speedygodzilla

It is not what we do but how we do it. Thanks for the reminder. I enjoyed reading your post and the the question link. Treat your patients with respect, and give them the best care you can. Hope your dad's recovery continues to go well.

Here are some answers from facebook:

Joe Hammond recommends Walraven, version 7

Jamie MacDonald recommends rapid interpretation of EKG's by Dale Dubin

and·

Ronnie Thompson recommends EKG Interpretation Made Easy

I have heard all these are great books but have yet to read them. Going through medic class I had Understanding EKGs 2nd edi, A Pratical Approach by Brenda M. Beasley. It is a Brady book! It does a good job by itself and really breaks things down to a beginners level.

If you search the forums you will find a lot of ECG topics etc. Feel free to ask any specific questions. Many of us here love to teach or at least attempt to.

Thanks for fighting this! I don't quite have $150 dollars as I am currently on disability but I would love to donate alittle. What can the rest of us do to donate what we have avaiable. 20 here and there would really add up.

Anyone else in the same $ as me willing to give "alittle" ?

After posting this I saw the donation button for any amount. Wish I would of saw it first. Although I do want to encourage others to who can't afford to give the $150 to give what you can.

First off did you vote yesterday? If so KUDOS To you, if not why didn't you?

I voted absentee since I was in Florida and I voted yes.

I certainly hope you weren't referring to me in making the rest of us pay? But if you were, why am I making the rest of us pay?

Yes I did vote. And no I am not personally referring to you. I am just tired of the current system. It is not working. While I am not sure this is the best solution I am more annoyed by the continued blocking of one party to another. Nothing seems to get done with our goverment!

Thanks for fighting this! I don't quite have $150 dollars as I am currently on disability but I would love to donate alittle. What can the rest of us do to donate what we have avaiable. 20 here and there would really add up.

Anyone else in the same $ as me willing to give "alittle" ?

As a Missouri voter I am very disappointed in this. I am tired of heathcare cost being so high. We are required by law to have car insurance! If we weren't many more would not have insurance and many more would have to pay. Our current system needs help and I think that it should be a requirement to have insurance if you can afford it. Stop making the rest of us pay for you!

The game does end. My results were above average in a bad way. My reaction time was 0.46 seconds slower while texting and 22% more gates missed while texting. Comparing that to the average is not good. The average is reaction time of 0.26 seconds slower while texting and 8% more gates missed while texting. And no I did not see the gray lady, I guess I was too busy texting. Glad it is just a game.

Luck and look are two very different things. It really did sound as if you didn't look.

I have to admit that from what little I read from the links on google search I say nothing significant for Boston 12-Lead Criteria. The criteria I found seem to be the basic that EMS should get 12-Leads. 12 Leads should be done soon, within the first 5 minutes/ early 12-lead.

What is your EMS Agency doing to protect the privacy and personal medical information as well as the billing information of those patients you transport?

Is your computer system secure? Do you still write reports on paper? What happens to that report when it is finished and submitted?

Do you allow the faxing of EMS records to unsecure faxes?

Has our ability to protect patients information not kept up with the requirements to do so? Is technology lagging behind the requirements.

One other question - Why did it take 4 months to alert the public. The damage may have already been done.

Shouldn't we hold the facilities accountable for delaying the notification of those affected?

I am not specifically sure what my service is doing to protect patients info, besides hopefully following the routine HIPPA.

No computer system is "secure." There will always be hackers that find a way in. We do still use paper charting but it later gets scanned into a computer for storing. I personally don't know what happens with the PCR after I turn it in. I would be interested in following the records path so that I understand to whole system better.

Not sure of our faxing policy as I don't deal with that. I do know that our dispatch fax is consider a secure fax line.

I think technology is lacking secure pravicy at least in the public eye. How many times do we hear stories like this. It makes me beleive it is not if your identity gets stolden, but when.

4 months does seem like a long time. I wonder how long they really knew about the problem.

I think we should hold the facilities accountable but at the same time want to know exactly what went wrong. Somebody was not paying attention and now others may pay the price.

On a side note I don't live any where near Massachusetts so this does not personally effect me. But at the same time I remember the fourm about copy machines talking about how they store everything that is copied in a harddrive! It is not if but when!

