All Topics http://www.emtcity.com/index.php Fri, 03 Sep 2010 22:43:10 +0000 15 http://www.emtcity.com/style_images/3_3_emt-logo-whitenewa.png http://www.emtcity.com/index.php http://www.emtcity.com/index.php/topic/18876-new-zealand-earthquake/ Just heard that there was an earthquake in NZ. You guys from there or OZ OK? Fri, 03 Sep 2010 22:43:10 +0000 http://www.emtcity.com/index.php/topic/18876-new-zealand-earthquake/ http://www.emtcity.com/index.php/topic/18875-stroke-resources-and-certification-for-healthcare-professionals/
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Crystal (HES)]]> Fri, 03 Sep 2010 19:21:36 +0000 http://www.emtcity.com/index.php/topic/18875-stroke-resources-and-certification-for-healthcare-professionals/ http://www.emtcity.com/index.php/topic/18874-i-feel-stupid/
I feel very embarrassed about bringing this up. I am trying to get a job with AMR for the new NH contract. I am having such a difficult time trying to pass the 12 lead exam. What really sucks is I studied very hard for all the exams, and only passed one and the practical. Well, just for the time being since my last service was nice enough to give me an unvoluntary leave of absence, I am desperate for a job. Everytime I've gone in for an interview and tested, I am not doing well. I have been in EMS for almost 17 years. The last 10 which were not exactly pleasant as a medic. Never really did have a great mentor when I reached my medic level. Well if anyone has some sympathy in your heart to help me out that would be great. Then I won't have to be one of those people you complain about who is actually talented in this field and you're paying for my unemployment benefits.

I don't know what I am doing wrong and if anyone can help me out....It would be greatly appreciated.

Thanks.
Kim]]> Fri, 03 Sep 2010 15:40:19 +0000 http://www.emtcity.com/index.php/topic/18874-i-feel-stupid/ http://www.emtcity.com/index.php/topic/18873-interview/ Hey guys, I'm taking a health science class at my high school and i was just wondering if there was someone out there who is a certified emt or paramedic and would be willing to answer a few interview questions for me through email.
if so, my email is sam-the-bear@hotmail.com

Thanks! ]]> Thu, 02 Sep 2010 23:51:43 +0000 http://www.emtcity.com/index.php/topic/18873-interview/ http://www.emtcity.com/index.php/topic/18872-interview/ if so, my email is sam-the-bear@hotmail.com

Thanks!]]> Thu, 02 Sep 2010 23:37:38 +0000 http://www.emtcity.com/index.php/topic/18872-interview/ http://www.emtcity.com/index.php/topic/18871-gsw-vs-pentrating-chest-wound/
I have a scenario i would like to run past you.

You arrive on scene to find 2 patients.

1 x GSW abdo, no exit wound. Patient is approx 35 years old, weighs roughly 79KG's (sorry not sure how many pounds that is) BP 126/75, RR 25, GCS 12, HGT 4.2 (glucose) , Pulse 78. Slightly diaphoretic.

1 x Penetrating chest wound, stabbed with a 5 inch serrated blade at the second IC space, Mid clavicular line on the left side of his chest. Patient approx 35 years old, weight 79kg's, BP 115/72, RR 32, GCS 12, HGT 4.2, Pulse 89, you notice slight diaphoresis and what could possibly be jugular venous distension. Air entry seems = on both sides as does chest expansion.

Edit: Your ECG and pulse ox are not operational.

Your in an ALS response car and are met at the scene by 2 x BLS in an ambulance. You can only take one patient. Which one would get higher priority and get attention first and what would your treatment be? Your in South Africa where you are registered and considered an indepedant practitioner (in other words there is no such thing as calling medical control and it's your decision in the end)]]> Wed, 01 Sep 2010 09:09:25 +0000 http://www.emtcity.com/index.php/topic/18871-gsw-vs-pentrating-chest-wound/ http://www.emtcity.com/index.php/topic/18870-what-would-you-do/
You have an elderly patient who is 97yo, her b/p is 107/84, RR 23, pulse is 182. (Pulse stays between 180 - 190).
She is A&Ox2. Her GCS is 14 (4/4/6) and she doesn't express that she is in any pain. ECG show SVT. She has an active OOH DNR.

Attempting to do vagal maneuvers is difficult - so you decide to give adenosine as per your protocols.

The adenosine puts her in to cardiac arrest. Do you honor the DNR or do you begin resuscitative measures since you, technically, caused the cardiac arrest?

