defib_wizard

Eww thats bad! ( I like it ) but isn't this a conflict of interest/ :shock:

morphine only for pain here in az.

He forgot the eleventh commandment; Thou shall not get caught!

I don't want too ask so please don't tell!!

crotchitymedic1986 said A junctional rhythm has a narrow QRS. While a ventricular rhythm is wide. Any rhythm that is faster than its " normal" intrinsic rate is considered accelerated. Until the rate is 100 or more then it is considered tachycardia. Junctional rhythm normal rate 40-60, >60 accelerated, >100 junctional tachycardia. Ventricular rhythm normal rate 15-40, >40 accelerated, >100 junctional tachycardia. Hope this helps.

It sounds like she would have been a perfect candidate for a full body vaccuum mattress. You can immobilize the pt in a semi-fowlers position. Then vaccuum all of the air out making it a custom fit to the pt. The only problem with the ked is on some people even with the sides all of the way up into the armpits. The back of the ked will hang down past the pts buttocks. So you are suspending the pt from her armpits unless you pad the void under her butt and the mattress.

In any hanging, the pts c-spine needs to be immobilized. But before you put a collar on the pt check his thyroid cartilage for crepitus. I suggest you have someone hold manual immobilization while you check the oral airway for trauma. If you are going to work him as a viable patient you don't want to be removing equipment that you just put on. ( C-collar ) Cricothyrotomy is a procedure that you will probably be performing on this pt. ( That was a lot of P's in 1 sentence LOL )

Saddest Call Ever is any call after midnight before you get off shift and have to drive more than 3 hours afterward to meet someone the next day.

If you feel like improvising you can do both. All it takes is a NRM and a SVN. 1. Set up your SVN with the saline or meds you want to give. 2.Here comes the creative part- Option A- Cut a slit in the NRM bag put the svn in it ( in such a way it wont spill ) tape the slit closed with the svn O2 line coming out. Hook up your NRM to O2 at 10 lpm and the SVN at 5-8 lpm. Option B-put the NRM on the pt as normal. put the SVN together with the T and extension tubing take the bag the SVN came in and seal the end of the T by putting the plastic bag on the mouthpiece and attach it to the T. Put the spacer tubing under the mask and start the SVN. If you need too, trim a notch in the mask for the tubing. ( This way of blocking off an SVN also works for giving SVN's with blow-by to a pediatric pt.) Hopefully this keeps you from getting called into a MDs office for not following protocol.

I would call it accelerated idioventricular rhythm with periods of sinus rhythm after coughing. How about transcutaneous pacing and some versed. Or at least have the pads on him.

A teacher is explaining biology to her 4th grade students. "Human beings are the only animals that stutter", she says. A little girl raises her hand. "I had a kitty-cat who stuttered", she volunteered. The teacher, knowing how precious some of these stories could become, asked the girl to describe the incident. "Well", she began, "I was in the back yard with my kitty and the rottweiler who lives next door got a running start and before we knew it, he jumped over the fence into our yard! "That must've been scary", said the teacher. "It sure was", said the little girl. "My kitty went 'Fffff, Fffff, Fffff'... and before he could say "F***," the rottweiler ate him!"

I'm in az also so no beta blocker in my drug box. I would like to start giving the pt morphine. I can give up to 14 mg under standing orders. Since this pain is not appearing as cardiac. and absent pedal pulses. I'm leaning towards a TAA. Patching for MD input would be a good idea. I would hold off on the ntg until I talked to a dr. Does morphine help him?

You cant argue with that type of thinking!

arizonaffcep - if I get to go to flying here in town on this call ( again) I'm gonna hurt ya! LOL But seriously; Lets get him out of the restaurant start him on O2, and do a 12 lead ecg. Does he have = radial and pedal pulses? Any pulsating masses? How does he describe the pain? Sharp and/or tearing in his cx and Im thinking PE vs Thoracic Aortic Aneurysm. Heavy and dull possible MI. Now for questions 1 Did the pain change with O2 2 Did the 12 lead show evidence of STEMI? 3.Any other changes with tx and does he have any allergies? As with any call like this an IV is indicated of NaCl 0.9% at TKO.

My advice is simple, when you start in Iowa. Get a copy of your protocols, standing orders, tx guidelines and learn them. If you want place them in sheet protectors and a 3 ring binder and carry them with you. Also get the profiles of the drugs you will be carrying that you are not familiar with. Last but not least get a little composition book that will fit into your pocket. Carry this with you and write door codes, patching channels, hospital phone numbers, etc. Or anything else you need to remember on a daily basis. I know you can do this with a cell phone but batterys die and people change phones. Above all stay calm, and welcome to being a medic.

