dougd

Bad puns over an austin martin about someone who was decapitated. Apparently this is a James Bond forum today. +5 jsadin for the Austin Powers pun.

firedoc, sorry to hear about your wife but, as everyone else said, glad to hear that everything seems to be working out and checking out ok at the moment.

Thanks for all the work Terr.... i. There, I added the "i". I added the "i"! :-)

Sorry if it sounded harsh. Thank you for explaining why you took the interventions that you did. My partner and I usuall run through all of our calls after and discuss what we think we did right, did wrong, didn't do... sometimes it's a bit harsh. But I find I get a lot out of it. It's the best thing you could do to help your patients. That's my plan.

You mean there are tattoos that don't look like trash? Sorry, I missed the memo. (I'm only kidding!) Where I work, corporate policy is that they are not visible. Likewise, no facial hair below the upper lip, and no piercings except for earings in females. It's not enforced as strictly as it is written.

I'd like to hear some more about this call. What did dispatch tell you - that the patient was post-seizure or that they were still actively seizing? What kind of Hx did the family provide? How long had the patient been seizing for? Nothing about this call sounds like it should have been handled BLS to me. 3yo actively seizing... probably now long enough that you could classify it as a 3yo in status epilepticus... that's a basic call??? Why are you messing around with the monitor and putting the leads on when your now supine (I assume) patient is compromising his airway - as evidenced by the need for suction? First of all, am I the only one who figures you're going to have plenty of artifacts if the patient is still "twitching?" Secondly, how is what is displayed on the monitor going to change what interventions you provide at all as a basic? It's not. It sounds like you did a good job in that the kid did ok, I don't mean to take away from that. I'm just curious what your thought process was because, from one basic to another, I want NOTHING to do with this call beyond getting the call upgraded to ALS and maintaining an airway until we can get to an intercept point or to the ED, whichever is first. That said, if that's all you have in your system, that's all you have. (But the way you worded your original post, I suspect it isn't.)

The ramifications: There would be a lot of people so worked up siting around IAFF and IAFC conference tables that blood would literally shoot out their noses.

Well, I can't disagree with the "fix it and forget it... as long as it runs." It's definately a problem. So are the run dodgers, but I'm not about to start sleeping with my supervisor to get around that.

I agree with JPINFV. If a pt is too big to carry with the number of people on scene or needs a bari truck, I don't move that patient until we have adequate resources. If that means we sit for 2 hours, we sit for 2 hours. Check your company policy. If it says you need a lift assist for patients over x pounds, get the assist. Failure to do so may lead to worker's compensation denying your claim if you injure yourself in the process. It doesn't matter what the dispatcher said. If the company doesn't like it, tough.

Hi Terri... this is God.

I was taught to palp as you inflate the BP cuff and then listen 30mm/Hg above that in basic school, too. Of course, I was also told right after, "and that's what the book says... tell me if you ever actually do this in the rear world in the back of a squad."

Anymore, people don't just get sick and die... someone has to be blamed and sued.

I had a professor once who liked to tell all of students about how jobs work: An employer agrees to pay the minimum amount of money they can to get the employee to show up every day and put up with the crap that is dished out. In return, the employee does the minimum amount of work required to keep said job and paycheck. When either of those competing interests get out of balance, the employee and the employer usually part ways. At the time, most of us scoffed at that. After all, I think I'm a hard worker and want to get ahead and do a good job, so I should be doing something for them in return, right? Get laid off from a job that you poured your heart and soul in to and you learn there's no loyalty there regardless as soon as there's a way to find someone who can do your job cheaper. At the end of the day, your doing the best job you can do in return for your paycheck IS doing something for them in return. It's making them money at the cost of your time. That's the arrangement you sign up for when you take the job. If you want to work for free, more power to you, but that certainly isn't the path to financial freedom. Look, I don't want to sound jaded. (Too late?) I'm just trying to give you a free lesson here. You're a smart guy and if you're anything like me you're going to roll your eyes at this and continue to shape your own opinions through your own experiences - and that's ok, too. As for the hospital in your area - there could be a variety of reasons that those surgeons left. Poor pay. Poor management. Or perhaps the hospital just didn't want to spend the money anymore because they didn't feel it was worth it.

