Jessi

I think we would be lying if we said we had never done it. You should not do it though,but u don't know that might have been there last sheet and they were planning on changing it before the next call.

I can honestly say it's NEVER happened with me. I am ridiculously OCD about my stretcher and my truck being clean.

Harder to Breathe by Maroon 5

en route to the hospital you call and give your report to let them know what youre bringing in. when you give the nurse her last name she tells you that she had just been released a week earlier from the psych ward b/c of a similar episode. the bottles you had seen were the larger bottles(the ones that have 100+ pills) and since there were 2 (you guessed it) she's done it before

the mom finally breaks down and tells you that she's been repeatedly trying to kill herself ever since her boyfriend broke up with her. there were no other drugs in the bottle other than the ibuprofen and although she took several ativan out of her moms purse the night before. no alcohol was involved you get her airway secured and get the seizures under control. no widened complexes are shown on the 12-lead.

you turn her over to the ER staff and complete your report. you check in on her a week later and find that she's once again been admitted to the psych ward and wont soon be released.

There is no ETOH on board and she is becoming very incoherent. She says that there isn't anying numbness/tingling but her headache is getting worse and her vision is starting to get "fuzzy" and she says her stomach is hurting really bad. en route she becomes harder to keep awake. she's speaking to you in 2-3 words sentences and refuses to tell you if she has taken anything or not.

she's on 15 lpm/ NR which brings her sats up to 96%.

Vitals:

BP- 108/66

P- 116

Resp - 12 labored, accessory muscle use noted

skin - pale, diaphoretic

Lung Sounds - wheezing is more pronounced

She loses conciousness and starts to actively seize. what's next?

She is sitting forward in the chair (tripod position) and you start noting accessory muscle use. she isnt on any birth control medicines. no new cleaning materials in the home and they don't have carpeting. only wood flooring which has been in place for several years. the house as a CO detector which is showing normal amounts of CO in the air. no new rashes, lesions, or bite marks. she denies any use of recreational drugs. other than a couple half empty bottles of advil, you don't notice any other drugs in the house. No difficulty breathing before she went to bed.

As you load her onto the stretcher you notice she is very unsteady, she says her stomach is starting to hurt and she has a really bad headache and thinks she going to be sick. she doesnt really seem to be oriented to time or where she is at anymore and is starting to become agitated.

You are enroute to the hospital which is 25 minutes away. What now?

History of asthma or other breathing problems? Does she have a rescue inhaler? Chest pain or palpations? Lung sounds? Percuss chest. Diaphoretic, skin color and temp? Recent cold or flu? Does she smoke? And how much for how long? Anyone else in the house smoke (second hand smoke)? Numbness to extremities or around mouth, in case of hyperventilating from anxiety. Is she crying?

Was there an argument or altercation between her and her mother? Or with anyone else that had left?

Monitor. Low flow O2 per NC. Wouldn't worry about IV just yet. Set up for breathing treatment (Medical Control's choice on request). O2 sat before and after starting on O2.

no smoking in the family. mother cant stand the stuff. no chronic lung diseases, no crying, no tingling in the hands or face. she seems "spaced out" and is very slow answering your questions. no arguments have taken place. the daughter was still asleep when the mother left to run errands. she left a note with the girl letting her know where she was in case something happen. when the mother returned home she found her daughter sitting in the chair having trouble breathing and called 9-1-1

her o2 sats are now down to 93%.

Okay, first things first - mom's freaking out so let your partner get ahold of her and try to get information so you can get the girl calmed down. Second, determine whether she's in severe, moderate, or mild distress. With that determined, figure out if it's anxiety related or a physical problem. Does she have a hx of respiratory illnesses? Any trauma to the chest? Any chronic illnesses? After going from that get baseline vitals, including lung sounds, skin signs, o2 Sat, meds list, and go from there. Right now differentials include asthma, COPD, CHF, chronic bronchitis exacerbations, possible anxiety issues, allergic reaction, chest trauma, pulmonary embolus, and then with the info you give, I'll have a better idea of how to treat this young lady.

okay, so you get the mom under control. there is no history of any respiratory illnesses in either side of the family. no history of heart disease. no trauma is noted on the chest. mother said she had gone out to run a few errands and came back and saw her daughter sitting in the chair having a really hard time breathing.

