Kiwiology

Dude thats hella funny

Man whatchoo talkin bout

Dude, no, get the hell away from me and don't come back anybody who drinks six beers then drives is somebody i do not wish to know , associate with or even have the unfortunate accident of knowing exists.

My best friend got killed by a drunk driver; so don't even THINK of becoming an EMT; I dont care how much change and sorry ass kissing you think you have done but you have clearly shown you do not posess the maturity to work in this field

Here, we do both as well...and the training is the same for all. However I think cos has a good point about making medics well rounded. (and I'm sure I'm going to catch flack for this). Transfers are a great way to learn how to TALK to your patients. I have seen mostly emerg services and they have little idea how to make a conversation with their patient. I have found transfers useful for learning too...lab values and rare diseases and such. And I have my days when I think I will probably cry if I do one....more....transfer... but they make you appreciate the true emergencies even more. (adrenaline junky by nature). I think the danger of an all transfer service, is that if you do nothing but transfers for several years, and then something happens and your post op patient springs a leak, or your psych patient suddenly throws a widowmaker, you end up lost. Heck, I went back to school cuz I was getting rusty...and our call volume is pretty good! Just limited on some of the stuff you see on a daily basis.

And for what its worth, some of those patients are going through some of the worst things in their lives...and a little knowledge and a little experience on both sides of the coin helps you give them a better ride. You need to know when to just sit and hold a hand...when doing nothing is the best thing you can do...and an all emerg service wont give you much opportunity to learn that....just my 2 cents...

Brat

LOL! The thief looks like he was lifted straight from that "Faces Of Meth" website.

The crew needs to join the unemployment list, alongside the thief.

Looks kind of like author and Paramedic Pete Canning ... maybe he has been hitting the PCP again?

Notice the resemblence?

So its fairly common for you guys to lock your trucks? We've had stuff nicked out them but it's fairly rare; we generally leave the back doors open to facilitate easy in/out of patients, equipment etc when at a job. I've known the officer that is driving to take the keys out and either stick them in his/her pocket or on one of those big, long homey ghetto style key chains. Most often they are left in the vehicle.

If anybody auctually looked at our vehicles, they'd notice that contrary to popular belief nothing inside the vehicle is of any value to them; has zero resale value and if they want narcs, well, they are carried on the Officer's belt or in a pouch in his pocket which is usually again, on the end of a great big homie ghetto style keychain.

Somebody made off with one of our ALS bags a while ago, the service had to put out a media note saying if you wanted narcs don't take anything in our bag because you might die

Get Lippincott's ECG Interpretation (a little brown book) from thier nursing series; it covers cardiac A&P, electrophysiology and 12 lead ECGs. Although 12 leads ARE more complex than a 3 lead I found it you learn 12 leads right off the bat that you don't have to learn 3, 4 or 5 leads seperatly as the same principles apply.

To get "certified" can take what, six months at quickie tech school for cook book firemedics who require a cert or it can take four years at a Bachelors program; or somewhere in between.

"Training" never ends, as a medical professional you will always be learning new things and should see education as a lifelong processs. Unfortunatley too few medics I know auctually take an active interest in post certification education; don't be one of them.

You need college level A&P, pharmacology and pathophysiology; the quick, cut down chapter in the Paramedic textbook is nowhere near good enough; I have A&P books that rival the length of my Paramedic book alone.

Although you may very well end up wtih required texts, here are my suggestions for some light reading (and you can probably get a decent workout if you bench them) ...

Marieb's human A&P

Lippincott's ECG Interpretation (little brown book ... reads almost identical to Portable ECG Interpretation also by Lippincott)

Bryant's Pharmacology

BUN: 4 mg/dL

CO2 (carbon dioxide): 25 mmol/L

Creatinine: 1.3 mg/dL

Glucose: 110 mg/dL

Serum chloride: 105 mmol/L

Serum potassium: 4 mEq/L

Serum sodium: 90mEq/L

Serum osm 200 mOsm/Kg water

CSF osm > serum (unable to find a normal range)

Urine NA is 40 mEq/l

Urine osm is 250 mOsm/Kg

FENa .14% (0.14)

UP Creat 150 (1.5 mg/dl)

Preg neg

BAC 0 ml/dl

BGL 6 mmol/l or 108ml/dl

If you would like the answer; it is below

Syndrome of inappropriate ADH retnetion, hyponatremia, increased ICP (cerebral edema), seizure

Sinus rhythm with global ST elevation

I'd be interested in seeing where this goes.

