mstovall

Two districts in our county have BLS ambulances that role, every other VFD has a rescue truck equiped with everything a BLS ambulance would have minus the transports capabilities. The VFD usually gets on scene 5-10 mins prior to the ambulance. We also have an ALS quick response truck that responds by the paid crew unless there is a fire. They can usually get there about 5 mins prior to ambulance.

Does it make a difference if you are IFSAC FF II coming into FL?

One of my last calls of my intership was a status epilepticu. We gave 20 mg valium and 6 mg versed and the chick was thowing my partner off of her in the truck from muscle tremors. He was trying to suction some while I was dropping a nasal ETT. I will always drop a tube on these people if I ever encounter one again. There is something seriously wrong with the electronics upstairs for them to be a status epilepticus. Airway is the first priority. What is the first thing a lot of seizure patients due when you finally get them to stop seizing after this? Throw up. While they may bite an oral tube into, the nasal tube is unlikely to be damaged (dislodged maybe which is why you should reevaluate often). This girl ended up having a tumor the size of a KIWI in the middle of her head. While I wouldn't just do this to any seizure patient, I think the treatment for a SE is to try and stop the seizure. However there may be times when all the drugs you have on board are used up and the seizures continue. Just hope you have a good partner and they drive safe. This chick also pulled out three lines from her hands and arms from her tremors, as the tape wasn't holding well. I kling wrapped the last one in her hand and it came out too over a period of time. To make things worse she was in the second story apartment of a very run down place. It was all that four people could do to get her down the steps in a stair chair while she was still seizing. My first 10 mg of valium and my first 3 mg of versed was in the apartment and the second doses were in the truck en route. This is also where I dropped the tube and established the fourth IV in a chest vein. Her glucose was checked by the EMT after every IV and never dropped below the 90's. This was one of my six true tests during my internship. My Med Dir said we did a great job and so did the preceptor, but I am open for comment on how to alternative treatment. They finally stopped the seizures after giving her etomidate in the ER (we don't carry anything on the truck except Versed and Valium). Michael

Thanks bare. That is what I meant by VC, sorry. This also explains why I spent about an hour trying to find something that didn't really exist. I can also now understand why we don't have it with the complexity of obtaining it. I did see some studies on animals, just nothing on humans. Thanks again, Michael

Doc and Bare, do either of you know the pressure of the VC vs that of the Pulmonary vein? I can't find it in my books. Now that I can't find it it is driving me crazy. I'm just curious what the difference in pressure would be or would there be any real difference. Michael

Just thinking out loud here, but I would think that the RA would need more contractile strength as the blood that is coming in from the Venae Cavae would be at a lower pressure than that returning from the pulmonary veins. I don't know this for fact, but it seems that something in the back of my head was pointing to this as the reason. I am trying to find something in some of my books. Someone please correct me if I am on the wrong track, as I am trying to pull a 8 sec. sound byte out of about a 40 hour lecture series. Michael

Don't buy these. There is a guy on the city fire that got these, but the light can't be seen when your head is still up your A$$.

OK..........You baited me in real good. I had to watch a few of the trailers on the web site. I'm starting to wonder what the big fuss was all about. Then I saw a clip about CPR on the beach. They had the AED and all. It seemed like it took quite a while. Then I started noticing I was seeing the exact images over and over again with a detailed dialog. Is this incompetence on the lifeguard's behalf, or is this the editors of the raw footage trying to make things bigger than they seem. I will give everyone a benefit of the doubt based because I think they are doing some weird editing on this show.

"Med-92.....You're en route, priority 1, for a person.............................................They did what.............................med-92, You're en route, priority one, for a person who sprayed Taco sauce in their eye and is now blind:

Ooooooooo. So philisophical. This is like you can never really touch something because you can always half the distance between two things. Yet we can feel, experience life through touch, even perform our work based on the evidence of touch. So can you really be somewhere, or are you just next to somewhere all the time out in nowhere? Michael

Ok. We have a supervisor that is fanatical about car maintenance. I mean you could eat off his engine it is so clean. He races every weekend off just about. Well if you empty a jar of caster oil in a latex glove, and then put said glove on the exhaust manifold, and the said exhaust manifold heats up, melting said glove, and having the caster oil fall all over the exhaust manifold, well..................let's just say it makes the smoke screen of the batmobile look tame. Just be sure it is done to the guy that warms his car up for 15-20 minutes prior to leaving each shift. Then watch for the great joy he has while trying to figure out what is wrong. Then watch as he flips the 10-15 EMS personnel in the windows laughing at him. That is what I call good fun. Michael

The ER this happened in is said to be the busiest ER in the state (the only major hospital in about an hour radius). The said dr. is routinely like this. I heard today that there is a lot of pressure from the top down on this one, but don't know if it is true. Yes I am offended by the treatment. I don't care who you are, everyone deserves the best effort. Calling off CPR and then waiting for the agonal rhythms to terminate for 6 seconds to print off a strip is wrong. Talked to one of my friends with PD who is a medic and used to work with me and was told that the body was going to the state medical examiner's office due to several reasons. I guess if progress wasn't being made (getting a PEA) from the asystole with ACLS, I wouldn't be so annoyed. I guess if the medics weren't so bothered, I wouldn't have been so bothered either. I know everyone has their time, but I just don't believe in helping that time come any quicker. It was a bad day 4 codes including this one + 18 yo that was in ICU from MVA (her car vs semi), but dang if we can get them there with something, at least spend a few minutes actually listening to everyone, don't just say, "Nah, I'm not going to work this one." Thanks for the responses, I don't know that I was really looking for responses, but more of a place to vent and see that others had to deal with the same crap that I was dealing with. Sometimes sanity is just knowing that you are not the only one that sees this stuff. Michael

In the ER (where we are posted if we are the only truck available in the county as it is centrally located), and we are waiting for a truck coming in emergency traffic with GSW to the chest. Pt. was a 27 y/o M. (note: no gun was found on scene) VERY LITTLE BLOOD ON SCENE, ACLS HAS BROUGHT BACK AN AGONAL RHYTHM!!!! Dr. in ER makes comment that, "If this is even close to asystole, I'm not wasting our time with it. F@#$ing suicides." The police treated this as a possible homicide due to lack of evidence at the scene of a suicide. How do you deal with Dr's like this? Very frustrated as the kid was a family friend's son. He was also the nephew of a very EMS friendly Dr.

This is especially true in the USA with title 7 and title 11. If an individual could prove that they were able to perform the mandatory tasks, then they would have an excellent lawsuit, probably argued by the ACLU. I think the best way to handle this is to have a minimum in performance standards, including things like lifting a cot correctly, paramedic skills should have to be performed standing, sitting, and on the ground. The same should be expected of EMT's. We are called to act in a variety of circumstances and should be expected to perform our skills adequately in these circumstances. JMHO, Michael -1 point for not using spell check Dust. I never thought I would see this from you

A seal pup walks into a club.....................