Just Plain Ruff

ok, heres another screw up, at the time of this incident I'd been a medic for 10 years from big huge services down to small 1 ambulance shops

32 year old female pregnant patient eclamptic - transfer from small hospital USA to big teaching hospital. She seizes half way thru the transfer, already had orders (precautionary) for valium if seized.

she did, I grabbed the valium and pushed 5 - seizure stopped, yet she stopped breathing

Get her to the hospital, she's breathing now

Get back the unit, my partner said, "Hey buddy, what did you give Morphine for?" You guessed it, I grabbed the wrong syringe.

Ran in told the doctor, he said no big deal, "I wondered why her pupils were pinpoint" He said it happens and at least I admitted it to him.

He was so cool that he even called my supervisor and explained that there was no harm done to the patient except give her a free high.

I was so distraught cause I thought I had hurt the baby.

I keep in touch with the mom and her baby. He's now 9 years old and smart as a tack.

I just saw the episode it was great. She's a hero, you can just see the fear in her eyes and she stays there.

I don't think the doctor was out of line either.

Does spelling and grammatical errors in patient run reports indicate shoddy or poor patient care? Please discuss!

this is bound to get some heated responses but it's something Dust and I have been discussing via private messages.

my understanding is that it takes a while to knock the respiratory drive out. But I am sure others can shed light on that.

I also remember that if the patient is not a true copd patient that you can't knock it out. Again maybe others have info I might have forgotten.

Ive transported a "COPD" patient for 40 minutes to the nearest ER on high flow and not a twinge of knocking their resp drive out happened. Patient kept breathin

that was one of the things that jumped out at me. I mean it's one thing to treat and street a laceration on the leg or so but another thing to not transport that lady.

Case in point.

Had a lady original call was for chest pain. On our arrival patient with absolutely no symptoms.

Had a high suspicion on this one but I could have let her refuse. I didn't and I transported.

We were driving down the road just off her driveway and she coded, I said Holy crap batman. worked her got her back. Took her to the ER and she coded 3 more times. We flew her to the cardiac center and she was having a right wall/posterior MI. they cathed her.

I called her house hoping to talk to her husband 5 days later and guess what

She answered the phone. what a feeling

http://jems.com/Columnists/emslaw/articles/15830/

This made me think. It's a two parter so make sure you read both.

Limbstruck that was funny sort of like the video I saw of a halloween video. there is a huge hulking black guy walking up the stairs with his friend, he goes to the door and off to the side is what looks like a scarecrow on a chair. The scarecrow stands up scaring the bejeezers out of the two guys and the big hulking guy decks the scarecrow and knocks him out.

that was funny

Suicide is the cowards way out of a situation. The only one who it's easy on is the one who is dead. they leave a family and loved ones to greive and also to feel the feelings of guilt as if they could have done something. I don't have much sympathy for someone who either attempts suicide or is successful.

I had a friend who told me this story.

his friend was a deputy for a small county, got a call to stop this semi truck. he also was told to call dispatch and he did. He was told that someone jumped in front of the semi and got hit and was plastered on the front grill of the semi.

he stopped the truck, told the driver to remain inside the truck, checked out the front and indeed there was a recently deceased guy. He told the driver to step out and come to the back of the truck. The trucker was getting more frustrated by the minute. He finally demanded to know what was going on and he was finally told. the trucker didn't believe it and ran to the front of the truck. Saw the dead guy and promptly passed out. He has not driven since.

so if you opt ot kill yourself then I have the option to call you a coward.

since this thread is still going strong here is what I do to get rid of the smell.

I was talking to a coroner in Jackson county and a CSI guy also and they gave me this piece of advice.

Carry vicks but make sure you use it prior to gettin in the nastyness. Once you have smelled the decomp the odor molecules will stick to your nose hairs. sounds far fetched but it's true. once they are there it is near impossible to get them off except to wait. The advice I got is once you get done with the call and change clothes and stuff, you need to sniff a little bit of water so it washes off the molecules.

i tried it and it worked. Very minimal smell left but I could continue to work. This works on almost any nasty odor.

