celticcare

Guilty.

Have you ever sworn loudly in front of a patient in the back of an ambulance?

Guilty.

Have you ever slept with anyone at work?

In terms of responsibility, if I have a student with me as an RN, I am responsible. The student has a couple goes at things, and then I take over and if I see something the student is doing that may risk the patient, I am to step in.

The tech however, should not have injected the iodine into the IV if it wasnt patent, should have checked with a decent flush and if it infiltrated then, then it was not suitable. The line was inserted by an RN, but the person injecting the fluid in etc, needs to make sure it is patent, anything can happen in transfer/transport, clean, check, flush and use.

On the side issue in this thread, I have to go with Doc in this, the OP talked about contrast, and I would have thought someone professing higher level knowledge and education would know contrast dye is often Iodine unless an allergy exists.....

And let he who has never cited google or relied on it cast the first stone.

Scotty

I'm sitting here with my blood boiling at the parents in this. I'm sorry but medications were made for a reason and what 13 year old knows about their condition and treatment after only one session of Chemo therapy.

WHACK JOBS and cult brain washing. yes Chemo is yucky, yes radiation is not pleasant, but this kid has a huge HUGE chance of survival but no, some whack nuts brainwashed and their kid who can't read apparently, yet has a total understanding of the consequences can say nope? Give me a Fu**ing break! Interpretation and understanding of consequences are not going to be there with this kid, he is only 13 not 31. I actually commend the state, yes there is individual choice but to think some herbs and a song and a dance is going to give your kid a recoverable chance more than the medicine that has been scientifically proven to have a 90-95% success rate, then you need a psych eval and your kids taken away.

To me, its like parents not wanting to immunize their children, whilst natural immunity is good etc, but Immunizations were developed for a reason, and the reason we are getting diseases left right and centre and Polio is coming back and a whole heap of others, is because whack job parents are saying "oh its unnatural" bring me these parents and I will happily slap them across the face. My brother is immunodeficient and cannot have live vaccines, the risk of them killing him is to great, parents in the community refused to vaccinate their kids and when the kids got sick with the bugs, it meant my brother had to miss time from school to be away from it, or ended up in hospital sick with acquiring their illnesses. Think your being kind and great to your kids, well think of the others that your hurting.

I am not intending to offend anyone directly, but man, this is something that is personal for me, and like I said above, wanna do your herbals, thats fine, dont jepordise your kids though, and dont wanna immunize your kids, thats you own choice, but stay out of mainstream schools, because parents who do that, deny people like my little brother so much and place their own stupidity and brain washing, over others health and safety.

Scotty

Stole these from a certain site. Thought they would be good for this. Answer will be revealed on 5/17/2009.

Let me know what you think.

Sinus Brady/arrythmia, 1st degree AV block *just a shame that PJC going in the middle as it could be wenkebach with a perfectly time PJC*, some degree of axial deviation but again, brain isn't awake just yet.

I have yet to find myself in a situation where my collar pins served any useful purpose. That's the main point here. It's pointless crap that serves no purpose.

Yes. We had to wear collar rank in the military til we finally went to epaulettes in the late 70s, and more than a few times I slung something over my shoulder, or leaned in on something that jammed them into my collarbone. Not life threatening, by any means. But since it serves ZERO friggin' purpose, I'd say there is ZERO justification for that risk.

Yes it may appear to serve no purpose to you personally dust, but it may to the OP's station or his area, not all of us are hot headed like yourself and rebel. It was a simple question asking had anyone seen these types of isignia, had anyone come across where to purchase them.

We don't have them here in New Zealand because we are not refered to as EMT's but ambulance officers or paramedics, so the EMT symbol and even the Star of life are not used in mainstream ambulance services here. Try Galls or even jewellery makers. They may help.

Scotty

Why the hell are these people out there, the arguements for advancement of care and skills, and we get idiots doing this????!!!! What sort of idiot takes a picture to start with, and then posts it on facebook of all places.

I'm boggled and baffled. Just what EMS needs coming up to EMS week, now that area has a further tainted picture of EMS and what many of us do because of one stupid idiot!

EMT Fired over Murder Victims photos

What is antero lateral? I'm assuming it's left or right recumbant?

Sorry Katie, lack of sleep from night shift makes my typing and brain not work lol, I meant anterior Posterior. *Paddle on front and paddle on back*

It's not common, but we learnt to defib infants, just with the peadiatric attachments on the paddles and put them on their side and antero lateral postion for the paddles.

God I pray I never have that situation.

I'm a little surprised to see that so many assign the possible mechanical failure of this guy's heart to the accident.

I saw somewhere, perhaps here, that as many as 50% of single car accidents that cross lanes of traffic have a cardiac element, perhaps bicycles too?

