Chief1C

Nice language. Even if you aren't directly related to the patient. If there is a family member there, and the patient is unresponsive and has glucagon.. coach them into using it. I'd say you did ok. I always tell my diabetic patients, to make sure their family, friends, etc., know how to use the glucagon, because we can't. If that's their difference between living and dying, well.. no comment. But if more people knew what to do in an emergency, my blood pressure would be a lot lower.

I sincerely doubt they offer electro-shock-therapy. But you could try... Maybe the cops will taze you into sanity?

Stole Employees? How do you own a person?

Motorola sells these things called alert boxes. It's like a pager, but more scanner shaped. It works with one frequency. You can monitor, or hold for activation only. We use one as a "house alert", just plug a standard speaker into the back and voila. Makes a sound like when a portable radio receives a page. Often a service is limited to technology, by whomever does their dispatching. If it's a large private service, either 911 or Non-E, there could be a private dispatch with options. But more than likely, you have a common PSAP that dispatches for a wide range of agencies. There are ways to upgrade, without touching the radio system, like an amplified pager charger with either a solid or flexible antenna. You could run it to a window, and bolt it to the outside...or just tape the soft antenna to the window. I keep my Minitor V in an amplified charger at home, with the antenna stapled to the outside of the window frame. Seems to work okay. Then, if your PSAP has CAD (computer aided dispatch) capabilities, you have cellular options and digital pager options. You could receive the page in text message, forwarded through an email address, or a system similar to "I Am Responding" (IAR). I'm big on IAR, it's kind of expensive, but on average, I get the CAD on my phone, before the pager activates. Then, if using IAR, not only can you use it for scheduling, and silent response (without radioing out), you have the option to have the address sent on a Google Maps link in the CAD Page. That way, you can open it up w/ a smart phone and voila, you have the address located on the street view, plain map or satalite view. So you can almost guide yourself to the scene w/o any further directions. You'll have no choice but to upgrade to an extent, because of national narrowbanding. After a certain date, a lot of radio equipment will be totally useless for public safety systems. IMO, it's a ploy to make communications companies billionaires.. B/c I'm well aware that this shit is expensive. But that's the way it works.

Access Denied.

Anyone who is terminally ill, with no chance of survival, and a dimming quality of life...should have the right to end their life by any means they choose. As with anyone who is in physical pain that cannot be managed. Over the past five years, I've lived with the consequences of intervening in someone's right to live without pain; and taken a lot of hostility for resuscitating someone that pretty goddamn near succeeded. All I did, really, was prolong their pain, now compounded by more pain, mental defects from a massive OD and even more medical bills than before. Courts should have nothing to do with it; someone wants out, with just cause, let them be in control of their own life.

Are you sure it's flesh eating bacteria? Is that a pulse, or larvae under the skin? It could be a zombie.

White shorts and a striped, red shirt with sandals? Ugh! Seriously? What, did he buy that outfit at Sears? That is a true travesty!

Regionally, there has been an increase in snakebites over the past two years. Used to happen all the time, when logging was a big industry, and even then, few people died. Depends on where the person is bit, and then you're more likely to suffer from the side effects that are life long; and disfigurment. But people still die from snakebites, it just depends on whether or not they seek care. If you want a swell time line, there's a video on Youtube of a lady picking berries, and she gets bit before it rattles, and the guy keeps rolling right till she gets into ICU. I've personally treated several snakebites, but they were all from a failure to educate ones self on local snake species. For instance, I've seen some pretty damn big corn snakes. And they look EXACTLY like copperheads.. Except for the eyes and heat pits. But people only associate the snakes actions and color, before killing the poor animal. Water moccoasins are very aggressive, as are common black snakes - or water snakes. They'll bite, and it hurts, and it will become infected. But the moccoasins aren't native, and water snakes aren't venomous. But people still call, because they don't know the difference. I took a class on snakebites last year, just b/c what *some locals do with rattlers and the influx of mexicans and gas workers. They'll toss them in machines, mail boxes, work trucks, etc. Like terrorism almost. Pre-hospital care is limited to managing symptoms, and simple first aid. MY best bet would be to fly them somewhere, b/c there aren't many hospitals that have antivenom. There is a zoo with exotic snake treatments.

We will all have, or we have all had a call that brings us down, that's just part of being human. I can sit here, and run down a number of calls spanning more than thirteen years, and paint a picture in words of exactly what I did. What is disturbing to me, may not bother someone who sees a higher frequency of calls. I try not to carry them with me, but you'll run a few that will always be right there. The best thing you can do is talk it out, and move on.

Whatever happens to be in the pockets of my turnout gear, is the only thing I carry in my vehicle anymore. I assume there is prolly like an odd number of medical gloves, like three. Prolly about ten pairs of used gloves, a few crinkled, empty gauze pad packages with bloody glove prints, the plastic bag from a collar or two, my shears which prolly have blood on them, a half dozen pens, none of which are in working order. A half used roll of kerlix, which may or may not have blood or dirt on it, and then all of my various firefighting and/or extrication gloves. Different calls require different gloves, yanno what I mean, prolly not. There may or may not be an unused, or maybe peeled open, but not broken out Dukal, Economy brand "Blood Stopper" in one of my bunker pants pockets. Its a pressure dressing, seems like a good idea, then you realize it was overkill and just stuff it in your pocket, since it's no good to stuff back in the ambulance's trauma bag... Where 99.99% of it originally came from anyway. The only useful tool... Road flares. Pretend you think EMS means Eastern Mountain Sports (a brand of camping/outdoorsy stuff).

...for a rural provider, I've treated a good number of people over the years. Some really personal calls, some that stained my mind for life. I rarely use a chopper, but there are some folks that are walking among us today, because I chose that method of transport. I'm a sore loser, when ppl die for lack of time, I second guess myself to death. One patient, died because people overuse helicopters. Used to be, hell you could call one for a broken toe, and you'd get one. Too many people called for broken toes - well, you know what I mean. They changed the protocols, so one has to call HEMS Medical Command, before a flight is granted, for everything except a trauma. STEMI's, CVA's, stuff that requires immediate special center care.. I don't have a choice, because I can't safely get to one in time to make a difference. One MI, I couldn't call Medical Command. No cell service, no VHF radio service. Dispatch passed the info I had along, and the HEMS Med Command wouldn't hear it. My request was denied. My patient died enroute, 25min after my request was denied.

Maybe they arrived and decided it was too late? Exactly one year ago, next week, we replaced all of our AED's w/ Lifepak 1000's. Haven't used them one single time, but we had at least six DOA's (whether they were dispatched as such, or arrests). None were viable, through obvious signs of death. I realize I probably just jinxed myself. At least I didn't say Quiet. Aw shit.

I can tell you, as a diabetic myself, that oral glucose doesn't contain enough of a powerful punch to do much harm...whether they need it or not. If they're profoundly hypoglycemic, oral glucose isn't going to be enough to do the trick. If they're hyperglycemic, it won't kill them.

Luckily, our ePCR software will only allow you to use the acceptable state abbreviations. I prefer people write things out, and use simple terms. You have a patient at an MVA. You're using AMBU Brand single size collars, which we don't, but I'm being general. One of the sizes is "No Neck", others say Neckless. The collar that best fits me, is "neckless". If you write, placed c-collar on patient. That's great, or placed neckless collar, tall collar, etc. But I've seen people write "placed no neck collar on patient". To me, that says placed size "no-neck" collar. To the general public, or a lawyer that wants to burn your ass, that says "I didn't put a collar on".

I can almost relate here.. We don't give people uniforms or equipment, you just show up with whatever you have on.. Yanno, unless it's like a fire. But that kind of stuff is only issued to people who are trained to fight fires. A person comes in, we sit down and talk, I find out what their intentions are, what they want to do. One person can't do everything, I find that it's best to equip them with an important skill, and educate them to carry out that skill. A young man came in, he wanted to volunteer. A thing in PA, dating back to the late 1930's, was a courtesy light. A rotating, solid, flashing or strobing light, blue in color, that historically identified a vehicle as being that of a firefighter who was reporting for a fire. It's not a license to drive fast, pass cars, etc.. People can pull over, they do a service to their community, if they do. But in this, the age of LED, since the Motor Vehicle Code only covers rotating lights. You can go beyond the two rotator rule. They come in all sizes and shapes, and yeah, some of them do look pretty cool. His objective? "What do I have to do to run a blue light?" I told him to go join somewhere else, and he left. Now, I'm in charge. I am the leader. Who walks in, with a stack of paper that says this person is trained by the state fire academy. This older, but only in age, kid. Child. Drives like a maniac, in personal life, never responds to fires, because they told him "no way, you'll get killed" to the blue light. Says, I wanna be an EMT... so I can run my blue light. No. But we'll get you trained to help people. Class comes around, doesn't show up. They weed themselves out, you just have to give them time.

