mshow00

Actually it was two police and one firefighter, the firefighter is the only one who died ( I posted the fox news report under the personal section)

It's the loss of another brother-in-arms; A fellow firefighter-paramedic lost his life while two cops were wounded by a guy who set an ambush for unknown reasons...

Maplewood Paramedic Killed, Community Mourns

Last Edited: Monday, 21 Jul 2008, 6:28 PM CDT

Created: Monday, 21 Jul 2008, 9:44 AM CDT

Stories

Ambush In Maplewood: Paramedic Killed, Two Cops Shot

Firefighter Chaplain Worries About Firefighter Safety

By Roche Madden

Maplewood firefighters and city officials are mourning the loss of a young firefighter. Ryan Hummert, 22, was shot as he got out of a fire truck on Zephyr near Big Bend Blvd. According to officials, Hummert and his fellow firefighters were responding to a vehicle fire. When they arrived on scene, someone began firing shots at them. Hummert was hit.

Firefighters were pinned behind their fire truck for several hours. The gunman also shot two police officers who responded to the scene. One of those officers was treated and released. Hummert was pronounced dead at an area hospital.

The flags in Maplewood have been lowered to half-staff. Hummert is the son of former Maplewood Mayor Andy Hummert and his wife Jackie. He graduated from Rockweed Summit High School in 2004. Hummert joined the Maplewood Fire Department just 10 months ago, graduating from the from the St. Louis County Fire Academy in March of 2008.

Emotions ran high at Maplewood City Hall as the fire chief announced Hummert’s passing. Crews from the St. Louis Fire Department are manning the Maplewood fire house where Hummert was stationed.

Have you considered a type of "boot camp"? My sister and I went through a similar rough patch in the years following my parents devorice. I was 17 when it happened my sister was 13 and my mom put up with us for about 2 years; and it was all she could take. At that time I had stubbornly held to my stupid anger and piss poor attitude and as a result went through the "school of hard knocks". My mom and step-father sent my sister to a finishing school ( I think thats what it is called) where she was able to work through her issues complete her sophmore- senior schooling in a single calander year. And she just gradutated from SEMO with a BBA at the age of 20. Just another thought...

Thanks for the well wishes... apparently everyones prayers worked. My son Alex had a total 180 starting last night and through the day. He ate better than they were hoping, they d/c the IV fluids and he kept himself hydrated, and he had a BM that was more than just brown water. The Dr said he passed all his goals and they sent him home. I just wanted to say thank you to everyone who thought about us.

My son has been sick for the last week, and woke up this morning with a fever of 104.2. We took him over to Cardinal Glennon today and the admitted him to the floor. I just wanted to give everyone a heads up as to why I wont be on for the next couple of days.

Your right Firedoc5, I'm sorry blond moment. I was actually refering to "normal limits". What is "normal" when each book you read has a different set.

Simple question: What are the baseline V/S? I was reading in my ITLS book today and it gave the baseline Resp. Rate at 10-22 I think. I learned it from my basic text, and my paramedic textbook as 12-20, the pulse rates for peds was also different. That was as far as I was able to read at my clinical, but the point is there an "absolute" range for V/S- as in a specific set that is the standard?

P.S. I know there are no absolutes in this career.

Firedoc,

As far as drugs being able to be given down the tube - valium is no longer being given down the tube as it is oil based so the new acronymn being taught is LEAN (lidocaine, epi, atropine, narcan). I'm not sure if versed could be given via ET tube as I've never given it that way.

You forgot the "O". It is supposed to be either OLEAN / LEANO. Lidocaine, Epi, Atropine, Narcan & Oxygen. :twisted:

Whats the Pulse? Resp? R & R of both? Skin Cond(other than pale)? What was she eating? Facial Droop? Confusion? EKG? Pupils? Heart Sounds? Any Allergies? Hx if possible...

First things first BSI and S/S(current medic student ha ha)

I would start with Airway maintaince(head-tilt-chin-chin lift; O2 at necessary flow), do a D-stick, start an IV, place her on the monitor, and physical exam.

Initial thoughts: possible MI, CVA/TIA, Anaphylaxis, AAA

I have not learned much about 12 leads, but is the pt not haveing a RBBB as well? As I understand(albeit with minimal knowledge) with the funky complex in lead II, III, and AVF in the "up position" means a possible RBBB correct? Please educate me on this.

Sorry for taking this off topic, but I fail to understand how being willing to help someone "off the clock" makes you a whacker? Maybe because I am still green and an idealist but I see no harm in at least offering help. I personally see that attitude as that of a burn out who needs to find a new line of work.

Ask her to describe pain location and type-pain on 10 scale, History? Smoker/Drinker? current medication(inc diffenative answer to BC in use), SAMPLE-OPQRST?

Fast 12 lead, O2 2-4LPM, IV 18 GA NSLock if possible 20 Ga NS Lock if not, condsider Nitro &/or ASA (depending on pts answers and 12 lead)

Have you noticed the user name "Admin" hasn't added anything to these discussions? I find that intriguing...

-be safe

ps. I'm still not admin!

