Kiwiology

Maybe it is the Long Islander in me, but I was confused about the issue with the speed of 70 in a 55. I guess the speed limit on Long Island is more of a recommendation than law (which probably explains why I didn't get my first speeding ticket until I moved to Michigan). Hell, on the Long Island Expressway, if you are doing 70 you had better be in the right lane with your blinkers on.

Same here, if you're doin 60 in a 60 zone every bastard up your ass gettin pissed and trying to pass

Ha hah ha hah hah ha hah ha thats the funny

Pilot's discretion here from what I understand.

The term is "engineer"

Yeah well the other kid passing out didn't really happen, I just threw it in there for good measure

Addl Tx

TKO 1:1,000,000 epi drip

2x 5mg nebulized allbuterol through the BVM (sorry no atrovent)

Vitals are now:

BP 120/80

RR 12

SPO2 97% on 15L BVM

PR 80 regular and stronger

Monitor shows the tachycardia is slowing (let's hope it breaks to a regular rhythm)

GCS has gone up to four, get it while it's hot! 8)

Cops have shown up

Can't do an NG tube coz we don't have 'em (and this isint an OD anyway)

Yeah that's basically it; started an epi drip (1mg in 1000cc) and mixed up a couple breathing treatmenets (don't carry any steroids)

You cric the sister and the brother who is watching passes out and whacks his head on the coffee table; oh I am mean

Ventilation through the cric tube yields adequate compliance and chest rise with the following-

BP 100/60 (no change)

RR up to 10

SPO2 97% (up from 80%)

PR 70

Cyanosis is decreasing

Monitor shows tachycardia decreasing to rate of 80

GCS is still 3

The cops are rolling to look after the kids.

You are unable to pass the tube even with suctioning all the secretions ouf of the airway due to angioedema.

This one is basically where the kid was given Zebeta (bisoprolol) for migrane headaches which have caused a slow anaphylactic reaction.

Tx

- 20ml/kg bolus of NS

- 2ml/kg of dextrose x 2

- 0.5mg naloxone x 2

- 0.5mg epi IM

BP 100/60

RR improves (!) to 6 but are very shallow and agonal; still cyanotic

Breath sounds reveal what sounds like bilateral rhonchi or rales

Pulse is still 100 and weak

Monitor shows the sinus tach is slowing

Brother states his sister is not pregnant, tampon check is a negative and the kid says his sister "got on the zebra to gain headaches".

In the trash you find a bottle of bisoprolol.

Sorry, your are inside the apartment.

No obvious hazards, building and some of the people you encountered on the stairs look like they have seen better days. No crack dealers or gang bangers in sight.

No trauma and only one patient. One of the kids states his sister is 14, she looks like she weighs about 50kg (100lb).

Respiration is limited to agonal gasps. You can place an OPA but the airway is full of mucous. There is some localized edema around the mouth.

Monitor shows sinus tachycardia at 140 and decreasing.

You get the following information from the oldest child:

S - obviously unconscious

A - none

M - states his sister went to the doctor and got the "zebra"

P - unknown

L - unknown

E - she was watching TV with him when he fell asleep and woke up to find her KO'd.

Vitals are as follows:

BP 60/40

PR 100 and weak

RR about 4

You are dispatched to a rough looking hood at 9pm for an unconscious called in by 5 year old who said he fell asleep watching TV and awoke to find his sister had done fallen down while mom and dad are out to dinner.

Having secured the ambulance with the trusty steering lock, you arrive on the second floor of the walk up to find two kids (one aged 5 and one aged 3) peaking out and crying over thier sister who is unconscious and cyanotic.

AMEN!!!!!!!!

<BENNY HINN> PRAISE THE LORD </BENNY HINN>

However, “basic-medical service responders can cover 90 to 95 percent of what advanced level can do,” he said.

Um ..... since, when exactly? Correct me if I am wrong but let's see ...

- Start an IV .... nope

- Give drugs .... nope

- Use a manual defibrillator .... nope

- ECG analysis .... nope

- Advanced airways .... nope

- Needle thoracostomy .... nope

- Cricothryrotomy .... nope

- Advanced assessment .... nope

Geez, I am not sure where this guy went to school but if a Basic can do "95 percent" of what a Paramedic can do on thier education I am worried!

Hey, maybe it's just as well I'll probably end up in Texas to get my Paramedic, let's see ... if I can do 95% of what a Paramedic can do as a basic with 150 hours, hmm, should only take me 157.5 hours to get my Paramedic, sweet! Not.

Don't be a sexist pig. It's not fair.

