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  1. yep I am , hope you're family is growing and doing well!

  2. hey! i see you're still rocking it out as usual. i hope you're doing well:)

  3. OK I'm go to make the title obsolete and say yes it was as this patients LOC changes dramatically about 15 mins after arriving at the ED. She was sitting up and conversing normally with no memory of the event. Initial dispatch @ 1am: 39 yo female unresponsive by the river at 601.... yadda yadda (The potential causes were going crazy in my mind!) In reality PT is in a nice RV/mobile home thing in a vacation park in bed with her husband standing there. (Pucker factor went way down!) The PT is "shaking"... looks like shivering. No major movements of the body just tremors all over. Her ey
  4. This is my guess: increased intercranial pressure because of irregular breathing. Maybe this ? Encephalitis MD started treating with antibiotics and was doing a lumbar puncture when I left.
  5. Those are some good differentials but not exactly what the Doctors were thinking initially atleast with their assessment and treatments. I'll post what those were later. Remember seizure activity was never confirmed but can't be ruled out either.
  6. So this was not my patient. The PT came in by ambulance code 3 return while I was writing my PCR. I'm going to present it though as if you were on scene with the PT and were running the call as a 1:1 Paramedic without access to all the good stuff the hospital has (except medical control I guess but that's me so it wont get you too far!) Also I'm very busy this week so I will present the entire case and everyone can just give us their entire call/impression and I will come back and try to answer questions. Dispatch: 1 y/o Seizures General: 10 mins to local ED, pediatric hospital availabl
  7. Is there more information? I find it hard to believe some evil firefighters are going out of their way to pass a law so they are not part of an EMS system at all. There must be something else going on that is causing this side effect which definetely should not take place. No medical oversight is WRONG. I wouldn't want to practice on my own in a million years with just a paramedic license or EMT cert. It's nice knowing that as long as I use sound judgement and common sense while following what the Medical Director wants us to do we are generally safe from litigation etc. Out here firefig
  8. #1 With that BP did she have a radial pulse? Since you said they felt an irregular pulse I'm guessing they did find one. Whether she had one all along or she got excited and her heart went faster when everyone arrived who knows. If not this would be a much more serious case it sounds like EMS showed up and found an OK BP to go along with a normal LOC. With this kind of call all the answers you can get are in the initial assessment... LOC.. ABCs and skin signs... For me an elderly patient with a recent infection and a low BP is probably septic despite how hot their skin may or may not be.
  9. JEMS recently had a great article on Cardiocerebral Resuscitation. It was great for me at least because my county has already implemented a protocol around it that made little sense before reading the article. If you're wondering what CCR is it's basically CPR without ventilations early in the code. This practice is based on evidence that shows positive pressure ventilations actually decrease blood flow and the effectiveness of CPR. JEMS: Cardiocerebral Resuscitation Here is our sample protocol for initial resuscitation: Sample Protocol "passive insufflation" is an OPA with a N
  10. Had a pt with a temp of 106.9 this weekend (taken in the ED). He was ALOC, hypotensive and tachycardic. I used the AC, fluids and cold packs with no changes. At the ED they got a 2nd bag of NS, more cool packs fanned him and other similair things. Several hours later his temp was 96.X (they over shot!) I think rapid changes would be bad yet you can't leave someone at 106 for very long. Watching this patient makes me think it is a more delicate science than forcing a temperature quickly.
  11. I think a few people nailed what I was getting at... The comment about AMR striving to give each ambulance a call per hour will have a big impact here. The current company strives to meet a 9 min response time 98% of the time. The contract is being bid at 90% and AMR probably doesn't meet 98% anywhere. So there will be less shifts available and some full timers will either be forced into part-time bidding for random shifts or let go. The trick is our union is the same union AMR employees have. They HAVE to side with AMR. It really feels like our unions priorities are 1) AMR 2) our employ
  12. I know not everyone has an Iphone but many of the people I work with have one and I'm going to develop an app to make our lives easier when dealing with medications (and possibly more someday). I think most of us have the app "Epocrates" and it can be used among other things to look up a patients medication. My experience is that this app loads way too slowly and it takes too long to narrow down the medication and is even impossible to figure out what the medication does sometimes. It's mostly useless on a scene call. I want to create a medication lookup and management application for pa
  13. I just found out the same guy invented LLR position that named FACE sheets ... FACE sheets (what the hell does that stand for anyway?)
  14. Congrats being a new medic as well it's great to get the first few shifts under your belt and start having fun with things rather tha n try and impress a prceptor. So enjoy and try not to kill anyone! =)
  15. Seems like there may be a big difference between AMR's west and east divisions. It's nice to hear people kept their jobs. Where I am the current company is doing a very good job overall but AMR pays more so the employees are focused on that I think.
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