crotchitymedic1986

Glad you said that Ruff, I was going to ask that question, but felt it might be inappropriate to ask in this thread since your friend died. My guess is that over 50% are probably not "necessary", meaning that ground transport would have been sufficient. I can remember having the flown patient close to being ready for discharge from the ER by the time the ground ambulances arrived with the "less" critical or "no mechanism of injury issues" patients from the same wreck many a time. But its been a long time since I have been in it, so I hope it has improved. Don't have any real statistics though, has anyone studied the proper use of helicopters at your service ?

Vicks in your nose works, but I could never find it when i needed it. Wearing your hepa mask will help some, a strong cough drop (extra strength) also can help. Any rub/salve/ointment that can be put in nostrils or right under nostrils is helpful.

A little off topic, but chbare, I wish you could work at my shop. I can't tell you how many times, after ordering a neb, I hear, "Well, I didn't give it to him because he wasn't wheezing."

Really, Really ? So you are advocating giving a treatment based on your assessment skills when the equipment says you should not, and then you get upset when newbie morons who cant assess without equipment overrules your orders ? Seems like I read a similar thread where you argued the exact opposite just a few days ago. Why the flip-flop ?

In case you forgot, I am discussing the thread where I advocated giving D50 (1/2 amp) to an unconscious diabetic patient with a normal glucose reading.

I agree with everyone, adrenaline rush is no reason for a career, and law enforcement is not near as "exciting" as you think, and when it is, it probably means your life is in danger, so I would suggest you try bungee jumping or join a sex club to release that adrenaline instead.

But with that being said, in more rural areas, it is not uncommon for the SWAT Team to create a medic team from their existing EMS (not a civilian). So there is the opportunity for you to do both jobs, just probably not in the urban areas of the country. Larger police departments will send their own folks to EMT school.

It really depends on the situation, both sides are right. If the patient is just having a normal "textbook" asthma attack, where they are in low to moderate distress, and EMS is less than 15 minutes away, I would not advocate using someone else's (if for no other reason, not to pass cooties on to someone else). You said "girl" in your description which makes me think pediatrics, so an adult inhaler may be of a stronger dose than necessary.

On the other hand, if the patient is in severe distress and you let them go into respiratory arrest because of rules, then you should get out of healthcare. That would be similar to you being at a pond that has a "no swimming - keep out of pond" sign up, and there is a child drowning 10ft from shore, and you won't go in because swimming is not allowed.

Sorry Ruff. Here is some information on air ambulance accident rates, that profession became the most dangerous job in the US in 2007. The NTSB has been promising to improve safety in this industry, but I don't know if they ever implemented any new standards.

http://www.ntsb.gov/doclib/speeches/sumwalt/sumwalt_050411.pdf

I was discussing a pacemaker alone, not an AICD

It probably wasn't v-tach, but an aberrant wide or narrow SVT, although it is possible to be alert and in V-Tach, or have runs of V-Tach that last for several seconds/minutes. Did they not try to fix with medicine first ? I agree people should be sedated, there are many drugs that have short half-lives that could be used.

Come to think of it, I have never seen a white or black person working in any traditional mexican or chinese restaurant (not the fast food chains). In the name of unity, maybe we should all enter a class-action lawsuit -- cha-ching $$$$$$$$

You could have chose to treat the Afib with medicine (I am guessing the heart rate was high, causing a low b/p). I would also recommend switching leads to make sure you are not missing the pacemaker spikes, that sometimes are not visible in just one lead (yes it happens), it would be bad to shut off the pacemaker if the patient is 100% paced.

So God tells people to do stupid stuff so they will die ?

Again, show of hands, how many of you have a black supervisor or better yet, Chief ?  I hear crickets again.  The only way a black medic can get promoted is if he/she is a medic in the military.  

But of course silly me, we have thousands of members, representing thousands of EMS agencies in this room, and maybe ten of them have a black supervisor, but thats not racism.  A court of law just past judgement on one of the largest fire departments in america, but again, most of you chose to defend the guilty, because you fear your department will be next, or that God forbid, one day you might actually have a black supervisor, and we cannot let that happen.  So of course, the courts, the EEOC, the NAACP are all wrong and are all in cohoots to keep the white man down.  Pleeeeeeaaaaaassssseeeeeeeeeeee.

And yes, i do paint with a wide brush, as there is no reason to use a 1/2 inch brush to apply a layer of "truth" on a 4x8 sheet of plywood.   But thank you for the discussion.

Ems is far more racist than Fire, due to its short history on earth. So the fact that racial discrimination is commonly found in Fire, shows how bad it is in EMS

Yes there are oppressed people in every race, I choose to speak for my race, as you have chosen to speak only for yours.

If you are a plumber, sometimes you have to put your hands in poop, if you are a cop there are days you have to direct traffic in the rain. In our business 95% of our patients would get to the ER alive if they went by car (I didnt say in great condition, I said alive). People abuse us, it happens, get over it. But there is a big lesson here: Always treat the patient in front of you. It is not your job to worry about how many ambulances are available, how many calls or holding, or whether or not your service is profitable. It is your job to treat the patient in front of you.

