AnthonyM83

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AnthonyM83 last won the day on December 6 2012

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About AnthonyM83

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    Perpetual EMS Student

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    Los Angeles, CA

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    Paramedic

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  1. Old folks Still here?

    Was cleaning out my mailbox and saw a notification for this thread... Good to see some familiar faces...
  2. Hello from Orange County, CA!

    Welcome from Los Angeles. The ambulance driver's cert takes like a day. Look up some study guides online. Then start applying right away!
  3. Croaker, I gotcha now. Yeah, definitely a trend away from GCS, from good reason... I do like the comment Busy made, though. When giving a report, either EMTs to arriving ALS, or ALS to arriving EMTs that are going to be helping us move them, it paints a better pictures saying, "He's like a 3-4-6" right now. After awhile, it gets pretty easy to use. Just gotta practice calculating it in your head without looking at the cheat sheet... it gets easier with time the more you use it in conversation. Gotta get that working knowledge experience and you won't have to guestimate.
  4. Various chemical imbalances.... ammonia, potassium, sodium, glucose, metabolic, etc. Drug poisoning / overdose. Hypoxia.
  5. Croaker could you support your claim that most agencies are going to the SMS system? I'm not refuting its value, just the claim. Also, there's been studies showing how inconsistent GCS scores are when done on the same patient by different providers. One reason might be the true exam has criteria we never hear about like patient crossing midline to localize pain. Question: what do people mean by taking the time to do a proper GCS assessment? You look at your patient, ask him a question, and ask for his arm for a BP or IV.... Or pain to see if any change. You end up doing that at least twice for all calls even if not thinking about it, no. Once at beginning and at least some other time along the way...?
  6. Wondering how many people here have had the chance to diagnose WPW with AFib in the field ... I can see this a bit difficult to catch... Though would be the time you'd really not want to use adenosine....
  7. Respirations

    But then his statement would be almost pointless, since you're never going to look at respiratory rates just by itself. Might as well throw out pulse quality. If you were to look at it just by itself, it's not very useful (some patients naturally have weak pulses...doesn't mean anything bad). But because the pulse quality by itself doesn't tell us much, we don't then imply that it's a useless sign.
  8. Respirations

    Uh, that's why assessment of respirations includes more than just rate and tidal volume. Rate, Rhythm/Pattern, Effort/Quality, and Depth, combined with history Similar to pulse Rate, Rhythm, Quality or skin Color, Temperature, Moisture, all having to be combined with history. I don't understand how respirations are so much different? (Respirations meaning an evaluation on the different qualities of respiration, not just rate or just depth etc)
  9. Ammonia levels

    I always wonder about those cardiac arrests with confirmed asystole that come back spontaneously without any interventions other than CPR. I imagine just like other dysrhythmias, asystole can be a transient one while there's hiccup in the system, then eventually self-corrects or compensates. Luckily this guy had someone doing compressions for him during that time.... On the same note, I wonder how many times an ALS crew arrived to cardiac arrest with EMTs doing CPR, then found a pulse upon reassessment, probably assuming that the EMTs had screwed up their pulse check...
  10. Experience with hydrocephalic patients?

    I've had a few patients with it. I think it was usually for altered or sick/fever/weak type symptoms. I wasn't lead on any of those calls, so I don't quite remember more info about it...
  11. To resuscitate or not (bus stop spin off)

    Quality of life cannot be judged by someone and then used to decide whether to make attempts at resuscitation...ESPECIALLY by some guy with less hours of training than a beauty school graduate (cosmologist). Each workup on someone who would not survive is training for when I run a code on someone who does have a good chance. Code saves don't define you as paramedics, but preserving life is a big thing for us. Most calls with critical patients, we don't know whether they're going to die or not. In a code, they already did die, so it's already "confirmed" so to speak that this patient is "critical". If that makes sense. Now don't go crazy and work up every single cardiac arrest, but if you've got something to work with, go with it. There's a difference between finding someone in asystole versus having a momentary asystole in the middle of a code with possible recent downtime with good CPR from your team (like in bus stop scenario). BUT either way, judgment on quality of life gets to be a choice the patient makes, not us, sorry.
  12. Drugs for agitated patients?

    LA County specific
  13. Drugs for agitated patients?

    It cannot be used for simple agitation, combativeness, or general chemical restraint. It is only to be used in the case of agitated delirium...which honestly I don't think we're trained thoroughly enough in. It's not just violent. It's not just altered. It's an unexplained delirious episode where the patient is working himself up physically....and at risk of sudden death. And we also use it seizures.
  14. Drugs for agitated patients?

    Los Angeles can use versed for agitated delirium. It's used pretty rarely, though. It's not meant simply for agitated or violent patients
  15. When to call ALS?

    A simplified answer: Call ALS on a trauma if there is a problem with ABCD's (and their ETA is closer than hospital). There are exceptions to this in both directions, I'm sure, but it's a starting point. For medicals, it can get a bit more complicated, since the patient could be stable, but still benefit from an assessment/intervention. Sometimes, counties provide a list of required ALS criteria