Vitals:

BP- 116/70

P- 108 sinus tach

Resp- 14, labored

Breath Sounds- wheezing bilat.

o2 sats- 94% RA

Skin- pale, diaphoretic

no medications, no history of chronic heart or lung disease, no history of anxiety attacks.

You are called to the home of a 23 y/o female with difficulty breathing. She lives with her mom who was freaking out upon your arrival.

What do you want to do?

Expanding your mind hurts. :shock: I think I will quit studying and just let my mind shrink.

Jessi keep up the good work.

in order for that to happen, i need ppl to post. lol

You establish your line. Her voice doesnt sound hoarse but sounds weaker than when you first started talking to her. BP in all extremities show little variance, distal pulses are present but are now rapid and weaker than before. You note no JVD. O2 saturation is at 94 % room air.

(sorry if it takes me a while to reply to these, i have to look up alot of stuff. :oops: )

the volly squad i run with, it's usually wrecks, diff breathing, or diabetic calls depending on time and how short handed we are :banghead: of course.

(Before you say anything, this call was one I ran, Terri just posted it for me. Bash me if you want, I don't usually pay attention to that stuff)

ok, here we go. she says "the pain is kinda in the center of my chest but its also in my left chest. and my shoulder and arm hurts too." she rates the pain a 6 or 7 on a 10 scale. no past medical history, doesnt smoke or drink.

S-chest pain radiating to left shoulder and arm

A- As listed above

M- none other than epi which she carries with her.

P-nothing other than an allergic reaction several years back.

L- about 6 hrs before the onset of the pain

E-she was watching t.v., sneezed, and the pain started.

O- after sneezing

P-nothing seems to help the pain.

Q- mostly constant pain, sometimes the pain fades from her arm but only for a minute or two

R- starts in center/left chest, radiates to the left shoulder and arm

S-6 or 7 on 10 scale (for the 8th time)

T-no pain until she sneezed, about 20 minutes prior to your arrival on scene.

No history of trauma to the chest or ribs, No history of surgeries of any kind. No cardiac history no family history of cardiac problems, etc. Chest seems normal, you note no deformities, bruising, or signs of trauma. Palpation cause no visible changes in pt. she states its getting a little harder to breathe. Pulse Oximetry is 96% room air. Pain only gets slightly worse with deep breaths. No pain in the throat or neck.

here is your 12 - lead:

WSLS News Staff

Published: May 27, 2008

Updated 10:08 a.m.

State Police have released the names of the two people in the pick-up truck killed in the crash last night.

They are 44-year-old Russell Meadows and 46-year-old Judi Martin. Both were from Alleghany County.

Troopers say both wore their seatbelts, and alcohol does not appear to be a factor.

WSLS News Staff

Published: May 26, 2008

State Police tell 10 On Your Side an Eagle Rock Volunteer Fire truck was on its way to another accident on Route 220 north in Botetourt Co. when it collided with a pick-up truck.

The accident happened between Eagle rock and Kelleys Market just after 6 p.m.

State Police say the pick-up truck was traveling south on Rt. 220.

Two men inside the pick-up truck were killed.

At this time, their names aren’t being released.

The man driving the fire truck was taken to Roanoke Memorial Hospital but is expected to be okay.

State Police are investigating and will release more information as it becomes available.

Here is a link to the news video:

http://www.wsls.com/sls/news/local/article...re_truck/11600/

I'll update this as more information is released.

at my school it is, well we go to the high school and get on a bus that takes us to a technical school, then after 2nd block we get back on the bus and go back to the high school to finish out the rest of our day. the state is allowing the classes as a trial class. its pretty cool. i dont think its offered in any of the other states, but it might be. i haven't really read that much into it.

my schedule looks like this :

EMT-B

English/History

Geometry

my school has block scheduling so we spend an hour and a half in each class...and my EMT-B class is 2 blocks.

at my high school Firefighter 1 and 2 training and EMT-B training is offered as an elective course. im not sure how it works in other states but here is about a 3 1/2 hr long class for fire for a semester and then its EMT-B. At the end of the course you can take the state exam and get certified.

hehe...i found this one just killin time at the station.

If you get an MVA at 2am in the morning, and you don't find a drunk- keep looking you've missed a pt.

Why is there so much reflective tape on the jumpsuits and gear? It just makes it easier for the only drunk driver on the road to spot us and run us over.