. The company I work for doesnt have PCN on the ambulances, I dont think any ambulance does but we do have prednisolone. I am unaware of an abbreviation for it.

Welcome to the city Sandstorm

If this is any consolation...I am SHIT with intubation. The company I work for does skills every month and this is the only one that I ever demand that I practice. And not just once or twice....dozens of times. ET in both adults and peds and LMA both adult and peds. And I still freeze up 90% of the time on a call. island hit it on the head for me....heat of the battle and sheer terror. Ask me to decompress a chest or do a crich and I'm good....ask me to do an ET and I just go to pieces. I have no idea why but I get sooo frustrated with myself because this should be an easy skill. I have one partner on a regular basis that wishes a cardiac arrest on me so that I can get over....whatever this is. Bastard lol. But I know deep down that he wishes it on me to help me. As odd as that sounds. I dont have the answer for you...but I feel your frustration.

Sometimes, in the worst of scenarios, meaning it's a friend or family member, the stars align and everything works the way it's supposed to. Prayers to your friend and his family and if you to vent more, just shoot me an inbox msg.

It's normal to be nervous. Just take a deep breath and let it out slow. Every single one of us has been where you are now. To be honest I was more nervous about going into medic school than I was going into the basic class. They will teach you everything you need to know and there will be lots of practice. By the time you are done with the class you will know it inside out. Just....breathe

Welcome to the city Armedic! Now...stop lurking in the shadows ( you're scaring the kittens) and join in some conversations

I've read and reread the cases posted and I have read everyone's opinion. The bottom line is this....the patient shouldn't have been exposed anywhere other than the ambulance. Packaging of a trauma patient is going to be I the public eye, there is no question of that. But exposing a patient where God and everybody else can see shouldn't be done. As for my previous post of asking for the phone and then snapping it in half, I probably wouldnt do that. Just becaus ei am busy with the patient. This thread has really been derailed. 2 parties in particular leveling questions that have been partially ignored. Posted case law that can be construed as pretty generic but never the less it is up to interpretation. What I interpret it to be, may be completely different than what JP and Dwayne interpret it to be. We are way off in the ditch here people. Everyone enjoys a good debate but to be honest, I am no longer interested in this thread because it has become a pissing match. Each trying to convince the other that they aren't reading or just ignoring what's been said over and over and over again. Agree to disagree and stop pissing in each others Cheerios. Dwayne, I love ya to pieces but ya gotta let it go. JP, I dont know you but you're pretty gungho on this, to the point of distraction. I appreciate the 2 of you more than you know but I've lost interest here because nothing new has been posted and no new opinions have been verbalized. It's become redundant to the point where it's a "who" category now.

A CEVO class is an insurance company driven class. You get a certificate of completion but it's not an additional "cert" to add onto the end of your name. The driving courses for both CEVO and EVOC are fun so I don't mind that part, the lecture part is a major snore inducer. Much like WMD classes and blood borne pathogen classes...both are important but when you've gone through them 20 times, you just want to say...gimme the test and lemme outta here. There are some online courses on the FEMA website that are pretty interesting and you get CME's for them. The ICS (Incident Command System) courses are something every new EMT should take, just to familiarize yourself with how incident management works. I have taken all of them and I warn you the last one literally put me to sleep because it basically walks you through the whole 400+ page Incident Command Act. Now that I have derailed the thread lol...I agree that an A&P class would be most helpful...ECG's not so much. As a basic you can't use them or interpret them...and it is one of the more difficult parts of the paramedic curriculum. I personally enjoyed the hell out of it but it also really interested me. I'm off to study new protocols and meds and take a test...good luck to you

Hence why I've been trying to guide musicislife AWAY from exposing every patient Ruff. It is totally unnecessary in most cases, especially ones that may be medical first and then trauma. Like a fall from standing after a syncopal episode. Yes they may hit thier head and I usually err on the side of caution and place a c-collar and get them on a backboard. However, in this case, I dont focus on the trauma...I focus on WHY they had a syncopal episode in the first place. Its kind of like having a beautifully packaged "trauma" patient whose airway is occluded because they were choking and they fell out of thier chair. Now they are dead because we focused on the fact that they fell out of the chair and hit thier head and not why they fell out the chair. As a first responder, supportive care and getting as much info from the patient and bystanders, is much more important to me than having a nicely trauma packaged medical patient, who is naked on the floor because the first on scene decided it might be a good idea to expose them. Now I have to deal with an irate patient who will probably call the EMS captain and complain that thier people are incompetent and doing things they really shouldnt be doing. Just my take on it and my 2 cents

If you are holding c-spine with a jaw thrust...how are you going to do a physical exam? Once you take control of c- spine with a jaw thrust, you can't let go.

I agree with you Doc..thats why I would ask about medical history and if the patient is now awake, how they felt before they passed out.