firedoc5

There's been a few times I was in back and the patient crashes on the way and you're stuck in the back. If you're still far enough out you can try and have someone meet up with you and jump in. But there's times where you're only a few minutes from the hosp. and there's no time. You just start in CPR. One day it happened to me and when we got to the ER there was assistance at the door and I just sat back in the rig trying to catch my breath. A buddy of mine (a doc) came out and asked me why the patient wasn't intubated and no meds were given. I knew he was just yanking my chain. So I flipped him off and collapsed back on the bench. He did buy me a steak dinner later.

was she the door knob type doc? :wink: :wink: :wink:

Yep, and vacuum cleaner.

At the time I was with a private ambulance serv. and it was more like a club house most of the time. So we had all types hanging around. It was sort of like M*A*S*H and "Mother, Jugs, & Speed" combined.

I had always stopped and helped, especially if it was in our district. I was on my way to my parent's and had a couple of units pass by me. There was a three vehicle MVA, along with a bass boat that was being towed, at a notorious intersection. Three dead. The survivors had already been transported but I stopped anyway. I wound up assisting getting the dead extricated and doing the deputy coroner bit. I was there a good hour when I noticed that one driver that was covered up had his feet sticking out. He was wearing these old slippers that I recognized. I was like, no...it can't be. I looked over the shoulder of the Trooper that was filling out some paper work and saw the man's driver's license. It was the father of one of my best friends I grew up with. That man had taken me squirrel and rabbit hunting and fishing many times. I was floored to say the least. To shorten the story some-what, I went ahead and ID'd the body so the family didn't have to. It was one of the hardest days of my professional career.

We had a blonde nurse that came up with some of the best blonde jokes. She was nick named "flipper". One day she was wearing a short nurse's uniform and one of the guys said "Nice a$$". She turned around and flipped up the back and said "Thanks".

We used 'groupies' or 'bim-bettes' for the most part. But there was one certain gal we called "Bunkroom Rhonda".

Way back when...BTLS was first being introduced, in class or testing the first thing you were to do was state "Is the scene safe or secure". We were like, right. Easier said than done. What constitutes a perfectly secure scene?

I've also seen it once done by a Dr into the brachial artery. It did indeed travel back up the line and into the bag pretty quickly :shock:

We were called to the dialysis center to transport someone having some sort of reaction. The nurse was standing next to the guy squeezing an IV bag of NS. :shock: They had the IV in the shunt and she was squeezing it to prevent the back up. WHY??? even have it? :roll: To this day I was never given a ligit answer. As far as I know there were no meds being given.

Hopefully not fired. This is a very common occurrence in the ICUs made by physicians, nurses or anybody using any type of electrical technology.

Yep, the second time the doc was standing right there. They thought he was going to hit her. But evidently she was on thin ice for more reasons that just that incident.

My brother-in-law had something similar. He really didn't have too serious tooth/jaw pain, but did have chest pain. He was diagnosed with paracarditus. More or less tracked infection to abscessed wisdom tooth. In the long run, no MI occurred.

Some may have paralysis come and go, especially if the receiving hosp. is somewhat far away. Repeat assessment and document any change one way or the other frequently.

Yep, thats what we use...we have some latitude though and can skip the 0.5 mg part if we believe it necessary.

Ditto

To what extent did the nursing home staff assess or treat? Or did they do nothing other than call, which happens all too often. Many elderly patients can not tolerate a board and/or collar due to osteoporosis or other skeletal problems. Immobilize the best you can while at the same time attempt to make comfortable.

Even though I'm not still in the field, I get updates on some things. In my former system they have regular "debriefing" meetings. Everyone can speak up, talk, vent, or just listen to others. If only they had something like that when I was active.

Guy had "kidney stones". Actually he placed two pebbles...you know where.

89 yr.old woman, her breasts were sagging more than usual.

A gentle who had "tired blood".

Patients should be completely naked but covered for privacy. We can not be bashful. Get in there look, listen, and feel.

We had a young lady ejected from a vehicle. Got her loaded and started to assess her. She balked at having her blouse opened. Understandably thought she was concerned of exposure. But when we cut her bra, BOING, out flew the foam rubber. That's what she was embarrassed about.

This is a topic that can go on and on.

Saw a medic in the field defib someone on the wrong side. Patient died later of liver damage.

An ER nurse attempting to hook up a foley catheter to suction. Got her stopped just in time.

X-Ray tech. unplugged ventilator in ICU, TWICE in two days. Can you say fired?

Radio call up that "patient had good neuro deficits". Same medic spelled broke "b.r.o.c.k.".

ACLS student couldn't identify a third-degree block, said to defib until got a rhythm that he knew and knew how to treat. We started laughing, until the guy said he was serious. Can you say flunked?

In the early '80's had a ER doc not know what MAST were, so he ordered them "cut off".

Back in the early '80's there was a band that was called "EMS Express". They did songs of EMS in sort of country/bluegrass style. They were pretty good actually. Song's were a riot.

I cant receive emails at the moment, something has crashed on my computer...

I just hate it when that happens.

Didn't Johnny Carson get into a little trouble when Jack Nicklas's wife said that before every tournament she kissed his balls? Johnny responded by asking her if that really made his putter stand up.

Probably ranks right up there with Mad Dog 20/20. Worse kind of puked up booze you'll ever have on your shoes. :puke:

The fewer "auto-mated" equipment the better. I just don't trust those machines, i.e. BP cuffs, etc.

I was teaching a BTLS class a while back and a buddy of mine was guest speaking. He gave a true scenario where a 22yr. female riding a bike collapsed. No outward visible sign of trauma other than minor abrasions to left hand and shoulder. Got her loaded and started to expose for assessment. Removed her loose fitting sweater, she had GSW to the chest. Evidently with the loose sweater no entry hole noticed. Her padded bra was absorbing blood loss. Can you imagine what it would be like if no one had exposed or did a hands on assessment what would happen when they got to the ER and that wasn't caught in the field? Sad to say, but stranger things have happened.

Fortunately I had outstanding instructors in classes that I took, and instructors I taught along side with that emphasized just this matter. I've been taught to use all your senses, not just with the patient but also with the entire surroundings. One way I put it is that you pay attention to every detail but don't get distracted by any one element.

I'm glad you brought this up, spenac.

One of the first things emphasized is that when someone is hooked up to an EKG is that you treat the patient, not the monitor. Monitor shows V-fib but the guy is looking at you and joking, you're not going to d-fib him. I've seen it tried. :roll: This can be carried over to other signs and symptoms.

It's not something you can teach, but I tell my students USE COMMON SENSE! When doing the SAMPLE history, many students think that all questions apply to all scenarios. They get a difficulty breathing patient and demand to know, Does your pain radiate? How bad is the pain on a scale of 1-10, even though the "patient" insists that they have no pain. Once they learn the patient assessment by rote, put away the written material and make them think through different scenarios. The ones who lack common sense will hopefully not finish the class successfully.

I've always stressed that Common Sense is your best route. Start with common sense and go on from there. Of course there is always someone in a class you are teaching that shows no common sense what-so-ever. But they usually come around.

Good luck, have fun.