scubanurse

After looking up that info...I was kind of on the right track? Thanks for the direction on where to look for more info ch!

That I'm not sure about... I know metabolic acidosis can cause the rapid breathing, but as far as contractility of the heart, I would have to cheat and go look at my med/surg text book.

The contractile force likely decreased with the decrease in venous return. With a rapid return of venous flow to the RA, the heart will not have the time to adjust and will be overloaded easily. The decrease occurred gradually as time progressed, but the increase would be sudden when the patient is laid down horizontal. Without doing any research this is all just speculation? ETA: Fixed my poor grammar I think... lack of sleep from studying can make anyones brain scrambled! No change in content though.

Grr...I'd be worried that the rapid return of venous could overload the heart and cause blood to back up into the lungs as the heart struggled to catch up to the increase in venous return? The LOC would be related to a decrease in cardiac output/gravity and venous stasis... Just throwing a random track out there...not sure if I'm on the right track or not though....more than likely I'm not. Also, I'm not sure LR would be the best option and I could be totally wrong on this but the excess electrolytes LR has could further contribute to hyperkalemia once lowered? I'm pretty sure that with rhabdomyolysis you get serum hyperkalemia. An isotonic solution would be ideal but probably not LR...I'd stick with NS, and probably even stay away from D5W?

no clue... Already got my new tires from my parents...not sure what mr. kate is getting me though... probably coal

I'd be weary about laying him down and rapidly increasing the venous flow to the heart... If only we could send someone up and get an ABG on him

That may not be enough in your service, but we do not know where the OP is from. I don't think the issue here was really about whether to report beyond what they did already as they replied saying they would be taking it further. I was merely trying to present a different side than what had been said over and over again... the point of reporting was already adressed in all the previous posts.

The coloring books really helped me... It will help also if you find one with blanks and arrows so as you color you can try to quiz yourself on the anatomy. Start with the big picture and then go down from there. Mike has the best advice to try and take a college anatomy class...A lot of them offer an intro to anatomy class that give a broad overview and might be perfect for you at this time... and earning college credits at the same time is a big plus!

I believe one was a PhD and the other had their masters in social work. I appreciate that there are differences, and if I were really frustrated or upset about a call being told to go talk to someone who had no qualifications or legitimate training I would probably tell them to piss off. I also know that sometimes people are unaware of resources available and can really struggle internally with issues and feel isolated. I don't know what the right answer is regarding after action counseling. OP: I am sorry for de-railing your post! eek

Our experiences with CISM teams must be very different. The two meetings I attended were ran by professional counselors and a small group of experienced providers. Our meetings with them were mandated but some just showed up said I'm good and left and that was that. Not all CISM programs are great, but not all are bad either.

I've always found that being told to attend gives someone the opportunity to talk...I have never seen someone forced to talk, just strongly urged to attend and have the opportunity to talk... CISM can also refer those who need further assistance to professional therapists and counselors. In my experience, it is meant to be a first step to help get the ball rolling if needed.

Get yourself an anatomy study guide, and brush up on your basic human anatomy. This is the best thing you can do in the next few weeks before your class starts. EMT-B does not cover nearly enough anatomy to help you succeed in this field. Also big kudos for trying to get ahead of the curve! Welcome to the city.

I'm with Dwayne... Everyone is tossing out mandatory reporting.... the OP did this. She/he reported their suspicions to the ER doc and it sounds like s/he was going to talk to some LEO friends. Any call like this, I believe should involve a CISM debrief afterwards. Calls involving violence to children should be included under their protocol for a CISM meeting after the call. You should not have to process the events alone. There are resources available through most departments in the US, and possible Canada but I have no clue, to help the OP handle their feelings after calls like this. To the OP and anyone else who has experienced a call like this, reach out to CISM, to a friend, religious leader, anyone you feel comfortable talking to. To the OP: Sounds like you did all you could to help this child, unfortunately, a lot of the time things like this fall through the cracks. Not all rapes cause physical damage to the vaginal area that would be evident to a doctor without the training to recognize such an issue. Someone previously mentioned SANE nurses and their value in a case like this a incredible. They can speak with the victim, and often times the victim is more likely to speak to them rather than the MD on the case. Does your area have access to SANE nurses? I am really sorry that you had to experience this call, but I do hope that you reach out and continue to process the events that happened. Best of luck to you.

I had the same thoughts as Arctic... My first intervention would be to remove the harness, but maybe that wouldn't be right as the shift could cause arrhythmias from excess K in the lower extremities... If the harness was too tight then that was essentially acting as a lower body tourniquet. Is there discoloration/edema to the lower extremities? Any sign of unstable pelvic fx? The jolt could cause a pelvic/hip injury depending on the type of harness and how it sits on his body.... Just some random thoughts on this case

This is just so depressing. My thoughts and prayers to the department and their families. And well wishes for the two who are in the hospital.

Get your mind out of the gutter!!! Geezzze!

Not as easily as you just giving me some

Welcome! Good for you for reviewing A&P!

Met a kiwi yesterday at the liquor store and it made me think of you! P.S. Can I have som valium too?!?

They way I always organize my binders for school is by unit exams. That way I can go back and look over specific sections I had problems with on the unit exams. For example.. one class had 5 unit exams and a final... I had 6 dividers in a 2" binder. Each section had the lecture notes, handouts, and assignments corresponding to that exam. For the final, I take the study guide and pull out relevant notes from each unit and put it behind the 6th divider. How this relates to you: Take all of your notes and organize them by the sections you have been tested on so far. In the future, starting this process at the beginning of the class rather than half way through. Good for you also, for sticking through the first posts here... sometimes it can be rough but we do have a lot of knowledge to provide. Good luck on your clinical time and eventually your state/national exam!

Sorry you're going through this!! I've had to fight doctors before and insurance companies so let me know if I can do anything!

That's amazing... What kind of camera did he use??

First step would be a grammar/spelling course. In all seriousness, it is not very realistic to start your own business with very little experience in business management or in EMS in general.

Great question! I would imagine the ER can place their pacer pads on and gain capture at the same time you have capture and then you can remove your pads? Or they should have the ability to switch the pads over and then re-gain capture?

EMT's don't deliver babies...mom's deliver babies...