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  1. Yesterday
  2. 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.
  3. Last week
  4. 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.
  5. Earlier
  6. Upgraded Software

    Ok, my first club BIFP's Big Important Fluffy Paramedics Now get me some membership criteria. List em out here.
  7. 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
  8. National Registry EMT Lapse

    Yeah, I understood that point, I was involved in a facebook discussion, no lets say a heated discussion this morning over what I mistakenly should have left on facebook regarding what I wrote. I just don't get that how some people are so hell bent on getting so angry about being called an ambulance driver or how their job is more important when in the end, we all serve one group, the public. I couldn't get it through the thin skinned facebook group of people who I thought I was a so called valued member of that I finally just said screw it and removed myself from their drama but I made a cardinal mistake of bringing that baggage and crap from that group here. But I do stand by what I said here though. And you know what, to your point of who gets their first, as long as the patient or member of the public gets the help they need, does it matter who get's their first? does it matter if it's a shiny fire truck with a paramedic or an emt(well sometimes it does) or does it matter if it's an ambulance. Sometimes all that's needed is a splint and a bandage. sometimes it's a defibrillator. Sometimes you need 4 trucks and a ambulance. Sometimes you need 4 ambulances and 2 trucks. As long as we serve the public. For many fire departments that runs 10% structure fires and 75% EMS calls and the rest are PR and lift assists and assorted other calls, do you really need more fire trucks than ambulances? Seems out of balance but the public sees the big shiny trucks and says "wow look at that fire engine, the city really cares about us citizens ya know" Do a news search on Fire Union versus City of Grandview Missouri and read the crap the union is putting out about how many citizens are going to die if the city doesn't put a sales tax on the ballot this year. More of the same gloom and doom from the fire union "the city will burn, people will die and firefighters will perish if the citizens don't approve this sales tax"
  9. CHF & Low BP

    Low dose dopamine is notorious for causing tachycardia and it has been seen in higher doses also. CPAP can drop the BP because of the increased inter-thoracic pressure causing a drop in preload. Let's face it, this patient scenario is a nightmare for ANY health care provider and if you get your patient to the hospital or to the end of your shift with a pulse, then you did a great job. A puzzlement to be sure. May the tube be with you. Spock
  10. Paramedics: Clear! the game

    Yes, you do deserve it. You deserve it for a variety of reasons not the least of which is that if you had actually done the research you claim to have done you'd recognize how the quoted statement demonstrates that you have no idea what you're talking about. Take your attempts at free advertising elsewhere, please. That you specifically mentioned that the other place requires a minimum number of posts before you can post freely points to your attempt at as much free advertising as you can get. Admin has already intervened in this thread. If he's interested in you advertising he'll respond to your queries. Otherwise, please, just knock it off.
  11. Bumper riders

  12. Books Every Paramedic Student Should Read

    I would recommend "Anybody can intubate" if it is still in print. Good luck with school. Spock May the tube be with you.
  13. Pathophysiology of cyanide poisioning

    Thank you guys appreciate the information.
  14. N/V Scenario pics

    This is the CT image for the Nausea and vomiting scenario
  15. Barely failed PAT. Short girl:(

    That would help a lot, thank you. I was able to initially unload the gurney so it seems to be a problem with lifting for me hopefully I find a gym out here that suits my needs. Ideally I would like to go to a fire fighter academy type facility, like the great ape- but you have to be invited -.- I have not yet gotten a call with a date to retest. Once finals are done next week all of my energy is going into training. Thankfully the group I tested with (separately of course) were very supportive after seeing me complete the other tasks.

    Carfentanil, is BAD BAD BAD mojo. I'm surprised we aren't seeing more of these overdoses and deaths.
  17. Finally made it back...

    Thanks guys!
  18. Suggested Schools?

