brock8024

I have not used either since i just got out of pharm and have been checked off to give drugs. The one thing they beat into our head is that EVERY drug is a poison. No matter what it is used for they are all poisons and you have to know what will happen when you give it. I know my school wants us to know the reason and the side effects when giving a drug and doses.

My basic was 8 months long but we only went for one night a week for 5 hours. I liked it because it gave us time to study and the teacher more time to go in depth. We had to do 95 hours of ems clinical time. The instructors did not want there name mentioned with us if we could not function LOL. but that also helps because well of course more time on the truck as a student the more time u get to practice. I think something needs to be done. I understand there is a shortage of medics but we do not see them herding nurses though a program because then need them. Why are we any different. We need higher education for paramedics. That is why i disagree with I99 it is just a water down paramedic that services will use because they are cheaper to pay and things. I mean we are responsible for peoples lives and normally it is just u and ur partner making the calls and shots. so why not make the medic programs harder??

I mean i am not bragging on my program, but I guess I am. In my first semester it is only pt assessment. That is it 9 weeks of it, plus We had to give a 15 min presentation on professionalism and include world ems into it. Second semester is trauma and we had to write a 10 page paper over a issue in ems. I picked Fluid resuscitation. Third semester is medical stuff and fourth is peds and ob. I know in that last semester we have to go to a daycare for 8 hours just to see how kids act. We do not just get to stand around we actually have to interact with them. We started off with 35 or so in my first semester starting my third semester I think we will only have 15 or so. The program normally only graduates 3 to 10 a semester. I have talked to other emt's and medics that have worked with them from the other program and most said they did not now how to do a EKG.

I know this has been covered a few times, but I never knew how bad the problem was. I chatted with a guy last night that is in paramedic school. We both live in Oklahoma and go to different schools. The school I go to will let me have a AAS degree in EMS Science. I think he can get one from his school to, but each teach different. My school is a national accredited school and is tough. We have 4 paramedic care classes. Our EKG and Pharm is not in those class but separate 3 hour college credit classes. Our program is probably one of the toughest in Oklahoma I think. I am not dogging that program but he said something to me that kind of scared me. He was like your program weeds out the week and only the strong survive. He is like ours work with the people to help them through. Now there is nothing wrong with that either but he was like you guys have to do a lot of extra things that we do not. Like give presentations and write papers. I do not understand why people would want to take the easy way out. I mean I am still realize that I will not know everything when I am done but how do we except to make more money when you have classes that are not tough and just give the bare minimum??

I agree with shane. In oklahoma if I remember right and since i will be taking this test in two weeks, We are a I-85 state. I do not understand the 99 stuff. I mean you learn the rhythms and stuff but that can not go into as much detail as the paramedic program. It is like a LPN and RN. the LPN knows how to do the skills but really do not understand the reasons why. I am nto dogging the I 99 but why learn something like then go to medic school just to find out why. Just go to medic school.

And sorry it takes me a while sometimes to post. I do this on my free time at work so, please forgive me.

Ok so you do your 12 lead nothing abnormal. O2 at 15 l/m via NRB. As you load her in to the ambulance she tells you that she remembers hearing the nurses talking in the cath lab. One said she hope that it was not to much and the other said naw she will be fine. She does not know what they where talking bout but was out of it from the valium they gave her to calm her down. Your partner looks at you funny and you decide to take her code 3 to the local ER. about 2 blocks from her house she stops breathing and becomes unresponsive!!!!! what you want to know now. And what do you think is going on. I have given you what you need to know. How is this treated and will this change your mind on which ER to go too??