Why Parents Have Gray Hair A father passing by his son's bedroom was astonished to see the bed nicely made up and everything neat and tidy. Then he saw an envelope propped up prominently on the pillow. It was addressed, "Dad". With the worst premonition, he opened the envelope and read the letter with trembling hands: Dear Dad, It is with great regret and sorrow that I'm writing you. I had to elope with my new girlfriend because I wanted to avoid a scene with you and Mom. I've been finding real passion with Joan and she is so nice. I knew you would not approve of her because of all her piercings, tattoos, her tight motorcycle clothes and because she is so much older than I am but it's not only the passion, Dad, she's pregnant. Joan says that we are going to be very happy. She owns a trailer in the woods and has a stack of firewood, enough for the whole winter. We share a dream of having many more children. Joan has opened my eyes to the fact that marijuana doesn't really hurt anyone. We'll be growing it and trading it with the other people in the commune for all the cocaine and ecstasy we want. In the meantime, we'll pray that science will find a cure for AIDS so Joan can get better; she sure deserves it! Don't worry Dad, I'm 15 years old now and I know how to take care of myself. Someday, I'm sure we'll be back to visit so you can get to know your grandchildren. Your son, Chad P.S. Dad, none of the above is true. I'm over at Tommy's house. I just wanted to remind you that there are worse things in life than the report card that's in my desk drawer. I love you! Call when it is safe for me to come home!

Why don't you go to their web site and review the felony policy. If that doesn't answer your questions call them.

I agree with you on performing the surgical cric. However some of the people posting and I believe the OP are BLS level. They can't go after it or cut the pt.

Two women friends had gone for a girl's night out. Both were very faithful and loving wives, however they had gotten over-enthusiastic on the Bacardi Breezers. Incredibly drunk and walking home they needed to pee, so they stopped in the cemetery. One of them had nothing to wipe with so she thought she would take off her panties and use them. Her friend, Diane, however was wearing a rather expensive pair of panties and did not want to ruin them. She was lucky enough to squat down next to a grave that had a wreath with a ribbon on it, so she proceeded to wipe with that. After the girls did their business they proceeded to go home. The next day one of the women's husband was concerned that his normally sweet and innocent wife was still in bed hung over, so he phoned the other husband and said: 'These girl nights have got to stop! I'm starting to suspect the worst... my wife came home with no panties!!' 'That's nothing' said Diane's husband, 'Mine came back with a card stuck to her butt that said..... 'From all of us at the Fire Station. We'll never forget you

It depends where you work for them. I have had some friends work for them some loved it & others hated it. The majority of the 911 calls, the fire medic will be with you. You will be considered the transport medic. Like anywhere else you have the standard " stage by the door with the gurney type", and you have the ones that will welcome your opinion. It's like anywhere else you will have to earn their respect. Some of them will never give it too you but others will in time. My advice to you if you decide to try working here is, Be objective, let them get to know you and your abilities. Pick your battles well, the fire dept's are well represented. You will probably do a lot a interfacility transports where the pt is entirely your responsibility. Last but not least STAY HYDRATED. The "dry heat" will kill you if you don't. Hope this helps.

That is the hope, either we dislodge it enough to ventilate some or hopefully push it past the carina down one of the mainstem bronchi and ventilate one lung. Yes aspiration is a risk but you have to be alive to die if infection. Your mortality rate is 100% without oxygenation. Hope this helps.

Cynicalwrote: Ok I have read the posts about your attitude and agree with them, The reason I posted this little comment of yours is simple. You are either ignorant or stupid. If you are ignorant then maybe you can learn something about YOUR scope of practice! You are a certified EMT in the State of AZ. YOU are as responsible for the well being of your pt as the medics on scene. You will be held liable by the state along with your partner if it is found the pt did not receive care that could be performed at your level. Also if your partner is named in a lawsuit you will be too. You will be held to the standard of care, for your level of certification. If you do not understand this ask Kaisu. "I was just following orders" doesn't work and you said you prefer bluntness.

There is still residual O2 in the blood. In fact there is a few studies going on with cpr with no ventilations but with a non-rebreather mask in place. The chest compressions hopefully will dislodge the foreign body by the increase in intrathoracic pressure. we check the airway to see if the obstruction is seen to remove it. We do ventilations because maybe it was dislodged enough to move some air into the lungs. Anything is better than nothing. I see this is your first post please introduce yourself and certification level, thanks. Hopefully this helps.

I have a better idea. He wants to be there for the funeral, he is supposed to surrender when it's over. The funeral was over he obviously wanted to go to the grave side service. The LEO's probably thought he might not go instead of turning himself in he would run. So handcuff him to the casket, He can ride with dad to the cemetery, while they follow. Its called compromise! Isn't that what they try to do with us. at least dad wont get combative or have a critical change of condition.

The day after his wife disappeared in a kayaking accident, an Anchorage man answered his door to find two grim-faced Alaska State Troopers. "We're sorry Mr. Wilkens, but we have some information about your wife," said one trooper. "Tell me! Did you find her?" Wilkens shouted. The troopers looked at each other. One said, "We have some bad news, some good news, and some really great news. Which do you want to hear first? "Fearing the worst, an ashen Mr. Wilkens said, "Give me the bad news first." The trooper said, "I'm sorry to tell you, sir, but this morning we found your wife's body in Kachemak Bay." "Oh my God!" exclaimed Wilkens. Swallowing hard, he asked, "What's the good news?" The trooper continued, "When we pulled her up, she had 12 twenty-five pound king crabs and 6 good -size Dungeness crabs clinging to her." Stunned! Mr. Wilkens demanded, "If that's the good news, what's the great news?" The trooper said, "We're going to pull her up again tomorrow."