fireflymedic

Maybe I should write, produce, and sing a country EMS song. It would go something like:

I was drunk when you got sprayed by a skunk.

You dialed 911 and I was on EMS 1.

You smelled really bad made me cry like I was sad.

Everyone abuses us why can't they just love us.

Then they cheated by calling another ambulance.

I got those taxi ride blues.

Thank you very much.

What not as good as the rap?

Actually that was a decent video and song. Some of it was a little cheesy though. So tsk is this you?

I'll take Spenac's version as it fits many I've worked with over the years better lol.

Wish I looked that good in a flight suit

Here's a great idea - don't ask on here, pick up the phone, call your state ems office, ask for the legal dept and find out what the state allows, then ensure that flies with the dept you are with. But as others have said, FR are on their way out quickly, most places I know will only hire them as drivers as they can't legally work the back here. Though that is just this area. But if you are serious about this as your profession, get your paramedic.

Thread title changed to reflect content. "What would you do" is a specifically prohibited thread title in the rules.

I don't handle them any different than any other run, and they don't bother me in the least. If they bother you, you should leave the profession, because there is no way to change that.

SO you are saying that experiencing my former partner choosing to murder his child should have had no effect on me? Along with going on multiple injuries from child abuse and other things. All of these experiences have taken a little piece of my heart and made me the caring provider I am. There are times I do get angery, but I've seen both sides of the fence, parents desperately trying to do the best they can, struggling hard and unfortunately it just isn't enough for no fault of their own. THey're working, but make just over public assistance poverty level. It's sad. Those make me change my mind. THink before you act, and don't judge - you don't know where that person has been or would you would do in those shoes. We can say what we like, but we haven't been there. Be professional, documment everything, and let the others handle it and do their job. Past that, it's no longer our responsibility, but to give the child the best of treatment we can in the limited time that we have them.

I try to maintain professionalism as best I can, but there are times that I am left going what snapped in your head? At a prior job I worked at (at this is public knowledge so I can safely post it) the partner I worked with one evening seemed a little off, but then again he was one of those people who always seemed a bit "off". I was scheduled to work with him the following evening, and while I was working two jobs, went on to a shift in another county considerably farther away. THat night when I came in, I was pissed because my partner was missing and assumed he walked off the job (a frequent occurance there unfortunately due to poor management and miserable pay). I started asking around and discovered he had killed his child the night before shortly after getting off work by strangling him with a thick rope chain (no not a ghetto chain - like a solid necklace) and killing the kid because he was "tired" of him. I couldn't process it then, and I certainly can't even now almost 10 years later. It's something I'll never forget. Sometimes you can't always read what people will do and there wasn't an individual thing that made him snap like most people say "the kid wouldn't stop crying" he simply said - I was tired of him...scary thought. THat is definitely someone that should not be allowed to further have children. We allow people with charges of animal cruelty to never have children again, but few have laws preventing those with child abuse to prevent them from having children. We have a problem, that we must address. THis can't keep happening, it's not fair to the children.

I know there are people that I would not trust independent functioning. Until the education changes here, unfortunately, there is a need for EMS personel in the US to be babysat. Sadly there are good medics that could function independent just fine, but there are the stupid ones that do idiotic things that ruin it for the rest of us. Change the education and maybe we'll see some progress.

I have used it on one patient and that's it. It was a unique situation, and the patient wasn't really a candidate to be cric due to some other issues. It worked, but I prefer to keep my fingers, and wouldn't do so without 'lytics on board so I know that I'm not going to have them bite down on me. Be safe and smart about it there is a time and place for it, but mostly it's fallen out of favor.

Hey there,

Being a female, my opinion doesn't count as much as I'm not a guy and weirded out by that however, in the female population you have the issue with working with lesbians. I am not homophobe by any means, but I did make it clear that was not my interest, nor was it going to be my interest and I've had a great time working with some of them, a few I even consider to be close friends. Some I didn't but it was because of skill or personality issues, not because they were lesbians.

