mrsbull

Thanks for the responses.

I am hoping that because I have already sent my prints in and not my pprwk yet that it will not take that long. I shall see. From what I have seen here in the springs is yes that AMR runs it here. I did my clinicals with them a while back when I did not pass the exam something like 5 yrs ago.

The FDs here in town are all paid and I think 2 volly/pd stations up north in black forest area. As well as out west in the wp area.

The cost of living is OK here. Not too bad but finding a place (I am currently looking for a new place to live) is hell. Craigslist is not helping any.

I have looked at ED jobs however they are taken pretty fast here. The only 2 hospitals that are even looking is memorial and penrose. Heck those are the only 2 here.

Spenac: I love it here. In the area I live paramedics are only working at AMR or in the ED or work for the FD. The paramedics here at amr are making 37-48k per yr BUT that is in denver. This was posted today. http://www.amr.net/Careers/Search-Jobs.aspx. That is IF you are interested in working with them. As far as I know amr is running colorado mostly.

I have been back home here in Colorado (Springs specifically) for about a year. I have sent my fingerprints into the FBI/CBI a few weeks ago. Today I will be sending in my pprwk to the state. I have a few questions and have seen more and more Colorado ppl on here lately so I am hoping someone will be able to help me in the right direction.

#1 If you transferred TO colo from another state how long did it take to get your info back from state?

#2 What are some decent companies to work for here? (I am willing to go as far north as Denver, south Pueblo, East Falcon, West Woodland park.

#3 What is the standard pay out here?

Thanks for any and all info you are able to provide.

From what I am seeing there are no jobs out here. Hopefully someone will have some more insight than I do.

First "Duh" moment something asked,said done etc. Or your first "Pucker" incident??

Just thought it might be a fun thread.

Mine was actually when I was in school. I was doing my clinicals it was near the end. Actually 5 mins to leave and an MI comes in. I asked if I could stay and observe. When the pt was given his meds and returned to stable condition. I "interviewed him" Sample and all that.

Doc walks in and said to the pt that he was going to the cath lab. I thought that would be cool to see. So I asked if I could observe. Mind you I had been "working" 12 hours but not much sleep before cause I was excited. I was told yes IF the pt was ok with it. I asked, he was.

So we went to the lab. Where I was told to gown up and put a vest on. There was a spare vest I was told to put on (It was a cardiologists vest) for the radiation. The tech in the Cath lab said to me if I have any questions to feel free to ask. I tell him ok. There was a student who walked in about 5 mins after I put the Docs vest on. The radiology student thought I was an MD. Said Hi Dr so and so. I had just asked what tools were used for what. The tech was nice until he started getting "obvious" on me. ie those are gloves, that is an ultrasound machine that is a syringe. He had started ticking me off I told him well "I have those figured out it isn't Brain Surgery After all" Boy did I get a look from the Cardiologist!!!

Let's hear them!!

Too funny. Thanks for sharing.

I know what he looks like. Not as scary as you would think.

Oh wow how this topic has given me cramps and bouts of irritability only my midol can handle, The nature of this discussion is one that can fly away or mabe with my new ultra absorbant tampons I just got I will wear a white outfit and go play tennis. I will let you know how long that works out.

WOO HOO what flavor is that?? White I hope!!!

HAPPY BIRTHDAY!! I hope it is a Great one!!!

Is there anyone in Lakeland florida that might be interested in showing me the town. I'm working at a local hospital down here. If anyone is interested in getting together for a drink or a quick bite to eat, drop me a line. ruffems@gmail.com

Lakeland!! What do you need to see. Dont blink or you will miss it!!! J/K If I was still there I would show ya..I lived in Clermont and Leesburg for a while.

I try to maintain professionalism as best I can, but there are times that I am left going what snapped in your head? At a prior job I worked at (at this is public knowledge so I can safely post it) the partner I worked with one evening seemed a little off, but then again he was one of those people who always seemed a bit "off". I was scheduled to work with him the following evening, and while I was working two jobs, went on to a shift in another county considerably farther away. THat night when I came in, I was pissed because my partner was missing and assumed he walked off the job (a frequent occurance there unfortunately due to poor management and miserable pay). I started asking around and discovered he had killed his child the night before shortly after getting off work by strangling him with a thick rope chain (no not a ghetto chain - like a solid necklace) and killing the kid because he was "tired" of him. I couldn't process it then, and I certainly can't even now almost 10 years later. It's something I'll never forget. Sometimes you can't always read what people will do and there wasn't an individual thing that made him snap like most people say "the kid wouldn't stop crying" he simply said - I was tired of him...scary thought. THat is definitely someone that should not be allowed to further have children. We allow people with charges of animal cruelty to never have children again, but few have laws preventing those with child abuse to prevent them from having children. We have a problem, that we must address. THis can't keep happening, it's not fair to the children.

