Arctickat

Why do we use a verb for aggressively grabbing something to describe someone who is having a seizure?

To Seize is to grab something.

To Seizure is an active convulsion due to illness or trauma.

I have actually had doctors confused when I stated the patient was seizing because their interpretation of the word was that the patient was grabbing for stuff. Now we use "Seizuring" to avoid further confusion.

The four point box is a fantastic back exercise. I used to always tweak my back until I started doing these. Here is what it looks like:

http://jennfit.ca/blog/four-point-box-exercise/

Try to hold the pose for 15 seconds at a time, then switch sides.

I've been a firefighter, and I've been a paramedic, and solely a paramedic for over 30 years now. No complaints here. I seriously can't understand how being moved off an ambulance and onto a fire truck could be considered a promotion.

On 11/6/2017 at 6:45 PM, BushyFromOz said:

Is this your experience KAT or a hypothetical?

Truly Interested as its not something i have seen.

Only once, and many years ago so I read up on it. There are a lot of research articles on it dating back over 50 years.

Highest BGL I have ever seen occurred last night. 75.8. More than double my previous high.

Around here you can't swing a dead cat without hitting someone who has a Narcan kit. Firefighters, Police, mental health, family members of known addicts, as well as the addicts themselves, are given the kits. Typically for free. Nasal administration and viola, get outta dead free card.

http://www.cbc.ca/news/canada/saskatoon/passersby-save-children-yellow-quill-1.4169445

http://www.cbc.ca/news/canada/saskatoon/boy-who-died-in-rollover-near-yellow-quill-heralded-as-hero-1.4171141

http://www.cbc.ca/news/canada/saskatoon/3-year-old-girl-fishing-lake-first-nation-dies-collision-1.4175949

I put this in LODD because of the second story. He died saving the lives of those he loved. He has the soul of a medic in my books and at his wake I made sure his family knew that.

On 2017-04-27 at 9:56 AM, rock_shoes said:

I'm very proud of my Ottawa brothers and sisters for being awesome enough to convince a firefighter to switch teams (to EMS). Oh and welcome to the city.

Chuckle.

Welcome Jackie.

8 hours ago, Off Label said:

Curious as to choosing NE instead of an inotrope like epi or even dopamine. Is there a specific element here that you like NE for?

Beta Blockers are a NorEpi and Epi antagonist, and typically target Beta-1 receptors, so BBs are actually designed to prevent those two drugs from working. However, with NorEpi, some BBs actually trigger the receptor while blocking the NorEpi. This would result in a possible increase in the heart rate as well and given the situation, a slight increase in the heart rate may be beneficial.

Epi has alpha and beta effects, however, the beta blocker prevents vasodilation, also, Epi has to be administered at higher concentrations to have Alpha receptor activation. At these higher doses, without Beta-1 stimulation, the vasoconstriction from the Epi could result in uncontrolled BP increase and worsening pulmonary edema.

Both of them have similar Beta-2 effects, which may also improve oxygenation.

Although they both have a short half life, NorEpi is about 1/3 shorter and will wear off quicker if it needs to be d/c and is, therefore, more forgiving.

Dopamine wasn't given consideration because we don't carry it in the ambulance. Studies have indicated better outcomes with NorEpi.

Why would CPAP be contraindicated? I know it increases intrathoracic pressures and reduced preload, but in this particular case, that could be a good thing. Sounds to me like he's in shock as a result of acute hypoxemia secondary to the CHF. The Digoxin will prevent any compensatory tachycardia. CPAP would have been my goto as I did an IV NS bolus and prepped a Norepi infusion in the event that CPAP was not sufficient in reducing respiratory workload and improving the hypoxia.

46 minutes ago, Just Plain Ruff said:

What if the patient demands to be transported to an UC facility?  Can we refuse to transport them there?  If it's an appropriate facility then is it wrong.  

 

"Transport to the nearest APPROPRIATE medical facility"

If they can be treated at a UC, do they need to go to the ED even if it is nearer? I think our protocol is a cut and paste of almost every other protocol out there.

"Transport to the nearest APPROPRIATE medical facility, bearing in mind that the nearest appropriate facility may be more distant than others nearby"

People have interpreted that to mean that we are to bypass the local hospital in favour of more advanced care at a cath lab or a trauma centre, however, I look at it both ways. If my patient doesn't need the services of that Level I Trauma centre two blocks away...I'll take him to that UC ten blocks away.