All that being said, the discussion was made once at work when we had two lesbians, two gay guys, and the rest of us heterosexual that it was either everyone could discuss their partnerships in a tactful manner (no discussion of sexual exploits but that they were going out that night, whatever) or no one could. I think this was a fair and reasonable compromise towards tolerance in the workplace. Ironically the two lesbians were partners for a bit (professionally) and couldn't stand to be around each other working, just like if I had a male partner I didn't care for. One of the guys was fired eventually after being talked to repeatedly about sexual harrassment issues and inappropriate discussions as stated above at work (note two other guys were fired for the same for equal reasons against females). While with patients he was completely professional, but when alone with his partner, or if at the hospital he was known for repeatedly hitting on other guys which was unacceptable. Eventually they just had enough. He and the other two guys mentioned were fired. At last check, the other gay guy was still happily employed there and doing outstanding work - they were quite pleased with him. One of the females is still employed, and the other has gone on to work at a private service with excellent references.

As long as it is understood between me and them (or even a male partner for that matter) that I'm not interested, I have yet to have a problem with the orientation of my partner. What they do on their time is their business so long as it doesn't affect me or bring detriment to the service. People are just going to have to understand that EMS workers come from all walks of life and so long as they treat patients and their coworkers with utmost respect I could care less.

And he's a hell of a nice guy. He will always stop to talk/discuss questions/etc (provided the timing is correct and he's not busy with a Pt). First time I met him when he started at UMC in Tucson, he introduced himself as "Peter." How many well known trauma surgons do that? He's great!

Out of curiosity, I know this thread is a few months from the last post, but I just wrote a paper on permissive hypotension for Lifeline, and was wondering if anyone had any interest in reading it. It deals with a bunch of different aspects all involved with blood pressure and trauma care. Including cited references to the thought that a systolic of 80mmHg will "pop clots"...

Would like very much to read it as this is definitely an area of interest for me. The doc that was discussing this at conference, will be there again this year with a follow up and so I'm interested to see how things stack up and would like to be educated prior. PM me and I will forward my personal e-mail to send it to. THanks !

At home - speedy gonzales cable - it rocks !

At work - usually DSL , but one still has dial up which is pitifully slow - it's ridiculous. I think it's carved out of the stone age,and when the site's having issues it's even worse !

Ummm wow - don't know that I'd be doing mouth to snout on a pig there - though I have attempted to rescucitate more than a few cats, dogs, and baby horses...guess to each his own !

One thing I would venture to question though is if you look at a patient on a backboard, especially if the patient is heavier, they aren't truly kept "in line" which is the goal. Padding really should be put under the head to raise it up to an in line position - part of the reason they say don't remove helmets unless absolutely neccessary - they actually put the head in a better position. Also, there are a lot of people (as another person said with the "no neck club") that don't receive appropriately sized collars in the first place. If you look an immobilized person has a pretty steep curve to their c-spine. Perhaps a shorter collar or padding under the head would be more effective - just a thought? Along with poor immobilization (especially with the three strap boards) patients slide all over.

As to the foam blocks, we utilize the "head beds". For those that aren't familiar, they are a foam piece attached to the backboard and then two foam blocks velcro to the sides next to the patient's head. Much more stable than the giant foam blocks and tape that many (at least in this area due to cheaper cost) are still utilizing. Though some are using blanket/towel rolls instead. Also, I have utilized a blanket roll for a large patient that couldn't fit a c collar. Wrap the blanket around the patient's neck, then fold the sides down next to the head to form "headblocks". Similar to the general round foam neckbraces seen worn sometimes by patients.

I agree that the study does bring about some questions to be investigated, and the preliminary information is something to consider, but I have difficulty believing that unrestrained movement in any direction with a potential or proven c-spine injury is better than restricting movement in some fashion. Just like any injured part - excessive moment does increase the risk for bleeding, inflammation and damage to nerves and surrounding tissue. I think we need to look into what the stress points in the c collar are, and find a way to eliminate those, as opposed to completely doing away with immobilization because from what I'm understanding of the study, it's not the actual limiting of movement that is potentially affecting these patients negatively, it's the stretching of the ligaments in the neck that are causing the greater potential for injury.

Okay -

For those states where medics are allowed to terminate resucitation efforts OR declare death on scene - what is your protocol for doing so?

