ERDoc

I miss my time on the bus (yeah, I said bus).  Maybe we make the past seem much better than it was but I would love to go back to those days.  I don't miss some of the shit that management pulled, like the guy in the Durango they hired whose only job was to sneak up on crews and find some way to bust them.

If I could talk to the young me I would tell him, "DON'T DO IT!!!  DON'T GO INTO MEDICINE!!!"  The enjoyment of medicine is being beaten out of the field by people who have no medical knowledge and have never taken care of a pt.

The good things are usually the little things that we don't even think about.  Clear numbers on the house so it's easy to find.  Clear pathway to the house and to the pt once inside the house.  Dogs put away so they don't become an issue.  List of meds/hx or meds easily available.  Parents helping to calm a child instead of feeding into the stress and anxiety the child is feeling and making the situation worse.  Although it was said tongue-in-cheek, calling 911 is probably the single most important thing they can do.  Without it, nothing else happens.

Called 911.

And some of the unhealthiest people live in those flyover towns and don't have any medical care until they are at the point of needing an LVAD.

LVAD?

Welcome!

In 15 years, I've only had one pt not respond to a dose or two of benzos and we ended up RSI'ing him.  Just remember when you RSI status that just because the body movement has stopped, doesn't mean the brain activity has stopped.

There definitely seems to be some increased activity now.  I'll admit, I haven't been here in a while but it's good to see things picking up.

Admin, is there any way to add a button just to see the new content in the forums?  There used to be a button like that previously.

Backboards are great for getting the ambulance out of the sand that is up to the rear bumper when you are at the beach, so I hear.  Otherwise they aren't too useful.

Sounds like some bad calls were made.  Would the outcome have been any different?  There is no way to know.  One thing you will learn in the medical field is that no one will publicly discuss mistakes/bad decisions.  Doing so, opens up everyone on the call (yourself included) to a lawsuit.  As others have said, discuss it with the medical director but I wouldn't say anything more about it in a public forum.

We responded to an adult female resp in a neighboring district.  It was an apartment attached to the back of the house.  We go in to this apartment and the place is immaculate, black and white decor. We walk up the stairs to the bedroom where the pt is and find a 20-something female laying on a mattress that is on the floor.  Above the mattress is a sign that says, "Welcome to Ms. Stacy's dungeon." (Name changed to protect the innocent and the naughty).  The ALS guys starts doing their assessment and I'm standing there next to the cop that responded.  Next to us is a coat rack and the cop starts looking through it.  There are all sorts of leather outfits, whips, chains, thigh high boots and a bunch of other things I didn't recognize at the tender age of 18 or 20.

http://www.snopes.com/medical/emergent/potato.asp

I think this is one of those situations where it was an on-scene judgement call.  Depending on exactly what was going on at the time might change one's answer.  10 minutes is too long to go without CPR but what exactly was happening when the arrest occurred?   Was the pt on a stairchair in between flights?  Were they in bed?  That would make a huge difference in how quickly you could start compressions.  OP, being that you almost chanted BLS before ALS, it makes me wonder about your experience level.  You may not understand why some things are done the way they are.  You say that there were other meds that the ALS crew could have given.  What were they and what were the indications?  We don't just push meds to be pushing meds.

If the pt lost his pulse in a place where it would be reasonable to start working the code, then it should have been worked.  Once the pt codes, there is very little that the ER can do that a properly trained and equipped ALS unit can't do.  Too much missing to make an informed decision at this point.

Welcome!

Hello from someone who used to live in the southern part of NY.

This is where blindly following protocols is bad.  Yes, the pt c/o chest pain but why might that have been?  Hearts weren't made to run at a rate of 160-180 so there might have been some ischemia, but it is most likely rate related.  There is not much use for ASA or ntg in a case like this.  You want to get the rate down.  I'd be very cautious about converting (ie, I wouldn't convert)  since we don't know the onset.

Not to mention that most of the questions aren't really 'medical' if you know what I mean.

On 10/29/2016 at 8:16 PM, scubanurse said:

Because not everyone wants to be a MD!

And that is what's wrong with America today.  I didn't mean it to come off like that, lol.  It just seems that if someone is starting in high school, it is just as long to go either route.  It's different for someone who has been a nurse and already meets most of the prereqs.  

Why do you want to be a CRNA instead of an anesthesiologist?

Welcome!!

Wow, someone seems to have a serious hero complex.  He lost any credibility at the mention of the golden hour.  The average EMT/paramedic/nurse/doctor should not be entering an active scene.  The only thing you will get is more patients/victims.  There is a place for specially trained medics who go into these scenes but since they are so infrequent, training everyone to do so makes no sense.  Yes, it sucks that people may die, but that happens.  Life isn't fair.  Would I be happy if it was me or my family in there that needed help?  No, but I wouldn't ask someone else to put their life in danger.  It's the straw that we draw.

Normally I hate necrobumps, but the names that come up with this one make this necrobump awesome, from the OP to Dust.

4 hours ago, Ruffmeister Paramedic said:

Unless you are watching reruns of rescue 911 or Turdwatch.  

The funny thing is that the show that most closely resembles real medicine is Scrubs.  

And back to the OP, the answer is, it depends.  EMS is very different from one location to another.  In my paid position I worked 8 hour shifts and was off on time, most of the time.  As for EMT class, it's really basic.  If you can pass high school, you have a really good chance of passing EMT class.  Most EMT books are written on an 8th grade level.  As for the calls, yeah, you'll get your saves in once in awhile but most calls are mundane calls that don't need an ambulance.  In some places you will be doing renal roundup or interfacility transports.  It's not the way they make it look on TV.