Wow that is something that had go to be hard to deal with. I get tired of my daughter whining,telling me she dosent want to go to bed, do her homework but I would NEVER hurt her. She is the one who keeps me laughing and keeps me going when I feel I cant anymore not the other way around. Makes me want to go hug my kiddo..

Thread title changed to reflect content. "What would you do" is a specifically prohibited thread title in the rules.

I don't handle them any different than any other run, and they don't bother me in the least. If they bother you, you should leave the profession, because there is no way to change that.

Oh alright Dust I suppose if you need to change the title then go ahead!

Personally I think bothering someone and letting it get to you are 2 different things. Absolutely things bother me I don't think "I" would be OK mentally if they didn't. But do I let it get to me to where I can't do my job? No. If it did then hell yea I would find a different job where I did not "see" it.

I understand where you are coming from but to be completely void of ANY emotion is something that personally I am not capable of. As a mother I suppose. Even if I had no kids I would still be bothered. Like I said if it gets to you and you can not differentiate your feelings or emotions and separate that from your job specially if you take it "home with you" then find another profession perhaps in social work.

But it does not mean it is not out there.

Annie I completely agree in Documentation!! It is the thing that will help the most. Not your "Personal Recollection" Even if/when that particular call stays in your head forever.

How have these cases affected you personally?

You maintain your professionalism at all times.

We deal with this in the Peds ICU unfortunately too often. Until the "parents" are charged, convicted and put behind bars, you will have to exercise your own restraint by focusing on the child and maintaining your composure around the "grown-ups" even if you know in your heart they are guilty. If you allow yourself to be sucked down to their level, you may give grounds for a lesser charge or even a dismissal on some technicality as well as putting yourself into the spotlight and subject to an investigation. Thus, put the child first and allow the justice system a chance to do its job. Or, give the inmates at the jail or prison an opportunity to show their "love" for child abusers.

I agree maintaining professionalism is key. When I was doing my ED rotation during school a few years ago. I went to help a nurse triage 4 kids ages 3 or 4 - about 13. They were all drunk. No one knew where mom was and the kids looked like they belonged in the movie "Annie". The younger ones were found wondering the streets at 1 am. I think the oldest girl about 12 was sleeping with moms BF at the time. I was able to do my job with the children. The ED was busy that night so I was the one who sat with the kids while PD was there questioning them.

I think eventually they found mom.

However I will NEVER forget that. I did my job. Sometimes tho the legal system is not very good about holding ppl accountable. I just hope the ppl in the penal system read up on abusers and are "waiting" on them.

Sometimes I am glad we do not know the "outcome" but it would be nice to know the kids are ok. The ones who survive anyways.

This thread will be one that I am sure many will not post on, however it is a topic that as EMS we see. Hopefully not often but it is out there. Being a mother I have found this site a bit hard to deal with. This topic is about Child Abuse. I have recently found this website that tells stories (with articles to back them up) of the horrors children go thru.

My question is If you have had to deal with care for one (or more) of these types of things. How did you do it? Hopefully you were able to do your job and the child is well off. However I can understand it being hard to complete a task when emotions run so highly. This is the website. http://badbreeders.net/

There are some children who did not make it. Some who lived in Squalor, some who were so abused they will not ever have a normal life. What is your thoughts on this?? How do you cope?

Here is just one article that is inside this website. THIS WAS POSTED ON APRIL 4th.

ABUSE DEATH IN NEWTON KANSAS:

Here is the article http://www.kansas.com/2010/03/31/1249145/mother-of-newton-toddler-who-died.html?storylink=fbuser

Mother of Newton toddler who died is charged:

20-year-old Katheryn Nycole Dale and her 26-year-old penis, Chad Carr, have been arrested in Newton, KS for the abuse death of her son, 19-month-old Vincent Hill.

Among them were “terrible cuts” on the inside of the boy’s mouth, fingernails that had been ripped out, a leg that was twisted in an unnatural position, a fractured collar bone, and an eye swollen shut, Yoder said. Evidence shows that the injuries “didn’t just start recently,” he said.

To make matters worse the egg donor and the penis had only been together for 4 months. How does one go into this form of abuse in a span of four months. Or were they both child abusers before that?

