JCicco345

Your spending $10,000 for an EMT career ??? Or was that because your planning on getting your medic after ?

Thanks that makes a lot more sense now, great explaination.

A moral duty to act if fine in certain circumstances. IE: Your driving home and come across an MVC (not a fender bender) with injuries, if you want to stop and give aid until the responders get there that's good. But scanning and going to calls is illegal, you are off-duty ( IE not being dispatched). Also following fire trucks and cruisers is not right, they are trained to deal with this stuff too. Unless you have a fully stocked ambulance what are you going to do that they can;t ?

Quick question I'm sitting here bored in my OB rotation waiting for someone to pop out a little alien and also studying for the mid-term that is approaching. I was studying cardiac meds, and came across a question about antidysrythmics. The Brady book says sodium channel blockers class 1A, slow conduction, decrease repolarization rate, the ECG effects of the medications are widened QRS and prolonged QT. Which makes sense they slow the rate down. The confusing thing is that class 1B says it increases the rate of repolarization, and reduces the automaticity in ventricular cells, the ECG effects are the same widened QRS and prolonged QT. Increasing the rate of repolarization would increase the rate, right ? So why does that show a widened QRS and prolonged QT. Plus if you are using lidocaine for ventricular arrythmias wouldn't you expect a narrower QRS. The only thing I can think of is that the drugs effect the repolarization rate but not the actual heart rate, they just put the cells into the refractory period for longer times. I was hoping one of the senior medics on here or even a fellow medic student can find another way to put this, it doesn't seem to be clicking right now. Thanks in advance.

Well doctor you see our patient here saw a video that showed what happens when you mix mentos with diet coke, and being the rocket scientist that he is, he thought it would be smart to use his mouth as a platform for the experiment. Yeah that would be a fun call to respond to. But what was this tool thinking ? Some how his mouth was going to prevent the reaction.

Isn't one use of the KED pediatric immobilization ??? I know around here anyways we tend to use that often for pedi c-spine.

I don't think we should be disrobing and putting gowns on every patient. However with that said if you're going to need a 12 lead then why not have them take their shirt off and put the gown on. It's going to be done in the ER anyways and it will make it easier to get all the leads on. Seems like something that should be up to the individual medic, not something that the ER should be expecting us to do. Also not every college girl who falls needs a gown.

That's pretty funny, although it sounds like they spend a lot of money on those damn pants.

I know your from NH and everything but here in cyberspace we have this cool thing we call spellcheck. It makes you appear smarter than you may actually be.

You already made SGT at 17 thats awesome. How did you manage to pull that off ?

We don't have that around here to that degree, our medics will turf a call to BLS if it's appropriate and going a distance. As far as your call, the severe RUQ pain should be ALS. If the medics deem BLS appropriate then you should assess the situation and if you are comfortable with it, then transport the patient. If not, than tell the medics your not comfortable with it, do so tactfully though, like you said you don't want to jeapordize your relationship with them. As for the situation of you and your partner having 3 mo's combined experience that is a problem that your service needs to deal with. That's unsafe.

I agree head bleeds suck. We had one last month, where she was caox4, talking with us c/o n/v/headache. Within the blink of an eye she went unresponsive, decorticate posturing, slow shallow respirations. Also, out of curiosity, D50 to a patient like that who is awake and not hypoglycemic, how is that justified. Especially in the case of a bleed where the d50 is actually detrimental. D50 will increase the oncotic forces in the brain, which will cause an even greater increase in ICP, right ???

I just took my cardiology portion last semester and we learner that V2, V3 are contiguous leads as are V4, V5. For the reason you said. V2 and V3 would be anteroseptal, and V4 and V5 would be anterolateral. Atleast thats the way i remember it. I could be wrong.

From reading his caption under the picture, it seems he was just amazed by how fast the ambulances came and went. I do realize it's not really the most thrilling picture and those of us who work in EMS understnad that ambualnces come and go from hospitals. Anyways just wanted to throw that out there. Be safe.

