p3medic

Cancel the fire.

Well I'll go ahead and wade into this mess. I have "on-sited" calls, i.e. witnessed an accident or been flagged down while enroute to a call, in most instances we stop. Our dispatchers do not tell the person calling 911 that an ambulance is on the way, they tell them they will send as soon as they can. This, from what our management states (and the city lawyers as well) is NOT a contract with a patient, and diverting the ambulance to another emergency is not considered abandoning the first. We don't dispatch on a first come first served basis, its triaged, just like the people sitting in the ER waiting room, just because you were there first doesn't make you first. Also ambulances are diverted by dispatch for a higher priority call, for example if I were responding to an altered mental status diabetic, and a cardiac arrest came in, chance are if Iwere closer to the arrest, I'd be re-directed to that call. Maybe we can get 9 more pages on this?

Last one I brought in ended up on vasopressin prior to a TIPS procedure.

I knew I was right! ^^^^^^^

Cancel the fire. Clock: 25 sec

The only time I call ahead is when a patient needs to be seen immediately.

LOL!!! I have actually done this call! Without giving it away, may I ask where he slept last night?

As JP said on page 1, bilat tq's and haul ass. There is no benefit to waiting on scene for ALS, as an ALS provider, the first thing I would do before lifting the load would be to place the TQ's. In addition to the problem of uncontrolled bleeding, you also have the sudden return of blood flow from the lower extremities, with hyperakalemia, clots and other badness in addition to bleeding to worry about. The TQ's should help with all the above.

We rarely transport pts in arrest, if no ROSC on scene, they are dead, with few exceptions.

I would ask your medical director to consider a policy of not transporting pts without vitals. To do half assed cpr with one person in a moving vehicle for 25 miles is stupid, plain and simple. I would wager that survival of pts in that senario is close to 0%.

Motorcycle accidents and shootings have produced the most cord injuries that I have seen, all with deficits at presentation.

Actually I don't, nor ever have worked for this department, it was an assigned field internship as part of medic school. It was the first call on the first day in the field, and in all the excitement my focus was on successfully managing the airway. After the tube was done, line had been established and a round of meds was on board. I then handed the airway off to the other medic and began to set up the epi and atropine bristojets while running though my asystole algorithm in my head. I remember I pushed the next two rounds of meds while the other medic set up the drip. I don't recall ever checking a pulse, ever. It was definately an eye opener, thats for sure. I am glad I was there, it has always stuck with me, and I tend to be very diligent in assessing the patient, regardless of what my technology might be reading.

Yeah, we used to have the old brown vial of 1:1,000 epi, looks just like the lasix. As for the patient in my senario, to the best of my knowledge it went unreported, but I don't know that for sure. I do know that I didn't do the paperwork, I was there doing my required field hours, which documentation was not a part of it. I do know that today, if something like that were to occur, I'd own it, but day one in the field years ago, I had no interest in pursuing the matter, and left the two medics in charge to take care of things. It is entirely possible they owned up to it, as they didn't just unplug it again and throw a sheet over her.

While riding 3rd in a city somewhere in New York state, went to a cardiac arrest. Patient was an elderly woman, apneic on the floor. Being the first call of my first day, I was very excited at the prospect of getting an intubation on day 1. Anyway, tube in, pt asystolic on monitor, LP5, three rounds of drugs and an isuprel drip per local protocol. Well things weren't looking good, nice flat line on the monitor screen, too flat infact with all that good cpr taking place. While the medic on the radio was getting orders for field termination, I noticed the lifepak cable was attached to the pt, but the other end was stuffed in the pouch on the case, not inserted in the machine! :shock: Well, I reach over and plug it in, she's in a narrow complex tach at 200, great blood pressure, still apneic. We took her to the hospital, no one the wiser. Lessen: Always assess the patient.

As a true American PATRIOT, I feel that those COWBOYS in Colorado went overboard, I would press CHARGERS against them and those CHARGERS WILL LOSE. Sorry, its early, Sunday, and I feel like crap.

Badge bunnie is popular around here also, not too far north and east of L.I.

Yeah, because FDNY firefighters love their EMS counterparts... That is rich! The fire guys call you "slugs" and don't consider you part of the fire dept. A little reality check is in order.

How many units does NYC run? I guess that is what matters, you can do a billion calls, but if you have a billion ambulances, your not too busy, you know? Just curious.

One of my partners uses one, seems pretty good, certainly and improvement over the abortion of a bag he used to have.

.....................................

A little over 100k, with 15 BLS and 5 ALS.

From Spenac: This provider broke the law by forces his way into the house to check on a child w/o parental consent and should go to jail.

Where do we draw the line when it comes to respecting the beliefs of others? Its ok to withold life saving therapy to a child based on the parents interpretation of a passage in a book, but not ok to have several wives? Is it ok to circumcise young women, or men for that matter? Is eye for an eye ok? How can we have laws that restrict one religion's beliefs yet not anothers?

Religion is the opium of the masses, the blind will follow like sheep....

I like my steak nice and bloody, the no blood thing would definately cramp my style.