JPINFV

Hehe, if you think EMT is bad, check out ABC. Charting accronyms are fine. My county actually provides a list of acronyms that we can use, but a lot of people ignore them (best example would be using D/S for "draw sheet" [pt transfered to gurney via d/s] when it means dextrose stick). Acronyms used a crutches for basic assessments (SAMPLE, HAM, DCAPBTLS, etc) are stupid. If you need an acronym to remember to look for signs and ask for symptoms, allergies, meds, etc, then you have more problems then an acronym can fix.

Unwitnessed fall (Alzheimer's care facility)~30 minutes PTA. Women found sitting in chair enjoying dinner in no real distress. No urine output. Patient claims otherwise. Initially refuses to go so the nurses surround him until he agrees [they aren't happy when I remind him that it's his choice. Ended up holding the wall for a few hours with him. Midline burning chest pain that comes and goes with hiccups. Hx of GERD and pt on pepcid. "Critically low sodium." Called for BLS transport. 10pm. lab values from earlier in the day. Na value per lab report was 120. SNF unable to place foley. Pt sent to ER right behind SNF. Another few hour wait. "Pregnant" female who claimed her water has broke. Pt sitting on bed rather dry and with no obvious complaint. 2 things become clear really quickly. Pt is fat, not pregnant and pt is missing a few screws. ER doc convinces patient that she isn't pregnant before she even leaves the house. Lac with "bathroom covered in blood". Pt has minor cut and staff is just finishing cleaning up what ever mess was made when we arrive. Any call that involves the words "Davita," "Gambro," "Renal Advantage Inc," "Renal," or "Dialysis" [yes, I know, it comes with the territory for the place I work at, but still...].

We don't have lab for anatomy at my school. My prof told us that the course is focusing on histology (basically getting us to the point where he can give us a slide of cells and have us identify it) and surface anatomy. In physio lab, we dissected frogs (cool little experiment where we took out the leg muscle, strapped it to a measuring device, and shocked it) and a sheep pluck (heart and lungs). In neuro lab, we are dissecting a rabbit brain and a sheep's brain, rabbit small intestance, siatic nerve from a frog, and do brain surgery on a rat (we're causing parkinson's disease in the rat).

actually, I do classes just for the gold star. /me loves gold stars

In the future, remember that people who disagree with you are not ass holes. You'd realize that when you mature some day (age and maturity are not as related as people like to think).

/me took EMT class along with 19 units of college work. Night class 1 day a week for a few months for the win.

I highly doubt that anyone is impressed with 50 calls. Especially if you aren't even a basic. Not exactly brain surgery. Vitals aren't that hard to learn. Administering O2 safely? Memorize some limits (1-6 for NC, 10-15 [i.e. keep bag inflated] for NRB) and make sure no one smokes around it. CPR is taught to middle schoolers. The question is, do you know the how [and not, 1. attach NRB to O2 source. 2. dial in flow rate. 3. inflate bag. 4 put on patient] and the why of your actions? 1. Legal issues of consent. Should someone who can't even sign a contract be allowed to transport someone against their will (psych, for example)? How about get someone to sign AMA? 2. Field advancement. You don't see 17 year old RNs. 3. Professionalism. Honestly, how many of your school mates would you like to be treating you after you've been in an accident? Laws have to regulate people who fit the rule [i.e. minors are, in general, immature], not the exception. Then these people are not just "only an EMT." I'm paid, and I'm not "only an EMT." I'm also a college student too, among other thing. These people are bankers, and repairmen, and clerks, and advertisers, and a whole host of other jobs, some of which help them be EMTs and some jobs that don't help. I'm not going to defend volunteerism and the whole 'sacrafist' mentality that seems to make volunteers think they are god-like, but these people are not "just EMTs." How many emergent/urgent calls are honestly BLS calls? Is a simple broken arm a BLS call? Shouldn't they get pain control? Psych calls? What about chemical restraints? Over a year working BLS part time, I've come to the conclusion that there is almost never a true BLS call outside of interfacility [dialysis, basic transfer, psych, discharge]. At the very least, most of the emergent calls (especially IFT ER calls) would benefit from the extra assessment tools provided by paramedics that basics can't use due to a lack of education. If anything, this is the best reason to get rid of volunteers. A provider should never use their cert level (basic or paramedic), call type (911 vs event standby vs on-site response [themeparks, etc] vs IFT) or their company as an excuse to suck. Your company might suck, or you might be limited by your cert level, but that is no reason for you to suck at your job.

