Asysin2leads

Lies made baby Jesus cry, you know.

As long as communities use retards to protect homes and property, retarded people will do retarded things. I'm taking bets on whether this guy had a Galls catalogue in the back seat. Any takers? Anyone?

All right, I'm calling. This thread is gone, time of death 1847 hours.

Part of the emergency medicine residency program here is a couple of MD ride alongs with us fun folks, so we actually get to have a doctor on board now and then. Without fail, it has been a pleasurable experience, the doctors have always been polite and down to earth, and they always walk away with a better understanding of what it is that we do in the field. The MD's are strictly there as observers, and we still run the show, but its still great to have them along.

The lesson for today is when it comes to scene safety, always be aware of your surroundings. (warning, some adult language)

I could be really cynical and answer your question with "availability of ICU beds, and emotional and financial toll on the family" in terms of why not to work him. I hope he was insured, at least.

Look, if you are dumbass medic who can't manage an airway, it won't matter how much time you spend on a BLS truck, you'll still be stupid. The medic in question didn't have a lack of BLS skills, he was either being arrogant and unwilling to admit defeat when it came to intubation, or he had not been properly trained on correct airway management and use of airway devices. doing BLS wouldn't have helped any. Cliche score: Paragod: +5 New medic screwing up on a trauma: +5

Not sure what you're referring too, windsong, and mediccjh, that was a low blow, we all know that folding metal chair lept unprovoked into the firefighter's face.

Dispatched to a multiple car pile up, and all of the occupants are medical malpractice attorneys. Your partner is wearing a shirt that says "EMT's save paramedics", and immediately grabs for his camera phone on arrival. Immediately rushing to aid are four RN's from the local nursing home and a podiatrist on scene who starts barking orders. Your FD back up arrives, and their apparatus is plastered with NASCAR stickers and confederate flags. PD shows up and they promptly write you because the ambulance is facing the wrong direction, then administer breathalyzer tests to the firefighters, who all fail miserably. You think another unit is coming to help but it turns out to be an investigative news team. Your ambulance then loses all power, its your first call of the night, and you can't go home sick.

Here we go. Pencil's down, turn off the lights, eyes front, people. Called for unconscious, 57 year old female, 32nd floor of office building, arrive to find patient laying on floor, feet on pillows, oriented and lethargic. Patient states she started feeling ill during meeting, complaining of dizzyness, neck pain and headache. Negative SOB, negative chest pain, negative syncope. No pertinent medical history except for fracture of the wrist, no meds, no allergies. Patient states she feels better laying on the floor, denies other complaints. PE:PERRL, negative cyanosis, trachea midline, negative accessory muscle use, equal chest expansion, lungs clear bilaterally, abdomen soft, non-tender, negative incontinence, PMS present x 4 in extremities, negative facial droop, grips equal, strong. Vitals: BP 240/140, HR 52, SP02 100% RR 12, GCS 15 EKG: Sinus bradycardia, rate 52, 12 lead: isoelectric. Patient has become increasingly confused. States age now is '22'. ETA to hospital: less than 5 minutes. Obtained IV access while enroute, gave notification for stroke to hospital, pushed 25gm D50, 100mg thiamine strictly to get obnoxious QA people off of back, who believe giving dextrose blindly is better than checking blood sugars with expensive glucometers. I knew what was going on and she needed dextrose like I need a kick in the head, but my unit is flavor of the month among administration and I have to keep everything on the up and up. Enroute, patient has become completely unresponsive, is now giving snoring respirations as we arrive at the hospital. If I had two more minutes I would have intubated, but we arrived at the hospital before I got the chance. Patient is intubated at hospital, CT scan shows massive subarachnoid bleed, with herniation through foramen magnum. Patient is as of this writing been declared brain dead. While I know we did all we could on this call, after I ruled out any sort of cardiac cause (as soon as I saw the vitals I was 99.999% sure what was going on, but wanted a 12 just to make absolutely sure) we did the 100 meter dash to the stroke center, I got an IV enroute and satisified our AMS protocol, but still this call was damn depressing. I've never gotten used to people going out on me, and I probably never will.

Lord help us, some of our stretchers are still two man. A few calls with the two man, and you can skip your work out for the evening. They are awfully good for getting someone off the ground though. They go down very low, and its then only one step from being in a squatting position to getting them in the ambulance. Then again, I need a permit for these GUNS of mine, so its like no problem. :wink:

Okay, now for a story about the radiation detector. Its small, fits on my belt, and I pretty much forget about it. So there me and my partner are, in the middle of one of the most posh hotels in midtown Manhattan, helping a rather beautiful Italian lady who was having an allergic reaction. Now, the elevator we are in on the ride down is absolutely packed, with some of the rich and probably famous and good looking. So, I start hearing BEEP BEEP BEEP BEEP BEEP. I look at my cellphone. I ask my partner if her cellphone is going off. Nope. BEEP BEEP BEEP BEEP BEEP. Finally it dawns on me what is going off. Very nonchalantly I nudge my partner and make a motion that our radiation alarm is going off. :shock: Standard procedure is to literally drop the alarm where it goes off, then get the heck out of there. Now I've attracted the attention of the other people in the elevator. I'm trying to figure out exactly how to handle this delicately, as screaming "OH MY GOD ITS THE RADIATION ALARM! RUN FOR YOUR LIVES!" Isn't going to go over well in a crowded elevator in a posh hotel in the middle of Manhattan. I reset the alarm. It zeroes out. Thank God. It turned out someone had switched it over to accumulated dose and slowly over the few days it had been incrementing from normal background radiation. It was still pretty funny, all in all.