What evidence, if any, is there that the arrest is cause by the trauma and that a mitigatable factor didn't cause the arrest that then resulted in him being involved in an accident?

Lots of blood and "gray matter" at the back of the head shouldn't immediately define this as a code to walk away from. Until I eliminate the causes of PEAs, specifically, and other causes that may have caused him to enter this accident, generally, then he gets worked...not like they're taking the drugs out of my pay.

Dwayne

Thank you Dwayne, I was just about to post to that fact, did he have a cardiac episode and then drift over on his bike or vice versa. We would make a judgement call in the field here as we can pronounce.

Personally, I would have worked him, go through the checks, the eyes to the side, does he naturally have strabismus? Is an eye a glass one, yes these may seem a little silly to think of during a code, but if you are going to call him on these issues presented, then they need to be checked. The head lacerations, again would not be a stopping factor to me to stop or not attempt resus efforts.

The H's and T's are in my mind here and also as croaker pointed out and reiterated, asystole and PEA are completely different, there is still something happening in the body as the wiring of the heart still has some life in it, yes I know it can still fire now and then for a bit after death, but still, its something. Go for the drugs, tube him, try anything you have in your skill set, that is why you do training to have the skills to perform them with the knowledge of what is happening in the body. Think outside the square.

So yes, I would personally have started the resus/continued the resus efforts. Alot of our resus efforts take place in the field, if we have no ROSC in the field after a certain amount of time, we call it, now yes every situation is different.

An interesting case I must admit

Scotty

To the op, you said sync cardio, I would totally agree with given the example of distress in your fire couple of senteces.

But it is not fast AF, his bp is still holding, a fuild challenge calmed him down, it would be more fear of Oh my god is this another heart attack? You seriously want to knock this guy out, bring the black shiny paddles in front of him first though, and then zap him when he doesnt need it????

Maybe perhaps it is in your protocols to which then I will accept it, but the general idea would be chemical before electrical. Electrical only if heamodynamically unstable.

I'm actually going to be pleased to take a break from ecgs for a while with finishing my current job..... though would be nice for a hardcore resistant VF arrest either tomorrow night or on mylast night that will be awesome especially as the patient will come back after my 5th shock muwahahahahahaha

That's actually not an incomplete LBBB. Note that the axis is around 60 degrees*. If you have a normal axis, you lack a hemifasicular block. Since LBBB is a block of both the left fasicles, you should be able to identify at least a single fasicular block to call it incomplete LBBB. Normal vectors, and R wave progression. That width you are seeing is probably due to early repol. Note notched J point most visible in V5(looks similar to osborn wave).

*You can figure this out by considering aVL to be perpendicular to axis of depolarization because it is the most equiphasic lead(not predominately positive or negative. Since lead 2 is perpendicular to aVL than your axis is almost in line to lead 2. Since lead 2 is positive, and the positive electrode for lead 2 lies at about 60 degrees....abracadabra. If you already knew this, disregard.

*Looks with a fresh set of eyes and more coffee on board*

Thanks FL

In one of Obama's campaign speeches, he said that 'the buck stops here', and that he wouldn't try to shift the blame for what his administration does.

Along with that, he pretty much ousted most of Bush's cabinet, and installed his own.

In MY book, that makes him responsible, either directly or indirectly...

Were the cabinets veneered or marble top

Wow Dust, you getting snippy with me?? Which am I, ignorant or dishonest?

Chaser, we just learn not to piss Dust off, he is the duke, therefore is always right, nothing rifles dust up better than talk about Jews, Nazis, Firefighters, cookbook medics and anything that is outside his little bubble of thinking.

No subtle undertones of sarcasm here, plain and outright with me

Hahaha... sorry... a little computer illiterate!

Naa, I am working BLS.

I did O2, IV NaCl 250ml bolus, 160mg ASA. It slowed the rate down and the chest pain faded so I was satisfied.

Although if I was working ALS I probably would have went down the Amiodarone route... maybe (student), Perhaps even considered a quick electrical cardioversion.

Its down to if he is symptomatic, I would have held fire on the DCCV route and gone with pharmaco first if he was unstable then yes the lunchbox of life would be great though.

Good thinking on the whole though Mobey

Sounds like an LAD stenting, wouldnt be surprised with some pain later on afterwards or even a stent moving. But it seems like new onset af which is causing the issues for him personally.

Notice our coloured friend hasn't posted yet? Oh wait, because now there is something to prove that black people arent as dumb as he says they all are. Do I need to dangle a race card for him, I have a hook and line somewhere and a stick. Here Crotchity, here boy.

New onset AF yes, icomplete left bundle branch. curious as to which vessels got plastied and with what sort of stent, BMS or DES. It was plastied right not just angiograph?