S/O: What is her LOC? A&O x 3 Quickly assess the ABC's and ensure her hemodynamic status is intact- resp 24 pulse 100, no breathing abnormalities. Obtain a set of baseline vital signs to include pulse ox and skin assessment along with tilt testing. 100 hr, 24 rr, pink warm, 94% RA, 150/84 Lung sounds, ABD assessment, and focused neuro assessment/HEENT exam. Clear bilat, soft non tender, weak grip on right. HEENT unremarkable but the blurred vision. 12 Cranial nerve exam and focused eye exam.- all normal but the left side of the face ROM and strength assessment of extremities. - moves all well but having trouble with right BGL? 110 Rule out carbon monoxide poisoning if possible. none that u can find. Obtain history of present illness and PMHX. CP two days ago and had the angiography this morning and was released. HX of HTN. SAMPLE & OPQRST -not feeling right, right side weakness, NKDA, HCTZ, CP two days ago, After angiography. Onset 20 mins before you get to the house. 4/10 head ache, does not really go anywhere. A: Based on the history and physical exam. - overweight female with head ache and right sided weakness. P: supplemental o2 cardiac monitor and 12 lead vascular access transport after detailed exam is finished E: ongoing assessments

PMH - pt had a Angiography this morning -Rx - HCTZ -LOI -Approx 1400 today -LMP & Para/garvida 2wks, 2 live normal births 15 years ago. -Alchohol?/drugs? occasional drinker and smoker -Prior events - was sitting on couch with husband and started to feel funny. -N/v/d - No N/V/D -S/S of CVA? pt does have some numbness on the right side of body. and some blurred vison -Possible previous trauma? Just the Angiography this morning. -Remove the pt. from the husband- why would u do this?

Ok I am going to answer everything. Sorry I was off this weekend and was spending time with the family. LMP - 2 weeks ago -STD's? None that she is aware of. -Fibromyalga? No past medical hx. -Psych hx? None -Pt.s weight? Pt is 5'7 and 200lbs.

The point of this is to think out side of the box.

Trevor, The scene is safe, and the house is a comfy 72 degrees. The husband seems to be very worried and you can tell loves his wife very much. The patient is sitting on the couch in the living room and looks very healthy. You do notice that she is having trouble with balance. What else

You are dispatched to a residence for a 38 year old female. Her husband tells you that she started having weakness this afternoon and now is stating that she just does not feel right. What else you want to know. brock

Well if they could not keep her Blood sugar up sounds like a Pancreatic problem. that is a weird presentation of hypoglycemia. I am with everyone else, she has to have a infection some place. I would almost put money on a pancreatic infection or they nicked a bowl. I was almost certain though it was going to be her ammonia levels. oh well can not win them all. Brock

http://www.clevelandclinicmeded.com/diseas...ph/henceph.htmt This sounds like ammonia toxicity which is a side effect of hepatic encephalopathy from what I understand. One of the drugs of choice for the ammonia is lactulose. Lactulose prevents the absorption of ammonia in the colon and increases water in the stool. It is used in Pt's with hepatic disease with portal systemic encephalopathy. I would treat the patient with supportive care. Drop a tube if needed and what ever else she needs. Brock

I will have to disagree I do not think that is standstill. The only reason I say that is there is no P waves or it does not look to have p waves during the pauses. I always thought that with standstill you would have noticeable Pwave but that was it. in that pause I do not even see the P waves. strip one - A.Fib with RVR. strip 2- A Fib with RVR. Then it almost looks like she either vagaled down or something and had a PJC, then have a normal beat. strip 3- It is a brady but it is hard to tell if it is a wondering atrial pacemaker or a combo of atrial beats with junctional beat . strip 4- It looks like strip three but then she goes back into A Fib with RVR. Now please note that I am in my EKG interp class this summer and will be going into my cardio stuff this fall in class. So I am not a paramedic just in school for it. If someone has some stuff to teach on this please do so I love learning this stuff. thanks Brock

This has to be the most stupid thing I have read in a long time. They are clearly bashing medics for something that even doctors do. You can not tell me that every doctor in this world always with 100% makes the right diagnoses every time. Even with all of the fancy test and stuff they still miss things. Hell I worked once and they had to call a patient back in cause the doc missed a pneumo. So why should medics be put under the microscope. We do the best we can do just like the doctor and nurses. The one story was stupid for trying to sue. I mean his mom was fully aware of the stuff apparently she was ready to die and knew she could. Nothing we or anyone else could do. That it seems like does not count. The other ones I do not know. Like I said not even a doctors are right 100 percent of the time. If the medics would have transported the patients against their wishes we would have been reading on Assault and battery of patients and kidnapping. So like many others have said damn if u do damn if u do not. It just makes me mad that they pick at medics and things but never there doctor friends that kill patients every year. There is a good topic the number of patients doctors kill or the number of mess ups they make. Brockie

