p3medic

How to talk to people, plain and simple.

Sorry about that, what did you expect from a book published in Massachusetts? Its actually not a bad text, maybe its out of print?

The text I mentioned in my previous post is Field Training Officer, Tips and Techniques for FTO's, Preceptors, and Mentors, by Bruce Nepon and Barry Eberly, published by Jones and Bartlett Publishers. www.jbpub.com.

Preceptors where I work take a precepting course, I forget the text they use, if I remember I'll find it tomorrow and post the title. There is a written exam, practical exam and oral interview involved, and they are active in the academy didactic and practical training process as well as field internship. All calls are documented using a standard form, everything from geography to hand off at the hospital, and everything in between. There are weekly written reports given to the recruit as well as the training department, and weekly rounds. It seems to work ok, definately better than feeding them to the wolves.

Its completely inappropriate. If there was a particular injury pattern or learning opportunity, that didn't reveal the patient identity, I might buy it, but breasts flapping in the breeze pinned in a car? He's an idiot, and deserves whats coming, IMHO.

I'm not black, and don't have sickle cell, but I can say that it looks like it hurts...If i'm working up someone with sickle cell crisis, they get all the pain meds they want, just the way it is.

never mind :?

We got sent to a nursing home around Halloween for a diff breather. When we arrived a private (facilities contracted provider)ALS truck was on scene. When we got to the floor they had the patient on their stretcher sitting semi-fowlers and a non rebreather on her face. On the LP-12 it clearly showed asystole in 3 leads. Well they said they were all set, and we ran into them in the lobby on the way out and suggested they take to decedent back to her bed as she had a valid DNR. They opted to ignore our suggestion, loaded the patient, one medic got up front to drive, the other sat on the bench and proceeded to apply a bp cuff and began to take a bp....on a corpse. True story....and yes, they were an ALS crew.

yeah, a bunch, last one was a 27 week premie, last week, maybe thursday....a girl.

I'd like to try it, I'm a fan of all three, so all together might be good. If given the choice, I'd take the duck over the other two, its my favorite bird for eatin'. I'm a yankee through and through, but the few years I spent schoolin' in Dixie got my taste buds diversity trained. I love southern cooking, although I rock a mean New England Clam Chowder.

The neighborhoods I work tend to be mostly non-white. I'd like to think I treat everyone alike, but unfortunately thats probably not the case. We have a multitude of ethnicities in my area, all with unique cultural "quirks" and what is an overwhelming event for some, is merely a nuisance to others.

OT, officer in trouble.

This is becoming the best thread ever! The initial senario never included a sat, didn't need to. I'm not sure why you are so hung up on the numbers. This was a hypoxic pt moving no air, with a tight chest with no compliance. There are only a few possibilities as to why, all of which were mentioned.

:shock: I'm almost speachless, almost. The only way to differentiate a pulmonary contusion from tension ptx is cxr? You don't have a clue kid. Pulse oximetry isn't a diagnostic test that proves or disproves tension. Do you even know how a pulse oximiter works? Do you wait until the sat is 89 and the bp is 89 before decompression? What happens to the physiology at 89 that doesn't at 90? You really ought to seek out some education and professional help before jumping down someones throat. Have a nice day, I think you should stick to fighting dumpster fires and rescuing cats from trees.

I don't have a list, but I can name some in a 25mi area around Boston: Kingston, Pembroke, Duxbury, Hanson, Hanover, Norwell, Hingham, Hull, Scituate, Rockland, Abington, Stoughton, Canton, Cambridge, Marshfield, Cohassett, Natick, Framingham, Needham, Lynn...There are more, but thats the best I can do at 7 a.m.

exercise induced anaphylaxis...

I'll start with A Guide to Physical Exam and History Taking, by Barbara Bates, I found it to be a great text.

Epi sounds like a good idea, we can debate the dosage, but it is the one treatment that makes the most sense. The diff's are few, mechanical obstruction below the level of your et tube (pretty much dead pt) tension ptx, probably not, but might be the next thing to consider in tx, and acute bronchospasm. I agree with the epi, gain IV access, and put patient on the monitor...Oh, and EtCO2 s/p intubation?

Like working a shooting in a bar room you couldn't enter off duty, or delivering a premie in the projects, or dealing with a suicidal 40 yo father of 3 in the midst of a bad divorce? I agree some life experience beyond highschool and 120hrs is needed to perform adequately.

While fighting with people might be the cops job, properly restraining a psych patient falls into the realm of EMS, at least around here.

Yeah, and if its not obstructed it sounds like he's buying the tube anyway...perhaps tight astmatic...

In addition to what chbare said, aspirin, o2 and pain management while enroute.

Had a 28 week premie yesteday, delivered in the ambulance by BLS crew, on our arrival, apgar of 3, cyanotic, bradycardic, limp....things got busy for a bit, but in the end delivered a pink perfusing kid to the NICU staff...

You shouldn't be using succ's on pts prone to, or known to be hyperkalemic. With that being said, stuff happens, and recognizing it, and rapidly treating it are key. IMHO.

I think I just wet my pants. That is just hilarious!!!