mshow00

Pretend you have the protocols for this or they are silent: To continue a discussion from class to night: Would/should you give albuterol to a Pt with CHF crisis? Speaking from a pathophysioloy stand point then it would be warranted. Yes it has some Beta effects on the heart, but more importantly (esp in this pt) it does more to "open the air way". The class seemed to be split almost 50/50, and our instructor said that field opinion was spilt the same. Around here (especially the older generation Drs) SNF docs often order albuterol for CHF pts. Now I am also aware of the flash PE, but is the benefit more than that risk? I mean you could always tube the pt and force the fluid out of the lungs in that case. So I am interested in hearing from more on this subject.

Just a quick question: can you be definitively positive that your pt is not hurt? I mean just because at the scene they don't have any complaints does not mean that will be the case later(after they talk to a shark or not so nefariously the sympathetic nervous system starts to relax). In the case of them talking to a lawyer not only may they have a claim against the other driver, but you and your company are screwed. So where I am concerned the Pts with "no complaint" get the most thorough assessment and documentation I can do, and I make them sign.

If for nothing else getting a refusal is a great SOYA. Anytime I talk to a PT that has no complaint then I get a refusal from them. It only takes a couple of minutes. The only time I do not is when PD &/ or FF discontinue me, and even then I write a very very simple report that says disregarded by PD( or FD). Again just a SOYA.

We had someone get on our radio frequency a short while ago: unkn: f***,f***,f*** medic in truck: be advised you are on Med 9 and there are PTs that can hear you!!! unkn: shut the F*** up a** hole. f***, f***, f***

I was thinking more along the lines: when you assume you make an a$$ outta u and me.

Don't you mean "assumed" to be emergent.

Our hospitals here have patch lines (unlisted numbers that tie directly to the ED and the recording machines) I started this thread because I do want to heal all wounds. Call me green, call me a noob, call me a ricky rescue with a hero complex I don't care(not saying you are, but go with me on this). It is part of what drives me to attempt to perfect my skills, to get up and take that next call(when for whatever reason the previous one got to me), and adds a deeper meaning to my life.

I had a call early Monday morning that was dispatched as a psych at a hotel. When we (my partner, a new hire, and I all males) got on scene, we had a local LEO escorting an early 30's woman to the back of our truck. I opened the back door and the woman climbed into the truck followed by the new hire and myself, the pt was very emotional otherwise seemed ok. My partner went to talk to the LEOs as I started the pt interview. My partner returned to the truck jumping in the drivers seat and started toward the hospital when I gave the ok. When I asked the pt why she called the ambulance and why she wanted to go to the hospital, she didn't answer. (1st little thing that went off in my head) I asked her the basic questions; ETOH consumption, Drug usage, Past Medical Hx, Current meds, obtained V/S(after specific request and permission) etc. She told me she "came home for Fathers day, spent the day with him, and went out with some friends-some not friends-and someone hurt me...." then shut down and curled into the fetal positon. (2nd little thing) I stoped asking. My mind was racing with what I should and should not do/say etc. We started to make small talk. She said "Alls I want to do is laugh." I replied with "I only know one joke: why is 6 afraid of 7? because 7 ate 9" She did laugh for a very short minute. She started to say something about the night before but stoped before saying anything, I used this window to ask if she was currently hurt(ing), if she was currently bleeding, and if she told the LEOs about this. She answered "no" to all and then said " I don't wanna talk about this anymore". So I dropped it. I continued to make small talk with her. When calling in the in-bound report to the hospital, I used my personal cell phone for privacy. My questions: is there anything I should have asked, or is does anyone have any tips for dealing with this kind of call in the future?

I used to work with a girl when I was in high school who had the same thing, so I do not believe it has to do with the spider bite. She told me it was a variant on the same skin condition that causes dark African Americans to get the white splotches.

We have the same thing going atm, only it's not policy yet and it is under the guise of being "green". All of our trucks ALS(911) and BLS(IFT) are posted in strategic locations(which also seem to be the least shady)

Amen, and if you need help give me a call.