The drug seekers and drunks are the two patients that will bite you in the ass. Drug seekers are not healthy, they dont eat right, and they are probably on several different drugs, and taking a dose daily that would kill an elephant. There is a reason you dont see too many 90 year old drug seekers.

Thanks happiness, for your post, but now you have learned something you will never forget. As to those who question my talent, that you see as impossible, let me ask you this ? If I had been in construction for 25 years, and during those years I worked in all sides of the field, residential, commercial, industrial. If I had built everything from dog houses to skyscrapers in those 25 years, do you think I might know more than the apprentice who is just starting out. If I worked in the day when I had to build my own roof trusses versus having them premade and delivered on a truck, do you think I might know more than the guy who uses the prebuilt trusses. If I had to cut all of my wood with a handsaw instead of a machine, and if I actually hung the sheet rock instead of subbing it out, would I know more than today's rookie builder ?

The same is true for me, I have been in this 25 years, I have worked rural and urban 911, private services, critical care transport, and worked in several emergency rooms (one of which was a trauma center). In the first ER i worked in, we had to call the doctor in from home. I was working when there was no glucometers, pule-oxs, 12 Lead, capnography, IV pumps or even dial-a-flows. I am not smarter than anyone in the room, I have just seen alot more, and like happiness just showed us, I learned from my mistakes.

In the future, when I share wisdom, I hope it will be greeted more positively, as I am only trying to keep you from making mistakes. If you do not appreciate the wisdom then just turn away, there is no reason for all this vitreous language and name calling. Thank you. Let's be adults.

not at all, blacks are not the only oppressed race

Wow 27 pages, that has to be a record. You guys know how i feel about muslims so I do not support the mosque and ground zero, but what do you guys think about the same controversy that is going on in Murfreesboro Tennessee. There is a mosque that has been there 30 years and they want to build a huge new one, and the locals are not happy. I think 60 minutes did a story on it too.

http://www.nytimes.com/2010/08/31/us/31mosque.html

Is it right to allow all other churchs to build, but not let the muslim churchs build ?

No, but I can spot a dissection from a mile away (either through my xray vision, or God tells me according to you guys). That is the whole point, I have seen too many medics treat the equipment instead of the patient. The overuse of technology has made you guys weak in assessment. I can tell the difference between Dyspnea that is caused by left sided heart failure, early COPD, or Pnuemonia, or pleurisy in a patient with no history of any respiratory ailments . Most Docs can't without a chest xray and a BNP (lab test). And I can tell you most of you miss it when it is left sided heart failure, and you end of giving an albuterol/atrovent treatment, and atrovent is contraindicated in CHF. So who is practicing bad medicine now ?

very interesting.

You killed your patient because you have absolute trust in equipment, you blew a hole in your credibility

In the box, there should be no sharp corners on any of the compartments, everything should be heavily padded with rounded corners. There should be a 3-5 point restraint device for the medic, not a simple lap belt. All equipment and stretchers should have mounts that hold them in place during a 40+mph crash --- see Dr. Nadine Levick's ambulance crash videos. The box should not be spot welded together, and should not collapse in a rollover.

Happiness, to save you from reading 5 pages; The original scenario was an unconscious diaphoretic, diabetic patient who has all normal v/s including the glucometer reading of 120. My treatment scenario, after experiencing faulty glucometer readings, was to push 1/2 amp of D50 and see if there was a response (because unconscious and diaphoretic diabetics usually equates to hypoglycemia). All of the newbies said I was crazy and should have my licensed revoked. So I asked if you had a symptomatic chest pain patient but the 12 lead EKG was normal, would you withhold NTG and ASA ?

Finally, some rationale voices have joined the conversation, as I have had to argue with the rookies who believe that you should treat the machine before the patient. Thank you all !

I did not say I was giving asa for pain, I said i was giving asa and NTg because it is a possible MI (I would then move to Morphine if Ntg didnt work). Someone then wrote back that ASA does nothing for chest pain, so I answered as I did to be fecicious. Wow DOC you never had your Chem-7 contradict your ER glucometer ? I can not believe you would let a known unconscious diaphortic diabetic patient die because you needed to do a head CT to rule out a CVA.

So following all of you guys line of thinking, we should not push Narcan for unconscious patients when we have no evidence of an overdose ? Why would we ever push thiamine, what test do you have to prove the patient is an alcoholic, versus just being drunk today ? Same thing. And I guess we should never backboard an unconscious patient lying on the side of the road, if there is no bleeding or fractures ?

I would agree with that statement DOC, for instance we know that we have convicted several innocent people based on eyewitness testimony and later found that the person was found innocent through DNA. But this isnt that kind of case. If there was not enough evidence this case would have not made it to trial. And this is not the type of case that demands a call to action -- meaning if a child was murdered, there is a reason for a police department and jury to seek and find the killer (someone has to pay). In this type of case there are two sides disputing the facts, and I would say it would be harder to side for the plaintiffs than the defendants on this one, because the plaintifs have to prove discrimination happened. I was not there so I can not verify what the overwhelming evidence was that made one side lose and one side win, but if the test was written on a 5th grade level by a black man, how could the defendants have lost unless something else was going on ? Neither of us know everything that happened, maybe some more details will come out in the days ahead, but I am betting there is something else at work here besides some poor grades.