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  1. Yesterday
  2. Barely failed PAT. Short girl:(

    Haha, being short does have some advantages thank you so much! I start orientation on 9/11/17 for AMR Southwest in AZ
  3. Barely failed PAT. Short girl:(

    Great to hear that you passed it! Congratulations!!! Yes, you can have a long career in this profession even if you are STA (shorter than average) lol! But I do stress the back brace and going to a specialist or experienced practitioner who will fit you with a custom one if you plan on remaining in EMS for a long period of time. Many have told me that it is not needed anymore since technology has advanced to the point of loading stretchers into the rigs, etc. but you will still have those scenes in the back corner of the only apartment building in town that doesn't have an elevator in which you will get to carry the patient down 15 flights of stairs, etc that will put tremendous stress on your back~~ I wish someone had told me this when I started but I'm fortunate that I didn't destroy my back before it was too late~~ out of everything that I faced in EMS, I think my height was the most challenging and sometimes entertaining (how I ended up dealing with things) LOL!! Plus you will be the first one they will want to shove into those tight, cramped spaces on a scene..... Good luck and hope you have a long and satisfying career!!
  4. I think that the Trevor Lowey guy should probably run for mayor or something like that I don't have much critiquing skills so from my stand point and experience I think you hit the nail pretty square on the head~~I wish more agencies would bring these 'life like' scenario's to the students on a regular basis. I know it takes a ton of people, planning and preparation but dammit our kids are worth it and if it saves one car full of teenagers lives and one grizzled old EMS'rs sanity, the pay off is immeasurable...... I have been involved in similar scenario's over the years that we brought to high schools, the only thing we've done different (besides not recording for a PSA which I'm sure involved a lot more time and planning) was to throw a few more students into the mix as first on scene observers/friends as well as one or two parents who listened to the scanner and heard where the accident was. We threw in a cell phone call message from deceased victims Mom on one of ours over the intercom that they had to listen to while watching the victim be assessed and covered up. ("Hey Jesse, it's mom. I heard there was an accident and I'm just calling to check on you. I'm on my way to the accident scene so give me a call back as soon as you get this message...."...etc. Some of the feedback that we got from the students was that call stood out in their minds as well and made them realize they were going to affect their entire family~~ P.S. In one area we were also fortunate enough to have the owner of a particular rowdy bar (read as-known to have several college aged patrons over the course of the summer who left there drunk, or 'slightly impaired' but drove anyway and were responsible for many of the tragic accidents in that area) sponsor the same type of scenario in their parking lot. That one got pretty interesting and did cut down on the accidents for a few year! I really enjoyed watching those PSA's tho, they were just the right length and done very, very well!!
  5. Barely failed PAT. Short girl:(

    I passed my PAT Friday! Thank you for the backbrace advice. I know this line of work is rough on the body. It is nice to know there are other successful horizontally challenged women out there in this field:)
  6. Barely failed PAT. Short girl:(

    Us 'horizontally challenged' women in EMS have encountered that difficulty since I started....lol....I am a lifetime EMS'r who is 5'1 and 1/4" and weight range of 105 to 130 throughout my 25+ years career~~one of the biggest things I would say to you right now is "Get yourself a back brace and wear it religiously!" You will thank yourself when you are a tad older and lifting a grandchild.....your back will thank you for it as well! Thousands of petitions to the manufacturers requesting that they locate ambulance boxes closer to street level never worked for me so I had to continue strength training my entire career instead ....good luck and let us know how you are doing!
  7. Last week
  8. And then there's this

    11.8 million in unpaid uncollectable bills. Here are several reasons that were cited as why they cannot collect Insurance denials patients without coverage and the fire departments inablity to gather accurate information So play the director or the chief, what of those three above do you think you should go after first before you ask for a increase from the taxpayers to help you out? I know which one I'm going to go after. anyone anyone bueller, bueller????? how bout holding the fire department staff accountable to gather more accurate information. But in all honesty, some of that inability may be not the crews fault, it could be patients giving them inaccurate info, not being able to get the patient to give them the correct info but I'm sure as heck going to find out why we have 11.8 million in unpaid bills. that would go a long way to pay for some probably long awaited improvements. But sadly, this isn't just this department that has this problem. If I had a crystal ball and could solve this problem I would be living like Joel Osteen.
  9. Dont' drive like this guy

