MSDeltaFlt

You're right. I thought I forgot to add something. Thanks.

I may not be legally savy in every state, however, if you are 18 or older, or an emancipated minor, Conscious/Alert/Oriented to at least 3 of the following: person/place/time/events, verbally appropriate, AND not a danger to yourself and/or to others, then you have the right to refuse just about anything you wish. Any deviation in the above, as patient advocates, you WILL lose your right to refuse. Due to HIPAA regulations, we do not have the complete story here, for we were not there. With respect.

1700#?!? Damn! The heaviest I ever transported was a 700 lb'er I DC'd from our ICU to the ICU in her home town. Our maintenance dept bolted 2 beds together. We had to leave our stretcher at the ER and had her on the floor of our truck. She was barely able to fit on their single bed at her hospital. Upon sliding this pt from the floor of our truck to her ICU bed, the bed rolled over my big toe joint; during a particularly strong gout flare up. I stopped crying the following week.

Maybe I wasn't more specific. I meant that it would take 1-2 more natural disasters AT LEAST on the level of Katrina; possibly more severe. Anywhere from a category 4-5 hurricane hitting Manhatten up to and including Yellowstone erupting.

The current preparedness of the nation belongs on the Comedy Channel because it is a joke. Katrina "awakened" the nation, but she did not "prepare" the nation. That will take 1-2 more natural disasters. If the Madrid goes like it has been said was overdue since I was in grade school, you won't have to worry about reading my posts any more, because I will more than likely not survive it. I distinctly remember being taught this when I was in grade school. They said the Miss River flowed North after the last quake. Depending on where, and how high the river is displaced and where the levees break when it does go: you can look at my avatar and tell that I will die. Mississippi and especially the Delta is so low on the national food chain, that when a natural disaster like the one in this post hits, we will get thoroughly thumbed in the ass. Have a nice day. :wink:

Where do I start? Oh, here we go: 1. Keep your kit with you. Don't take a dump without it. 2. Almost as bad; make sure you have your stretcher. 3. Don't go on a code without your cotton-pickin' monitor. 4. Make sure your truck is in Park BEFORE you get out. 5. Learn the generic names of your drugs. Dexamethasone is NOT Benadryl. 6. Do NOT get frequent NIBP's on the same arm that has an A-line. NIBP's go on the OTHER arm. 7. Amiodarone post cardiopulmonary arrest should be given through a PUMP, not SLOW IVP. You will resume CPR. 8. If you have a pt on a NTG, and you need to change pumps. Clamp the line off! CPR will ensieu. 9. If you're in a code and the doc says to bag faster, let the pt exhale after each breath. Massive iatragenic subq air is not a good thing. At least give the family an option as to an open or closed casket funeral. 10. If you have to RSI a pt, make sure you restocked that AMBU bag. Failure is not an option. 11. Intubated ground transfers that are extubation risks and on sedation drips: add a paralytic drip or reserve your right to refuse to take the trip. "Oh %$#@!" won't fix an extubation in BFE nor will it prevent a pt from crashing on your ass.

This Jesus dude get around. I picked up this lady who told me that everyday when she falls out, Jesus comes by and brings her back to life. She must be telling the truth because sometimes she'll show up and can only write notes to the ER nurses in English because she's stuck speaking in tongues. She can't figure out why. Hallelujah!

I've had the 911 calls for nightmares, too. That @#$% is funny.

You guys are definitley right. The order I was taught for assessment is: Inspection, Auscultation, Palpation, Percussion (Look, Listen, Feel, Thump). In that order. Because if you palpate or percuss before you auscultate, you might scew the way something sounds and alter your assessment findings. You must have a methodical approach to patient assessment each and every time. That way nothing is missed.

I've often thought of this. I have a Littmann Master Cardiology. It is a heavy scope. I've wondered if you can hold the ear pieces and use the other end to knock someone the @#$% out! ... if need be of course...

V/Q stands for ventilation/perfusion. Why they have a "Q", makes absolutely no sense to me. Every healthy person has ventilation/perfusion matching. It's when you have a ventilation/perfusion "mis"match that you have a problem. Either you're ventilating more than you are perfusing or you're perfusing more than you are ventilating. A PE would give you a V/Q mismatch, or pneumo, or Pickwickian Synrome (morbid obesity with hypoxic drive and known CO2 retention), yadda, yadda, yadda. I tend to chase rabbits. I'm sorry if I did.

I agree with both spenac and incognitogirl. I do not mean to offend, HOWEVER, I believe there are very important points that were not mentioned. 1. What were the explicit instructions on the court order? Did it give the LEO's permission for forced entry? 2. Unless I'm mistaken lay people do not need evidence to call 911 stating suspicions of child abuse or neglect. And once they do, it is the government's and DHS's responsibility to assess the situation to determine whether or not this had happened. When that ball is set into motion, WHOEVER is caring for that child does not have the right to refuse treatment. The field personnel also do not have the right to allow a refusal. They MUST transport and let a physician and DHS assess that child. This has nothing to do with the quality care being given by the parent(s), legal guardians, etc. All it has to do with is proving with documentation that the child (or any person unable to properly take care of themselves) in question is being given proper care. When you think about it (at least I do), any loving parent would want laws in place to ensure that their children were taken care of should anything happen to them. Now these laws may vary from state to state, but that's how it works where I live. I aught to know, I'm always getting these ethicolegal issue 911 calls. Just my two cents. Stay safe.

