Just Plain Ruff

Just be very very very careful

Dont let the inmate get between you and the door

Don't be left alone with the inmate

keep it professional (I know you will) but don't let them pull you in to their sob stories.  

and above all, please please please please, be very very careful.  

Get some self defense courses too.  

If Turd watch or Rescue 911 or even Emergency showed what we really did on a day to day basis, then they would have only lasted one episode.  

If those reality shows on right now showed what we really did on a day to day basis they would be on for 1 episode

People don't want to see that we may spend the entire day taking dialysis patients and nursing home patients back and forth to the hospital and their houses on one day and then spend one day taking care of a heart attack victim and a couple of sick kids and then the rest of the shift we sat on our butts waiting for a call.  

People want to see that we are out saving lives, fighting the big 5 alarm fire, saving kids, doing field amputations and delivering babies.  Throw in a water rescue and a lady completely covered in Ice in her basement with just her mouth and nose protruding out of the ice and saving her life and then top it all off by going down into the sewers and doing a hand stand defibrillation on a guy in a  flooded sewer all the while your partners are holding on to the pipes on the cieling of the sewer.  Damnit that's what the public wants to see.  And what's really cool to top it all off, everyone of those people, wouldn't you know, we save em.  Nobody ever died on Rescue 911.  

But to be completely honest, the last couple of shifts that I worked prior to pulling my arms and legs into my turtle shell and moving on to my IT career where I don't have to do hand stands, I sat on my rear end and binge watched the walking dead until the last call I got was a transfer from the ER to KU medical center for a post MI patient who honestly was healthier than I was and really could have walked to KU.  

I'm with Medicgirl

These are the steps i'd follow

1.  find out if there's a settlement coming?  sounds like he''s been in the LTC facility for a while so he should be getting some sort of settlement unless they didn't sue or something like that. 

2.  Find him a receiving facility where he's going.  That task is on his folks.  

3.  Start calling the transfer services - they are going to want to know a lot of info, such as distance, if he's on Oxygen, what kind of care he needs,  does he need meds and all that stuff. If he doesn't need meds then a basic crew would be fine to take him.  If he's on oxygen, the crews will need to make arrangements for replacement oxygen tanks.  It looks like in the picture he might need it.  

4.  Will the medical director sign off on such a long trip, especially when you are going way way out of state.  You will need to find a service that specializes in those types of transfers.  Not your local 911/transfer provider.  AMR or Rural Metro would be my first call if they are local to your area.  

I've transported a patient from KC Mo all the way to Seattle and we made arrangements with Apria healthcare so when we got low on oxygen, we just called their 800 number and they told us where the next town was with an Apria in it and they took care of us.  

don't forget bathroom and food breaks for the guy, Kind of difficult to transport someone who has a very special diet so you might be looking into a specialized transport unit with someone who can take care of this guy's needs.  Not sure if the transfer ems crew is ready to change diapers and all that.  

Our patient was a 26 year old cancer patient going to a specialized cancer treatment up in Seattle.  

Needless to say, this is a terribly long trip for anyone to take this guy on.  He's likely not to tolerate it very well.  

Not sure if I remember how far he was needing to go but back when we did our transport it was nearly 2000 dollars and that was 1992.  I'm sure it's at least double or triple or even higher.  

It's good that you want to become an EMT but you shouldn't be stressing over this.  Why are you stressing over this?  

You should get an anatomy and physiology course over the summer, that would give you a good understanding of the human body and why it does what it does.  

A good english composition course would be a good idea, if you are tasked with writing reports you will need good grammar and spelling skills, not what you have been taught in college unless you've been through college level composition courses.  

Next I would think about working your upper body and lower back strength.  You will need to be able to lift very heavy patients and sometimes you may just be with your partner.  

Conflict resolution skills and basic self defense skills are a must in this line of work as well.  

That's what I would do during your summer break.

See, nothing to stress about.  

The best thing that I think one patients wife do was give her husband an aspirin and his nitro prior to our arrival.  

One other thing was not remove the scissors from the man's chest.  he was walking across the dining room and fell.  The scissors he was carrying ended up in his left chest, causing a closed pneumo.  He wanted to pull em out but his wife refused to let him.  This probably saved his life.  

Julia, you didn't disappoint.  

On 1/18/2017 at 10:25 AM, julia edward said:

I wish you good luck on your test.  The best advice that I can give you is to get a good nights sleep, eat a good breakfast, take deep breaths, and to read through the test carefully.  I wish you the very best.  

don't forget to eat your veggies

Ok, we've all seen the stupid things a patient do or a family member do for a patient.  Let's discuss something a little different. 

What is the smartest thing you have seen a patient do for themself or a family member do for a patient.  

This could be something that someone did for a patient that saved their life or helped save a life or even just made your role as a rescuer easier!

Come on, blow us away with smart people or smart things done by people out there, come on, I'm sure theres at least one or two instances of Pure Genius.  

9 hours ago, Stafford higgs said:

Hi am a 5 year correctional an canine officer and now a immigration an border protection officer. Just finished graduated my studies in ems an really like it so far an wish to make it my final career.

