crotchitymedic1986

It would never work. To be a fireman you have to have a "real" job in construction, electrical, or plumbing, and use the Fire Department for benefits only. Paramedics work at their full-time profession, and then freelance at their part-time EMS job. If paramedics took over the fired department, it would no longer be a frat house, it would be forward moving, thinking man's profession. Cant have that.

I am thinking morphine may be a bit strong for your SS patients. Much like the patient who has learned to go an hour away to get his narcs, once word gets out that you are giving morphine to these patients, they will always call the ambulance. Do you have a less potent narcotic like Fentanyl or Versed ?

I am shocked you whities didnt come up with more, I left the door wide open for you. But if you are out of african american comments, we can move to other groups --- what would it be like if mexicans, asians, canadians, or white rednecks join in ?

I would be interested in seeing the ER's chart. What were the initial v/s the ER got, how long was it before he coded. The details we have been given were from an EMS review, where a rosier picture may have been painted by medics who knew the patient died and were covering their butts. The H&H stated is hard to believe with the B/P listed (not impossible). If the patient died within 10-15 minutes of ER arrival, I am thinking the medics may have not recognized the severity of the situation. Obvioulsy, I wasnt there, so i cant second guess them, but my guess is this was an altered, pale, critical patient who got a "pediatric bolus".

I am sorry, but with those scant details it could be anything from an orgasm to a AAA or SA --- give us some details.

I wished I had a copy of one i had last year that perplexed me for several minutes -- the patient had a pacemaker which was firing with every beat. The "p" wave initially looked as though it was "moving", indicating a complete heart block, but when you measured it out, you discovered that she was really in wenkebach, but the pacemaker wouldnt let the QRS drop.

You didnt mention why the patient is on two narcotics. The most likely scenario is granny was high. I would have started with some Narcan and see if LOC improved. But the main lesson to be learned here is that all old people need to be transported. I cant tell you the number of times i have seen medics leave elderly people at home that have had a single syncopal episode. I am sorry, i dont care if you are 98 or 18 it is not normal to lose consciousness. My general rule is that i transport everyone under age 5 and over age 70, regardless of complaint.

Thats odd, I would think Madonna's bikinni waxer would have the germiest job.

OK, and here is one for EMT CITY POSTERS -- sorry if i step on someone's toes here. If you are the first to respond to someones question or post, there is no need to copy and paste that question or post into your response. It's right there above your post, we can see it. And if we dont need to copy and paste it twice, we surely dont need to copy and paste 6 or 7 times. If you must cut and paste, can you please just copy and paste the name of the poster, or maybe the first line of their question, instead of the entire 200+ word rant ?

How about the amount of money we waste on 911 Centers. Why do we need one for every county and city ? If microsoft and dell can handle all of their customer calls from one center in India, why cant we cut down the 911 centers to maybe 2 or 3 mega centers per state ?

Lets take a lighthearted look at ourselves --- What things do we do in our industry that are absolutely stupid ? For instance ---- it is absolutely taboo to roll someone backwards on a stretcher to or from the truck (head first instead of feet first), but then they ride backwards all the way to the hospital.

The King has been creeping me out in his commercials -- i will leave you an original Captian Kirk Lunch box

Leave it, as a medic, i am not allowed to believe in sunshine. Leaving a LARGE Marie Calendar's Chicken Pot Pie, fully cooked.

stupid is as stupid does ......

now thats funny --- damn funny --- i dont know, i am still trying to figure out how to keep the "weave" attached to the mane and tale

A man with leprocy (if you dont know what it is, you wont get the joke) was told by the leper colony doctor that he only had a few weeks to live. His name was Joe, and he was well liked by the other lepers. One of his friends asked him if he had any last wishes during his last few weeks. Joe replies, yes i do, but it could never come true. I am originally from Arizona, and I love baseball. Unfortunately, I have never had the chance to see the Diamondbacks play in person, I have only seen them on tv. My dream would be to go to a home game and watch them play. Joe's friend says I have lots of money, I can make it happen. Joe says i cant go out in public looking like this, it would cause a panic (all but one of his fingers had already fallen off, and he smelled pretty bad). His friend says yes, you are probably right, but let me think about it. The next day, Joes friend comes to him, and says I have figured it out, I know how we can go to the game: We will cover you from head to toe in clothing, a big floppy hat, glasses, trench coat, and we will wait until the third inning to go in the stadium, by then we want have to wait in line. Once inside the field, we will wait until there is a big play and everyone stands up to cheer, to walk to our seats, no one will notice you, and if they do, they wont be able to see anything that might gross them out. Joe says you know, thats a damn good plan. Joes friend says i have already booked the flight, the tickets to the game, the hotel, and the limo, we leave Tuesday. So they followed their plan and it worked, they got to their seats without any problems. What they didnt factor in was that it was July in Arizona, and it was brutally hot the day of the game. By the fifth inning Joe was feeling horrible and told his friend we are gonna have to leave, I cant take this heat and all these clothes. His friend says hang on, lets keep working our plan. Wait until the next big play, when everyone stands, we will take off that heavy coat and scarf, and that will help. So thats what they did, and it worked out fine -- everyone around him was watching the game, and no one noticed that he had disrobed a little. Then a young boy who was sitting in front of Joe, turned to look at the scoreboard behind them, and he saw Joe. The boy immediately vomited all over his seat, the boys dad turns around, sees the same thing, starts vomiting, then everyone in that row looked around and started to vomit. Before long the whole section was vomiting. When the dad/son regained their composure, Joe apologized to them, saying I am so sorry I ruined your day, but i only have a few weeks to live and this was my dieing wish. I will be happy to buy you and your son tickets for a future game, I am so sorry that I came here, I knew I shouldnt have come to a public event with my hideous appearence. The dad says, oh no, it wasnt you --- it was the guy behind you dipping nachos into your neck.