Thanks to Cara for the tip.

I am on his FB. I know how to post it if I have permission!!

LMAO a rash on the bridge of her nose. Apparently it was not a short term "allergy".

Ok blonde moment does she mean her upper lip (from canula)?? No pun intended. (although it would have opened a few doors) ok it likely just did...

I am not sure. What do you consider an "allergic reaction?" I go by the literal definition relating to an immune response involving immunoglobulin E (IgE) mediation of mast cell and basophil activation among other mechanisms as the proper way to define an allergy (when considering anaphylaxis). Most everything else will fall under the umbrella of an adverse reaction.

From evidence I have seen, postoperative complications including puritis, nausea/vomiting, and urinary retention in patients on PCA were significantly higher in morphine groups compared to fentanyl groups. Therefore, I could say with some confidence that the incidence of adverse reactions may be lower overall in patients who receive fentanyl.

Take care,

chbare.

I did not clarify "sorry I thought I had". I put a reaction (sensitivity/adverse) to the drug instead of an allergy. Personally when I refer to an "allergy" I think shut down time anaphalaxis a TRUE med emergency. Not a ohh I am sensitive to something.

I hear a lot of pts when doing my SAMPLE in my A part, what is the reaction that xyz does to you. If you say itching well that sounds (to me) like a sensitivity. My DD is allergic to Rocephin. It is not pretty. Now if a pt says I am allergic to penacillin and your reaction is you stop breathing then OK fair nuff that will HAVE to be relayed to the intake facility.

Does anyone put a sensitivity to a drug on a pcr or only TRUE allergies??

Somebody can give you greater info than I can, but here is my 2c

Morphine and fentanyl are both opiods; however fentanyl is an outright synehetic opiod which is manmade; morphine may very well be able to be synthesised but it can also be made from opium. Good to know. Thanks!!

Fentanyl requires much smaller doses in mcg (micrograms) whereas morphine is talk about in mg or milligrans so fentanyl is said to be roughly 10x as powerful ss morphine.

Pareternal analgesia (IV/IM morphhine or IV/IN fent in this case) is given here for moderate to severe pain that is not controlled by entonox.

Please forgive me as I have several questions about this drug at this time. Feel free not to answer all of these as I am sure they will get quite time consuming for anyone who has knowledge on this.

I did a search on Entonox because I have never heard of it: It appears that it is inhaled?? Also the short duration appears that it had a quick effect. The article I am referring to was for a Childrens hospital. Looks like it is primarily used for "procedural procedures" ie sutures, wound cleaning and the like. The article as stated here http://painsourcebook.ca/docs/pps24b.html says that is is inhaled and self administered. (going to look up adult protocol in a bit). The inhaled method of administration is a new concept to me to be quite honest. I have seen fentanyl suckers (looks like a big q-tip.) Iv, im and oral pain relievers however never heard of inhaled pain relievers. Is this given like an inhaler or like a neb? I have also seen another "route" nasally however that was the flu shot,as well as administration rectally such as phenergan and tylenol. It is uncommon if not even used in the pre hospital scene. I know there is something else given nasally in the pre hosp care scene but I don't recall what it is. (Also please bear with me I am not working active in ems at this time because of some medical problems that requite surgery next week and it has been a while since on a rig.) OK I am looking up Entonox it is becoming difficult on this search engine that I am using. I am mostly seeing peds usage and ophthalmology uses. I have found this however "" ENTONOX nitrous oxide/oxygen mixture is used for analgesia during treatment or in the prevention of short term acute pain, where rapid onset and offset is needed."" http://www.entonox.co.uk/en/entonox_in_medical_therapy/condition/pain_analgesia/index.shtml How would you determine the need for this? Would you use it to relocate a dislocated extremity? Also it appears that a contraindication is noted when the pt is unable to inhale. Is this inhalation the ONLY route this drug is taken? Is this Drug used in the United States in pre hops care? I think that is all the questions on Entinox at this point. Thanks for staying with me if you have made it this far.

You might start out with some nox and then move onto IV morphine or just go straight to IV morphine. As an example if I have a guy with a broken leg he might do swimmingly on some nox but if his leg is totally shattered with an open # and he is in severe pain I would start off with morphine and go from there.

Cardiac chest pain and acute severe pulmonary edema are also candidates although for these conditions the use of IV analgesia is not really an effective treatment but it is good at reducing anxiety and pain.

Here we can use combination analgesia with morphine and midazolam or ketamine.