10-4.

Send 'em over to the ED Marines at Bellevue or Kings General. They'll have them whipped into shape in no time. Real quote from Bellevue: "You were just shot in the face, and now you're giving me a hard time about getting an IV?!?!?"

Wow, you know, when the show came on years ago, I wanted them SO bad to do test this myth. Until I saw this video I refused to believe it, only because of how much the military spends on developing "bunker busting" bombs to do about the same thing. So, on this day of 10/22/2006, asysin2leads, was...sigh, God this is painful. I was ummmm.... well, you know... wrong. THERE I SAID IT! But that still doesn't mean every single person claiming to see it happen is telling the truth! In fact, I bet almost all of them were lying! So, I wasn't completely wrong! Yeah!

Take a wild stab as to why I deal with so many intoxes.

What does it say about the Major and Assistant Commodore? Do they get red lights? Oh, oh, oh and how about the Overlord and Lance Corporal?

Leave my family reunions out of this. And yeah, if you find the right goth chick, it can be kind of sexy. Morticia Addams, Elvira, there's a little something something to be said about that. You know, a little black leather, dungeons... okay I'm starting to go a little far here, never mind. Catwoman in black leather.... Michelle Pfeiffer I mean, yowza.

Real conversation: "I'm captain of my squad!" "Yeah, well, I'm treasurer of my Dungeon's and Dragon's club, you don't hear me bragging about it."

St. Vincent's Downtown, HOS-21, ambulances come, drop off the patient, spend about 20-25 mins on clean up, go back in service. What's your point, Magic? 21 is busy, and works in a pinch as a trauma center, but you're still better off making the trip to Bellevue if your patient is going south. 21 usually has two or three ambulances parked outside, not all of them are dropping off patients. The actual ambulance bay is a small little two ambulance entrance on the left, which is a pain in the ass to park in when 7th is at all busy. I'll take a photo of when Bell gets back up sometime. That is a cluster fuck and a half.

Mtnsldr, that dragging their asses out shit only happens in movies. Start living in reality.

My idea of tactical medicine: "GET DOWN ON THE GROUND! GET DOWN ON THE GROUND! LAY ON YOUR STOMACH! DON'T MOVE! ARE YOU HAVING ANY CHEST PAINS?" Okay, now in all seriousness, tactical medicine actually does exist and is even used sometimes, even though it happens less often than say, the Mets winning the $@%ing NCLS series. To give you an idea of how little tactical medics are utilized, lets look at the numbers for the NYPD. Officers: 40,000. ESU (Combination Rescue, SWAT Team, Counterterrorist, etc. etc. bad ass dudes): Around about 60 officers. ESU officers designated as medics: less than 10. You can crunch the numbers and see that one of the world's premiere law enforcement entities does not need tactical medics very often. In my mind, the best 'care under fire' can be rendered as augmented BLS provided as part of the tactical training of the SWAT officers. If you can learn to rappel and use laser sights and flashbangs and night vision, bleeding control and BVM skills should really not be that hard to learn. We even teach the firefighters how to do it. The need for advanced life support in the 'hot zone' is dubious at best. Whatever the bad guys do to you when bullets are flying really isn't going to be helped by an IV, and if you expect someone to try and pull off an intubation while worrying about cover and/or concealment, you have another thing coming. That being said, in my mind, emergency medical procedures are important considerations in a tactical environment. However, any care that is to be provided in the entry area should be done by a cross-trained member of the team, not a field EMS worker who has been given a crash course in how to dress and look like a bad ass. If an paramedic is really called for, they should be used in a support role, as a safety officer or standby someplace well behind the line of fire. This is the best utilization of resources. It's not going to win any points with people who have drawings of M-16's on them, but then again if you really want to patch up wounded comrades under fire, the Army and Marines would love to have a chat with you. Somedic, tell your ninja I said stop screwing around before she gets hurt, and if she's free friday night we can chat about it over a drink. :wink:

Hee hee, nice somedic. I have a few: Being attracted to police work for all the wrong reasons. Putting more hours into esoteric knowledge of firearms than into anatomy and physiology. Believing that you are some how superior or above other EMS professionals. Living in your parents basement. The delusion that tactical EMS is a highly demanded skill that is used everyday in the 'war' that is raging on the streets of America. Bad tattoos, and lots of them.

Then why are they screwing around at the CC level and lowering everyone's salary, then? Spite?