Mateo_1387

Did you read the article? The FD apparently was forced to wash the elephant. According to the article they did not want to be involved with the task. As much as we love to bash the Fire Departments, I feel we cannot do so in this case because, no pun intended, it was over their heads.

That had good potential to be a memorable birthday for that lady at 90 years old... It is quite hilarious that they planned the party for weeks. Anyways, better luck to them next time !

Is this the same Emerald Isle off the NC coast? Why move to Canada? If you are in NC, then why not find a job in one of the other 99 counties?

Someone mentioned a delay in treatment being unethical. To combat this... Arrive on scene and complete your initial workup. Once you realize this is a diabetic patient place the patient on the stretcher. Start with some oxygen, start an IV, and begin your slow infusion of Dextrose 50%. This medication needs to be administered slowly, so while moving your patient towards the ambulance keep pushing in a few mL's. This will solve your delay in treatment and get you moving towards the right direction (towards the ambulance). I am hoping you mean that Dwayne should have these 'what if' scenarios thought out before hand and not on the scene, although at times we have to think about a dilemma on the spot. This is just my preference, but I would rather figure out these dilemmas on my own than to rely on someone else's thinking exclusively. I am willing to bet Dwayne feels similarly. He is a bit of an amateur philosopher...

Dwayne, I do not believe you violated his rights to refusal. First off your patient is not capable of refusing until he is treated. The way I see it, once the patient becomes alert, weather he is located in his home, in your ambulance or in your ER, he can then refuse care. Being in an ambulance does not mean he is forced to be seen by a doctor, provided he is alert and able to make competent decisions. It sounds like the best interest of your patient is to reverse his immediate threat of hypoglycemia and transport him for evaluation by an ER Doc. I think the situation would become unethical/immoral if you patient becomes alert and competent, refuses farther medical care, and then you force him to endure the medical care. I will give you my justification for calling you out as a terrible medic. You take advise from a hairy monkey located in Afghanistan on how to medically treat your patients. Nuff said... Hehe Edited for wordiness

If you cannot aspirate blood from an IV line and can easily push fluid through the catheter, then I would go ahead and bolus 100 mL of saline and check for local edema around the catheter. I say that if there is none then the line is patent. If you start to notice edema with the fluid administration around the catheter site, then do not use the IV. You may be able to pull the catheter out a little and then aspirate blood, as the tip of the catheter may be sitting on a valve in the vein.

Honestly bro, I preferred to learn one formula, it as as follows... Weight x dose x volume x drip set ------------------------------------------------- = amount to administer Concentration x time Basically, you take what you need from the formula to get your answer. If your equation does not need a drip set, then just remove it from the formula. For example, try a Lidocaine Bolus. Weight of the patient is 100 kg Dose to use is 1.5 mg/kg Concentration of the drug is going to be 20mg/cc So, to set up our formula... Weight (100 kg) x Dose (1.5 mg/kg) x Volume (1 mL) ----------------------------------------------------------------------------- Concentration (20 mg) 150 mL ------ 20 = 7.5 mL of Lidocaine to be administered Notice that in the equation we did not use Time or Drip Set because this is not a drip. To complete the equation multiply everything on the top. Then multiply everything on the bottom. Divide the two numbers. Also, remember that you have to cancel out the units. The kg and mg cancel out, and that leaves you with mL. Next we can try a drip. Again, we will use the basic formula and just plug in the numbers. Weight of the patient is 100 kg Dose to be give is 5 mcg/kg Volume of the drug is 500 mL Concentration of the drug is 800 mg Time in which it is to be give is 1 min Plug the numbers into the basic formula. Multiply, divide, then you will have the answer. Weight (100 kg) x Dose (5 mcg/kg) x Volume (500 mL) x Drip Set (60 gtt/min) --------------------------------------------------------------------------------------------------------------- Concentration (800 mg) x Time (1 min) For any formula the units need to be the same. In the previous equation there are mcg and mg. We will change mg to mcg. Thus... Weight (100 kg) x Dose (5 mcg/kg) x Volume (500 mL) x Drip Set (60 gtt/mL) --------------------------------------------------------------------------------------------------------------- Concentration (800,000 mcg) x Time (1 min) 15,000,000 gtt ---------------------- 800,000 min = 18.75 gtt/min Remember, kg, mcg, and mL all cancel out. Thus leaves you with gtt/min (gtt=drops)

(In reference to the thread title) Thats what she said ! Sorry, sometimes my fingers just type things....

Where exactly is here? Paramedics in Raleigh/Durham make more than $10 an hour.

Congratulations Dar ! LOL Did anyone else not care for the poll? The only answers I see are 1. Its stupid, and 2. I'm stupid.

Sept 16, at 2am.

I have to agree with cosgrojo (that is a first ) Also, where are these news stories about persons getting years of jail time for accidentally leaving a dog in the car, and it subsequently dieing? Please show me one. Now, I can show you stories of persons accused of housing multiple dogs in unsafe places, puppy mills, fighting dogs, and far worse things than this woman did. Those are the people she is after.

I do not think he said that. I do not get the idea of putting her in front of the firing squad though. I mean, the irony of the situation is kind of amusing. For them to care for a 16 year old deaf and blind dog, they probably did not want to see the dog dead. Just guessing though.