Every so often someone gets the "gloves v no gloves" debate going for the non-icky patients. It never fails that someone throws out Hep, AIDs, etc. It got me to thinking, though. How many of us have had our shots and do regular maintance. Do you have your Hep A, Hep B, and meningitis vaccines? When was your last PPD (or chest x-ray if your PPD is positive)? If not, why not? Should these be considered standard requirements to get and maintain a cert/license? (For the record, I have meningitis vaccine because I was in the dorms freshman year and my school requires Hep B, but student health offered a Hep A/B combo series, so I got that. I get a yearly PPD because I do research at the school's med center).

Well, you should be able to get skin temp while getting a pulse and getting a resp can be estimated easily while looking at the person. Heck, if you time it right, you should be able to get skin temp and pulse while taking a BP anyways.

examples: :-k [-( [-X :shaking: :angryfire: :happy11:

There is no one measure of a patient's condition. Sometimes I'll grab a BP first thing on a patient. Sometimes I'll take it half way through my exam/interview. The patient's and symptoms of a 70 y/o M complaining of "chest pain 10/10" can tell you much more then a set of V/S will (CP man in this case has a hx of GERD, and the pain was midline, intermittent and existed only when he had hiccups. Denied pain when there wasn't any hiccups. Denied numbness or pain radiation. Skin signs were normal).

"Neither the Father nor the Holy Ghost could be reached for comment." Best line. period.

The one in the middle needs a smidge more protein.

My good sir, if not pursuing additional training and education in the field of EMS (i.e. staying an EMT-, may I as what you have done to further yourself in this time frame (college degree, etc)?

I guess we can't be too anty-typo till it works.

Hopefully his O2 stats is a diatomic molecule of 2 oxygen molecules that are connected by a double bond leaving 2 sets of lone pairs on each oxygen molecule. There should be 1 Pi bond set with the s bond hybridized to an sp2 configuration.

/me was never upset.

Just a pet peeve of mine. If you're willing to participate, be willing to take critisism. It's how we learn. Sure, some people can be a little harsher then others, but ignorance (not knowning better, please don't take that as an insult. Everyone is ignorant of something) is not an excuse. The fact that it is your opinion, you're a volunteer, or your a basic doesn't make what you say immune. Same would go if you were quoting a medical study, as a paid paramedic. No offense, but this "we can't decide this or that" is poppycock. We decide every day if a patient is stable enough to warrent or not warrent emergency (code 3, L/S, what ever you want to call it) transfer. I bet your intructor also warned you against using specific words to describe the situation because it could be considered "diagnosing" too. Ohh, and if you want to know more about blood pressures, look up "mean arterial pressure."

^ /me groan

Tell them to wake him up then! I'm more concerned with this then you telling us that you "drove like crazy." What good is med com if the EMP isn't awake to give the orders?

^ I had a transfer from an ER to the county's main psych evaulation and treatment center ("threatened suicide," long story). Apparently she was a case manager at the hospital we picked her up at.

^ minus 7 for being unclear who got the minus 5. The two other posts before me were recent, but I was the only one to acknowledge the bump.

First, note large bump. So, umm, because you don't want to have to tell a patient's family that their loved one is dead, it's ok to pass that on to the hospital? You are just delaying the news. Furthermore, please tell me where this ER with an unlimited number of ER docs, nurses, techs, and beds is located so that I can move there. Taking up a bed in the packed local ER and taking away 1/5 of their doctors, ~1/4ths of their nurses (going off of a 3 RN/code in a 32 bed ER with a 3:1 RN:Bed ratio+ charge nurse (scribe (normal charge), plus 2 RNs) for 20-30 more minutes to work this asystole that EMS has brought in is not helping anyone else either. Congrats, your clearn sooner, but now the hospital is even more backed up. Something to think about next time you're holding the wall.

Haha. I feel your pain. Care Ambulance: Can't Assess Real Emergencies.

I love one of my local hospitals. It has some of the shortest door to balloon time in the country (offical hospital goal is 60 minutes or less, average per a Spring '05 article was 47 minutes. US national goal is 120 minutes). Their ER tries to do a 12 lead with in 10 minutes of arrival (note: Arrival at the hospital, not at the time you are brought back). They'll do a 12 lead in the family/consult room or the code room and send you back to the lobby if it's negitive and there are no open beds.