air.stump

IMHO most people with migraines go to great lengths to control their pain. If the list is long and contains antiemitics, beta blockers, NSAIDS, and narcs, etc.... then, my thoughts are that they have tried many different things to live with this aliment. I'm not picking on people with migraines, it's just what I've seen and experienced. I also ask about triggers and their history in dealing with the headaches.

Why is Nova Scotia an easier place to start?

ED, Bob Dole, good one, Doc.

What VentMedic said plus, 9. Don't' buy into the drama. 10. It's the patient's emergency not mine. Never stop learning and asking questions.

When a patient of mine tells me that they have a drug allergy, I ususally ask what it did to them the last time they took it. It is more a matter of curiosity than anything. During all this questioning, I have heard a few surprising things. One of my favorites is, "My mom is deathly allergic to it so I must be." I didn't challenge this statement, I just nodded my head. When I hear a long list of allergies, I just question more. It has been my experience that the longer the list, the greater the chance that a history of Migraines will be found. An older ER doc told me that most people aren't allergic to codeine. He said that the drug breaks down into something that causes a reaction and that the codeine is too small for the body to recognize it? Anyone else heard of this before?

As an EMT-P, you will get to skip ahead in training a few weeks but not that much. What Flight-IP said is true and helps. Another benefit is that a current NREMT-P cert gives you 40 extra promotion points.

I remember during clinicals at a burn center that the reason for recalculation of BSA is that there is usually an increase in % because the size of the burn increases during the first couple of hours. IV placement for IV access and fluids is important during the pre-hospital care but most significant burns received a central line during the initial workup.

The one thing that stands out here is what the nurse said and the lady that died in the ER waiting room. I can see that one happening again. There aren't any fakers out there only people that want a ride and people that don't want to train. All of them are patients to some degree or an other.

Yeah, what Sarge wrote. Combat Lifesavers (CLS) is all of what you mentioned and a bit more thrown in for good measure. There is a bit of IV therapy in there also. It only covers the medical / buddy aid aspect of combat care. Hope it helps.

DUI calls where the impaired driver is uninjured and the occupants of the other vehicle are. Any burn, I don't like the smell. The smell has a way of sticking with you for a few days especially the bad ones. I just deal with it at the time and vent / rant / talk about it after the call is over, with anyone who'll listen.

Life!! Life, do you hear me!?!? Give my creation LIFE!!!! Young Frankenstein

I fly for the military so, my salary is locked in until I am promoted. In the northern part of the state, flight medics get paid anywhere from 36k to 52k. It depends on who you work for. Our helos are maintained at standards that exceed most civilian standards but, we still have mishaps and that's here in the states. I can only imagine whats happening in the sandbox. I can take the easy way out of why I do it and say I was assigned here but.... I came from a ground unit and now can't imagine going back to one. This is probley one of the best jobs I have had in awhile. It seems to "fit" me better than anything else I have done. The flight part, that is. I am now trying to find a place in the civilian sector for when I get off of orders.

I say don't confront her. Instead, talk to her. The difference is that confrontation will make her throw up a barrier and close down all communication. Friends talk. It sounds like you have a decent rapport with this patient and a casual conversation about how she has gotten to where she is might help seek help else where. When I transport patients with an abuse issue, after about the third or fourth trip, I usually ask them why. Sometimes they get mad and refuse to talk about it. In most cases, they want to tell you how they got addicted. When they finish their story, I take the opportunity to advise them that there are alternatives to their life style. If you are wondering if it works, well........ Of all the times I have done this, I only know of one person that took steps to make a change. For what its worth.

What everone else said... AND Smile and show a bit of leg. Relax

I did the education thing backwards. In other words, I got my basic in the military and got my paramedic cert after the military. I then went back to school and started a BS in science. What I learned from the general education courses of the first two years, re-enforced and enhanced what I had learned in paramedic school. Things were crisper and clearer and made way more sense than following some cookbook set of protocols. Education is the key, everything else falls into place after EDUCATION is the standard for EVERYONE. toutdoors, I have a question for you. Are you going to your paramedic program because you honestly want to be a paramedic? OR Are you going to the program to be more competitive for the FD promotion boards? No dig, just curious.

Keeping a list in your wallet is good as is keeping a list with your vehicle registration. LEO will get that stuff from your vehicle and give it to the medic. Medical alert bracelets are also a good idea. Call the fire station in your area and ask them if they have any suggestions. We will give, upon request, a medicine vial and a form we created to anyone that asks for it. What they do with this is fill out the form with medicines and medical conditions and place it in the vial. The vial is then placed in the freezer. Everyone in our system knows where to check for this vial on an unresponsive patient.