Remember:

I jsut spent the last hour on the phone with Dustdevil.

he is currently nursing a broken Arm and a broken leg(it's an old healing break). The arm is new.

He has been going to physical therapy 5 days a week and popping vicodin like pez or skittles.

He says that he refuses to come back here until he can type with both hands. That should be in about 6 weeks. Amazingly he hasn't even been lurking if you can believe that.

'nuff said.

that were funnier

Are they even real reporters? I mean at one point they call themselves "bloggers". I agree with BEorP, I think they were just out for sh*t disturbing.

Sorry to hear that man, but glad your boys got out without loss of life.

Thank you ERDoc I finally had a chance to check those links you posted. It's kinda funny that I have never heard of the adverse reactions to the use of morphine in these cases, yet almost everyone I talked to said they would push it. At any rate it was very helpfully, so thank you again.

Ohhh! So now the truth comes out Ruff is looking for a date :shock: .... lol

I wonder if I whine enough they will just let me become a paramedic instead of going through class and clinicals, and all the testing. :shock: #-o

Most of the Drs. I have spoken too say that you can and it does not hurt to do so, especially if they are wheezing. One of the smartest medics I work with told me to use nitro, lasix, and bvm/et as needed. Can someone tell me why there are different points of view on this. I mean is there just not enough data to say one way or the other, or is this one of those things people do as always done regardless of the "new science"?

You also have to consider the burnt out ones and those who are green. I have seen some really really sh*tty attitudes from both that make everyone in EMS look unprofessional.

PatrickW, I am not talking about assessing everyone we cross on the streets, but if I am called to a scene I do a refusal save when the local FD/PD disregards me. Anytime I make Pt contact (talk to them) and they don't want to be transported (note I say nothing about treating) I fill out a refusal. Being totally honest, a refusal does not take all that much time. That's a pt interview, assessment, two sets of vitals, treatment (if needed), and education: knowledge needed to make an informed decision. Those are the people I am talking about.

Since you brought it up: "How do I know that the family member of the full arrest I'm working isn't going to stroke out from the hypertension associated with the event?"

you don't. But according to any of our textbooks (and my personal ethics/morals) they are our pt too(regardless of the current condition). I suppose that is a personal call.

"I can't police the community for illness and injury, assessing everyone I come across or everyone involved in an event I'm called for. "-PatrickW

Neither do I, not the witnesses, not the by-standers. But the people involved yes I do. Again CYA, how do you know they won't have some pain later? How do you know that they won't go home and get hurt and blame it on the call you did not document? How do you know they won't talk to some slime ball lawyer (or even a damn good lawyer)? Then what? if they push it your career is over. They have you for neglect and abandonment. You were called to the scene for them, and you did not treat them in any way. Your word vs their's, they are hurt and you have money(at least your company does). It was nice to know you.

"If I get called to an MVA and a pedestrian jumped out of the way to avoid it, do I need to get a refusal from them if I ask them if they're ok? How about a school bus that brakes quickly, one patient complaining of neck pain. I have to obtain histories, physicals, and refusals from all the other children and their parents? That's ridiculous. " -PatrickW

Ridiculous or not, the point is if you are required to get them do, if its your choice then its your choice. I would do it. Bottom line. No harm can come from me doing it. So it takes time to do an entire school bus full of kids. So what. Lame lame lame excuse. Not to be offensive here, but it sounds like you are just lazy.

"The 911 service I work for does have a transport policy, and we are able to treat and release some patients if they do not meet our transport criteria and both crew members are comfortable doing so. "You call, we haul" is ridiculous."-PatrickW

With that we are in TOTAL agreement. I don't transport everyone, but I do get refusals on them. If there is a difference in opinion between "us" and "them", well thats what medical control is for.

We might be getting away from the original question. I think we all agree that to avoid litigation, we should be obtaining signed refusals. My question was, do YOU think it's right if there are no injuries. Not so much "do you think you should document the call?" or "to CYA, should you get a refusal?", but, do you believe that you should have to get a signature if the patient does not have any complaints. Documentation aside, what is your person feelings on the matter. If your service told you tomorrow that it is completely up to you if you want to obtain signatures for refusals, as long as there are no injuries, would you?

Calling a tomato a potato does not change it. If my company came to me and told me my choice, guess what I will still do a PCR (we are stone age pen and paper) and a signed refusal. It only takes a few minutes to do (generally plenty of down time to complete it), and it will only serve to save my company and I from some sue happy "non-pt". I live in the sue captiol of the world. Aside from the legal stand point, if you don't spend at least a few seconds talking to the "non-pt" then how do you know if they truly are ok?

I apologize here, I think I should have been a little (lot) more descriptive here: I know that albuterol does not do anything to remove the excess fluid that hinders oxygen diffusion. What I am getting at is you have your Pt in high fowlers and have followed most or all of your CHF-PE protocols. Your pt still has decent respitory distress and you don't have a CPAP (as in my company). Would you give albuterol to help open up (even slightly) the "clear" part of the lungs?

I argued that I would give the abuterol and my reasoning is if you have 50% of "clear" lung space and then give the albuterol and gain 4%. The 54% is obviously better, but does it out way the risks?

PE sorry I thought I specified that.