Again...this is hypothetical. I'm just curious as to what you'd do?]]> Wed, 01 Sep 2010 02:29:46 +0000 http://www.emtcity.com/index.php/topic/18870-what-would-you-do/ http://www.emtcity.com/index.php/topic/18869-reclassing-to-68w/ Wed, 01 Sep 2010 01:46:25 +0000 http://www.emtcity.com/index.php/topic/18869-reclassing-to-68w/ http://www.emtcity.com/index.php/topic/18868-hypothermia-cardiac-arrest-use-of-d50/ When dealing with a patient in cardiac arrest the textbook says not to administer any drugs until you have warmed the patient to at least 86ºF, the point came up that if one of the reasons the body is not thermorgulating is due to lack of glucose should you not give that patient D50 in addition to CPR and warming the patient in an attempt to improve their outcome. What are everybody's thoughts?]]> Tue, 31 Aug 2010 22:10:23 +0000 http://www.emtcity.com/index.php/topic/18868-hypothermia-cardiac-arrest-use-of-d50/ http://www.emtcity.com/index.php/topic/18867-i-need-help/ Tue, 31 Aug 2010 19:35:41 +0000 http://www.emtcity.com/index.php/topic/18867-i-need-help/ http://www.emtcity.com/index.php/topic/18866-new-emt-student/
Mike]]> Tue, 31 Aug 2010 19:19:08 +0000 http://www.emtcity.com/index.php/topic/18866-new-emt-student/ http://www.emtcity.com/index.php/topic/18865-wake-county-ems/
I am looking for a little information on Wake County EMS from the employee prespective.

1. What can a first year paramedic expect to make their first year?

2. Is overtime avaliable?

3. What are the benefits like?

4. How is the retirement?

5. What is the call volume like?

6. Are you assigned to a base or do you rotate?

7. Is the turnover high?

8. How is the equipment?

Thanks,

Ben]]> Tue, 31 Aug 2010 17:26:35 +0000 http://www.emtcity.com/index.php/topic/18865-wake-county-ems/ http://www.emtcity.com/index.php/topic/18864-new-emt-finishing-up-clinical-work/
Im 24 and just moved to the great state of texas and started my course for my EMT-B at TEEX. I have finished all of my non-Truck Clinical hours and this week i start and finish my 48 required hours on the truck. Im excited to be here and excited to get started in this career field. I got my 4 year degree in Public Health Admin and the job field has been very close to non-existant. I've always felt that I would like more to be on the clinical side of things first and maybe do Admin stuff when i'm older. The hope is that the two will connect at some point and I hadn't wasted 4 years of life. Anyways, nice to meet yall, and any advice for my truck hours is greatly appreciated.

-Andrew]]> Tue, 31 Aug 2010 14:41:14 +0000 http://www.emtcity.com/index.php/topic/18864-new-emt-finishing-up-clinical-work/ http://www.emtcity.com/index.php/topic/18863-looking-for-new-emts-in-florida/ Tue, 31 Aug 2010 01:26:45 +0000 http://www.emtcity.com/index.php/topic/18863-looking-for-new-emts-in-florida/ http://www.emtcity.com/index.php/topic/18862-treatment-of-high-2-heart-block-and-3-heart-block/ In paramedic school and reviewing from cardiology that ended a few weeks back, If you are dealing with a bradycardic 2º type II or 3º AV block that requires treatment (poor perfusion, ALOC, etc...) do you attempt to use atropine first are are you reaching for the pacer off the bat? Reason I ask is in a study group we found mixed things in articles online and even in our textbook. My view is that high degree 2º and 3º AV block are past the point that the atropine is going to work, yet some articles are saying to still attempt 1mg IVP (for adults) prior to attempting to pace the patient. What to get some other student views and those who are working on the streets. Tue, 31 Aug 2010 00:18:40 +0000 http://www.emtcity.com/index.php/topic/18862-treatment-of-high-2-heart-block-and-3-heart-block/ http://www.emtcity.com/index.php/topic/18861-my-travel-day/
My travel day started at 0300

Got to the airport - so far so good

First flight takes off without problems until we land. ON landing we hear this big boom and then the left side of the plan starts to shimmy and vibrate. I immediately think, Tire blow out. We have arrived at Dallas Love Field.

WE get to the gate and I'm scheduled to take the same plane to Houston. The captain says "sorry folks, we can usually take off with one tire out but not with two." in a joking manner. We are delayed 40 minutes to get the two tires replaced.

We get the tires replaced and head on in to Houston. No problems there.