Actually Irregardless is mentioned in the American heritage Dictionary. So according to the American Heritage Dictionary online version it is a word.

Not a word that the bright people out there should use but it's used in language so it must be a word.

here's the link

http://www.bartleby.com/61/84/I0238400.html

Here's another source

http://www.worldwidewords.org/qa/qa-irr1.htm

If the big one hits, no-one is going to be able to handle it. Bring in all the resources you need but the fact is, if you dont' have the infrastructure or facilities or equipment to handle it you will NOT handle it.

You just do the best you can with what you have. it's a common theme in America to throw money at something and it will get better. That doesn't work.

I wrote a paper on mass casualty situation with a WMD and got an A on it in my master's level health management class.. I'll try to post it here in a link.

We need to look at the overall picture like a post earlier said,

if you put all your resources into a MCI and then you have 1 or 2 people not involved needing an ambulance or a house catches on fire and you cannot respond then those people are not served well.

larger cities are better prepared cause there are more resources there, more hospitals, more resources a shorter distance but take the small county I used to work in. We covered 800 square miles with 3 ambulances but only 2 crews, sure we could staff the other ambulance but it would be tough. get a incident with 30 patients or in my paper 400 patients and you see the problems.

ok, clarify something. do they have to accept all your treatment modalities or are they able to pick and choose.

someone in a car wreck, they do not want a board but want transport, are you going to tell them they cannot go with you unless they consent to your full treatment?

i don't understand your logic or maybe I'm missing someting or misreading you.

Thunder wrote:

"If he had no pain, I can understand this one. However, if they have a significant mechanism of injury and they say "My necy/back/head hurts." they are going on the board. It's not thier choice any more."

well you just opened yourself up to litigation for forcing treatment on someone who didn't want it. I can tell you that if you were treating me and I said no on a backboard and you took that line that it's not my choice then we'd have some significant problems and your boss and EMS agency as well as the state bureau of EMS would be hearing about it.

You say it's not their choice anymore are you saying that if they need an IV and they refuse that they get one anyway? You are on a truly slippery slope if you believe what you wrote in your post.

If someone refuses treatment be it an IV or a backboard and you force them becuase you say it's not their choice then you are way out of line.

Please tell me you don't force these patients into things.

I have never been a fan of trying to diagnose a cardiac event from just 3 leads. Sort of makes it difficult to do unless the monitor is a diagnostic quality monitor.

It's been a while since I've had a 3 lead monitor to use, usually it's the lifepak 12 4 leads.

I have a great CD that if copyright allows, I will post in a rapidshare link for everyone to enjoy. I'll have to check the copyright and see if it's free to share and if it is I'll share.

i have a theory

It's called Devolution

for every sitcom, reality show, knockoff's of american idol, remake of old popular songs that comes out and the american people gobble up hook line and sinker we take one more step back on the monkeys/apes take one step forward.

So far the apes are about 50 steps behind us.

I have found that staples work quite well.

Let me set the record straight here, IF you refuse to treat me due to your religious beliefs then when and if I get better I'm gonna come back and whop your ass right then and there.

You have no business in the medical field if helping someone conflicts with your religious beliefs. That is not what you are there for, you are there to help everyone who needs the help and calls on it.

Keep your religious beliefs out of the patient care arena. If your beliefs conflict with helping people then get the he(*)( out of the field and let the people who aren't offended do the work.

I have refused to transport only one person in the past 15 years and that patient beat both myself and my partner up. She went ballistic when I told her that her brother could not ride to the ER with her. She scratched my face, kicked my ribs(bruise the size of montana), and nearly kicked my knee cap off. My partner fared worse, broken nose, bloody lip and black eye. We had a BLS ambulance there and they ended up taking her because I now had 2 patients I had to take care of.

Needless to say she didn't go with me. She actually ended up in the long run a resident of a long term facility with a date of release in 2006.

But just to refuse a patient transport is not something I would ever do.

/Sarcasm

Heck no don't fire em, promote em

/sarcasm off

If this was an isolated incident then just a verbal

If consistent then more forceful reprimand

But to fire em, well maybe not that far.

Did the patient get taken care of in the end?

Lot's of unanswered questions on this.

