Mateo_1387

OMG, that was a good laugh Dwayne. I was reading parts of the site to the lady I stay with and she was like "Oh my god, matt, that is horrible" and "they are not of age to consent" and my personal favorite "Matt, be glad you live in the United States where that cannot happen !"

Yea, it is hard to believe I have been doing it wrong for two years !

I know, kind of addicting !

Dwayne, I know I am currently an Intermediate, but I still hold a basic card, as it is still in date, so I guess I am a basic too. Since nobody has, I will start off this thread This is very ungood. Two concerns that enter my min are that I have two critical patients and we need to get a paramedic intercept and the patients delivered to a trauma center in a timely manner. My safety. I know my answers are short and simple, but I think they are relevant to the video/scenario. Take it from here folks ! Dwayne, I know this was intended for newer basics, but I am young, so I guess I am still kind of new !

Or better yet, prevent it !

I am not too sure, but I guess you could just preamble your call-in with this song.

Then try THIS Note: When she gets stuck, left click and drag her free...

Of course they will not ! They have compassion........... :roll: NC has very cheap community college tuition rates. I have paid for all of my paramedic education and all education I have received in the community college system. It would be nice to have others pay for it, but it is a good investment in my opinion. What you mention Riblett about people getting a free ride when they seem to be able to afford the "nicer things" in life is why I have a problem with NC trying to make community college free to everyone. I fell that it will end up clogging the system with lowlifes that have no business in such a setting. These will be the same people that demand that the state provide them money to go to school. I think the more quality people that attend college are the ones who have to work to get where they want to be, not the ones who have it all paid for them.

Exactly ! I have a question about the above. Does atropine affect how acetylcholinesterase processes Ach? I was under the impression (from what I was taught, and what I have read) that Atropine's mechanism of action is to block the muscarinic receptor site to promote Sympathetic nervous system control. I respect your post AZCEP, as this is not an attack on my part, but an effort to understand what you are saying, as I have not heard of this.

To me it sounds like there is some hinky stuff going on there. On a serious note though, they got a dispatch saying the patient was clammy and sweating, so I would wager that the patient was already in V-tach. My guess is that these medics are some of "load and go" type and are not willing to stabilize their patient on scene so they do not code. I know I may be reaching kind of far with what I am saying, but that is just what my gut says happened.

I am not really clear what you are meaning by "this application." Is the Atropine supposed to be rendering the resuscitative efforts futile, or is it the neurogenic shock? I have another question, why are you working a trauma code? To have these injuries is it not likely they have other internal injuries that just cannot be fixed in the field? As far as working the code, the use of normal resuscitative efforts may or may not be applicable. Being in neurogenic shock, his arteries have dilated and the blood pooled towards gravity. To me, a logical recourse (if I were working the code by some chance) would be to get the blood up to the core. This may mean loading with epinephrine to cause vasoconstrictions causing and increase in pressure so that oxygen could be circulated. Maybe the use of some Antishock trousers would be indicated. Overall, to me, I think that the above scenario would be a case of fixing the underlying problem of why the person is in cardiac arrest, which is that the blood is not able to be circulated due to no pressure (I know, I know, its ultimately due to the spinal injury, but I am talking about what we could possibly fix). After or while that is being fixed the use of vasopressors and atropine to increase rate would be indicated.

Why not do continuous compressions as a health care provider. I know AHA may not say it, but test show there is good air movement, and that if you stop compressions for say ten seconds to breath, it will take about 15-30 seconds of compressions (not sure on the exact numbers, but I know this should be close), and that is just to get the blood moving, it probably going to take a few more seconds to get oxygenated blood to the vital organs. So the person receiving compressions is not perfusing for roughly 45 seconds, just to put two puffs of air in. In my opinion, it should be continuous compressions, BVM/Mask or not.

If neither of those work for you Dwayne, you might try it in Internet Explorer. That is what I had to use, it would not play in the Opera browser.

Wow, Durham Co. EMS in NC still uses those boxes ! Besides school and Durham EMS, I have not seen boxes used, most places are going with the packs.

