Mateo_1387

I will give it a go. We know we have a 6 hr flight ahead of us, so it is important to start collecting information on the ground. Things I will want to know or do will be.... What assessments, diagnostics, and treatments has the clinic already done? What were their findings? Did the patient improve with any treatments? An assessment will be in order before we leave. How does the patient present? Current vitals? Will want to listen to heart tones before we take off, as I assume they will be difficult to hear while flying. What kind of equipment do we have for diagnostics?

I might make it, but I do not know if the hot cuz will make it. Besides, I was thinking of bringing a stripper this time !

Funny Because they(people) are insecure with themselves.

They do have paramedics on their trucks, some good and others not so good.

One day bro, one day.

I asked the question because I was curious if you still thought the age of the patient should be criteria for CPR. As far as the device, I am not sure where to find one. I may be imagining it, but it seems that I remember a device where the practitioner could insert it into the chest abvoe the heart, and it would be used to provide compression to the heart internally, but from external forces. I have no clue what it is called, but I suspect the idea of the device is to have less damage with better compressions.

If one medic talks a patient out of transport that needs treatment, just because he is being lazy, then that also means the partner is lazy. Fire them both. I would say the whole 'supervisor calling and talking to patients' deal is pretty silly. It is a piss poor way to 'protect patients'. The best way to fix the problem is to have educated paramedics who can deny transport to those who do not need emergency services. Education will be the best patient advocate.

The next meeting is whenever you get finished with you latest star of life, ya know, the 6 foot one you plan to put over your bed. Everyone wants to see it at the meeting. :twisted:

Dwayne, would you change your mind if your service used an internal chest compressor?

That is JakeEMTP's vehicle above with the radios ! He makes the wife ride in back. :twisted: Here is his house. Seen 'em both with my own eyes. Click on image for larger and better view !

You know it !

I hope nobody takes me as cocky or anything but... I am a n0ob parapup and was released after two days. When I go on calls, I do not feel scared or start spinning. Sometimes (kind of rare) I get nervous, but I think that is just being a n0ob. In fact, I have had a few calls where my coworkers have or probably would freak out. I just handle myself as calmly as possible. I normally am fairly mellow. Also, I firmly believe that education has a lot to do with how much one spins. Some old paramedic classmates and I share EMS experiences, and we have all come to the conclusion that the Associates Degree prepared us much better than a continuing education course. We ride among other n0ob paramedics who graduated from Con. Ed. Courses, and we collectively notice they spin on rather simple calls, where they deal with a sick person, but they are an easy patient to manage, medically speaking. I think it is all in how much you know, the more education you have, the more confident you can be.

Mine go something like this. Patient---- I need to go to the hospital Burned out Medic---- What for? Patient---- Well...earlier today I stubbed my toe, and it hurts still. I want to be seen. Burned out Medic---- Well Sir, we would be happy to take you (shakes head "no" while speaking) Patient---- Well, I guess I could take myself... Burned out Medic--Sir, we would be happy to take you (shakes head "no" while speaking), but, if you like, you can take yourself (shakes head "yes") Patient---- I just don't know if I should go now? Burned out Medic---- You should (shakes head "no") Patient---- Well, then I will just go with you. Burned out Medic---- We'd be happy to take you (shakes head 'no') but if you want to go on your own, that will be just fine (vigorously shakes head "yes") Patient---- Ok, I'll just take myself. Burned out Medic---- Thank you sir, sign right here....

Oh, and to add, I would probably use a 10gtt/ml drop set, that way, the drip rate will be the same number as the volume of your fluid. That is the quick and easy way. (If you understand the generic formula, and see how the numbers work, you will understand how I get the "easy" way.) Good Luck. Matt(y) :wink:

Generic formula. (patient weight)(Dosage)(volume of fluid or drug)(Drip set size) ---------------------------------------------------------------------- (weight of drug)(time to be given over) Plug in what information you have with the appropriate units, and you should be good to go. In your example, it would go as follows. [s:a8bfc7819d](patient weight)[/s:a8bfc7819d](150mg)(250ml)(20gtts/ml ) ---------------------------------------------------------------------- (150mg)(10min) The 150mg dosage and weight cancel. Ml's cancel also. You are left with... 5000gtts ---------- 10Min Reduces to 500gtts/min ***edited multiple times due to my stupidity.