A few things Ruff. You asked for ideas, I gave you a couple. What is the problem with the policy? Hard to be a paramedic in a house when all your equipment is in the ambulance. If the rest of your people are doing the right thing, then a policy should not affect them. Also, I'm not sure what the word 'sans' is supposed to mean, but I am having some trouble reading what you typed.

Squeent.... The ol' punish all for a few bad apples' problems. I also disagree with that approach. If the rest of the system is full of crews doing the 'right thing', then implementing a policy for doing the 'right thing' should not be a problem. Also, when the people who already do the 'right thing' work with those who are used to being lazy, a policy will reinforce the correct decision and back up the EMT/Medic already doing the 'right thing'. The alternative though is that if it is an organizational problem with crews not taking in necessary equipment, then a policy would be a start to fixing the problem. It is not truly punishing those who are already doing their job, it is rather going to affect those who are lazy.

The idea is not to increase thoracic pressure with aggressive ventilations. Increased thoracic pressure decreases preload to the heart, and in a sense can cause blood to be stagnant.

Two things. 1. Start hiding refusal forms from that medic. 2. Make a department policy to carry a minimum of the first in bag, oxygen, monitor, and stretcher into the home. First person to disobey gets an automatic 3 days suspension. Oh, and for the bad attitude, start spanking them. It supposedly works for children.

I honestly hope you are joking bro. Otherwise, you need to realize that these patients are sick folk. They honestly need medical care. Their cases are going to be tough ones to manage. The last thing they need is a bunch of disgruntled EMTs who do not like to do the job they signed up for. You should take a psychology class or two and learn about the psychological aspects of being addicted to food. Then of course you should do all sorts of studying on the medical aspects of being morbidly obese. After that, you might think about taking a professional writing class.

She is about the same height as Dust, but a hell of a lot cuter !

I have pictures, but they will cost ya ! Besides, there was a post about the Orlando meetup on the city, anyone have a link to it? I have been unable to find it.

Is it generally acceptable to touch anyone's butt? This question is excluding engaging in sexual relations and diaper changes. I am going to call BS on people grabbing your butt being ok. If you are about to get hit by a Mack Truck, anyone in their right frame of mind is not going to be standing beside you, grabbing your butt and trying to get your attention to move out of the way while a Mack Truck is barreling down on you both. I bet after they pop your butt, you will turn around, become offended, and waste precious time worrying about some dude touching your butt before you realize your life is in peril. That is, if the dude is foolish enough to stay beside you while the Mack Truck is on its way sending you to….hello….. There are more appropriate methods to grab someone's attention than to touch their butt. If it is ok to grab your butt to get your attention, then it will be as acceptable to grab your boobies, all in the name of getting your attention. I honestly do not think any of those parts of the body would be acceptable to touch in order to get your attention. You are a fairly newcomer to EMS, at least that is what I glean from your posts. Hypothetically speaking.... You are on an EMS call with a need-to-treat patient. You, being new to the field and still learning are a bit nervous, have an adrenaline rush going, and are not thinking clearly. You decide you want to administer a medication to your patient that is not appropriate and has high potential to kill the patient. I, your partner have tried to tell you multiple time in a very discreet manner that you are about to make a huge mistake, but you do not get the hint. Out of an effort to save the patient from harm, I decide to get your attention by popping your butt. Sounds like a real respectful thing to do, eh? We, as a general population, perceive our butts as a no touch zone. Out of respect, we do not touch another person's butt. Why are children not given that same respect? Probably not. The question was asking why choose one option over the other. Since you are a person, but also the mother to your kids, that makes it acceptable for you to touch your child's butt? Is it just the fact that you and your children share such a special relationship, (as any parent should) that you are more privileged to be allowed to pop your child's butt? I fail to see how this question is going to change a logical debate. Therefore, if you are genuinely interested in the number of kids I have, we can talk in PM. I will welcome that.

So why is he calling you 'just an EMT'? Are you more than that? Being in his 20's, a no0b medic, and working with you his first released day does not explain why he just started to call you out on just being an EMT. You piss him off? He trying to piss you off?

This really depends on your system. Inducing hypothermia in the field can be done effectively. EMS induction of hypothermia is a neat thing. It is one intervention where paramedic treatment influences the care the patient receives in the hospital environment. Also, in regards to your first sentence, our actions are to start cooling by applying the ice packs/infusing cold saline, the patient's benefit of such action is a better chance to recover neurologically intact. Delays in inducing hypothermia show to increase the incidence of neurological deficit.

The point I am trying to reach is that just because a method works to modify behavior does not make it right. All I am trying to get across is that as a universal law, physical punishment is not an ethical method to modify behavior. As others have asked before, if it is ok to use a physical form of punishment on kids, why not do it to adults? What makes children so special that they are allowed to be hit vs. and adult? I have not even so much as hinted that you are a bad parent. Why all of a sudden this defense? Feeling guilty? I am assuming you are using a pop on the butt to grab your child's attention when they are in a mentally chaotic state? If that is the case, why not just pinch the child? Would it be ok to hit your butt to grab your attention? Why do your children not deserve that same respect?

Can you explain this in more detail? Initially I want to disagree with part of your comment. Before I do, I want to understand exactly what you are meaning behind the comment above. Thanks