I had the same question emt322632, the story does not quite add up. I think it is kind of amazing that they took the tubes out of her and she started waking up. 4cmk6, I see what you are saying, my question would be why would god not prevent that from happening, causing every grief and pain thinking their loved one was going to die? Also, I am not convinced that medicine "saved" her. Sure they treated her cardiac arrests, but what did they do to make her return neurologically intact (for the most part, she look a little out of it, but we can give here the benefit of the doubt, I mean come one guys, her heart stopped three times !). I would be willing to say that medicine may have helped support her, but I am not convinced that it "cured" her. I would bet that her brain just needed some time to repair itself. Just my .02 cents Cool video Chbare, thanks for sharing.

I think this says it all Apparently the city is doing this Maybe we ought to give Cleveland a little break. I mean, if the above is what they are really reaching towards then I have to hand it to them. It is about time everyone used their resources efficiently. I still say they should put an ambulance near where they put the ALS engine if that is where they feel "a lot of high priority calls originate from."

Your Name:Matt 1. Famous singer/band: Miles Davis 2. 4 letter word: milf 3. Street name: Modesto 4. Color: maroon 5. Gifts/presents: Money ! 6. Vehicle: Mazda 7. Items on a menu: Mixed vegetables, Mild Salsa 8. Girl Name: Michele 9. Boy Name: Mike 10. Movie Title: Men in Black 11. Drink: Martini 12. Occupation: Mom 13. Flower: Marigold 14. Famous Person: Michael Jackson 15. Magazine: Money 16. US City: Memphis 17. Famous Sports Team: Mariners (stole this one from Marty, just too lazy to google one ) 18. Reason for Being Late for Work: Married 19. Something U Throw Away: Money 20. Things You Shout: Motherf*cker (yea, kept this one too !) 21. Cartoon Character: Mini mouse

WOW :shock: They saved the life of a 103 year old person, great job guys, did you think maybe it was time for the person to die? Oh, but it is about saving lives. Why not put an ambulance at that location to answer all those "serious medical calls" in that area? And all this comes in light of them possibly refusing transport in the near future.....

Well, along the lines of asking permission.............

I do not know if your agency does this, but my agency looks at patient outcome along with medications that are administered. With these statistics they are looking at if the medications we give really make an difference on patient outcome. One drug they are looking at taking off in my area is lasix. It is not the "favorite" drug of choice for PE anymore in my system, yet for the moment we still carry the drug. It has to do with evidence based patient care. This of course can vary from area to area. Lasix here may not be a big benefit because of short transport times, and blah blah blah, but for someone who has 3 hr transport times, this may be a different story. Did they give you a replacement drug to give for a-fib with RVR such as amiodarone?

Just from my general impression the news media is what pushed the issue. EMS commissioner Jackson called out councilman Polensek about media pressure, only to be told by Polensek that it was a matter of common sense. Well, where was your common sense years ago when the problem started? I thought the use of the Richmond Ambulance Authority was a good idea. I did not know they had such a system in place. The only problem I see with the Richmond model is that it seems the RAA medics were not allowed to refuse transport. So if a nurse saw it as necessary for an ambulance, then one would be sent, and just like old times, you call we haul. Mike, you say it was easy to make commissioner Jackson look incompetent. I would have liked to hear what he thought of the situation. Although I will most likely disagree with what he says, I think it was probably slanted by the media. He obviously called out councilman Polensek about media pressure, for us to find out that Polensek lies saying it was not media pressure but common sense that pushes the issue. What a moron. My observation is that he is going to ride this one out taking credit that he was the fix of the problem come time for re-election. Too bad more people were not aware of what shambles the EMS system is in. I hope support like that moves us toward change. Just thinking out loud here, I wonder if Commissioner Jackson's statement about leaving people out of the health care system because of a policy made due to media pressure is meaning that he is for change, but not hasty change. Maybe he thinks quick change that is not thought out and well planned will end up hurting his ambulance system in the near future or allowing people to fall through the cracks. This is probably not the case, but just something to be thought provoking. Oh, and I loved the comment made by someone in the interviews, but I cannot remember who. He said something along the lines of "well, everyone found a way home from the hospital" (in reference to non priority patients).

I love how the paramedic just smacks the old guy's face a few times after he cardioverts him.

Man, That was GREAT !

I am not saying it cannot be done. I just think that it happens more times than not. For the people who are truly racist, how can they be unbiased?

Makes sense to me. I have no experience with it, that is why I asked. Only one place I work for transports codes. It should be a thing of the past IMHO.