Scotty

Spenac my friend I am confused.

Are you saying these medics, in your opinion, put the dog before the patient?

Here is the way I see this call:

Paramedics respond to a scene

Paramedics find a stable patient suffering from physical pain and emotional stress.

Paramedic #1 attends to patients physical needs (spinal, pain control etc etc)

Paramedic #2 calls Med control (read Vet) and "deals" with patients emotional needs (dog)

Patient is loaded and taken to hospital.

I realize this is not the normal flow of a call.... but really.... I have also spent a few mins "emotionaly treating" the spouse or child of a patient which relieves emotional tension from the scene and my patient. I kinda think of this the same way.

Believe me... with ACoP and Calgary EMS reviewing the call with a fine tooth comb there is no doubt the patient did not suffer any further injuries based on the few mins it took to deal with the dog.

The reality is, they probably took him to a Calgary hospital and sat in the hall for at least an hour... possibly even turned over care to a hallway medic (as they are called)

Mobey, the response from Spenac was more at the attitudes of posters prior to him including myself.

This was an event orchestrated and executed without the knowledge of either the President or top brass at the Pentagon. If you're going to blame Obama for what you perceive to be a waste of money then you also have to level equal blame at Secretary of Defense Robert Gates, USAF Chief of Staff General Norton Schwartz and any number of high ranking USAF officials at the Pentagon (most of whom, it seems, were equally ignorant of this event until they saw it on the news). It's interesting that you failed to level the same amount of blame at the latter and chose to single out the former.

The head of the White House Office of Military Affairs, the guy responsible for all of this, has already resigned from this poorly handled event.

It was said before and I think it bears repeating. Check your facts.

Look here.

If you're going to gripe about the President, and there will be many things that many will gripe about over the next three and a half years, at least make it an intelligent, well thought out and fact checked gripe.

I still think it's a pretty cool picture.

-be safe

Ummmm can anyone say OWNED

This link was posted to me by a friend on MSN, honestly it will make you think about patients at MVC's.

There is some swearing in the video so be aware where you play it.

Scotty

Swedish Suicide Teens

I will make only one comment on your reply to me Dwayne, because this will be seen as a whiny post but hey, can think what you like.

The fire comments from dust, are insulting, its not just my feelings in regards to this, its the fact that he was probably booted off the fire squad or something and so has a problem with fire monkeys as he so likes to call them. Be aware that not every fire department is as loose unit as Dust may believe or portray.

We protest and cry and whine about EMS will never advance any further on certain aspects, yet we knock and beat on the department that many of us should credit in some way, for bringing EMS to life. Specially trained firefighters and rescue squad members, became the first paramedics. I am not saying bow to the almighty fire service, I am merely saying that when Dust posts something that makes out firefighters are stupid or have no clue or anything of the sorts, it is insulting plain and simple.

The rest of the comments you made Dwayne, I frankly could'nt give a F**k what you like to think about me.

The report also states that the patient would not leave his injured dog and the dog was protecting his owner. So of course the paramedics would have ascertained ABC's of the owner and ensured that care was delivered adequatly. I do see it would have been a tricky situation and perhaps not as clear cut as you percieve it or portray it could have been Dwayne.

Oh and Dwayne, thanks for being a real downer on this thread, there are enough threads where people bash others and for once a good feel story comes through, about thinking outside the box and utilising other medical/healthcare/vet resources and just being blunt makes it seem like its not ok to praise these medics for doing so.

You also imply that paramedics *mainly these two* wouldn't take human life over animal life, which I think is just dumb, of course we are going to treat humans over animals, but animals in their own right deserve care etc.

And in regards to the pet ambulances, ours are staffed by Vets here and minimum of vet nurse.

Again, I had enjoyed reading the first three pages of this thread, then came to your post and felt blah. Heck even Dust's post was more constructive and looked at future care policies and protocols. (Except the fire service comments, dust they are actually getting really old and frankly insulting thanks)

Pleased the guys are back on the truck and it sucks that they had to miss out on wages whilst it was "investigated".

Scotty

I thought you were doing security work? Anyway, work on that grammer and spelling and start applying bud.

Everybody knows that Latinos are smarter than blacks.

Don't shit stir DUST!

Crotchity, we dont have african americans here, because wow surprise I'm on the other side of the planet....

But in terms on the natives here *maori* we have quite a few in staff, including educators, advanced paramedics, all levels of care provider, cultural liason team etc. But yes the majority of workers here are white, why, because simply the population ratio here is European outnumber Maori 5:1 roughly, and the similar reasons that are listed above for AAmericans. If they don't want to work or apply themselves in the area, they don't apply. It is hard to get Maori into the service mainly because they arent interested. Can't force someone into a role they dont wanna do, including a role of being responsible for themselves.