MedicRN

Wether it's fiction or reality, it still reflects on our profession. The reality is even that fictional show was as close to reality as they could get it in that day and age.

If you want ideas from us for your fictional story, then be prepared for some reality answers.

This cat was found abandoned in Iraq. His owner is believed to be hanging around the area but we are not sure. If you would like to adopt this cat, click on link below for his picture and instructions on how to do so.

------AK

I should have known better................ :roll:

Hello all. I am going to be starting nursing school next fall at Holy Name Hospital School of Nursing in Teaneck, NJ. This program is only two years, so I graduate as an RN with an associates in Nursing. Is anyone here familiar with a New Jersey RN to Medic bridge? And if so, what would be the steps I take after graduating to become an MICN?

Try searching the forum for related threads before posting questions. Many times, the question has been answered ad nauseam. There is a current thread pertaining to this subject. http://www.emtcity.com/phpBB2/viewtopic.ph...&highlight=

As far was what steps you need to become an MICN...... many years in an ER or ICU.

Doesn’t America have the double degree of Paramedicine and nursing?

Where I'm from we don't have a double degree. The requirements of both programs make it impossible to do them together. We do, however, have bridge programs (medic-to-RN and RN-to-medic). Can't say I've heard much good out of either program.

If you truly need to speed (example: working a code) you need to have a PD escort. I know these are rear, but the places I have worked I have tried to work with the PD to be able to arrange them. They respond to all codes when we call them back to dispatcher as on scene with arrest. (along with everybody and their mothers around here) And when we leave they shut down intersections in front of us, so we can go full speed code 3 safe.

I'm a bit late getting into this thread, but I just had to put in my $0.02 on this matter.....

I don't care what kind for rapport you have with your local LEOs; PD escorts (as well as any other caravan of emergency vehicles running hot) are too dangerous to be worth the effort! The only way I would accept a PD escort would be if they were stationary at intersections and not playing leapfrog with me (I despise local funeral escorts for this reason). Other than that, they are useless and dangerous. The public sees the first unit go passed and assumes there are no others following (generally), so they proceed into the intersection only to be clobbered by the next L&S vehicle. I've seen it happen and have almost had it happen to me. I will always turn down an offer for an escort and will find an alternate route to my destination if another unit is L&S from the same scene.

For those who haven't figured it out..... Use the arrow keys to direct Santa to his drinks and snacks........

Ruff........ if you're level 32, how 'bout giving me a hand with 14. I'm diein'!!! And don't tell me to 'right click.' I need help IN the right click.

I'm stuck on 14 and it's killing me!!!! I've figured out the answer in the text, but I can't seem to find the other half. Does anyone have a clue for me??

Can we get a lock on this thread which has run amuck???

The first 2 levels were easy but sadly I'm stuck on level 3.

Same here............. any hints???

I've been an AHA instructor for 20 years. I have maintained through them as it is the easiest way to get any updates. However, I now teach primarily through Emergency Care and Safety Institute.

....... bad URL ......

In my opinion, you can never have too much documentation. If nothing else then to have a record to say you responded to the call (and CYA if something were to go wrong or be strategically/accidentally omitted by the other company).

However... (there's always a 'however'), if you are first on scene, a PCR needs to be completed documenting what you did for/to the patient, results of treatment, and to whom you handed care over to (and any other pertinent information) - all just as if you transported and released to the ER. Even if you arrived on scene the same time as ALS, document such..."Arrived on scene same time as XYZ ALS Company. Assisted with patient care/treatment as directed by J. Schmoe, EMT-P. Patient transported by XYZ ALS Company." If no patient contact is made by your service, document such... "No patient contact made. XYZ ALS Company on scene. PQR BLS Service released by XYZ ALS Company." Even if you ride in to the hospital as an extra set of hands, document it... simply add something to the effect of "J. Doe, EMT-B, assisted with patient care/treatment as directed by J. Schmoe, EMT-P, while enroute to ABC Hospital." You don't have to write a novel.

Wow. Bad luck. Something got to his brain stem. Can't usually live through that for long.

Based on the hx of DIC, I would venture to guess he had a rapidly expanding subdural bleed (and maybe a few other bleeds) and herniated through the Foramen Magnum. The last VS he gave was showing increased intracranial pressure and a probable herniation in progress.

Sounds like Shelbmedic did his best to get him the care he needed.

I would have to agree that bagging while doing compressions would not be effective and would at best cause alot of Gastric Distention. So that is kind of odd to me. A couple other things in this scene don't make sense to me, maybe someone can help me understand or you could clarify.

He was in V-Fib, You shocked him at 360J? Right off the bat? And that converted him to PEA, but he had pulses? You should have gone through the 200J, 300J, 360J on a Monophasic Defibrillator or the 120J, 150J, 200J on a Biphasic Defibrillator. Maybe clarify for me because on the last post you said he converted to a First Degree Heart Block, which also isn't PEA. Thanks.

New guidelines are 360J monophasic (200J biphasic) on all shock deliveries. AEDs are being reprogramed.

The Dr. on call couldn't belive that this lady was even alive after the first night in ICU. He said another hr at home she would have been DOA.

Yes, she is quite lucky.

I think someone just commited professional suicide :shock: :shock: :shock: :shock:

My first post So here we go.

Called for a 55y/o F. Intentional OD on ASA. Being told by dispatch that scene is safe no need to stage, but we sent PD due to location is 45 min from the main town. Arrived on scene @ 11:45 hrs to find a 55 y/o female inital scene safe PD on scene

Pt took 100tabs of ASA ES 500mg/tab ingested at 19:00hrs.