I don't think it's a matter of "can we" Mike, but "Why don't we when we already have a protocol in place for it?"

Maybe, back in the day, transporting to a lower level of care wasn't the spirit of the protocol when it was first devised, but then, your founding fathers never considered the possibility of easy to conceal automatic weapons when they wrote the Second Amendment either.

Why not? Isn't that what we've been supposed to do for decades?

We already treat and release in the home.

"Transport to the nearest APPROPRIATE medical facility"

Why does that have to be an ER? We transport to nursing stations rather than hospitals on a routine basis. Many communities have a primary health centre rather than a hospital, and often the ambulance transports to the nursing centre.

Want a copy of my profit/loss statement?

On 2017-04-12 at 7:48 PM, scubanurse said:

I'm really curious how 3 adults on backboards fit in the back of an ambulance...

 

If you've been in this job long enough....

We had a 1981 Chevy low roof van, had a main cot, portable cot mounted on the squad bench, and a hanging cot that hung above the squad bench. I'm pretty sure I uploaded a picture of the cot hangars in here some time ago.

Ahhh, the good old days.

For child restraint systems we have the pedi-mate from Ferno, but that's only for short distance emerg calls. We keep certified child and infant car seats at the base for IFT.

Thanks Mike. I already filed a complaint with them too.

21 minutes ago, emt2359 said:

For the purpose of discussion, what if this was was just a scanner buff that recorded it and sent it out?

The moderators of Ghettomedic are not however. They are also paramedics and they would know who uploaded the video.

Just to be clear. I'm not talking about the dispatch information. I'm talking about the fact that someone recorded it, address and community included, and posted it on Facebook.

I've seen kids commit suicide for less than that.

I tried reporting it Mike, Facebook says it doesn't contravene their standards.

For those who can't view the video it states the EMS company, Town, Strert Address, responding for a teen female with her braces caught in her boyfriend's genitals.

1 hour ago, cekuriger said:

 and that's just wrong, those companies don't care about their employees. 

 

Or their patients. CPR is much more effective when you aren't bounced around.

Anyone here follow the Ghettomedic facebook page? I started a while ago and for the most part there is some funny stuff on there. This post however:

https://www.facebook.com/GhettoMedic/videos/1658091117552123/

seriously pisses me off.

It provides the street address, Town, patient information and call information regarding the call.

What's worse, this is a call about a teen girl and her partner in a sensitive situation and the comments section is going crazy with stupidity. I protested and I have been banned from the page. I've filed several complaints to Facebook without success. The EMS agency involved denies that any of their people uploaded the video and Law Enforcement has been requested to investigate.

What do you think? Am I over reacting?

Just so I am clear, are you defining Community Paramedicine as doing Health and Wellness checks, checking vital signs and educating clients?

One project we've been working on is prehospital ultrasound.

50 minutes ago, Ruffmeister Paramedic said:

 

If you think that most of the US is shit, then just stay in Canada, Sorry Canada, but you can keep Jihad Jerry,  the US doesn't want him.  

No worries buddy, you still have Bieber and Dion.

Actually, braniac, I was referencing the second word. An institution is a prison, an institute is a school. Jesus I'm glad I own my companies in Shitsville so I won't see your application for employment cross my desk.

What Mike said

Greetings from Shitsville.

Several years ago the Paramedic Association of Canada developed what is called the National Occupational Competency Profiles. The NOCPs provide a recommended scope of practise on a national scale for each provider designation. Most of the provincial registration bodies have adopted the NOCPs.

PCP = Primary Care Paramedic. They possess a scope including blind insertion airways, manual defib, IV starts, and a few meds like Narcan, D50, Epi for anaphylaxis, Salbutamol, Gravol, foley insertion, and a few more.

ACP = Advanced Care Paramedic. Pretty comparable to the EMT-P, Endotracheal intubation, ACLS, PALS, antibiotics in sepsis, transport ventilators, opiates for pain, and so on.

CCP - Critical Care Paramedic. Typically your flight folks. Surgical Crics, sutures, invasive monitoring, central lines, etc.

The provinces signed an interprovincial labour mobility agreement which means that any paramedic training from an approved CMA accredited school can be hired in any province. However there may be some provinces that will require a small amount of remedial training.

I suggest you consider an occupation in the field of Fire Truck Driver, from your first post I don't think you have what it takes to be an Ambulance Driver.

Edit:

Oh, and it's called the Justice Institute of British Columbia. Not the Justice Institution of BC.

We used to call that the "Coma Cocktail"