Quick question and this may sound stupid but I would've thought to go with pacing, or atleast consider it due to the unstable bradycardia. Well i quess the question is, if you have the patient where you are suspecting cva and they happen to be unstable and bradycardic, do you treat the brady like you normally would ????? I'm just trying to put all this info from school into practice. Thanks in advance. o2, monitor, IV with fluid challenge (250cc), consider pacing (maybe call med control).

Secondary was unremarkable, her grips were weak but equal, no slurred speech, a little lethergic, but nothing major. I not great with lung sounds but the bases had some fluid but it wasn't much just enough to hear a little junk. I considered ALS but it would've just been a chase, the closest hospital was like 5 minutes away.

Oh i meant to put how long she had been there, she said she walked into her bathrooom at 8 am or so and this was 1:30pm so 5-5 1/2 hrs. Unknown Hx (asthma, cardiac) Only meds we found were for asthma, and then some nitro (which she hadn't used today at all) Also once in the ER based on her lung sounds the MD sent her to get a cxr, he was going with pneumonia, however i dont know what happened with that. But with shock i wouldn't really expect her vitals to be that stable, if she'd been septic she probably would've been a little hypotensive.

I view the posts on here daily, however i don't post very often. I did a call today and i was looking for some opinions of what was going on with her, and what else if anything could have been done for her. I am a paramedic student so i've been trying to look into the deeper pathophysiologies of what is actually going on with the patient. Anyways, we are a BLS truck, we responded to an assisted living for a fall. Arrived to find a 96 year old female, supine on the bathroom floor, she is caox3 with some periodic confusion. She had no obvious injuries, denied pain, was pale central and peripheral, her hands were really pale and her nail beds cyanotic with refill times of 6-8 seconds. She knew that she was on the floor and unable to get up, but was unable to explain how she got there. C-spine precautions taken. Patient had also been incontinent of bladder and bowels prior to arrival. So we load her up quick and i went to get my vitals, i was unable to palpate the radial pulses, explains the pale extremities with the delayed refill. I tried for a brachial, carotid, both with no luck, also no luck with auscultating for a blood pressure, couldn't even see the needle jump (i know that is somewhat inaccurate anyways but i was trying to get something). I asked my partner to give me a hand for a second and he couldn't get any of them either. Attempted auscultation of the apical pulse, with some weak/faint heart sounds, however with her respirations it made it hard to get a rate. So she had already been on 15 liters via NRB mask, and by the time we got to the hospital had pinked up a little centrally. Still unable to get a pulse. After a few minutes in the ER, someone got a femoral pulse. But here's the weird part, she got hooked up to all their little toys and showed a rate of 88 with a pressure of 112/60. So i don't see how we couldn't come up with anything ? Ever had that many problems with vitals on a patient ? Thanks in advance for any opinions.

Unstable, bradycardic, wouldn't it be a good opition to atleast consider pacing ??? Just curious. thanks in advance.

If i send you some money will you take an english class ? You don't need to be perfect, just type well enough that people can understand it. Enough of this lol s#it too.

A patient with a hx of AF and on digoxin or something similar. When placed on the monitor are they going to normally be in AF or sinus. I know this is a stupid question, i just have never heard the anwser to it and it was something i was wondering. Thanks in advance.

What station are you going to be doing shifts out of ???

Out of curiousity, would the vasovagal be cause by the sight of the blood, or maybe from the cold water causing some vagus stimulation and causing him to become hypotensive and pass out ????

Sign me up. If they did something to get them on death row, and all the appeals they got failed, it means they belong there. Iwould have nothing against doing that.

That's great, 16 years old and already showing the adult what to do. Not out of high school, can't drive, can't even type without using words like "n" "itz" "altho" "ppl". It's one thing to have the 16-18 year olds do ride alongs, i agree with the no patient contact, except maybe taking vitals on a non-critical patient. But i don't think 16 yeards olds should be working as EMT's. End of story.