ladybear

busted!

I'm lucky Toradol works for me both for kidney stones and migraines. I happen to be one of those lucky folk who has allergic reactions to the majority of narcotic medications. Toradol and Phenergan have been a blessing for me. I can't speak for others, but I'm personally a little skeptical about Fentanyl mainly because when I was being treated for a possible ruptured appy they tried it on me and it didn't do a thing for my pain, just made me more nauseated. I've passed four stones in the last year. The last one was while I was at work. Thankfully I was able to get through without any meds, however I wouldn't want to have to do that again. One of my co-workers said I was pretty pale for a bit....geeze I wonder why.

That's more like Wilderness rescue... not rural ems.. a different monkey altogether

Primary emergency indication for intubation: the patient lets you intubate him. Primary contraindication to doing CPR: the patient pushes your hands off of his chest. Joe Lex, MD, FAAEM

I have used the ones itku2er posted the link to. I like them a lot better than the straight angiocaths because there is a lot less mess.. in hospital. I am not sure if they would really be as effective in the back of an ambulance bouncing up and down though. The patient definitely can't be moving to put them in unless you have GREAT IV skills. I have yet to see the other type posted. I wonder when we will get those out here.

I'm actually surprised that more of you don't carry your stethescopes with you. I carry mine on a clip made for it, that way it's not on my neck. Since I work in the ER what I need is a bit different than you guys. I carry my shears on a clip attached to my waistband, my id clipped to my lower right pocket, a few pens since I always seem to be misplacing them, and a roll of plastic tape attached to my pants with a pair of forceps. I love plastic tape sometimes... Keeps my pockets clear and things handy. Those are my basics I have all the time. Now if it's busy and I'm running like crazy starting IV's all night I might have a handful of IV flushes in my pockets.. but that is occasional... not nightly. My backpack which goes every place I work.. my asthma medicine, a variety of food and drink products since a 12 hour shift often turns into a 14 or 16 hour one, my personal cell phone, off since I don' t use it at work anyways, and anything else I shoved in there the day before and forgot to remove. Oh yeah.. my palm pilot because it has reference material in case we can't locate it easily otherwise at work, like drug dosages and such. I used to carry it on me but ended up dropping it so many times I figured it was safer in the pack than in my pockets.

I would have had to back up in traffic in order to park behind him. I wasn't planning on stopping if it was a simple fender bender like so many are. I only stopped because I noticed what appeared to be an unconcious male in the rear vehicle with major front end damage. The accident happened a few car lengths in front of me... 60 to nothing in a few seconds. We were lucky there weren't more cars involved.

The ambulance ended up parking in front of my car but I couldn't park behind his and be safe. I thought I had parked far enough in front for them to park between. I was gone before they removed their equipment from the ambulance.

So that's pretty much what I did do. Due to the failed air bag I was reluctant to do a more thorough assessment for both of our safety.. so instead I kept talking to the guy, monitored his respiratory status and maintained his c-spine until a medic actually took over and placed a collar. I let him know that help was on the way, when I could see the ambulance coming, etc... As soon as the medics took over and I told them what I knew of what had happened I got the ok to leave and was on my merry way. I was the only one who actually stopped. I drove ahead and parked and walked back. The dipsticks who stopped to yell and cuss were causing more delay than I did. Oh.. and the tow truck driver who thought he would be helpful and tell us to move it to the side of the road. The accident happened in the fast lane, along a concrete border, next to a construction zone during rush hour traffic. I was on my way to work.

Ok.. so I'm posting this as a learning lesson for myself. I'm interested in YOUR responses. The incident involved is a freeway speed MVA, major front end damage to the rear car, I believe it was a Toyota, two door sports car type. Young male driver, mid 20's. No seat belt and the air bag failed to deploy. Upon arriving at the scene, the driver of the vehicle initially was unconscious but breathing, aroused to noise. He unlocked the door. At that point I opened the door and told him to not move anything any further. Having no rescue equipment, and having just called 911, what would you suggest from this point on? My inital assessment of this gentleman... rapid shallow respiration rate, complaint of "not being able to breath", positive jugular distention, equal radial pulses bilaterally, under 100 beats per minute, positive tenderness to mild pressure to the abdomen, positive cervical neck tenderness.

Am I allowed to flip off the original poster for acting like a 2-20 moron? I'd love to tell him to shut the mouth and open the ears since that's why God gave him one mouth and two ears, hopefully so that he could learn twice as much as he spouted out about. It's great that he and other paramedic student decided to keep on doing compressions while the rest of the ER team took care of the rest of the care of this patient, but that doesn't mean that the entire code was a cluster.

Ok.. the song I can't get outta my head the last couple days.. Animals by Nickelback.. :iroc: :headbang:

I've been laughing at so many of these posts. Thanks for sharing folks.

Hi folks. I should probably introduce myself. I'm currently working as an ER nurse, usually at night. I love learning and I try to ensure that I learn something new every day. I have two teenagers who have both given me gray hair and several near heart attacks, but I love em anyways.

Dang, my teenage son with learning disabilities spells better than this! :scratch: Go Spell Checker Herbie!! :thumbright:

There's pills for crazy... I'd rather be considered insane... :geek:

Place patient on the hands-free pads, Add Oxygen to compensate for the cardiac work, Drop the largest line you can and add a deisel bolus to land at the nearest appropriate facility. Be prepared to administer Amiodarone and possibly shock patient enroute. If possible, please attempt to obtain as much prior medical history as possible. Also, have the patient blow through a straw, or try to blow up a glove.. it might slow his heart down. That's what we do while attempting to place the lines.