crotchitymedic1986

what does it matter, just answer the question, its not like we are protecting nuclear codes on this forum. If he is lying about who he is, so be it. I believe in GA you have to take National Registry then apply for a ga number. I am not sure about the other states, but you should be able to google that state's ems office to find out. Most states accept natl registry now.

To answer questions posted: The nurse may or may not report, she says she will, but obviously it will create all kinds of problems if she does. Do we not have an obligation to the child ? She is not old enough to realize the risk she is taking. What if 6 weeks later she has an STD or is pregnant ? Scenario 2, no cop on scene, called in as chest pain. Do you call one ?

I could be wrong but I think HIPPA has specific language that excludes crime activity

I would take you a whole different route. Do the medic thing, get an ER job as medic instead of ambulance (save your back). Use that experience to learn more (instead of a class), hopefully you will find a hospital that would be willing to pay or reimburse you for your PA school. To those who do not know, those who already have a medical background, have a leg up on other candidates trying to get into PA school, so doing Paramedic school is not a bad idea other than it delays PA school, but if that is the poster's long term plan than so be it.

If you know for a fact that a crime has been committed, do you have to report it to the police in your state ? If you do not report it, could your license/certification be pulled ? Could you be held legally liable in a lawsuit if you do not report it ? Here are some scenarios:

1. You respond to band camp, to a 15 year old female who recently had sex with a boy of the same age. It was concentual sex, but something went wrong during or afterwards that scared her and made her report to the camp nurse (no reason to get graphic or perverted here, you pick your own reason). In your state, the age of consent is some age above 16, which she is not, so a crime has been committed. The camp nurse signs your refusal paperwork and you go back in service. Do you have an obligation to report this crime to the officials ? Do you have an obligation to notify the parents ?

2. You have an adult male who develops chest pain after using cocaine, you see the cocaine in his home. Do you have an obligation to let the police know that illegal drugs are in this home ?

Roy and Gage would have taken the scalpel out of the OB kit, make an incision between the bite marks, and sucked out the poison. If I remember correct I think there was an episode where Gage got bit, had to treat himself, and ride to the hospital on top of the rescue truck for some reason.

It does vary from snake to snake, elevate the effected body part, start an IV, transport.

Sorry Dwayne I have to disagree. Regardless of the situation, the OP is searching for an answer to educate students or newbies about these type of situations. Yes, this one is pretty easy, but I say you should involve a supervisor and/or MC anytime you encounter a problem where you do not have a protocol or policy to protect you. Not because you are too stupid to figure it out, but because it gives you another layer of cover should it "go sideways" as you state. For this particular call:

1. The woman is 100, anyone over the age of 70 with any medical problem or injury should be transported, if you can talk them into it, regardless of how stable they appear. If you newbies do not learn anything else from the crotch, transport everyone over 70 and all drunks.

2. He states he could not auscultate a B/P

3. The patient could not ambulate under her own power.

4. You have no idea how long she had been on the floor.

5. Unless you have mobile CT or xray, you have no way of knowing if she had a TIA/Stroke or fractured a bone during the fall.

A more experienced supervisor may have been able to talk her into going to the hospital, if not, you can then show that you went above and beyond to get her to go. Do you really think she isn't going to fall again ?

Hey let's go there. Same hair dressor comes back that night to check on her, and finds her dead. The family is outraged that you did not transport her the first time, and did not attempt to call them when you were out there the first time. You really want to defend leaving this patient at home ? Here is my first "lawyer question" - How long were you on the scene ? 15 minutes, 20 minutes ? Wow, you really went out of your way to help her, let me guess, you wanted to get back to the station so you could watch TV, sleep, or eat ?

Did I change anyone's mind ?

If you are unable to get MC involved, then you should rely on your supervisor.

The answer for all "weird" situations is the same, get medical control involved.

I imagine the reference is into not being so scared that you beat yourself in the game. In any sports, confidence makes a big difference. I can see the same in a Paramedic, after years of experience, IV attempts on kid, tough intubations, critical calls, don't scare you like they do the rookie. I do not think there is anything wrong with saying I am confident enough in my skills that I doubt there is a call that I am scared of.

I would caution you against giving it up for now. You never know where you may end up 10 years from now, and its not like Michigan's economy is getting any better. Its not like you have to walk through fire to keep it, so why let it go ?

I will take this "dodge" of all my questions to mean: "I was wrong, High doses of lasix alone is not indicated in the presented case"

No, I imagine that if the OP ever comes back and tells us what treatment the patient received in the hospital, it will include high doses of Lasix.

Without much information from eyedawn on the specifics, i would remind everyone of this:

1. Those who do, do, those who cant, teach, those who cant teach, dispatch.

2. Like someone responded, you are advanced in your knowledge because you have a medical background, most of the students in your class probably do not, and maybe the questions you ask in biology 101, would be answered in biology 102, so you are ahead of the class, and you may be bringing up topics that are too much for the current level of the class. Imagine if on day 1 of EMTB school, someone was asking questions about 12-Lead EKG.

3. Most nursing instructors are like me, they went to school over 25 years ago, and medicine has advanced tremendously. They have an obligation to stay "current", but many do not.