Here there are a few things required

1. Determination of Death class must be completed

2. 6 inch strip must be ran confirming asystole in all 3 leads

To even qualify for it -

1. Injury incompatible with life (burned beyond recognition - and no large surface area does not equate, we're talking entire consuming of body by fire and is blackened, or complete decapitation)

2. Resucitation effort exceeding 30 min with no return of pulse or shockable rhythm (or complete exhaustion of provider, but I'm not aware of a case involving that). They keep flipping back and forth - have to work it to the hospital and let doc decide

3. Presence of Dependent Lividity or Rigor Mortis

Anybody else out there follow a similar protocol? I should think so, but with the amount of these cases happening, it's making me question whether the medics are just not following protocol and calling people dead they think should be dead OR further training needs to be happening. Either way, there's a problem and it needs to be fixed !

I'm like Jim, I'm not going to judge as I wasn't there and I don't know what their protocols will or will not allow. I've been in the situation of having a patient considerably larger than me attempting to beat me up and it wasn't pretty. Didn't have the luxury of meds to give (basic at the time with basic partner) and pd was nowhere to be found. Yep we did some unconventional things to take control of the scene, but we had to. I certainly don't promote that, but if that's your only option, so be it.

Now - the flip side. One I'm wondering if the reporting is accurate (like it ever is but.... ) because I've dealt with many a seizure patient, and yes, they will become combative post ictal (or ictal if complex partials), but the aggression is usually not directed - this sounds pretty directed to me. Most of the time it's because you won't let them up and they become restless trying to fight to get up or you are blocking their path if they are wandering. I have yet (not to say it doesn't happen, but not yet to me at least) to have one intentionally hit me, and then continue to do so. Obviously yeah, I've been in the way of a swing or struggle to get up more than once, but not intentionally. Also - alot of times if you de-escalate the situation, make it more quiet and relaxed they will as well because they are simply disoriented (think about how people are when they first wake up - not totally with it and fuzzed - well that's the feeling). Should restraints have been utilized - yeah - perhaps wrist and lap restraints in addition to normal stretcher straps would have been considerably more beneficial than taking a swing. That likely only made things worse. All else fails, there are such things as backboards and spider straps (or backboards and restraints). Would have been much easier to justify and get out of hot water with the department and also the state than taking a swing. At a minimum people - you were in Chicago ! You can spit and hit a cop ! Let them be the ones to get in trouble dealing with a combative patient, not you. Protect yourself, protect your cert and if all else fails, let the guys with the guns be responsible for restraint. It can always be sorted out later. Also, this doesn't say whether meds were within range, but for a seizure patient, I think one could easily justify giving valium, versed, or ativan (versed and ativan IM) for sedation. I know many have bent the rules on combative seizure patients and utilized this with justification with no backlash.

Be safe, be smart, be wise out there.

Thanks for the reply... I am excited and have heard how different 911 can be and I know that I will love the change. I will be working in an urban area, I haver respect for rural ems workers and appreciate how close my hospitals are.

Each has it's own challenges as many here have stated. Two very different worlds and some prefer better than others. I did urban time for a bit just to see how I'd like it and decided after a bit that I loved my long transports and middle of nowhere to praying that I didn't run over a pedestrian or end up lost in the ghetto. Be safe, keep your ears and eyes open, and with your bad self !

Good find terri ! I'm not much into the energy drinks and had never really looked, but I had no clue they were putting alcohol into some of them. Wow - who'da thunk it?

Hey Wig wag,

Welcome ! Glad to see you've gotten your feet wet and are ready to wade a little deeper. We promise not to drowned you. That being said, 911 is a different ballgame, but I think you'll enjoy it. You don't mention whether you are urban or rural, as sometimes rural 911 feels like a transfer service . Take care, jump right in and enjoy !

Welcome back welsh - good to see ya around again ! The majority of the crowd is in from 10 on - hope to see you in there !

I never thought about the pacemaker thing.