    Hey all thank you for your input. Paramedicmike, thank you for finding that list for me. I had been looking around for a while, but I was getting a plethora of answers regarding if they had those programs or not. So thank you for taking the time and helping me find that. At this point I'm thinking it would be worth it just to start fresh again. And just go for new certification, and if they tell me otherwise, that's great too. Just Plain Ruff, I appreciate your input. I believe that the accelerated program was more of an impulse than anything else for me. I saw the endgame in sight, and I took advantage. Didn't think to wonder that it could be more of a curse than a blessing. You both are right it is a profession and needs to be treated as such. Now that I know that it didn't work for me, I am going to try to dissuade anyone from doing so. Sure it may work for some people. But the fact of the matter is, people's lives are in your hands! Education needs to be taken seriously! If you had the choice between having an EMT who went to college or an EMT who took a 6 week course, I would hope that the patient would choose the student. I believe that it is programs like this that help students get the original information, but don't necessarily teach them how to retain it. It has been a year since I took the original class and I have lost so much. One can just imagine how an expedited EMT may feel if they don't practice a skill or keep that detailed terminology, and have it fall from their grasp in a critical moment. That one disease, condition, or symptom that your expedited teacher said you didn't have to know... might be the death of your patient. Please if any students are given the same opportunity that I was give to take an expedited class for a flat fee, DON'T DO IT! I would much rather take my time and spend more money on a college tuition to become who I want to be, than quickly become a medic and lose someone because I rushed through the course load that seemed insignificant at the time.
  19. City of Ottawa Firefighter

  20. confused

    No this forum is not for online classes or education. I'm not sure where you saw that there were online courses. If you saw the CME link that was a banner ad, then that link was just for online medical education for physicians and that was an advertisement. There has never been any online education provided by this site. I hope that this clears up your confusion.
  21. Midterm tomorrow and I still feel unprepared

    I was screwed in my situation BC only knew one school, then found out there is a city website with programs listed. The certifying body in Florida should have a website with course list and ph number. You Can call the dept to find out too. Also Google it.
  22. www.traillifeusa.com 

    Trail Life USA is a Christian Outdoor Adventure, Character, and Leadership Program for boys and young men.

    Operating from Troops that are chartered through churches in 48 states, the K-12 program centers on outdoor experiences that build a young man’s skills and allow him to grow on a personal level and as a role model and leader for his peers.

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    Ask me more


  23. Violyn, why go to an empty place when there's nothing there??
  24. new nyc emt

    Lot's of good info in this site from good people. Listen to the advice given it may save you a lot of heartache in the long run. We know that you probably only want 911 or emergency transport experience but that's very competetive (at least in Missouri it is, I would assume New York is as well) so look into getting experience in a non-emergency service as well. Listen, watch, ask questions, drive safely(you have not only your life in your hands but your partners, your patients an oftentimes at least one other family members in your hands as well). Learn your job and do it well before trying to learn the medics job. (many of my emt's never learned that aspect of their role). Know where everything is on your truck, down to the alcohol swabs. You never know when you are going to need to go get some for your partner. i know you asked about places to work, but this is good solid advice for a newbie.
  25. Question about cardiac arrest

    Teaching point What is lividity? Answer that question and you I think answer your question to this group. But no I would not have worked this patient either. Lividity to me, equals death. Lividity added to unwitnessed no estimated down time definately equals death. the dead person is no longer your patient. The family is. Walk them through what is going to go on from here on out. Prep them for when the coroner gets there and their loved one is prepped to be removed from the home. Ask if you can help them make phone calls if they need someone to be called like a family member or their pastor or Imam or whoever they want you to call for them. If the police are there, you more than likely can clear the scene and leave. there is no sense for you to remain on scene if you do not have to. go with the flow on what feels comfortable and right. there ARE NO right or wrong answers here after the family member has been called. Ped's opens a whole new dynamic and that dynamic sucks big donkey balls simply because it's a pediatric patient. Your emotion and the emotional quotient ramps up a thousand fold especially if you have a kid about the same age as the one who passed.
  26. Do mine Mike, Do mine!!!!
  27. New Here & Cert Question

    let us know what the answers you got were. That way others will benefit from your efforts.
  28. Afib RVR

    I would have been reluctant to give ASA & Nitro to this patient. I would have been more inclined to administer either Amiodarone, Cardizem or Lopressor.
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