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BurnNurse

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  • Location
    Long Island, NY
  • Interests
    Golf, My Kids, My wife not in that order

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  1. Ok burns are an evolving injury, what you see in the field may not be the whole extent of the injury. First is to stop the burning process. every one is good with that. Don't get yourself crazy over the sterility of your dressings and what the patient will be on in the field. nothing is sterile in the field and darn few things are in the ED. the thing that kills burn patients in the beginning is one of three things Hypothermia (skin regulates body temp) that leads to metabolic miscues (acidosis, hyperdynamic state) Fluid loss Parkland and other fluid replacement formulas are fine . IV access through anything you can get . Fluids started in the field get a head start on the damage done. if an ED nurse gives you trouble for this they are wrong (being an expericed Burn and ED nurse I can say it) Infection is not the immediate problem for prehospital providers. Be aware of it and do what you can to prevent it but don't get crazy. Transport if possible to a burn center, that will give the patient the best chance of survival. Oh and the last thing that kills burn patients in the beginning is hidden injuries. be proactive and don't get distracted by the burn, do a good head to toe. To deal with burns better the american burn association has advanced burn lifesupport. if you get a chance take the course. get your local burn center to do some teaching, thats what they are there for. Rob EMTP/RN ect..........................
  2. OK on the streets we used the drugs sparingly because it was a PIA to get it from telem... also was a big issue in the system i was working in , under investigation for excessive use by crews and ect... while others were stealing it from the lockers at the station.... as for the use now. I think it should be used with good clinical judgment. as far as a doc not believing in it.. the go work renal or the clinic you don't belong in an ER, talking to professionals who are caring for people outside the hospital. I work in a place where morphine/ fentanyl and pain control meds flow like water. Doses that are very high... yet no one walks out a junkie and no one dies from an over dose. Hmmm, Pain management is just as important as other treatment modalities that we use, and should be used by pre-hospital as well as in hospital providers.
  3. Check with you local fire department or volly ambulance corps. They can always use the help and will get your training for free as far as paid ems jobs , it is mostly ALS first responders and House men in the 9-1-1 sector , scattered through out both counties. Private Ambulance companies as mentioned before, not a bad place to get paid while your new and learn from some of the senior staff, but if you want experiance , then NYC is the place to work, either for FDNY or one of the Private hospitals or providors in the 911 system . Also find out from you county suffolk is www.suffolkremsco.com or http://www.co.suffolk.ny.us/webtemp1.cfm?dept=5&id=147,
  4. The Two medic system was in place as on site medical control believe it or not, it has to do with the way the controlled substances were distributed back when dirt was new, The two medic system worked because there was very few medic units and the idea was to have both medics in the back with the patient while the emts drove the buses, we also had PRU's but not enough transporting BLS units to back them up. The system has gone through many changes but keeps coming back to the beginning, As far as doubling the ALS capability, you still need two medics in a cardiac arrest and I would like it if i had a little bedside back up when the poo-poo hits the rotary oscillator, I have worked in a fly car system and a one medic one emt system , and the two medic system , I like them all for various reasons. BUT NYC may benefit from a combination of the two and maybe a return of the PRU ( Paramedic Response Unit.) The other thing is FDNY still as far as i know has paramedic interns or Jr. Medics , who can not be on there own until they complete 960 hrs with a senior medic ...similar to FTO. at least we were trying to get that title back then, don't know what happened ....
  5. I feel both are good traits in a medic and both have advantages, As far as college goes it is a reality that until all paramedic hold at least an Associates degree that the profession will limit it's self, nursing is going through a similar debate, whether all Rn's have to have a BSN...I think yes ... education leads to greater professionalism and less old cowboy stuff, the days of cowboy medics are done let us tell the stories and move on , the profession as a whole will be better with an educational background instead of the quagmire we have today
  6. to all you out there be safe , Greetings from the BurnCenter
  7. I love stress, gives me an excuse to play bad golf, play with my kids , play in the pool, play pool ( like 9 ball) , Play in the ocean, play on my kayak , play with my wife ( what we play is none of your business but its usually strip Parcheesi if you must know) , play , and play and i go camping, collect FD and EMS stuff, pretend I am a teacher sometimes and try to spread my knowledge and wisdom ( actually relives a lot of stress for me I don't know why) Oh yes and there is the occasion a beverage of the adult type :twisted: and I don't smoke anymore. Just go out for giggles and grins , to an Ice cream shop or an exotic beer store, and lately have been writting stuff. so there it is.....
  8. I had a few that night.... Taste good ,not good for spelling
  9. AAGGGGGGGGGGGG... my favorite least favorite was " Turn the page" Or you ever said.." City wide i think your going to handle this one" You know Kenny from the Bronx even knew when he said " alderten" he ment Allerton... or that if he had a job down south that ment you were going to 138 and St. Annes.... Usualy very quickly.... You know how to stealth buff... You know a 3 fingered captain.... You never wore the orange rain coat, but the green vest liner was an every day wear (for the pockets) even in August. You stood on line at a phone in a bar to talk to the sick desk.. heard a boss say"The MOS in question will not be with us tonight"
  10. In my fridge no some Yinglang(sp) Porter and some Coronas and a few limes, some Chinese food ... but no Kwell
  11. Well actualy no injury but bullet holes in vehicle, taking cover with a patient inside building while gun fight in the courtyard. These things did and do happen , Have i been shot no, have i been shot at? Yes and never by a jelious husband or boyfriend. The Marcy houses in Brooklyn NY is a place where gun fire erupted regularly, dose it anymore ... that i don't know. As far as the new years gun fire .. that still happens.. i worked the ER as a nurse last new years and yes gunfire still happens and peole still get shot in urban areas... is it safer now then in the 80's and 90's. I think so and NYC is a great place to visit crime is down and we have fun things to do... give a call or an e mail and will gladdly show you around. will cost you a cup or two of coffee. Cram no sugar dark. Be well all
  12. I talk about the good days and bad days(in my case nights) with my best friend , who i happen to be married to. I have had beer crying as an Olympic event, i have drank enough Jim Beam and Jameson's to float the titanic again, I have sat with brothers and Irish waked to many friends, i have made bad jokes about serious stuff and know that if i go to hell i have a table waiting by the bar, and if I get to heaven St. Pete is going to have a nice cigar a comfy chair for me . some times professional help (counseling) helps too, actually got some after WTC.
  13. I have a blue light on the dash gathering dust, here in NY we blue for vol fire green for vol ems, I am aloud by my department to respond to scenes if als is requested, or if its between me and the fire house(rarely) or some other company has the duty and it is dispatched as an als assignment. ...and my light gathers dust..... Its not the light that makes the response. drive like a kid is going to pop out at you any minute. drive like you a balancing an egg on the seat next to you... if you crash on the way , two things happen ...first , the original call doesn't get handled and second there is a second call.. I like to get home and harass my kids as often as possible
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