Get off the plane, wait for the next plane and board it. I am sitting in the row behind the exit row. Exit row only has 1 person in it.

The plane pushes back away from the gate. We get 500 feet away and the rain comes. Downpour that caused all traffic to stop and wait the storm out.

So the lady sitting in the window seat takes out a set of nail clippers and then takes her shoes off and begins to clip her toe nails. After the 1st nail lands on my lap I ask her to stop. She continues. The 2nd one lands in my book that I'm reading. I took it and put it on her lap. She got pissed, called the stewardess and made a complaint.

I told her she was F*(*&&ing nuts and moved. The flight attendant told her that she needed to put her nail clippers away. The lady complied but only reluctantly.

What the hell is with the flying public. Are they all going nuts.

Every flight I'm on has rude passengers, people who cut in line when they should be behind me or others. Others who drink so much that they can barely walk when they get off the plane. Others who don't listen to the flight attendants. Others who get up to go to the bathroom when we are landing and get pissed when the flight attendants tell them to get back to their seats.

I fly because I have to for work, if I didn't have to I'd chuck it all.

I just had to vent. I got into my destination 2 hours late and the car company had closed my reservation. I then have to re-set the rental and they ran my credit card a 2nd time so I have no money tonight until I get paid to eat anything other than what my hotel has at their food area.

What a great day!!!!!!!]]> Mon, 30 Aug 2010 23:18:06 +0000 http://www.emtcity.com/index.php/topic/18861-my-travel-day/ http://www.emtcity.com/index.php/topic/18858-how-did-you-like-doing-inter-facility-transports/
]]> Sat, 28 Aug 2010 14:42:57 +0000 http://www.emtcity.com/index.php/topic/18858-how-did-you-like-doing-inter-facility-transports/ http://www.emtcity.com/index.php/topic/18857-emt-i-or-emt-p/
]]> Sat, 28 Aug 2010 14:39:28 +0000 http://www.emtcity.com/index.php/topic/18857-emt-i-or-emt-p/ http://www.emtcity.com/index.php/topic/18856-weird-but-true/
I hope this the right section.

I thought that this may be a good area to present unique cases for all the members of the form to learn from.

CASE:

A 52 year-old male was riding a motor bike accross North America. Traffic ahead was breaking and he was caught by surprise. He applied the breakes and the bike torqued to the side and threw the drive in to on coming traffic. He slid along the ground and was clipped by a small car a tossed in to the ditch.

EMS arrive shortly. He was lucid (GCS 15)with no deficits (strong x 4). He c/o right sided chest pain (# ribs) and left arm pain (humerus #). His VS were:

HR 80
EKG - NSR
BP 70/28
Resp 20
SpO2 99%

EMS called a trauma alert and insert IV x2, gave 1L NS, and Morphine and Gravol IV.

Upon arrival to the ED a full trauma work up was done (FAST, CT, XRAY). No source of bleeding was noted. However, despite this the patient remained hypotensive despite fluid challenges. In fact, a central line was inserted. CVP was noted to be quite low (3) and Levophed and more fluid were administered.

This fellow was Dx with SIRS. The violent impact had set off a septic-like immune/inflamatory response that caused the low blood pressure. He was weaned of Levophed and was transfer to the ward and was discharge shortly after with a surgical of his fractured arm.

It was very wierd to have the patient so profoundly hypotensive without any major injuries....

Cheers]]> Sat, 28 Aug 2010 06:47:27 +0000 http://www.emtcity.com/index.php/topic/18856-weird-but-true/ http://www.emtcity.com/index.php/topic/18855-potentially-facing-arthroscopy/
I spoke to the orthopedist that has been treating me since they found out that my right wrist was broken in 3 places (transecting fracture to the radial styloid, oblique fracture to the distal radius and and avulsed fracture to the ulna), and after steroid injections to the wrist didn't provide the intended results for the intended time, they're now talking about possibly doing arthroscopy on the wrist.

I understand the concept of what they're proposing to do... a small incision and the insertion of a small camera and light to 'look around'.

The concern I'm having is this:

The last time I went in for a 'day procedure'...I ended up in ICU for 3 days with respiratory failure because when they removed the LMA they used, I ended up aspirating because the airway wasn't protected. I REALLY don't want to go through that again!

Has anyone gone through this procedure? What can I expect (besides having another 'owie' to heal?]]> Sat, 28 Aug 2010 04:47:25 +0000 http://www.emtcity.com/index.php/topic/18855-potentially-facing-arthroscopy/