Please verify..... ingestion at 7PM (1900)?? On scene at 11:45 PM (2345) or AM (1145 the next day?). Don't think this would make much difference with a potentially lethal dose ingested.

Pt is CAO x 4 vitals P-120 reg strong B/P 130/90, Resp-24 shallow reg, Spo2 94 on R/A C/S of 8.1mmol,Skin Pale cool sweaty.

Only other C/O of abd pain going across abd left to right 8/10. No abd distension noted no pulsating masses,Lungs clear equal bilat. no JVS no TD no CP, No N/V/D. pupils E/R @ 5mm hand and feet strong. 12 lead shows sinus tach no ectopy noted.

We were on scene with the pt 10min then transported code 1 to local hospital which is 45 min away. While in route pt states she needs to pee as she put it. The pt goes to the voids out 350cc of bright foul smelling urine and now c/o of a H/A 9/10 across her forehead. Vitals now are Hr-126 reg/strong ,Resp 24 shallow reg. B/P 188/96, Spo2 100% on 15L/min.

Pt is very restless and needs to pee every 10 min pupils are E/R 5mm. Pt was still CAOx4

we treated this pt. with Vitals o2, via nrb@15L/min, 12lead x2, 2 large bore IV 14RT AC and 16 Rt arm Heplock, Rapid transport as well we called for life flight but it was on a mission.

How would you treat?

Since this is an intentional OD, scene safety is mandatory. PD should do a quick pat down.

Primary assessment = ABCs (per scenerio - airway patent, breathing (though probablly not optimally), circulation present (rapid pulse)). VS = as noted in scenerio (would have expected the BP to be HYPOtensive). Since pupils are still midsize (or larger), I'd suspect that something additional (or entirely different) was ingested.

Additional questions would include presence of hearing and vision deficits, ringing in the ears, hallucinations, dizziness, extreme thirst. Does she have a fever (despite the ASA)?

Continue to confirm level of consciousness (would anticipate a decrease in status (confusion) if it hasn't happened already).

Treatment would consist of highflow O2, large bore IV, monitor for cardiac arrhythmias and get the heck out!! What is her blood sugar?

After consult with my medical control (or your protocols may cover it), I'd consider an amp of NaHCO3 and a liter bolus of NS (provided her lungs will handle it - be on the look out for pulmonary edema).

Regardless of the elapsed time, because she apparently took 50 GRAMS of ASA (usually lethal dose depending on body weight), I'd have my intubation roll handy (with blade ready and tube selected/prepped) and be prepared for vomiting, seizures and/or coding.

In my opinion, her prognosis is rather grim............

No shot for me. I'm too much like my dad..... He got the flu shot for years. And for years, about 2 weeks after getting the shot, he'd get the flu. About 5 years ago, he quit taking the shot and he quit getting getting sick. Go figure. :-k :dontknow:

#-o #-o #-o #-o #-o #-o #-o #-o #-o #-o #-o

I'll start by saying that you labeled yourself a village idiot in your profile not me , but you have now proved it as well. I suggest you read all my post before becoming a drama queen.

Sounds like the pot calling the kettle black (no offense, AK).

I will be the very first medic on here to tell you that there are people with way more experience and BTDT military experience than me Some members of my unit are members here as well. There are plenty of examples of people I have developed respect for Asysin2leads and Dust devil are two examples.

Yes, the military Health Services Branch does more and has seen more than any of us put together, but they can also tell you that being a medic in the military doesn't mean jack crap in the civilian world (been there, yada yada). Civilian and military are VERY RARELY interchangeable.

Rescue 911 was a show you would never see me on.

Good!! I'd hate to have to defend EMS's black eye to my civilian and military superiors.

From now on why dont you stick to your business and let the person I addressed originally in my last posts make their own argument.

He is sticking to his business...... but he doesn't need me to defend him...................

After a rather traumatic EMS call, I got out of the field for a while (about 3 years total). I eventually got a job in an ER, but quickly found out how frustrating it can be for a pre-hospital provider. While I could still use my 'head-knowledge,' I couldn't 'do' anything with it - I couldn't even DC the IV I had started an hour earlier while sitting on the ER apron of the facility in a different uniform!! Yes, I did get quite proficient at placing foleys, cleaning up rooms for the next pt, taking VS with a machine and applied more plaster than Paris has available!!. I also wore a rut in the hallway tile between the ER and CT scanner (averaging 25 trips a shift). I did get the occasions to assist with the repair of severe lacerations and learned more about the human body then I thought possible. Would I change it if I could do it all over again? Not on your life!!

PS.... I did get back into part time EMS for a rural service (600 calls/year). But also during that time, I returned to school to complete my nursing degree (started some 18 years earlier).

I wonder if the same thing is happening in, oh say, Wichita.............

Come spent a few days here....... you'll love it!!! We have everything you could ever want.... all of it in about any 10-block square area in town........ McMansions, hookers, malls, housing projects, car dealers, drug dealers, fireworks after the local major league farm team games, gunfire every night of the week and a beautiful flowing river with a rich Native American heritage!!! Oh, and half the population would just as soon shoot you as look at you!! And as the Air Capital of the World, we have 4 airplane pieces and parts manufacturers within our midst (with at least one having some union on strike at any given time).

You can't beat that with a stick. Ya'll come visit now, ya hear!!!!!

Ok, I need to hijack this post for a few replies. How exactly is the best way to test out a patiens cranel nerves (specificially I, VII, and IX) prehospitally?

Better yet, start a new thread....................................................................

CBC, BMP, Mg, Phos, ICa, HA1C, UA, CT (maybe an MRI).