brock8024

Another clue she is on no anticoagulants. No warfin, ASA , or plavix and she is in A.Fib and recent hip surgery.

Hip surgery and A fib. She has PE right there. IV, O2, Monitor. She needs Diesel to get to ER. Get ready to work a CODE

She has a PE.

What her meds?

What pt hx? Lung Sounds?

1) Exacerbation of COPD 2) Exacerbation of CHF 3) AMI 4) PE

Does she have a DNR? That would have been my first question. LOL

yeah i just noticed that. I was typing fast. LOL

Thanks Timmy. I am looking at NZ and Australia. I am not for sure what parts I would like to live in. I want to be able to enjoy the culture and life. I think it would be a good way to further my skills. I would also like to further my education if possible. I do not mind starting at the bottom of the food chain again as long as I would be able to move up and people respected what I knew.

I found a migration website and it is asking what area I want to live in. I am not for sure at the moment and need imput on good areas for american paramedics. Thanks

Why did you not give oral glucose. I mean you can rub a little around on gums and under tongue. that a very vascular place. SO you did do two ekg's right to check for right sided mi

It all depends on the pt. Is the BP 102 or 110? If I have a iv then I can fix a pressure problem if needed. Both MS and Nitro are going to lower pressure. I treat all patients separate. It is a critical thinking skill. You have to be able to look at the whole picture not just, Ok his bp is 100 or greater going to give the nitro.LOL

So you done two ekg's on this man and sent both of them to the ER? So what level are you? Just wondering. So he did or did not give the nitro? I am lost now. Did he give any other meds or treatments for his pt. At your level if you know how to check for a right sided MI but not know how to read a EKG then you should take a class. It would help in the future. It also show that u have motivation to learn.

Did you do a V4R on this pt. IF not then it is my understanding that you cannot tell that they are having a right side MI. I was taught never to trust they writing at the top of the paper. With that BP and heart rate I would not have giving the nitro but I was not there. Did he ever get the IV started?

I agree Ruff. The service would be out of business if that happened. I think that there should better schooling and programs to help people with these disease processes so they can work.

We are a smaller service and the boss already knows everything and came to me. I know I am his last hope if you will. We was sitting down with him for hours at a time for a while but he seemed not to care. he would not take notes at all. It seemed like we was forcing him into learning. I am going to talk to him and start off simple. If this works then I will be happy but I am not going to spend a month with a partner that is not willing to help himself. I mean if you are not going to step up and help yourself and do better how do you help a patient in need. Me and my last partner done very well together. We had it down on how the call would go. I would assess the pt and she would talk to family and get meds and a hx from them. Or visa versa. If it was a critical pt then we would move and she would do stuff with out me asking. I loved it. I am spoiled. Now I get a partner who knows to get a set of vital signs and a blood sugar. He does not know when a pt is critical and we need to move. Now it will be up to me to get all pt care skills done as he does not know how or when he needs to do them. Our basics and intermediates can get protocols for nitro, asa and c-pap. It is person to person thing. They have to be tested over it and understand when to and not to give it. This guys does not get those protocols yet so that is more I got to deal with. It makes it difficult because we area rural service. We cover the entire county and my first day I am the only paramedic. I love going and helping my co -workers out but I do not want to be 20 mins or more away from the ER and have to bust mine ass while my partner is standing there. Ok I am not whining just venting. Thanks for the support and suggestions. I will let you know how it goes.

The first thing we are taught is DO NO HARM. How often are you ever cut on scene? It is possible to do but does not happen very often. I would think that if they where to get cut that the ER could test the pt for what ever they have. I am torn between if they should or not. We do not want these people working around our kids, food, or anything. On the other hand if they are healthy enough most do not qualify for any assistance. I know a Infectious Disease doctor and we was talking about this.She said that if a person with HIV takes care of him or her self and takes meds like they are suppose to then they are very healthy. There are some people who was HIV pos and with the right treatment are now testing negative and would be very hard to give someone the disease. I guess it depends on how safe they where and would have to be watched and made sure they where on good meds and trying to protect themselves and others.

Thanks for the tips. Firedoc me and u seem to be alot alike. LOL I have worked codes and car wrecks and he seems to like that. It is just that he forgets a lot of stuff. We gave him case and 5 mins later he could not remember the blood sugar we had given him. I do not think he understands a lot of the stuff. I am going to help him in the morning and give him talk. I am going to start off with basic communication skills. I am going to quiz him and see if he has any motivation to look stuff up himself. He sits around and plays games on computer and watches a lot of tv. My plan give him a few hours or days to look stuff up just to see if he has motivation. Quiz him over simple things to get his level of knowledge then go from there. we are a intermediate service. there are about 5or so paramedics that work there. we have a few intermediates and lots of basics. I was lucky that my last partner was a basic and very good. she understood a lot of things and was always willing to help anyway she could. my iv bags where always spiked when I was looking for a vein. She would put them on c-pap while I was getting stuff together. She was awesome. It will be hard for me now because I am going to have to do all pt care except finger sticks and vital signs. I will let u guys know how it goes. I start my shift in the morning with him. We work 48 hour shifts. 2 on 4 off. wish me luck.

I am changing partners at work. I am not really excited because I loved my other partner. We worked together for 6 months and clicked really well. The new guy is having trouble and I am kinda his last hope. I was told I am very patient person. I also love to teach and talk about calls and different things with my partners. This new guy has trouble with critical thinking and just having the motivation to learn things. He went through a basic class and passed everything but seems to have forgotten everything. I need help!!!! how do you teach someone critical thinking skills and just motivate someone to want to make themselves better. The crews I work with normally get together and talk about different calls, signs symptoms, treatments, and things like that just to learn. I work for a service that has all three levels. PLEASE GIVE ME IDEAS ON HOW TO HELP THIS GUY!!!!!

I love the diabetic patient. They are always interesting to help and deal with. I have had pt's with FSBS in the 30's and be talking to me and others in the 60's and be out of it. I always try to start with the oral stuff unless they are out of it. D50 is a aweosme drug and love watching it work so fast. When my pt wakes up I tend to go with a PB sandwich and a glass of milk. I only have them drink OJ if that is all that is in the house. Normally with the milk and PB the sugar stays up. I try to take my pt's to the ER to atleast get checked out. I mean I am already there so why not. Plus who knows what is going on that the pt is not telling me or that I do not know. There are many reason why the FSBS is low. The hospital where I work they have came up with a intersting formula on how much D50 to give. I know that they do not give a full 25g. I think it is 100-FSBS x0.3 or someting. I will try to find out but the actual one is.

I will have to do that. I am looking at cali the most right at the moment.

I live in Norman , but work in Altus. It is a good place to work just want to move out of oklahoma.

That is just it. I want to live where it is sunny but not to hot. I like mild weather. I liked galveston when I visited last year. I have not traveled much and this is why I want to move. I thought about the coastal states mostly.

I am a new paramedic and wanting to look for a place to work. I am currently working for a service, but I have never lived out of oklahoma. I am looking for different states to work in. I have went to different website to try to find jobs and have found some nice sounding jobs. Here is my think I need help from people with what places to stay away from or good places to go. I am not wanting people to bash services just want incite on different companies. So far I like this place--- ACADIAN AMBULANCE & AIR MED SERVICES I Looked at galveston texas, Hawaii, and other nice temp places. Can anyone please Help. Brock

Here is another thing. Why not just try basic airway first. I mean he might be out of it, but why knock down a guy to try to tube him if you can vent him with just a BVM and oral airway. MAybe this is a time we do not need to jump to advanced airyway just use the basics.