One more thing, people are here complaining about these people, but are they doing anything to help the problem. There has to be something u can do in ur community, wherether it is going to schools and trying to teach kids stuff through ur ems or vol at free clinics or something. It is funny it is like the person who @#&$^ about the president when they did not vote. same here stop #%@$* unless you are trying to do something to fix or help the problem. Brock i know this is going to make people mad and i am sorry up front.

This subject makes me mad. I hate it when people come in and know the more kids they have the more free money they get. I worked in a ER and one of our ladies that does the admitting almost got fired one night. A woman came in with her kid who had been sick for a week( btw the kid was playing) and the admitting clerk asked for her insurance cards. and the woman was like here is my FREE insurance. The clerk looked at here was like it is not free it cost me and every other tax payer money. She filed a complaint and the admitting clerk got writen up. I have even seen patients who called a ambulance came to our er and went to triage and then called another ambulance from our waiting room to go to another er. Why cause they had to wait. It is a sad world we live in. I mean no one takes care of themselves. As far as it goes we are in this to care for people. When u get mad at one of these people just think of all the others u help. One of my fav calls are the little old ladies that just want someone to talk too. to me that makes everything else better. Just think of someone u get to help and forget about the rest. we are here to help people not judge them. Brock

I am not for sure if this fits but alot of people think that capillary bleeding can not cause hemovolemic shock but from what I remember it can. My instructer gave us a example like a Patient in a motor cycle crash has a large area of road rash. It is a lot of capillary bleeding that if over looked and not watched right can lead to hemovolmic shock. And also they can loose fluid which can lead to hemovolmic shoc, so it is like a two fold thing. that is about the only way I can think that a capillary bleed can lead to hemovolmic shock. Brock Up front sorry for my spelling.

I personally like the LMA. When I done my OR clinicals the doctors showed me different ways of putting them in and things. I got use to them and like them. They are not the best because they do not help prevent vomit but as a back up it works well. Brock

We have about 502 hours in the program i am taking. We are a nationally accredited school. I love our program i just wish there was a way for us to do stuff on breaks and summer to better our assesment skill and other skills. that is all this post was for. I am not for sure if it would work, but if it was a vol thing why could they not mutual assist or something with the city that the college was in so there would be a higher call volume? that was my whole point. Brock

I guess where I am coming from is that students need more time than they are givin to learn what we need to learn. what I mean is where I go to school it is a 2 year degree program. My pharm class is a 3 hour class my EKG class is 3 hour class. That is not counting my Paramedic classes. So we get summer breaks and things. I feel like schools could some how get us more experience by students riding over the summer with services. I am all for more education and seems like there is a way we can get it just have to find the way. I am by no means bashing vo tech schools or anything. As a matter of fact i have no idea how they work. I do now though by taking my paramedic class at a college there is alot we cover and go over and i do not see how they do this at a vo tech. in the alotted time. My point to this whole post was how do we get better assessment skills while in school. clinicals are good but we only get some many of those and why waste a summer when we could be learning and practicing our skills that are the most important. Brock

Dust, I am sorry u are getting the raw end of the deal here. I respect ur opinions no matter what. What my point is that students need more clinical time and education to master the art of history taking and patient assessment. Here in Oklahoma there are ten services that have went under due to either money or not enough staff. One town even had a guy die because it took a out of town service over 25 Min's to get there because that town does not have enough EMT;s. What i was wondering is why do schools not pimp out their students that are licensed. I mean hell make them a first responder if u have to. Just something to help the community and the students.

do u think this helps with the students education? I would think it would to some extent. That is what I am wondering. How much would this help. I seen on the news last night that there is 10 rual areas in oklahoma that now do not have a ambulance due to shortage of money and emt's. I figure this could help in some respect. thanks brock