Dude,  hats off to you as the Immigratino and border protection officer.  I had a friend (long time ago) go down to the border, I think he ended up near Natches or (similar sounding name city) Mexico or Texas, he lasted about 9 months and then left.  He told me it was the worst 9 months of his life.  He's now working in the oil industry over in the UAE making 3.5 mil a year.  How things changed for him.  I haven't heard from him in about 5 years.  I hope he's still doing well.  

feel free to email me  ruffems@gmail.com with whatever you wanna chat about, drop me your phone number and whatever and I'm happy to brain dump whatever I can for you.

I still think you are Julia, or maybe I'm julia

2 hours ago, scubanurse said:

I'm still around lurking in the shadows.

Are you Julia?

I meant Syphillis

But she's also Like Janice from Friends,  she kept coming back to see Chandler.  

8 hours ago, ERDoc said:

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.

i hear that phone call to the supervisor isn't very fun though.  

Julia's post count seems to be picking up as well.  

Oh my goodness, she is like herpes, she keeps coming back.  

hope you find the person you are looking for.  

our service makes all trauma patients walk, no matter if they still have their legs attached or not.  

Just kidding.  I'm not currently working so I'm not a good reference.  

21 hours ago, EMT City Administrator said:

I agree.  I have seen the visits increasing lately.  We have automatic posting of teasers on Facebook whenever there is a new post here.  That has attracted some new members.

 

 

really, I may have dropped off the facebook emtcity site.  I'll have to go look again.  

Absolutly Admin,  If we could get more regular posters and more engagement I think this site could become better.  

Facebook is great for immediate feedback and that's also it's biggest weakness.  

here posts can be cultivated and we can have great discussion, even it it takes longer to get that discussion rolling.  

Welcome to the city

44 minutes ago, CROM said:

I've been away for years from this site. Stopped following because I lost interest and there were always  someone arguing about a post. Just lost interest and began other hobbies. Came back to site today to see if anything had changed. Who knows? Maybe I'll visit more often again.

hey, I don't remember you but you are right, people always bitched about a post, I unfortunately fell into that habit at times.  

Unfortunately, this site is a shell of what it used to be,  seems that Facebook EMS groups has taken it's place.  

I am still here though.  

On 1/28/2017 at 4:08 PM, DartmouthDave said:

Hello,

I agree Matt, outside the hospital, things are more worrisome with many unknown factors.  In fact, in most cases, the etiology of the seizures is unknown and airway protection is a great idea. Especially, in the case of a TBI, SAH, and so forth. As opposed to a 'neurology' consult with a chart and background information.  In fact, many difficult to manage seizure patients (if local) are know by the neurology service.

I was referring to the approach outlined by the authors and not critiquing ED seizure management at all.  Again, it is better to have a secured airway in most situations.

Cheers

I've been in a situation on a uncontrolled airway on status seizures.  IT was awful,  the mother was right outside the room when she heard the physician(local general practitioner) and a CRNA saying "I can't intubate her, we're losing her"  

IN the end, we were able to get the tube but not after some very very tense minutes.  She never lost oxygenation but we paralized her and then had a very difficult time intubating her.  Took about 10 minutes to fully secure the tube but all her numbers and color was what you would expect from oxygenating her well.  This patient made the CRNA earn his on call pay.  But I was sure we were going to code her.  But someone was watching over her that night.  She had no negative issues based on our intubation attempts except for some scratches on her soft palette.  She should be about 15 years old now.  

Dartmouth,  I agree with their premise.  I always felt that in most ED's they are too quick to resort to the next medication before allowing the first to work.  

Are we causing more harm than good sometimes when we move on to the next med.  I think we found that we were in a code situation but this is promising research.   

I worked for a service that was hospital based.  We had all the 1st and 2nd line antiseizure meds.  We basically had what the ED had in it's formulary on our rigs.  yes we had a crap load of meds that often went expired before we ever used them.  

I've used most if not all the anti seizure meds on one patient or another.  

Flash forward to my second time working there, the list was decreased significantly due to a new medical director.  

sometimes more is better, often times more is worse in my opinion, I cannot imagine how much money we wasted on expired drugs.  

To expand,  our formulary on our rigs included  Dilaudid, mepergan, demerol, Fentanyl and Morphine.  We also carried toradol and tylenol, ibuprofen and aspirin.  

Our patients were very well pain controlled.  

i don't believe german licenses are accepted anywhere in the US but since most of the US is National Registry based, I would send them a query asking them how to get your National Registry based on your German education/licensure.  

https://www.nremt.org/rwd/public   find in the lower left hand corner of their site under Contact Us, then click Email the NREMT and ask that question.  

Hope it all works out.  

I'm sure that this software doesn't do this but it doesn't track patient names does it?  

But otherwise, I'd be willing to look at it and give it a once over,  I work currently in IT so I do have some experience in Testing out new software/programs.  If you've heard of Cerner you probably know that those of us who make Cerner software work do a lot of testing.  

Let me kn ow if I can help.