Quakefire

Man you guys have a low tollerance for the odd, or mine is just way to high. I love the sound of the crunching glass. I be this guy has new appreciation for just how strong his sphincter is

If you read down he states that he has scripts for the meds from several different doctors who all know each other and that they are for personal use only or for his family. The fact that he has enough morphine to supply all of Saskatoons ambulance service is besides the point

My question is he has 10 different pain killers. Some very, very strong ones. There is a reason they are not used in prehospital care, they dont make sense. Why would he carry morphine, dilaudid and vicodin? Its a great kit, and if I worked in a unit that had a kit that clean and organized, i'd be in heaven, personal use, i'd scale that way back.

So he was morphine (injectable and tablet), percocet, dilaudid vicodin, plus IV administration with things like D5W and a heparin flush. Yet he doesn't have a pulse oximeter because he doesn't know how to use one. This guy scares me

Let us know if you need anything else!

Alright. Not alot changes from your respiratory scenarios to your cardiac scenarios. This is where ALS will be needed more (they never come but call anyway), do your assesment, look listen and feel, palpating can tell you alot in a chest pain case. Learn your rhythm rules and know them well, you get marks for interpreting the correct rhythym. Really our treatments dont vary much. You want your abc's you want your vitals, and you want your full assessment just like all your scenarios. Most of your patients will get oxygen, some may get nitro. The treatment is simple, whats hard is getting into a groove where you go through everything the same way every time. It helps, you forget less. Some tips I learned. BSI " I'm protecting myself from the patient, and the patient from me" (thats very basic but you get the idea) Keep the head to toe idea in your brain at all times (it will really help in trauma) Airway: is he breathing is he talking Breathing: fast/slow, laboured, depth Circulation: is there a pulse, fast/slow regular/irregular strong/weak Skin lots of people forget this, temp,color, and is it dry/moist/sweating like hes on trial Next JVD (your instructor may want you to check for pitting edema here as well), is the trachea in the center,what does his chest look like is there urticaria, swelling, paradoxical movement and so on. What do the lungs sound like. Does it hurt more when you press on the area. Is there pitting edema. Thats the order that I used for all my cardiac scenarios, and with a little modification it fits almost everything, just get an order down. You'll think less about what you need to ask, and what you need to check and more about what you found and what that means. On a side note, if your get a patient with subcutaneous emphysema in your practicum, or after, feel it. Not many medics find it in the field and its a weird sensation/sound

Where are you in your program?

Mobey I was waiting to see you in this thread hehe

Stitches I know exactly how you feel, I just graduated, and your right, that rubric is hard. BSI: Easy marks, get a speach down pad and you'll get a 4 or 5 every time. Scene Assesment: Remember your POPP talk through everything, do it once outside, once inside, maybe again in the room with the pt. Get your general impression here ABC's: Make sure you ask! Lots of people lost alot of marks because they didn't ask right away, remember the skin! Assesments: Look listen and feel, ask about everything, You wont lose marks (as far as I know) for pertinent negatives, but you will if you dont ask. State stable or unstable and if you need ALS The biggest thing is to get into a routine, every scenario can be treated the same way and if you get into a rhythm you'll forget less and be a little more relaxed. Calm down. Deep Breaths and Calm Down. Hope that helps. By The way, what campus are you taking your course at?

My Sympathies to the family of the fallen one. A speedy recovery to the nurses and EMT.

I actually plan on skipping ICP and going right to for full paramedic once I get my hours in. ICP just looks like a lot of money for something i'm going to relearn soon after anyway

Personally as a PCP I would like IV access and a combitube or other airway option just because i'm looking at being employed in a rural service which means some long transport times

Moving along with the same idea, what if she didn't code, what if something the drugs were cut with, or something else caused an anaphalactic (sp?) reaction. For epi I need orders, I have a M.D on scene high as a kite telling me to give epi, should I still call med control or trust his judgement. If he wants to take charge of the patient, do you let him?

If the Dr. attempted to provide medical care to the patient, then he needs to be reported, just as if a surgeon showed up smashed. In your trip sheet do you not have to report that CPR was in progress when you arrived? Its one thing to see him in the living room with a 20 rolled in his nose and reporting him, its quite another if hes providing care

No this was in hospital, for a pt. who's anti-psycotic drugs turned on him and rotted out his brain. Parkinsons like symptoms, decreased LOC and a fever. The acetaminophen was crushed and mixed with jam to facilitate swallowing

Last time I saw Acetaminophen was in jam, strawberry to be precise

PCP seems to be the worst level for cross country equality. In saskatchewan i'm trained to the bare minimum for the NOCP, no IV access let alone pain meds, where as some provinces allow their PCP's IV access, pain meds, and other fun skills. Kinda why I want to start training for ACP asap

And it used to be a required step, not any more though. ICP's are treated as EMT-A, PCP EMT, and ACP EMT-P

In Saskatchewan (another crazy Canadian province) At the PCP (BLS) level we got nothing, The ICP/EMT-A (ILS) have entonox and the ACP has morphine

Me thinks we need Versed in a dart gun

They may still in the ACP program, but not in the PCP, which is only a 5 month program

Unless its inservice, Saskatchewan provides no self defence training, other than booking it when you see the gun

Well Atleast I Would Edmonton Paramedics Face Handgun

Why you wear a Vest