    Just because you are in an ambulance doesn't give you the right to drive like a DICK!!! https://www.ems1.com/fatal-incidents/articles/314329048-EMS-provider-charged-in-fatal-4-vehicle-crash/?NewsletterID=&utm_source=iContact&utm_medium=email&utm_content=TopNewsLeft1Title&utm_campaign=EMS1Member&cub_id=usr_rYgxvJiMpoxX5g7Z
  10. Posting EKG's Potential Hipaa violation

    ok, in a facebook thread today, someone brought up that posting a 12 lead or just a ECG tracing is a hipaa violation even though you black out the patient name and identifiers. NO, you say it isn't, say it aint so!!. Well actually it is according to the article I will post below. The event ID of the tracing of the 12 lead specifically identifies the patient, not by name but by piece of equipment and a specific patient and can be used to trace it back to that specific patient, and in effect IS a hipaa violation, Here is a great article that was posted to this facebook thread: http://www.the-hospitalist.org/hospitalist/article/126200/how-avoid-data-breaches-hipaa-violations-when-posting-patients-protected Your cardiac monitor identifier numbers related to number 18, and even if you get rid of the first 17, a resourceful person, albeit not very bloody likely, could connect the monitor identifier, patient identifier back to the patient and thus hit you with a Hipaa violation. Advice on this situation - BLACK OUT all identifiers in the top and the bottom of the EKG tracing when you post it to facebook for a case study or you post it here. The facebook thread I was on even said that many of the EKG review sites and case study sites have as a rule for posting that ALL identifying numbers and codes, names and any other numeric identifiers be removed prior to posting or the post will be deleted. It's a one in a million chance that someone will connect the dots, but do you want to be that 1 instead of the 999,999? I sure don't. Be safe out there.
  11. Earlier
  12. NREMT Written test Paramedic level

    Welcome. You're right. No sense worrying about it now. What's done is done. Wait and see what your score turns out to be. Let us know.
  13. Today I just took the NREMT paramedic level written test. It was very very very difficult. I know everyone says that it makes you feel like you failed no mater how good you did. I passed all the tests through paramedic school and feel that I adequately studied including 2 months of one of those online test prep sites. The test shut off way sooner then I was expecting which reading other forums could be a good thing or a bad thing. I called the NREMT to see the 2017 min number of questions to pass the test and the lady said between 80-150 and my test ended around mid to high 70 maybe 80 I was not really paying attention. I see other forums say that the ended in the 70's and passed but I dont know. I feel that the questions were either really easy or really hard. Every test I have taken in prep of the NREMT was had one or 2 key words that que you in on what is going on such as pin point chest pain or long flight with new onset SOB or some other word that you could say "hey this is a PE but a bunch of the questions had a set of vitals and what is the patient most likely having? It reminds me of those joke questions where they go "if you have 3 apples and 4 bananas, what color is the roof?" I felt like a good 60% of the questions were like this. I now have to wait through the weekend to find out how I did so no point on worrying.
  14. Upgraded Software

    Ok, my first club BIFP's Big Important Fluffy Paramedics Now get me some membership criteria. List em out here.
  15. Upgraded Software

    OMG, Calvin and Hobbes! My all time favorite comic stopped and I went into a six month funk. How about a Spaceman Spiff Club? This made my day! Spock
  16. Medical conditions causing crush syndrome

    Off Label has a great post. I really do believe that obese patients that fall and can't get up for an extended period of time will exhibit signs and symptoms of crush injury. How long does that take is unknown but I suspect it depends upon BMI and the amount of tissue compressed. I've had patients with crush injuries from traditional causes (building collapse) and medical causes and they are very challenging. Prehospital concerns are acidosis, hyperkalemia, low BP, and pain. A crushed extremity that does not hurt is a very bad sign and will result in amputation and possibly death. Saw far to much of that in Haiti. May the tube be with you. Spock
  17. Upgraded Software

    That's pretty funny, Mike. Well played.
  18. Upgraded Software

    LOL. I can add reaction icons. Do you have suggestions? I fixed a few of the things that made the site look odd, like margins, etc....
  19. Upgraded Software

    Clubs, OOOOOOOOOOOOOHHHHHHHHHHHH so you mean like the Calvin and Hobbes club GROSS (Get Rid of Slimy girlS) club??? Can I be the first to make one? Please please please.
  20. Upgraded Software