I agree There is so much in terms of personal safety that it just so wrong with letting a deaf person in.

1. Extrication scene - they need to be able to hear over the tools

2. Auto accident scene on highway - if they cannot hear the commander say move then they are dead.

3. Fire scene - they are near a wall that begins to collapse - can't hear the shouts to get the (*)(&)()* out of the way then they are dead.

4. Can't hear a blood pressure or listen to lung sounds - nope doesn't cut it.

5. How do they give a radio report

So there are a lot of items that they need to be able to do but cannot. I for one do not want a partner who is deaf. No offense to the hearing impaired but they have to be able to do the same job I do and I don't want to be completely responsible for them.

I left the field to pursue a higher paying job. I was already having back problems and they have gotten worse not better since I left the field.

My higher paying job was actually just a little more than 5k a year higher. I have since changed jobs and work in the consulting field going around to hospitals and helping them implement a ER tracking system that tracks patients from when they walk in the door to when they leave. It's challenging and puts me out of the house in a different city 4 days a week plus I increased my pay by 100%

I am looking now to get off the road and have found that I've priced myself out of the local market for Hospital IT due to being paid consultant's wages. I'm gonna have to take a paycut. Not sure how much but It will be a big chunk, upwards of 10K or more. But the trade off is that I am home every night and not flying on a plane monday mornings and Thursday nights. That's a good trade off

So yes I'd take a lower paying job but it's a case by case basis for me.

ok let's talk about this a little more.

/Over the top example but

You are driving in Washington Dc the president has snuck out of the white house and is jogging, you come tooling around and hit him. You leave the scene. Are we to understand that if we continue this line of reasoning that you should be charged with both leaving the scene, and assassination attempt???

/end of over the top example

But its the same thought process

There has to be intent to charge the person with attempted murder on this poor doggie.

Actually I don't know why we(I) are gettin so worked up over this.

I think I'm done

I'll give the failure to stop at an accident scene but to charge this guy with striking a police officer or attempted murder is absurd.

Yes I am sure he heard a thump and all that but there is no way that he should be charged with anything other than leaving the scene.

Attempted murder charges - no way.

/quote in previous post

Police K9s *are* officers. They are referred to as the handler's "partner". They work for, and in conjunction with, the police. I'm glad to hear that the K9 should pull through.

I agree that, at a minimum, the driver should be charged with a hit and run. He hit an officer and left the scene. /end quote

Above is my point. He hit an officer. Heck, I've hit a dog and never thought about it being an officer yet we are supposed to want to charge this guy with hitting an officer. No way.

/rant on

whoa whoa whoa let's step back from the Kool Aid and think

I'm an animal lover to the rafters but charging this guy for hitting a dog and leaving the scene is preposterous.

Attempted Murder - Goodness what is that one smokin

to make the person who hit the dog take the leap of faith that that dog might be a police dog is absurd even if there is police officers present.

I hit a dog on the road the other day, damn thing darted out in front of me and I ran it over. I'm not about to swerve for any animal if it means that I may go off the road and either hit a tree, overturn or go down a ditch. My LIFE is much more important than an animals.

To make the driver say, OH That dog I hit mi ght be a police dog so I should stop and go back - Heck no. I had not inkling that the dog I hit was a police dog nor do i think that anyone out there would put two and two together.

Police presence on scene where the dog was hit, well how many times is there a police dog on a basic call. I think about 1% of the time.

I'm all for taking care of the animals, I wish that cruelty laws were more strict. But to take this to the extreme and charge the guy with all these charges that are being leveled is absurd.

Animals are animals, plain and simple.

So to take this absurd argument that if we hit a dog we should possibly relate that that dog is a police dog to the next extreme, driving down a country road, I hit a horse and kill it and I do not stop. Am I to put a correlation that that horse might be a police horse because horses are often used by police departments? I think not.

/OK rant off

State of Missouri

If I remember right

First Responder

EMT-B

EMT-P

I like the KISS principle. Keep It Simple Stupid

I never understood the need for multiple types of certifications. Seems like overkill to me. I mean come on Police First Responder?? Who thought of that silly thing. No offense to the police first responders out there but really.