I think it relies on why the patient is hypoglycemic. I would think that their blood glucose levels would rise rapidly and start to fall immediately if the cause of their hypoglycemia was incorrect insulin dosage; too much. I thought we gave Thiamine with D50 to help avoid Wernicke's Encephalopathy in thiamine deficient patients, like alcoholics.

I think it has nothing to do with healthcare or lack of. I think the high mortality rate speaks volumes to the state of EMS in the US. This only proves that the profession puts more emphasis on response and transport times than the proper operation of vehicles and following proper safety procedures. It also shows a lack of proper education. EVOC is nice but it is only the tip of the ice berg. Practical driving experience is the component that lacks from this course. There is no way a person can be competent after sitting in a classroom and driving around a few cones. All this "lack of healthcare" talk just muddies the water. You don't drive to the patients expectation or the medical emergency (or lack of) they have. A person drives the same way regardless of what is in the back. The emergency is theirs, not the drivers.

That was neat story.

I worked at a service that changed medical directors. The old doc had us stock five different narcs in the drug box and had protocols for use with each one. The new doc thinned out the stock and dropped it down to two drugs, MSO4 was one of them, and changed the protocols with them. On one hand, I didn't mind learning all the meds from the first doc. On the other hand, it kind of made it easy when it came to narc use with the new doc. If I have a choice, I like MSO4. I am comfortable with it and have used it a lot. Besides, we use it now. But, if the director chooses to use fentanyl, then I would learn to use it and eventually be comfortable with it. One of the things that I enjoy about treating patients with a medication is that in most cases, you can see changes in their condition in less than ten minutes. This is especially true with cardiac patients. NTG and MSO4 work quickly and their effectiveness can be evaluated, seen. Not using a drug because you are ten to twenty minutes away is BS. Not using it because of the masking crap is also BS. We treat patients as do the cardiologists. Pain is only one of the symptoms. AZCEP has a point, if the old heads don't like change then they should leave the profession. Change is one of the only constants in EMS.

The college levels courses are good starts but another thing that needs to be addressed is the continuing education requirements. More than once, I have from partners and other medics that the CE classes are boring and redundant. For NREMTP you take a refresher that is 48 hours and then another 24 additional hours to get the hours required. I have always taken the extra step and mixed up the courses I have chosen. I have even went to other places to hear a different spin on the same refresher topics. Fact is that they are pretty much the same regardless of where you go. All this education is essential but maybe we should also focus on quality of refresher education. More soap box ramblings.

Education, Education, Education. Thats one of the keys to waking up the profession. I do advise caution here though. Here where I am at, all the schools in the state, took the right step and made all the paramedic programs associates degree level programs. Class sizes then went from mid thirtys to under ten. I thought that was interesting because the mentality of the students in my area was if I am going to go to school for two years then I may as well become a nurse. They (RN's) get paid better. To me thats a double edged sword. One one hand, good riddance, your heart probley wasn't into it to begin with. On the other hand, I see what you mean. A person's gotta eat. The other thing our profession lacks is respect. Respect is earned and to me starts with appearance. Who is going to get the time of day from an ER nurse, a clean cut presentable person that uses correct medical terminology when giving report? Or is it going to be the pierced, tattooed person that acts as if the world revolves around their arse? Companies need to move away from the pulse and patch requirement for employment and look closer at the employees they hire to represent their companies. I am also for one certifying agency for all aspects of prehospital care. All states on the same page. If a state has a need for an advanced care guy like the Canadians and the military have then that certification should be available to all who qualify. One last thing. We aren't nurses. We can model our profession after theirs. But.....when we work in their environments, we should be equally trained as they are and certified as they are. In other words, both professions are fruits. Ones an orange and the other is a banana, two different professions with two different educational backgrounds. Sorry all, didn't mean to ramble. I'll put the soap box away.

More than a comedian, more like a modern day philosopher. He used words like a surgeon uses a scapel. I saw an interview between him and Bill O'Reily on Fox about him using the F-bomb. He was unwavering about his use of the word. It is an excellent interview if you are a Carlin fan or fan of free speech and thought.

Ah, come on, he was angry because he had to file a claim on the earlier accident and didn't want to do it again. ;-)

I wonder at what speed did the administrator catch up with the ambulance? Why wouldn't making a note of the time, place, and unit number and THEN calling it in be more appropriate? Sounds like the administrator had an anger issue here.