What is heard in an Mississippi EMT's bedroom just before sex:

"Get off me daddy, you squishing my cigarettes"

Now that we have an African American President, we can finally break that last barrier that whitie has held too long --- we can finally start purchasing horses and race them at whities track. Of course we will have more colorful names for our horses, here are some likely names, i look forward to your suggestions (yes I am an AA with a sense of humor:

Eightball

Section 8

On no you diiiiiddddddnnnnnnttt

Malt Liquor

Jerri curl

I wished a muther f***er would

Eldorado

Escalade

Shaquita

Whaaazzzz up

East Side

West Side

Crunk

Slapabit*h

Blount

punkin or peaches

Sha-na-na

or my personal favorite.......................

I like big butts, and i can not lie, other brothers might deny

Who let the dogs out ?????????????

Kaisu, its ok to be a scared newbie, no matter how good your school was there is no way to prepare you for every situation you will face in the field. If you continue to study, learn from yours and other's calls, you will be fine. And when you feel the pucker factor remember these simple rules:

1. ABC always works, if you take care of that regardless of symptoms you and the patient will be fine.

2. Patients do not get brain damage because Paramedics fail to intubate them, they get brain damage because paramedics do not venitlate them. One day you will be an intubating god, but if you are still unable at this point due to lack of confidence -- just make sure you ventilate them well.

3. When you dont have a clue whats going on, transport them -- its never wrong to transport.

4. Trust your gut.

And when you get a chance, try to get an ER job (paid or volunteer), you will learn more in a month there than you will in 2 years in the field. Being able to see a patient from start to end, signs and symptoms, how the doctor's made treatment decisions, and what the outcome was will help you immensley in the field.

Umstudent is dead on. No matter how much education or years of experience you have, there is always that handfull of patients each year who didnt get transported on the first request and either they go to the ER on their own and are found to have a serious problem, are transported by another ambulance on second request -- after getting worse, or die at home. And those of you who have worked an ER job, and have had to treat the patients that ambulance crews leave behind know what i am talking about (when you work an ER you usually get to see 5-6 counties of population, whereas if you dont work ER, you may only be familiar with your services mistakes -- since we dont advertise them). You have to have lab and radiology to know for sure. Like I said in another post, the AMR study that found that 2% of all patients not transported (refusal or not needed) are admitted to ICU and 1% die is accurate. You figure out what that means for

your services call volume:

Number Not Transported ICU Admits Deaths

1000 20 10

2500 50 25

5000 100 50

10,000 200 100

But you can still claim that "hey we were right 98% of the time", but that 2% of wrong can cost you alot of money

well said, and well thought out -- good job. But what happens at 3am when you have that lazy medic who would rather be back in his bed ?

Without seeing the patient it is hard to say, but since he died i am guessing he wasnt A&O with great color and vital signs. As one of the previous posters stated, it takes 3cc of fluid to replace 1cc of blood and you stated there was atleast 1500 cc lost (I missed that during my first read of your post). If he was alert, then orthostatic vital signs might have painted a better picture for you -- if he was altered, they should have been much more aggressive. I dont remember reading about your "scene" times, only that you had a short transport time. I probably would have ran in 1000-1500 via pressure bag or pump with that much blood loss, and then reevalutated the patient. If no one has told you -- the bowel movement in your pants is an ominous sign in healthy adults (not nursing home pts persae) that cardiac arrest is near. Does it always mean they are going to die -no, but it should get your attention.

Brethine is a good drug --- if you dont have it, you should add Xopenex and Atrovent to your aerosol aresenal.