    I can check on the reaction Icons. I may be able to add more. There is a new area called clubs. Creates a separate area for those that want to set up their own groups and conversations. Not sure how it will be deployed yet. I can see it being used for those that want to talk about their department or service. I would be interested in your thoughts on it.
  21. Medical conditions causing crush syndrome

    sure, just call me Plain, it's easier to type.
  22. Medical conditions causing crush syndrome

    Not just the obese. I recall attending a pt, elderly, frail, and quite small that awkwardly fell and landed with most of one thigh basically under her squashed against the ground in what would have been quite an impressive accomplishment if she was doing yoga...unfortunately she wasn't and was found some 8-10 hours later with marked visible discolouration (of what could be seen) to said limb. She had multiple co-morbidities including renal failure. Anyways, we treated her as per crush injury though she ended up having a cardiac arrest after being moved. ps. can we start calling you Plain? And for the OP. there was quite a good topic some time ago on suspension trauma, if you have a chance its probably worth a look.
  23. Medical conditions causing crush syndrome

    This is perfect. I believe this is my exact form of thinking but put into words that I can digest and fully understand. Thanks so much! Hey Plain, You are right my friend I see not benefit it getting an "answer anyone can cut and paste but it doesn't help me to learn. Imagine showing upto treat a patient and being like huh? Where my cut and paste treatment haha. Stroke patient is definitely a candidate I think anyone that can be immobilized without help is something that is a potential candidate for crush syndrome. Thanks
  24. Upgraded Software

    Once I was logged in and then closed internet, I logged back in and had zero issues. Are there only 4 reaction icons?
  25. Upgraded Software

    No log in issues here.
  26. Medical conditions causing crush syndrome

    I've only had a crush injury patient in the truest sense, where the patient or the extremity has been crushed by a heavy weight such as a car or a large weight. Obese patients after thinking about the true etiology of a crush injury I do not believe would be able to cause enough force on the extremity to sustain a crush injury.
  27. Medical conditions causing crush syndrome

    You might be drifting into the tall weeds here. To break it down, "crush injury" for the purposes here is distinct from blunt trauma, although blunt trauma is obviously a major component in the crush syndrome. Crush syndrome or injury or whatever you want to call it is a constellation of problems that are superimposed on the blunt trauma problem, and, as your question suggests, does not require blunt trauma to set in motion. So....the problems we've identified so far... 1. Massive liberation of muscle protein, myoglobin, into the vascular space leading to renal damage/failure (rhabdomyolysis) 2. Sudden release of severe, blood flow restricting limb/pelvis compression after an extended period of entrapment. Accumulation of anaerobic metabolites and cellular release of potassium from cell death, (to say nothing of vascular injury and thrombus formation) is capable of causing sudden and catastrophic cardiovascular collapse via sudden and profound metabolic acidosis and hyperkalemia. How can these present through a medical mechanism? 1. Rhabdomyolysis can occur when a poorly conditioned athlete attempts an activity that is far out of his depth, ie a marathon. Hyperthermic emergencies, diabetic emergencies, drug reactions, certain infectious diseases can all have the same effect. 2. As far as this goes, a scenario will be instructive...Say a poorly conditioned alcoholic is on a binge one weekend and spends the weekend on the couch drinking and goes into a fib (maybe has a history of p-afib). He ignores it and continues to drink until Monday when he sobers up. As the week progresses he notices pallor pain in both legs which he ignores for a couple of days until the pain is unbearable. He's admitted to the hospital for pulseless lower extremities 2/2 embolization of thrombus most likely caused by is immobility and a fib. Several days of no flow to both legs from a clot does the same thing as a two ton concrete block on the pelvis. When the surgeon fishes out those clots and reperfuses the lower half of the body, that "acid wash" will occur and the consequences are the same as if he were extricated from a building collapse...get it? Obviously, the severity of the syndrome with vary with the situation. While these things can occur, most times the degree to which they present are not clinically significant and resolve on their own with no treatment except rest and fluids.
  28. Medical conditions causing crush syndrome

    The fact that you are still asking these awesome questions are going to get you props from all of us here brother. Shows that you want to learn and just don't want to get it spoon fed to you. I would definately put the obese patient down as a candidate, especially an extremity that gets caught under their weight after they fall and are unable to get up on their own. Depressed patients, I'm not so sure. What about the stroke patient who falls, lands on the affected extremity and is not found for 2-3 days or even 6-8 hours?
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