I am going to open up about myself a little more on this public forum than I normally would (by my own choice this time...(the previous time was something that had to do with Sphincter Velocity......only certain persons will get that.... do not worry if you are not one of them )) Everyone who posted before me gave good advice. I think the biggest thing going for you is you do not want to be "that" guy (or gal). Knowing what you do not want to be and working to improve yourself will help keep you from being a true "paragod." The sad truth is, someone will label you as one, more than likely. Most of the time, persons who get the nickname "paragod" do so because of their own insecurity, as Dust said. My advice for you is to continue what you are doing, that is, being aware of what you could become, but do not let that interfere with your leadership when you are finally handed the reins. Letting people run over you because you do not want to be perceived as a "paragod" is not good. When it comes to your patient, ambulance, and whatever you are responsible for, be a leader! As a no0b paramedic, this has probably been my biggest challenge. I was labeled a paragod during my full-time new employee training (transitioning from part-time to full-time). I was labeled "paragod" on the second day! I have not found out who called me such, but an administrative person brought it to my attention. They told me just so I could be aware of it and work on it. But..... anyone who knows me, knows I am one of the nicest "good" people around. (Yeah Yeah, I know, if I am tooting my own horn, I am probably lying, but not this time ) So the question remains, why was I called such. My best guess is that the person was insecure about herself. So when I was handed the reins and placed in charge of an ambulance and patient care, I worried about being a paragod. As such, it was easy for me to be non-argumentative and compliant to the suggestions of my partner, just so I do not start a conflict and then have to become a 'paragod' to do what is right. It took me a little bit of time to realize what I was doing wrong. My patient care is fine, but ambulance operations and the interaction on calls between my partner and I are hindered. I finally realize that in my plight to be an "easy going friendly in no way shape or form of a paragod" paramedic, that I was losing my reins as the leader in guiding how things are supposed to be done on calls. Now I have to play catch up and set things right. What I am getting at is that there is a difference in being a paragod and being a leader. Paragods are insecure in themselves, or just plain @&&holes. A leader though will make the calls during an emergency. Being a leader requires a sense of presence and authority that is not ment to be demeaning, but just straightforward and simple to get the job done. I do not know if you will have the same problems or situations that I am currently in, but being aware of what could go wrong will hopefully be helpful to prevent it from happening to you. Good Luck !:thumbright:

But I do not think it is a junctional rhythm.

Me thinks it could be an accelerated junctional rhythm with the p waves burried towards the end of the QRS complex which make it appear wider than it really is. But I have been wrong before....

Probably due to that thing called tradition.... I worked for a service that was transitioning trucks to 12-hour shifts. They ended up with nobody interested in the 12-hour shifts. Now, a few years later, they have waiting lists to get on the 12's! (Some) People are realizing that the 12-hour shifts are not so bad.

Be sure to thank them for not being axe wielding maniacs ! :wink:

Stretcher 81, You are in a great area for EMS and Education. If you have not done so, go to the local community college and speak with persons in the EMS department and student aid departments. That would be your best starting position. If you really want to focus on college, just get your significant other to make all the money. :twisted: I do not have any specific information on the grants you are asking for, but I do have a ton of information about the area and college you are looking at. I sent you a private message. We can continue from there.

Happy Birthday Ruff ! I hope it was a good one.

Do not expect to speak less than 100 words to the student the whole day and then try to bring up your concerns at the end of the day when signing the student's paperwork....you already lost any respect you had....and just gained an enemy. :evil:

I figured someone would dispute what I wrote...but you??? :twisted: Let me ask you this though, did your EMT-I course require all that darn book learnin'? (not direcly toward spenac, but...) Just as much as the patient needs those skillz...they also need an educated provider.

I think you should go back and read what the OP said. Nowhere did the OP state anything about transport. Now, the original thread is about the usefulness of 12 leads with patients who have GI bleeds. EMS49393 gave a good write up as to why a 12 lead would be applicable to a patient having a GI bleed. Agreed In fact, he never said anything about the patient going to the hospital at all. Its a moot point. From what I can tell, EMS49393 did not go via ambulance to the hospital. Why, we do not know. It is a waste of time to hash this out. Lets say the 12 lead shows ischemia in the heart, then the 12 is showing you that your patient is even more sick than you probably realized. I agree that your senses should be used, but when given the tools, I think you should use them when indicated. That is one of the reasons this is not a basic call, which is what I thought was an ignorant statement on your part. No NoNoNoNoNoNoNoNoNoNoNoNoNoNo! You do not get it. I realize you have been doing this for a long time, but unfortunately, an EMT-I cannot give the same assessment and care that a paramedic can give. Shoving these calls on basic and intermediate units is going to cause people to fall through the cracks. That, to me, is lazy. These patient may beneift from treatments such as fluid boluses, ECG monitoring, a 12 lead ECG acquisition and interpretation, NG tube, pain meds, and an antiemetic. I am not aware of any intermediates that can do all of these treatments. On the contrary, we have advocated quality patient care, where you have stated that a 12 lead is at the bottom of the list for GI bleeds and these patients do not deserve paramedic treatment en route to the hospital. I still have not seen a big mistake made. You are assuming a mistake was made with no evidence.