We are looking at removing morphine and replacing it with fentanyl. Paramedics have morphine and Intensive Care Paramedics have morphine, midazolam and ketamine.

I was searching some drugs reactions and OD type things. I found this website that seems to be quite informative http://www.thegooddrugsguide.com/drug-guides/index.htm

Fentanyl is not associated with histamine release unlike morphine. Therefore, fentanyl is less likely to cause hemodynamic changes and may be better tolerated by people with compromised hemodynamics such as trauma patients.

Take care,

chbare.

I got the histamine part. Thanks!! This is good to know since I have seen histamine effects of morphine. Not horrible but itching and mild hives. A dose of say benadryl is appropriate for this type of reaction, I would say.

What I am reading is an allergic reaction to Morphine is more likely than an allergic reaction to Fentanyl. Am I under the correct assumption?

I was just reading up on the Fentanyl/Morphine post. Without bringing it back to light. I have a few questions.

I am an NREMT-B so please bear with me. I know fentanyl is a quicker acting pn med. Morphine is a longer acting drug.

What other than what I have just stated above is different about them?

Why would you give someone one or the other??

What would your Criteria be? ie b/p, resp rate, MOI/NOI

Is it a personal choice or is it a Med Dir thing?

Also what is the difference between the 2 mentioned above and Demerol?

I ask because these are the most commonly talked about narcs available to EMS personnel? This is not related to any study I am doing just personal knowledge. Thanks for taking the time to respond. I hope I have asked these questions in a manner that is easy to understand. It is late here and I am getting sleepy.

That Succinlycholine is a potent drug that may cause respiratory depression. I do know of a nurse who was told to give the medicine to facilitate intubation and she gave it in the X-ray department of the hospital and then went to get the intubation supplies from the ER. (NEW NURSE happened over 15 years ago) She got the intubation supplies but by the time she got back, the patient was Dead.

So did she keep her job?? Never know!! Some ppl will keep it.

And how many women will go THAT far??

Well, when your entire community is practically an assisted living facility I would expect it to be much more of an issue. Though perhaps you're right, it's possible that my experience is unique to my area, though although this population is small, it has a significant geriatric population percentage wise.

Wouldn't change my argument however. I'm simply unwilling to remove the rights of those that sacrificed to secure them in the first place. This requires a better solution...

Dwayne

(And you have to admit, "poke the Yetti" has kind of a cool ring to it!)

Dwayne, I suppose mostly you get to worry bout is not picking up hitchhikers in Canon City huh??? .

Take it easy on her, she's got time on her hands as she's recuperating at home from illness, and probably might resurrect numerous old strings.

I will do it!! I have so much time!! I have surgery next week so the "posts" I might bring up will not be because I feel like it it will be cause I feel GRRREAT!! or miserable... Either way ill have fun.

I GIVE UP!!! You win!!!! A 5 year resurrection...you are the Queen of saves!!!! :)

What you have already forgotten this??? Cmon you are smarter than that!!

Well I had to make this blog private (my ex was being nosy). If anyone would like to read it please PM me with your e mail addy and I will have to add you. Sorry about the inconvience.

I hope everyone is doing well.

Personally Elderly and Teenagers scare the hell out of me driving. However, the norm is yearly vision tests. I would think that when someone visits an optometrist the Doctor should have the right to say yes or no to driving. (Not the eye Dr ONLY however) The eye Dr should have the authority to send any recommendations to the DMV in the area and request (they can't demand of course) that the patient have a current prescription and WEAR the contacts or eyeglasses. It can be as simple as a form or as complex as examination by an optometrist FOR the dmv. The DMV/Eye Dr is unlikely to happen tho.

If this is not done by the pt yearly then the DMV can suspend or revoke a license. It would be a simple check yes or no type box and turned into the DMV. The Optometrist is not the only one who should be able to do this.

A pt who has the onset of dementia, slower reaction times due to medication, an uncontrolled seizure disorder and any conditioned deemed unsafe and uncontrolled that can put someone else in danger (as well as the person with the "condition") should also have a form to fill out and fax to the DMV. Filled out and signed approved or Denied from the pts primary Dr. I personally believe this SHOULD be the responsibility of the Dr as well as the pt.

Hi guys. It has been a while since I have posted. I have been going thru some medical problems. Pancreas problems really. If you care to read up on them feel free to do so. http://traumachic.blogspot.com/ Make sure you read the older ones first because it will not make sense unless you do. If anyone has gone thru this or wants to comment please do so here. For some reason no one is able to comment on the blog directly.