4. The teacher may be teaching "the test", not the knowledge; just as many EMT/medic schools teach you how to pass the Natl Registry Exam. Do any of us really care what order the KED straps should be fastened, and who has actually used a KED enough to make it something that should be a pass/fail on a test ?

5. It is usually better to choose to "be nice" versus "being right". As mentioned earlier, you could pay a heavy price for being the pain in the instructor's ass, and a spot in a nursing class these days is a very special spot to hold.

If I were visiting an Asian (true asian, just moved here) for dinner, I dont think I would expect them to cook me a dinner consisting of fried chicken, mashed potatoes, pinto beans, and homemade biscuits. Hopefully if he/she came to my home, they would not expect me to make a traditional asian meal.

People who have come to this country should respect our traditions, as we should if we went to their country. We should respect each other and try to honor each other's values if we can. With that being said, why hasn't anyone taken the proactive role (oh i forgot this is ems, we are always reactive, never proactive). I bet that no matter what city you live in, there is a church that represents these various foreigners (muslim, buddhist, johovah witness, mormons, pentecostals, goat worshipers, whatever), why not invite that church to create an inservice to educate you to their beliefs (you could create a file on your laptop that allows you to see these issues by clicking on the "muslim patient icon" you created. Why not go speak to their church, and walk through some scenarios to educate them to what we do (remember the youtube video of the guy transporting a dead patient on the back of a bicycle, and dropping him), maybe they do not know that we can do a 12 lead, and ambulance in their country might be little more than an empty van with lights and sirens.

So let's quit whining about what it should be, and get proactive and create what it WILL BE. Nah, lets sit on our fat asses and bitch about it, that is much easier.

I applaud your efforts, but doubt you will have success. Chatting in a chat room is so 1990ish. I can't remember the last time i was in a chatroom. Most of us choose to chat through texting or by posting on a social site like this or facebook, and then returning when you have time to follow up. Sitting in a chatroom for hours is just too inefficient.

I think that is very generous of you. Since you have decided to reward someone from this forum, then I think you should base it on which 5 forums have received the most feedback or participation (the longest forum topic), or maybe you could do a combination:

1. The poster with the longest thread gets one.

2. The poster who has the highest "grade/score" number from their peers on here.

3. Maybe one for the poster who has been active on the site for the longest time (one of the forefathers).

4. Maybe one for whoever has posted the most topics.

5. Maybe one for the best topic posted, but not sure how your would judge it.

If you asked the question 10 years ago, I would have a totally different answer, as there were more Hummers and F-450 size vehicles on the road, but like in the 70's, high gas prices will probably keep most folks out of those vehicles for the next several years. I agree with checking with the National Highway Safety Council's, the Consumer Reports, and the National Insurance Institute's crash ratings, as scientific results or usually better than personal opinion. With that being said, most of these studies use the same type of crash test, which may or may not represent real world collisions. In my opinion, any small truck or car puts you at greater risk, especially if you are hit head-on or broad-size by a larger vehicle. The bigger vehicles often give a false sense of security, which let's their occupants choose to not wear a seatbelt. Unfortunately, these vehicles have a higher probability of roll-over, so passengers die from being ejected from the vehicle during roll over. Unlike the crashes you see on tv, most do not result in a roll-over and an explosion.

I would say choose a vehicle that has multiple airbags and has some girth to it. Drive safely; no texting or cellphone use, wear a seatbelt, put your kids in carseats, and use defensive driving practices that most of us do not use. For instance, if I were to get in your car with you and ride for 20 miles on any road, if I turned to you and asked, "Can you tell me what the last road sign said that we passed ?", could you ? If we were on the interstate for say 30 miles, and I turned and asked, "if we broke down right now, could you tell me what was the last exit we passed ?" , could you. Truck drivers are taught to constantly scan left, middle, right, rear-view mirrors every second that they are on the road, most car drivers do not. How many times have you driven for several miles, zoned out, and then suddenly realize you do not remember the last several exits ? The vehicle does not matter as much, if you are driving safely and defensively.

At the end of the investigation I am sure we will find it was a combination government-stupidity and union-greed issue.

I am sorry, I did not mean that you should not treat the patient prehospitally as you normally would, Just pointing out it was CHF and not some other rare disease that only "House" could figure out.

You dont have to fly anywhere, the OP can tell us, and its not dehydrating the patient, it is draining an overload of fluid.

Sure I will, read the chart and see what treatment the patient recieved, I bet my paycheck against yours that the pt was in CHF and got treated with Lasix. We can speculate all day, or go see what the truth was.

If reassesed "several times" the amazing bruise would have been noted prior to arrival at the ER. Using a KED upside down is for a hip fracture, not a femur fracture.

your patient was in CHF. just needed alot of Lasix.

Your mistake was in not reassessing the patient during transport. Luckily, didn't cost your patient their life, so its a good learning experience. Sometimes with hip dislocations, it is possible for the patient to pop the hip back in place by trying to get off the floor (or when you move the patient). The femur probably became displaced when you put her on the stretcher and straighten out her legs.

I can judge the quality of medic by whether or not there is a pillow on that stretcher. Sorry medics do not have one, as patient comfort is beneath them. Ditto for a blanket.