I'm gonna guess that the end of the video was not a really the or even a firefighter but an actor with the late night television show. Still very funny!

Edited:

Dang it Ruffems, you beat me to it! LOL

you did this kid's work for him. Now he doesn't have to think and he can go on getting others to do the work for him.

Part of me is laughing the other side is annoyed! It takes seconds to google! So what is so special about Boston 12-Lead Criteria? (Maybe I should read about it ........ but I kind of want to see a real discussion......)

Hey Ruff, can you post a link?

Here try this Boston EMS 12 lead Criteria

I would go ahead and treat the patient.

I would try for a 12-Lead and even leave it attach to retry enroute. Who knows, maybe you'll get lucky. However I would not focus too much effort on it. Of course be sure to document.

Yep

IV fentynal is not part of my scope, weve given 10mg salbutamol and 500mcg of atrovent

I looked up salbutamol and found it to be albuterol?

10mg? Normal dose is 2.5mg repeating as needed.

So what are you giving for pain? Morphine?

If pt is allergic to that than looks like you'll just have to stick with breathing treatment. What other drugs do we have at our disposal? I know some one was considering versed earlier.

Edit:Added content after rereading 1st post.

Speedy...you're hereby grounded from the trampoline for the rest of the summer!

Good idea lol!

So in the first post it said the patient "has been given IV fent by the hospital when needed"

So we are not carrying Fentanyl? What are we giving nebulize for pain?

I would like to treat both, but since that is not a choice let’s try treating pain and watch for improvement or deterioration and go from there.

Please tell us that the phrases "Hey y'all! Watch this!" and "Here, hold my beer..." were never uttered before that fateful "giant leap for all 'zillas everywhere"......

Nope I was totally sober lol. I don't need beer to get hurt. I had no idea what was about to happen, it was suppose to be just another jump with the kids on the trampoline.

It is gonna be a long month.

Well the 4th was eventful. I broke my arm! Gonna be out of work for awhile ! Accidently jump off trapoline landing on my side/arm. I did still get to blow some stuff up before it ended up raining

Thanks to all those who made and continue to make the 4th of July possible!

Sounds like a great idea!

Cancer sucks! Sorry for your loss. We are here for you!

I just recently went through all my testing and static cardiology really didn't have much a scenario. Basically a small paragraph with the patient's presentation and vital signs. I ask the proctor at the start if I needed to include scene size up and he said no this is just skills portion. Still a good idea to ask to make sure every one is on the same page.

Always treat completely and assume that the rhythm and patient presentation does not change no matter what treatment is rendered.

A helpful acronym we were taught was every patient (in NREMT Skills) gets VOMIT

V-Vitals

O-Oxygen

M-Monitor (EKG)

I-IV

T-Transport

So at the very end I would just repeat the basics again making sure I fully covered VOMIT.

Good luck.

So it sounds like my reasoning is reasonable. Turn out to be an interesting discussion. Feel free to add more.

They call we haul. Even if there "emergency" seems nonemergent or even nonurgent that is not our decision. It is better to legally and ethically to just take to patient as they wish no matter what we think. I never discourage a patient for transport.

The ER may say something to you which in my opinion is uncalled for. I always respond with "they call we haul" or "they ask for your facility by name." If needed I take the time to explain our role, but I have yet to find a nurse that doesn't understand it. They know we have no choice in the matter just sometimes feel the need to vent as we all do.

Define stable.

I have seen patients with a decreased LOC that are stable.

The MOI should indicate to you what potential injuries the patient may have. It is reason to transport to a Trauma Centre. Last time I looked, we were not carrying X-ray, CT & Ultrasound for FAST in the ambulances. (If you dont know what FAST is, click here.)

Yes you need to look at your patient, but remember patients will compensate & in some cases deteriorate quickly if there is multi system trauma in place.

The MOI is the single most important piece of info you have to indicate the injury that may present in time.

I am going to go with stable being a providers discretion and that there is no set definition. Thus saying that I don't see much benifit especially where I work transporting "stable" patients emergent. Mainly due to my already short transport time. This being said if I was 30 mins out I would be more likely to upgrade my transport base off of mechanism. I think the main focus should be on scene time because that is where you can really gain time.

Thanks for everyone's input!

Very nice, thanks for sharing