Jobs shouldn't be about sacrifice nor should they be about being available "whenever physically possible." When I was your age, I lived for work and it wasn't uncommon for me to be working 60-80 hours a week - and this was for a salary job based off a 40 hour work week. These days, I work to live. My priorities have shifted and when you realize that you're going to work for the rest of your life and there are so many other things that are more important - you start to cherish the time you have off and away from it all. (Although my girlfriend would probably tell you that I'm a workaholic still - but at least doing the things I want to do now.) But getting back to your Doctor comment: If I spent a cool quarter-million or more on my education, not to mention 8 years of my life on getting run like a dog, dealing with megalomaniacs for instructors, insane shifts, and VERY rigorous studies - I'd be confident telling you I sacrificed enough already. Screw the night shift. (Wow! Did I really just write a post that started with, "When I was your age?" :shock: I'm officially getting old... just put me out of my misery! )

We had a list of departments in the area, with dates and times, that we could sign up for to ride along. We were required to do 10 hours with FD, 10 hours in the ER and to have a minimum of 10 patient contacts for which we filled out sample run reports and returned to our preceptor. Those were the bare minimums.

Does she call herself Terr? :twisted: :twisted: :twisted:

I know I saw a link to the original story on this somewhere around here - but after searching for the past 15 minutes, I can't seem to find it. In any event, Tiffany Forte was indicated today on 14 counts relating to stealing credit cards from one of her patients and using them. http://blog.cleveland.com/metro/2008/07/pa...or_stealin.html Oh, and as an aside... if you DO plan on robbing your patients and using their credit cards, you might want to wear something other than your agency's T-shirt while using them. :roll: If it wasn't so pathetic, it would be funny. Proof again that most criminals are complete idiots.

Ten nurses working at hospitals and health care facilities throughout Cuyahoga County were indicted Tuesday for stealing prescription drugs from their employers for personal use. Many of the nurses helped themselves to high-potency painkillers, such as Vicodin and Demoral, from drug-dispensing machines at their respective facilities, prosecutors say. But in other cases, the nurses stole the pills that were on their way to patients in pain. http://www.cleveland.com/news/plaindealer/....xml&coll=2 More black eyes for the medical community around here. The list of facilities these people worked at is pretty widespread. :roll:

Have fun, do good, and most of all... be safe.

That sort of goes with the territory...

My basic class was 110 hours of classroom / lab. 10 hours of ER time. 10 hours of FD ride along. I passed the NREMT-B test the first time, so I'm one of the ones who did the 110 hour and passed. Now then, that 110 hours doesn't count the time I spent studying outside of the classroom, that was probably another 100 hours. Also, I learned that the EMT-B teaches you the bare minimum and you really don't know crap about crap. Which brings me to... I'm looking at starting paramedic school in January. That's a ways off yet, but I've been banking the money I'm making working part-time with the ambulance company to pay for it, and that's the next time the Cleveland Clinic EMS Academy is offering their night program. I'll most likely leave my part-time job for the year I'm in paramedic school. Somehow, I doubt I'm going to have the time to work my full-time job, continue taking 12 credit hours towards my BS, attend paramedic school and the required clinicals AND work 2-3 nights a week running squad.

I'm assuming that was the SPO2 upon the staff finding the patient. I doubt they left her like that. It's easy for us to trash the folks at extended care facilities, but we don't work in an environment where 30 to 1 is considered an acceptable patient - provider ratio. I'm not saying that bad care doesn't happen, but Itku2er already told us she was the nurse at the facility and I think we can agree that she's smarter than the average bear.

Clipped a mailbox on the side of the road with the right side mirror once. It was a narrow road without curbs or sidewalks and orange barrels in the middle of the street to close off the left turn lane at the upcoming intersection - I was a bit too focused on the barrels and allowed myself to get too far to the right. No damage to either the mirror or the mailbox, I just grazed it and was traveling slowly at the time. Still, a rather butt puckering experience when you hear that "thwap." :shock:

*sigh* I'm hardly insulting the intelligence of diabetic patients. I'm fully cognizant that my diabetic patients know more about their disease and how it affects them than I could ever pretend to. The point I'm trying to make, and perhaps I worded that poorly, is the actual act of taking a blood glucose reading via a finger stick is an easy skill to teach and learn. Now then, understanding why it is a good diagnostic tool and can provide some useful information as to what is or is not going on with your patients requires education. I'm all for increasing education in EMS across the board and I certainly don't believe we should just be pushing skills down the chain to EMT-B's for grins and giggles without increasing what we are teaching. I already listed in a previous post on this subject how I believed it could improve patient care: "On a squad running B/P, it frees the paramedic up to take care of other parts of the assessment and on a BLS squad it at least gives you an idea of what you're dealing with. Sure, if they're down far enough they're going to need a line, but if we can identify and treat our hypoglycemic patients before we have to move to an invasive intervention, I'm all for it. "

Well, it's a big assumption on my part - and we know what happens when you assume. I'm going to see someone tonight when I get to base who should know, I plan to ask.