Serum osm 200 mOsm/Kg water

CSF osm > serum (unable to find a normal range)

Urine NA is 40 mEq/l

Urine osm is 250 mOsm/Kg

FENa .14% (0.14)

UP Creat 150 (1.5 mg/dl)

Preg neg

BAC 0 ml/dl

BGL 6 mmol/l or 108ml/dl

If she has been in a super hot kitchen and is that hyperglycemic she is probably massively dehydrated; need to start some fluids so either do an intercept with ALS or take her to ED

OK I've looked into it more; all lytes, CBC, ABG, BUN and creat are WNL except what I put above

The UA shows UrNa at 40 mEq/L

Foregive me I'm not too up on all those blood tests and this is starting to get a bit above my head so I will forego firing off a lot of "normal" values when they may infact not be normal and misleading everbody.

The important stuff is below

Serum osm 200

CSF osm > serum (unable to find a normal range)

Urine NA is 40

Urine osm is 250

FENa .14

UP Creat 150

Preg neg

BAC 0

BGL 6

I did read one or two articles about it a while ago randomly on the interweb one Saturday at 1 or 2am (yeah, my life is boring) and all said significantly improved outcomes for patients who has prehospital steriods or corticosteriods.

One small service here currently has hydrocortisone the rest of us have ventolin and adrenaline only.

I'd love to see us get some steriods in our tool box!

Patient is unconscious w GCS 4 (1/1/2)

Nuero will localize painful stimuli

No track marks

BGL is 6 mmol or 108ml/dl

Temp is 37°C or 98°F

Pupils dialated

Negative meningitis

New vitals

PR 50

RR 24

BP 170/100

Cool potatoes .... with no prev sz hx any guess at what might have caused it?

You know this very was just in an episode of Emergency! I saw the other week and no no I would not attempt it beyond the reduction we apply with the traction splints (Hare or Seger).

I don't want to go playing with moving broken bones and risking lacerating an artery or nerves; those x ray glasses that came with my Marvel Man comic suck balls. I'm not an orthopedist.

Patient is still seizing; 5mg of midazolam settles it down nicely.

You get the following from da ho's:

S: N&V, lethargy, headache, unable to pass urine, generalised cramps x 2 days

A: NKA

M: NA

P: NA

L: Unknown

E: Was hanging out with the other frat sisters

BP is 160/100

PR is 84 reguar

RR is 20 NL

ECG shows inverted T waves in Lead II

So I posted this earlier and it vanished ....

You are called to a local frat house for a seizing female about 20. Her frat sisters report she was feeling unwell/N&V the last few days, uanble to pee and had been having cramps. Tonight she was partying when she began to complain of a headache and started to seize shortly thereafter.

The college med school lab is at your disposal should you request it.

You don't get "hired" as a First Respoder from my experience. First Responders are usually cops, boondock volunteer fire/rescue squad or people who need some form of medical training but not enough to be an EMT, AEMT or Paramedic - like people who work at Disneyworld (as an example, but they have EMTs)

First responders typically do not drive, render any patient care beyond oxygen/AED and are used as a stop gap measure in very, very isolated and rural areas where the response time for even a BLS unit would be long enough to compromise outcomes.

With that in mind, did I mention Flordia does not have them? (from the FL DOH EMS site)

Take a chill pill dude and wait. If you are so uber keen go down and see if you can volunteer at the local ER or something or go out with Fire Rescue on some ridealongs.

The answer is NO, simple. It does not matter how badly you want it, think you should get it or need it, the answer is NO.

I realise that you are young, sparky and ambitious but the National Registry of EMTs (which is the certification body used by most states) has a requirement of 18 years of age or older (click for more info).

With that in mind; I must ask WHY you want to be an EMT; is this a career move? do you need it to be a firefighter? do you want to become a doctor and it would "look good"? .... or, are you a nutjob who is into red lights and sirens?

I would ballpark a liver problem simply because of the size of the liver in relation to the RUQ; but it could very well be something else.

How large is this mass? Like are we talking a pimple or golf ball sized?

It could be a herniated liver.

Lets see .... RUQ contains gallblader, duodenum, right kidney, part of the liver, pancreas and colon (go Marieb's A&P) ... could be anything from a big ass hernia to a ruptured liver or something in between

If it were altitude sickness or elevational hypoxia he sure isint showing it

What did hsi brother have?

What is the enlarged area like; does it pulse, change colour, move etc, what does palpating it produce; tendernedd, rigidity, pain etc?