As for bee venom, there have been studies that say people who have experienced multiple stings have enjoyed various health benefits. I seem to also recall reading about people who intentionally get stung to get relief from things like arthritis. As a matter of fact, I just saw a recent story about a woman who was in anaphylactic shock and nearly died after multiple stings. She spent time in the ICU and when she woke up and fully recovered, she realized that her joints that were stiff, sore, and achy (knees, ankles, hands, etc) were free of arthritis.

I don't know if it's some inherent properties of the venom itself or the result of some immune system changes, but it's pretty interesting stuff.

I have heard similar with MS patients - interesting phenomenon definitely worth looking into ! Perhaps an intentional bee sting will be the medicine of the future for certain patients who knows?

Thanks, I kind of thought so. I've actually heard of instances where someone that was embalmed but did not have their pacemaker turned off and the deceased exploded due to the decomposed gases that were emitted and the pacer set these off. One instance where the deceased was in a mosuleum and nearly blew it apart. Whoops.

Not heard of that, but I am aware they cannot be cremated with them in place as it can cause issues. Same with other stimulator devices. Learn somethin new every day !

Interesting that you should bring this up Wendy. In this thread My linkI talk about my mother's recent illness.

Yesterday, when I went to see her, she was hallucinating. Her visuals were vivid and real to her, yet when I told her that no one else could see them she would re-orient herself. She was disturbed by the fact that she was seeing things that others didn't. I discussed it with the ICU nurse, who told me that this was a very common phenomena in ICU. The RN could not tell me exactly why this happened. She said they theorize that it is a combination of medications, post-surgical chemical release, and a lack of visual stimuli.

I immediately gave her her glasses, instinctively thinking that if she could see clearly, then her brain might not need to create so much stuff. It really made no difference. The cool thing is, after I explained that what she was going through was normal and she was not crazy, we actually had a ball laughing about what she was seeing.

(she has no idea of popular culture or internet virals, but she did see ceiling cat)

I'm guessing from the content she was dealing with ICU psychosis - phenomenon that happens causing hallucinations, temporary irrational behavior, etc. From my reading, the understanding is that occurs due to constant stimulation environment and no distinct sleep/wake cycles. In an ICU it is always daytime, but for some bizarre reason, similar to sundowning in elderly patients, it gets worse at night.

http://www.emedicinehealth.com/script/main/art.asp?articlekey=7769

There are also some physical reasons that are non psychiatric that patients can indeed see visions (temporal lobe epilepsy is known to produce religious visions - such as case of Emily Rose). Dehydration, hypoxia (the general explanation for the visions people see when dying), etc.

Very interesting though - thanks for posting !

Very sad. Perhaps there needs to be some improvement to the current warning system to ensure this doesn't happen again? I'm not familiar enough with trains or the railroad industry to understand how these deaths/inuries can happen, but I should think there was an attitude of comfort and guard was let down. No different from what we do in EMS. You get comfortable with the every day and that's when accidents happen. Prayers for their families and hope for comfort for them.

I'm not sure what they do in other nations, but wouldn't you think that since he is already in a coffin, the person has been embalmed? If so, how can the body function? Just curious.

It is very possible that with him being in Poland that he could have been Jewish, which depending upon the person and sect (I guess that's the best way to describe the individual variations?). Judaism prefers people to be buried within 24 hours and do not want to be embalmed. It is very likely that they had no plans to embalm him. No I'm not saying that just because he's polish I automatically assume that he's jewish, but there is a great chance of it.

Muslims are the same wanting to be buried within 24 hours. Hindu people as well do not believe in embalming (though all of the above permit it for homage back to their home area Israel, Middle East, etc as international body transport laws require it for public health reasons). There are not rules within the US requiring it (unless body is to be shipped internationally), but it is certainly preferred. That's about the best explanation I can give for the situation.

I didn't start this thread to get into a major debate, I started it to show the "complaints" we had with trauma weren't just isolated to the one show. To be fair, if we're going to fuss, need to carry it across the board. I think I'm gonna stick my head back in my shell now !

From my understanding this is along the same lines as the cooling blanket idea

http://www.emsresponder.com/online/article.jsp?siteSection=1&id=11860&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+emsresponderrss/top_ems_news+(EMSResponder.com:+Top+EMS+News)&utm_content=Google+Reader