miscusi Posted July 29, 2013 Posted July 29, 2013 oh well, I'd take him to the closest hospital immediately. I might call ahead because of the shock.
scubanurse Posted July 29, 2013 Posted July 29, 2013 oh well, I'd take him to the closest hospital immediately. I might call ahead because of the shock. Do you actually work in EMS????????? For real? You MIGHT call ahead? Dear lord. The point of scenarios is to talk through patient care actions and critically think about the presenting patient, not just say well transport and maybe give the receiving hospital they are about to get a very critical patient that will likely need an OR prepped and ready.... Seriously dude. 1
MariB Posted July 29, 2013 Posted July 29, 2013 /> Do you actually work in EMS????????? For real? You MIGHT call ahead? Dear lord. The point of scenarios is to talk through patient care actions and critically think about the presenting patient, not just say well transport and maybe give the receiving hospital they are about to get a very critical patient that will likely need an OR prepped and ready.... Seriously dude. I was thinking... don't we always call ahead? I mean it is part of transport. Its called " radio report I am wondering if this person does work in ems also. Just did a search on this poster. He just finished his class last year in NYC. So he has been an EMT for a year. Unknown if he is working as one at this time.
Just Plain Ruff Posted July 29, 2013 Posted July 29, 2013 Do you actually work in EMS????????? For real? You MIGHT call ahead? Dear lord. The point of scenarios is to talk through patient care actions and critically think about the presenting patient, not just say well transport and maybe give the receiving hospital they are about to get a very critical patient that will likely need an OR prepped and ready.... Seriously dude. I never call ahead, I just show up with a mystery patient every single time to each ER. I'm so LOVED in the city I work in. I get the Medic of the year award each year. In fact, I just got the target off my back last week.
miscusi Posted July 29, 2013 Posted July 29, 2013 (edited) Sure I work ems. yes I might call ahead. ( meaning emergency room notification ) it may sound strange to you, but I'm in NYC. Calling ahead is really a courtesy and is not mandatory. the ER is always operational and not very far away. Teams are always at the ready for more easily identifiable and serious things to call ahead for like CVAs and etc. This patient don't sound very dire to me. "57 yo, male, in sitting position c/o coughing and spitting up copious amounts of thick yellow secretions. Pt is looking gray. mother states he had surgery a month ago. coughed up blood and a piece of metal two days ago. Pt appears weak." So I will take him to the hospital. because he is gray (read pale) he may be in shock, the yellow indicates some kind of infection. there is nothing I can do ( we are BLS) for him. So Its Air and Chair. I would do the standard stuff I would do for everyone else of course, the assessments and the questions.... fill out the PCR... I would definitely ask the mother for the piece of metal. I can imagine if ALS was present, they would use the pulse ox to see the SPO2, start an IV and administer fluids, if his breathing is so bad, may use CPAP. do a bigger assessment, ask more questions and then it would be transport to the hospital, and they will decide if they need to call ahead, depending on how bad the pt is. Edited July 29, 2013 by miscusi
MariB Posted July 29, 2013 Posted July 29, 2013 (edited) /> Sure I work ems. yes I might call ahead. ( meaning emergency room notification ) it may sound strange to you, but I'm in NYC. Calling ahead is really a courtesy and is not mandatory. the ER is always operational and not very far away. Teams are always at the ready for more easily identifiable and serious things to call ahead for like CVAs and etc. This patient don't sound very dire to me. "57 yo, male, in sitting position c/o coughing and spitting up copious amounts of thick yellow secretions. Pt is looking gray. mother states he had surgery a month ago. coughed up blood and a piece of metal two days ago. Pt appears weak." So I will take him to the hospital. because he is gray (read pale) he may be in shock, the yellow indicates some kind of infection. there is nothing I can do ( we are BLS) for him. So Its Air and Chair. I would do the standard stuff I would do for everyone else of course, the assessments and the questions.... fill out the PCR... I would definitely ask the mother for the piece of metal. I can imagine if ALS was present, they would use the pulse ox to see the SPO2, start an IV and administer fluids, if his breathing is so bad, may use CPAP. do a bigger assessment, ask more questions and then it would be transport to the hospital, and they will decide if they need to call ahead, depending on how bad the pt is. What about this patient doesn't sound bad to you? And call ahead. This patient is sicker than you think. He needs more than you can give him. I would be calling my medic if I was going to have a longer transport time. One of them would meet in route. In town, it would be quicker just to go. Someone this ill deteriorates rapidly. His history and what he has going on now would kill him without medical intervention. Who knows how he would be had he waited until tomorrow So what about this patient do you not see being that sick? Edited July 29, 2013 by MariB
ERDoc Posted July 29, 2013 Posted July 29, 2013 I think our young padawan is suffering from a case of "the not knowing what you don't know". This guy should scare the hell out of anyone that has a clue. He's septic with airway issues and has the potential to have a nightmare airway 1
miscusi Posted July 29, 2013 Posted July 29, 2013 What about this patient doesn't sound bad to you? "57 yo, male, in sitting position c/o coughing and spitting up copious amounts of thick yellow secretions. Pt is looking gray. mother states he had surgery a month ago. coughed up blood and a piece of metal two days ago. Pt appears weak." well Im not saying he's healthy. but this isn't really so bad..... because.... He's sitting, that's good. he's coughing, that's good, looks grey, (but sitting) not so bad, the surgery was a month ago, not bad, the coughing up of a piece of metal was 2 days ago ( if it even really happened at all, senior citizen's story is not always reliable ), that's not bad... what the pt really needs is a doctor. so if he survived the last 48 hours after the metal cough, he can do 10 more minutes on the way to the hospital. 1
MariB Posted July 29, 2013 Posted July 29, 2013 I think our young padawan is suffering from a case of "the not knowing what you don't know". This guy should scare the hell out of anyone that has a clue. He's septic with airway issues and has the potential to have a nightmare airway what scares me is the answer above this
scubanurse Posted July 29, 2013 Posted July 29, 2013 Never getting sick when this dude is on duty... If he even works for NYEMS 2
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