To expand the OP a little, those how have experience with both the traditionally decompression kit and the Turkel needle, which do you prefer? When our region changed to the Turkel most of the medics I work with were very unhappy. They did not like the fact of having to use a scaple with the Turkel system. I was wanting something a little more in-depth as to the pros and cons of each. I know that Turkel "needle" is blunted(reason for the scaple) so as not to puncture the lung... I am just looking or a little more info...

I think this guy is a piece, as much as everyone else who goes on this show. Everyone knows what they are getting themselves into and fully deserves what ever they get. hey Ruff- if your kid is a toddler check out sprout tv... totally dedicated to children.

That was along the lines of what I was thinking, thank you.

Even at the risk of the pt loosing part/all of his leg due to the restricted blood flow? With that SLU had a vascular surgeon in the ED room 30 seconds after we walked in starting his test and prepping the pt for emergancy surgery later tonight. So I doubt greatly that he will loose the leg, but under principal?

A question to the doctors here (or anyone who may know the real answer): My partner and I just finished a transport to SLU hospital from a local Metro East hospital of a 44 yo male with a blocked(or severely reduced) arterial block in his right leg. He and his wife are OTR truck drivers. Anyway, the pick-up hospital had him on a heparin drip(through a pump) and I was wondering why heparin, I mean would not tPA(or other clot buster) be the better choice to restore blood flow to the leg? I have only minimal very minimal knowledge of these medications and just looking for some knowledgeable input.

I do apologize, I misinterpeted what you had written. We don't really have any medic mills around here, closest thing is a Community College (or hospital based) sponsered program that is a school year(fall and spring semesters), so I dont have any experience with these "medic mill" medics. I don't understand when you say they take short cuts, because it is "easier". Is that not the more dangerous route to take?

No offense Mateo_1387 but your examples seem to be more about the laziness of the paramedic in question. I have seen both(degreed medics and "mill" medics) do both in your examples. Just because you are a "mill medic" does not mean that you incompetent and can not differeniate(sp?) between the proper and the necessary treatment, and the reverse is true as well. Example a co-worker of mine is a life long student. He has several degrees and is back in school to get yet another. This guy called off Arch(medical flight unit) and attempted to work a trauma code in which a biker left over 3/4 of his brain on a stop sign(80 mph no helmet), while is partner was working the rider(level 1 trauma). I agree that education is very important (especially after coming here and talking with the people here), but it does not compensate for common sense(at least on a basic level)

[quote="craig Just to set the record straight, they are PROTOCOLS not GUIDLINES. by the implacation that they are guidlines also takes away the security of the authorisation of the states medical advisory committee. by having Protocols (even though we can alter them and report the changes in an variation to protocol form) keeps the STANDARD of treatment that the public expects and deserves.

The private company I work for has several couples that work here including one on-again-off-again couple that even work as partners.

It is part of our Pharm chapter/knowledge. My instructor has assigned everyone(17 of us) a specific medication used in the field we have to research it and present our findings to the class however we want. He left it completely open to us to decide how we want to do it. I am just struggling to find its (D50) history.

I have to do a presentation for my paramedic class on D50 and am in need of a little help. I have found lots of web sites that talk about the drug(indications, contraindications, side effects etc) but I am looking to find the history of D50(when it was discovered, when was it first used in the field etc). If anyone can point me in the right direction it would be greatly appreciated.

In my basic class I had to test out on the LMA(King LMA for company), CT, and ETT. We dont use the the CT in our area, and the LMA(King LMA) and ETT are all advanced airways.

Is there a program that can actually read the ECG correctly 100% of the time? My company uses the Philliaps 12 lead moniters and it analizes the ECG at the end, however I have noticed that more often than not, it is wrong. Most recently we transported a female vent Pt over 40 with sever rep. distress; when we ran the 12 lead it read Acute Infirior MI. We transmitted the results to the ED. When we got the the hospital we were told to put the Pt in a room. Confused as to why, I respectfully asked the Dr. why. He broke the 12 lead down for me and my partner that in lead to there was a PR depresion not ST elevation, and that ment they pt was not having a MI instead ment the pt has/had hypertrophy of the heart. My medic partner missed it, and the 12 lead misread it.