Who in the hell do you think you are coming in here and making such assumptions on a person you've never met based on an internet forum? Don never said anything remotely sexist

Google defines sexism (to be sexist) as "...the belief or attitude that one gender or sex is inferior to or less valuable than the other". Don said he doesn't care if you're male, female, black, white, Chinese etc as long as you can do your job which I think is fair - likewise, I don't care what you are, male, female, black, purple, white, rich, poor (hey thats all of us in EMS init?! ) etc as long as you can do the job.

I'm unsure which banned member who has come back under some pseudonym you are but give it up, it's just sad mate.

Ben

Hmm ... if the ECG does not show any dysrhythmia or abnormalitiess beyond the bradycardia (which does not seem to be severely haemodynamicly compramising right now) I am going to look for a differential diagnosis.

Since she was shooting up, what about a thrombus or embolus?

Where abouts in the chest is the pain? Left, right, radiate etc

OPQRST?

Could she just be seeking drugs?

Could this be an attempt to rip off our drugs? (Somebody hidden in a closet etc)

I would want to either have myself or my partner have a look around the apartment and make sure there aint no junkies hiding under the bed with a blade or some shit like that.

Now I am no master of ECG's but here's what I see:

- Irregulat R-R interval

- Dropped P waves

- Runs of what looks like A Fib or consistent artifact

- Irregular ST segment height and length

Could be a block or some sort of electrolyte imbalance ... I'm not really sure

I believe as late as the 1980s here you had to call for orders to defibrillate and unless the doctor knew you were qualified to defibrillate you'd likely get denied.

Man I saw an old wooden longboard behind the second stetcher the other night, apparently its for show ony

I don't see the problem with her taking hubby along for the ride; if she's fixing to drop dead then it will give her some comfort.

I think I read somewhere we are supposed to be nice to our patients

Now, when Uncle Henry died and my buddy Marty was taking the urn round to auntie's place and they all flew out the car window man I tell you what I had to smoke a lot of cigars to make one uncle Henry

..... if Don tries to tell you that is him.... he is LYING.. :evil:

Auctually thats me ... wait, no it's not, guess I shouldn't like huh :evil:

HAPPY FREAKIN' BIRTHDAY NAT HOPE YOU HAVE A GREAT DAY!!!!!!! 8) 8)

Kia Toa Kia Ngakaunui (have courage, desire greatly)

November 2005 and she is filing suit in November 2008; three years later? Yeah that's bound to be because she has a genuine claim and not because some bills cropped up or she wants a new car or some shit.

Like Chris my cop friend says, take a handful of harden the !@#$ up and get over it.

Thats mental, I mean, if I go dress up as a gangbanger for Halloween then yeah maybe .... but that's just very sad

I once read, heard or looked at something which said a six year old kid did CPR on his teacher. I dno where tho sorry.

If you ask me CPR should be part of something every kid has to learn at school; we did it here but only if we wanted to and CPR classes here aren't free like I've seen in the States, they sting you about sixty bucks to take a class.

...And no, they do not speak English in New York. I dunno WTF it is that they speak...

I dno WTF they speak either Dust; but between thier myriad of accents and some guy asking how to get the 6 train being told "yo, do I look like a freakin map to you?" it sure makes for an interesting time 8)

Oh and for the record; I used to work with a Scottish chick who used to talk really fast and was quite hyper, man I couldn't understand a word she said (nice girl tho)

I know what you mean Timmy.

I currently work with an overwhelmingly large number of Aussies, Canadians and Brits. It is so frustrating when they do not speak English, which is most of the time. I can not understand a damn thing they are saying and then add their twisted slang on top of it and man it is just a mess.

When are these guys going to learn and speak English???

Oh my god that was funny. I spent the summer working with Americans, Brits, Canadians, South Africans, Germans and I think one or two Ozzies and I couldn't understand a word they said

Nah just kidding; but seriously tho we have a simmilar problem here with the Indians and Asians who come over and allbeit most speak English to some degree; its pretty piss poor most of the time.

I don't believe you should have to learn English as if you were born here to live here but surely you could make at least some effort to learn some.

But then again, on the other side of the coin, if we all moved to ______ would we make the effort to learn whatever lingo they spoke there? (OK silly question, I guess we would)

Their "paramedics" (using the term very loosely) are still doing the same 13 weeks of monkey training they were doing three decades ago....

How the hell can you get your Paramedic in thirteen weeks? The shortest program I've ever seen was for the Dallas Fire Rescue medics and that was six months of 5 days a week, 7 or 8 hours a day.

I wonder if Brackett and Early are still running it ..... :roll: