emt322632

Enjoying this thread immensely, makes me want to go and review CRF!

It seems like with this patient there was very little that could be done at the BLS level. If I had been on an ALS truck, everything Asys said: 12 lead, IV, O2.

Seems like you handled the call very well.

I posted my dislike for the woman because I in fact do not like her. However I did not say that I believe she should be fired or let go.

These are rumors, and only rumors, and have not been substantiated in anyway whatsoever. My post was meant to convey the question to everyone:

If this sort of thing happened in your company/volly squad or the like, what would you do, how would it be handled.

Perhaps I should have left my personal dislike of the individual out as it really doesn't pertain the the post, but at the time I felt (foolishly)that it mattered in some way.

A bit more information:

She has only been employed at her paid job for 2 months, they have a 1 year probationary period.

She has been with the volley squad for 3 years.

Should she be removed from the paid job? Should she be removed from the volunteer squad?

I personally believe that no she should not be removed. She is a good medic and, while my personal feelings toward her are to the contrary, is good at what she does.

Should one stupid episode be enough to dismiss someone? No...should she be placed on indefinite medical leave until all her ducks are in a row? I believe that yes she should be.

Very interesting replies everyone, I love the input.

Something else to consider that I didn't think about until now. We live in a very small area, very close knit EMS community. The cat is already out of the bag as Dust said, nearly everyone knows what happened.

I wonder if she would ever be able to return to work without people pointing their fingers and talking behind her back. This type of stigma would be very hard for people to forget I would think.

Recently here we had a medic who is employed by a private agency and a volunteer agency attempt suicide by downing most of her meds for her bipolar disorder and antianxiety.

She was recently dx with bipolar disorder, and has been extremely noncompliant with treatment. She was diagnosed after she was sent to IMHU for depression, they discharged her after 2 days with the dx of bipolar disorder and a prescription.

Recently, she downed most of her meds while at home with her 2 children, and it was the private agency that employed her that picked her up.

I have heard rumors that she is going to be fired, and that she will lose her state certification.

While I personally do not like this woman, I honestly don't know if this is something that can be done or should be done. She has a genuine problem, she just needs time to get her act together.

Any thoughts?

How long ago did he wake up? Is the paralysis starting to fade?

I think I know the answer too lol.

Capt,

Heck no I didn't let her start the IV lol. I was as polite as I could have been and asked her to move. I don't like making a scene in front of my patients unless it is absolutely necessary. If I'm calm, the crew is calm, and the patient is calm.

If she had refused to move though, I would have definitely had a patrol intercept with us on the way to the hospital, or meet us at the hospital. However there wasn't really a need for me to be a smart ass, though I came pretty close when I saw her reach for the cath...

I had an incident last week where I had a problem with a nurse outside of the ED.

We got called to intercept with a neighboring squad for 51 y.o. male chest pain, hx of MI 3 years ago. We go, intercept with the other agency, and I bring my equipment into the back of their ambulance.

There are 3 people in the back, which I find a little strange. One woman immediately begins to place the electrodes on the guy. I figure she is a basic with this department and is helping me out. I don't think anything of it.

I begin to get my IV supplies out, and am laying them on the stretcher. I put my IV bag away, turn around and the woman who was hooking up the monitor has a tourniquet around this guy's arm, looking for a vein.

I stood there stunned for a few seconds, just as she was reaching for a cath I said, "Excuse me..."

Her response, "I'm an ER nurse, I have ACLS..."

My response "That doesn't mean anything in the back of an ambulance, please move..."

At that she got very upset and told me that I had "Better get it..." in reference to the IV.

Turns out the patient was her brother, and she felt that since he was her brother and she was a nurse, she could start an IV.

At no point did she identify herself as a nurse to me, until I caught her that is.

It really p&#!ed me off. But I felt I handled it in a very good way, I didn't complain to her supervisor or anything, because she wasn't working so what were they going to do? For the rest of the ride though, she sat up front.

Until It Sleeps ~ Metallica

We Will Rock You ~ Queen

Fight Fire With Fire ~ Metallica m/

All Shook Up ~ Elvis

For Those About To Rock ~ Ac/Dc

Rock and Roll All Night ~ Kiss

Rock and Roll Hoochie Coo ~ "Uncle" Ted Nugent

Children of the Grave ~ Black Sabbath

All God's Children ~ Uriah Heep

December's Children ~ Rolling Stones

Fight For Your Right To Party ~ The Beastie Boys

It's My Life ~ Bon Jovi

Good points Dwayne.

I say get him to the local small town hospital and arrange for air txp to meet you there. No point in making a bad situation worse, and if you get him to the local hospital at least there they can do some stabilization that you are unable to do before he is transported by air.

Is she normally hypertensive? Any visual disturbances with the headache?

I'm thinking pre-eclampsia here...not a good thing. Any history of pre-eclampsia during pregnancy in her family?

Also let's get a BGL, O2, IV, monitor....has she been seeing an OB/GYN during her pregnancy, if so have they told her of any potential complications? Any family hx of pregnancy complications? What pregnancy is this for her?

Hey, look, it's not the police's job to control your little crotch fruit in your own home. Maybe next time she won't suck at that entire parenting thing.

hahaha..."crotch fruit"...

Observe abdomen for ecchymosis, bowel sounds? Last bowel movement, last oral intake.

History of pregnancy? Surgery? Chance of pregnancy? When was last menstrual period?

Any associated vaginal bleeding?

Which quadrant is pain located in? Pain upon palpation? Anything make it better or worse?

Pain scale, 0-10 what is it rated?

Meds? Vitals...

Had one yesterday as a matter of fact, but the photographer got there too late to catch us. Car vs. pole, pt. died, probably the only reason it was in the paper.

HA! Very nice, clothing never occurred to me either. It's kind of scary all the little things that can slip by us sometimes if we aren't on our toes eh?

Very nice scenario, thoroughly enjoyed it!

Alright, let's ask the stupid question. Does she have a foreign object stuck in her throat? lol

Continue high flow O2 and reassess q 5-10. Monitor patient for return of symptoms. Maybe toss in some albuterol for good measure to open her up a bit more. Have her sats improved much from the 90% they were?

The way this is progressing leads me to believe it's an allergic reaction.

Did she run through any vegetation while jogging? Poison ivy or poison oak comes to mind, maybe a severe reaction to something along those lines.

I'd start treating for allergic reaction, epi 1:1000, benadryl, solumedrol. Let's see what that does.