Yeah, by the neck. I can't say I was "hurt", because in all seriousness, I never believe any story from anyone that pops on one day, and begs for sympathy. Granted, there are a lot of people out there that wake up the day after being told they're going to die a lot sooner than planned, and want to do something great with what time they have left. They start out, get sick, die trying, and sometimes it gives people inspiration and hope.. and sometimes it turns into a Lifetime Movie. If I were 16, and going to die, I'd wanna get that solidly confirmed. Then go somewhere that I could legally drink, and have as much unprotected sex as possible, with anyone. Because really, I've never wanted to inspire anyone to do the impossible. I just want to live in my corner of the world, grow old and die someday. Which will inevitable, be sooner than it would have been, had I lived a healthier life. But that applies to everyone. Truth is, everyone is an attention whore, some days. Everyone wants a little spot light, a little of their fifteen minutes of fame. It's never hollywood spotlight fame, sometimes it's just wow, what an asshole fame. I get that a lot. I'm a dick, no question, but I'm a good person, unless I think you're a dick.. Then I'm a dick to you. See how it works. Yeah, everyone is like that. The only people who think they're normal, are the ones the rest of the uniquely odd people think are totally fucked up. Probably a high percentage of the population of the globe have a mental illness that will never be diagnosed. I'm pretty sure I would be diagnosed with something, if I took the time to spill my guts. Hell, some days I'd probably be locked up for 72-96hrs. But as I told a patient today, who like many of us here, was suffering from a form of an illness of mental nature; there is no prescribed medication that will make you happy or normal. But there are meds that can help you find your happy life, and it's up to you to determine what that is. You just have to find a way to ask for help to get to that point. Maybe you need some help, maybe that help comes in pill form. But it may just come in growing the #@!% up, and not involving the rest of the world in your inner drama. I suggest a diary. My diagnostic process for folks who create a life beside themselves, is that they have complete control of it, they can create it, they can change it, they can end it. Where as, they can only create new life, and end their life, if they have no control of their own real life... Once you enable yourself to control your actions, your personality and your lifestyle, you see how foolish it was.. My alter ego. Dr. Phil.. usually involves excessive amounts of alcohol.

I give everyone a chance, just to see if their heart is in it. If it's not, or they're doing it for the wrong reasons. They lose my time and my respect.

Never heard of Transcare. Susquehanna Health is the largest ALS provider, and I believe the old ALS provider in that area.

I just sold a '71 EMT Text - The Orange Book - on eBay for $39.99... That was the highest priced book since I sold "The Paramedics" for over $700. Granted, I paid about $575 for it to begin with.. Jim Page autographed it.. Needed the cash.

I could use one right about now; and a line in each arm. Drank some of that low cal Gatorade after a fire.. Ugh.. ralphed till there was no more to ralph. Took some Emetrol, supposed to be Cherry flavor!?!?! OMG.. That made it worse. I've never, in my life, tasted anything so vile.

A sheet and a swaddler will work; so will the warming pouches that are available for EMS. I'd caution about getting them too warm, as they cannot exactly say, dude - I'm hot!

Reputation type deal.. The green / arrow would be something to press if a topic reply was well thought, constructive, added facts, researched info; had a positive impact, etc. The red / arrow would be.. Say, if you felt like you lost brain cells reading the topic reply; or someone is blatantly being utterly stupid, or you feel the urge to personally retract their provider license, certs, etc. Just before I hit enter... Hal 9000 popped one in there.

Tattoo Soothe - To be used on "broken skin procedures". "This anesthetic contains 5% Lidocaine, 2% Tetracaine, .02% Epinephrine for numbing." "This product is intended to be used DURING a tattoo procedure. Another product such as Tattoo Sooth Cream can be used BEFORE the proceedure starts, but this product is ideal with cut skin. This product will bring amazing results to your clients. After the first initial tattooing strokes, place a thin layer Tattoo Sooth Gel over the area being worked on and wait 3-6 minutes. As you continue tattooing, repeat as requested by your client for comfort." The actual purpose of the purchase...has nothing to do with tattoos. Ordered it with overnight shipping, $36 for a $13 item to get here in less than 24hrs. I needed two sutures, and the town doctor is a fricken moron. Worked like a gem. But I'd use it for a tattoo, too.