Job security

Race has absolutely zero impact on whether or not I treat pain. That article frustrates me because nowhere was there mention of the different socio-economical stati and the different cultures and educational backgrounds embodied therein; which transend race. I say this because the state and area I live is in the top 5 for poverty, lack of education, drug abuse, teen pregnancy, high risk pregnancy, unemployment, STD's, litigation. You name it, and we beat out just about everybody. My state has the highest ER & OB/GYN MD liability insurance than anywhere in the country, and my area has the highest than anywhere in the state. This is a documented fact.

Own me?!? Neck deep?!? Low blow, sweet, but I love ya anyways.

I have stopped more times than I have helped. Usually I'm not needed, and I go my merry way. Twice I was used, and only one of those times I was actually needed. I had to ride in with the first medic on scene. Luckily it was in my county, I worked for this service, and the EMS supervisors and manager all knew me. This was on my way home from my fulltime job. This was before I was flying, incognitogirl.

I've lost count. So much so that I've been told I'm quite photogenic.

I tend to help out by asking if anyone needs any help; like that. I usually know my boundaries legally, and if not, I'll ask. "Normal" is a very relative statement. Yes you're normal because you're weird just like the rest of us. Know your boundaries. Don't go past them. Hope this helps

I've had two, one boy, and one girl. The first one, boy, was a transfer I should have refused to take. Mother snowed with meds from sending hosp, baby born a mile from receiving. Didn't make it. Learned my lesson to get ALL the info before transport. 2nd one, girl, 911 call 28 mi from hosp. Normal cephalic birth. Everything went great. When a multgravita OB says the baby's coming, you'd better look because it is. Never heard of stork pins. Would love to have them.

I've always said: "The best RN's have strong LPN skills, and the best medics have strong basic skills". There is no such thing as a bigger and better mouse trap. If you can't do it with the basic equipment, then you can't do it. It ain't the arrow, it @#$% indian. With respects

That being said, some actually think I was serious about pleasuring in causing harm?!? Oh, that's rich.

"Putting" and "slamming" are two completely different words with two completely different definitions. I say what I mean and I mean what I say

That's why God created Valium. Me, my partner, the cops on scene. Multiple people to put pt on their face and I also give a sedative. I never said anything about "beating anybody up. They need to see a doctor. Cops aren't medically trained. I'm the chief medical officer on scene which makes me the HMFIC, and I say they go with me. If you can prove that you are advocating for your patient and do no harm, you might get into a little trouble, but not punished.

Let the cops place them into custody?!? Wait just a cotton-pickin-minute here. If you have a pt who is a danger to themselves and/or to others ESPECIALLY with a plan, they have lost their right to refuse treatment and transport. They need to be evaluated by a medical professional who is specially trained in psychological disorders. Period. Without question. End of discussion. A doctor once told me, "When you are met with a crazy person, you have to ask yourself two questions: 'Are they crazy because they're sick, or are they crazy because they are crazy?'" Crazy because they're cick means chemical imbalance. It's medical. They're sick and need to see a doctor. They got to go the hospital. If they're crazy because they're crazy, they are "nucking futs". They are just plain crazy and need to see a psychiatrist. Still gotta go to the hospital. Either way, they're going to the hospital. Usually I can get them to go easy. But make no mistake about it. If they don't want to go easy, I WILL put their faces on the floor, and they're going anyway. Besides it is a little therapeutic.

I can see where both sides are coming from on this thread. I work fulltime with incognitogirl, and feel safe hearing her voice on the other end of the radio. If there is not much info, it's not because she isn't trying. The CIA calls her for help on interrogation techniques. She can get blood from a rock. I used to think the same as the original poster when I first started in EMS. I work part time on a rural ground service in a very impoverished area of the country. 60,000+ city, majority of it is hood with few street signs or house numbers, very bad streets, over worked and under staffed PD, you get the picture. EMS also runs >1000 calls/mo in this county. That's when I started to really learn things. Dispatchers are very trained in what they do. They are a very integral part of the EMS system. They get more information than you will ever realize. Let's just say they didn't. Let's just say, for the sake of arguement, that all they gave you was the location. There isn't a call out there that you shouldn't be able to handle. I've been called for "sweating". They were dead. I've been called to a dead person. Got a refusal on them. It happens. We've all had calls like these. Dispatched for a vaginal itching. Met us on the side of the road doing the PEE PEE dance. Late 3rd trimester OB constipated >1mo. A naked Schyzophrenic 8 yo - WTF?!?!?! But you handle it. Just like every other call, with or without information, you just handle it. A true patient advocate can. Skids up