ccmedoc

I didn't necessarily mean narcs. We use Tylenol, Toradol, fentanyl, morphine, dilaudid, versed, and valium...Nice to have these options and I understand most don't...I understand your comment, but this patient and those like her would most probably need the pain addressed..with which one..??

WOW!!! For nothing more than to humor the egotistical rantings of a health professional with an inferiority complex...Or something like that... :naka:

8/10 or 5/10 from someone with chronic pain....treat the pain! :angry1:

The Medics an idiot....Probably didn't have a clue about fibromyalgia, nor should it matter. Online forum, hypothetical or real...this person is an :bootyshake:

If they inject an epi-pen into a child that doesn't need it..he may get tachy and anxious...If they need it, it saves their lives, or calms the reaction until ALS arrives. win-win. Either way they get to the hospital. Maybe not the case if the epi-pen is not there.

I, for one, am very pleased that these are in place. In lieu of a school nurse, which most schools do not have anymore, usually administrators are trained with these, as well as the phys/ed teachers and various others. The vast majority of teachers and administrators are at LEAST masters trained...Although not in medicine, I think they could pick up the S/S of anaphylaxis as well as follow an AED. This is a ludicrous statement and has no relation to your post.. I have to believe that you have seen a pediatric anaphylactic reaction or asthma attack...how could you be offended by the presence of epi-pens?? I have seen more than my share of pediatric deaths from asthma or anaphylaxis before EMS was able to arrive..These at home with parents present.. Absolutely... I applaud the school district for their foresight =D>

On the upside...today isn't the worst day ever.....Just the worst so far. Ya got something to look forward to.. :wink:

I understand the company wanting you to stay for coverage. I don't, however, think they can report you for abandonment if you don't have a patient in care, or have been dispatched to a patient. I think this is a scare tactic. I would believe that the staying for relief is a business decision as opposed to medical necessity..If I'm wrong.. :oops:

Most likely, Yes...after my own assessment and report from you guys..I dont see a problem as long as all good with mentation, vitals, and allergy info..

I agree, far from perfect..not even good. I was expecting worse though..Not sure what. I don't think a KED or equivalent was needed..I don't like them much as a rule.. I don't know what paid service or not has to do with it..Paid EMT's can be just as clueless as volunteers..ya know? :wink:

This is about the only respectable comment in this discussion..at least after it got past the initial comments. As said before..two different jobs and, most of the time, two different types of individuals do them. The bickering never ceases to amaze me.. :roll:

http://www.naemt.org/AMLS/aboutAMLS/

Its alright..I think it would strengthen your assessment skills..maybe change your mindset a bit...

WTF???? :dontknow:

I agree with checking the patient. A-line waveforms can become flat from positional caths, clots, or kinked lines. Takes a few seconds to actually check the patient and is the prudent thing to do. Unresponsive does not=pulseless and apneic..right? Until the patient is found to be pulseless, the waveform is in fact..just flat :wink:

Exactly...Move the machine, assess, pack wounds, tourniquet if necessary, stabilize, and transport to a better facility than you have...Life over limb folks!!! If you wait, he will die from shock...whether hypovolemic or hypothermia, your choice. Inaction is as much negligence as acting inappropriatly...same thing. Unless the ALS carries blood products, it is a waste of time to wait for them. Get your poop in a group and do something for your patient. don't be a :knob:

Rapid ventricular response

The codes I have worked alone, my partner set up the meds we would need, and drove carefully to the hospital. He used the L&S, just drove sane. I have done it maybe 6 times, and had only 2 survive to be doners. Just a fluke I think. It is far from model cpr, but to take 5 seconds or so to push a med and check a pulse q 3 minutes is acceptable, I think.

I agree with this...NG tube should be in place. Besides charcoal being MESSY...it has tendency to gag people when they try to drink it. I think an NG is the only way to go..IMHO

I've heard of glucagon used to treat refractory bronchospasm from anaphylaxis. Complex mechanism of action, supposedly bypasses the beta2 receptors and acts directly to relax smooth muscle in the bronchi. I haven't any literature on it though...

No, not just to cover my ass. There would have to be an elevated index of suspicion to do that to anyone, especially an elderly woman. That board is darn uncomfortable even for you. I doubt she would tolerate it very long anyway. Just depends on the assessment..from mechanism to physical assessment..the whole picture.

Narrow complex tach with no pulse....No...I would not shock..PEA ??

Yep..also check the Genesee County Michigan sherrifs department..They are deputies, and the actual police work is frowned upon. Mostly ALS first response for private alpha unit transport. Kind of a cluster f%$# of sorts. Genesee County

I'd have to say capillary blood glucose level...just sayin?? :wink:

While assessing vision and cranial nerve function, one of the tests would be to hold a pen or finger about 12" from the tip of the nose and have the patient focus on this point. Both eyes should converge equally and pupils should constrict slightly. After a few seconds, have the patient focus on a point on a distant wall..10 feet or so away...like a picture or prepositioned tape line. The pupils should dilate back to normal and the eyes return to midline..equally. This is known as accommodation and I have seen the test in either order..far to near or near to far. Often, it is easier to have the patient focus on a far object first an then focus on a penlight of pen... The absence of constriction, convergence, dilation, or an asymmetric response should be noted and reevaluated.