kevkei

I believe Ridryder was making reference to the Medic on the call and using it as an example of how to tread carefully in your workplace. Remember, we are hearing your side of the story and are absent of the Medics side to see what he saw and thought. Don't assume that you know everything and start blaming them for being wrong. Maybe in this case you were right, but what about the future? You had better be damned sure to be 100% correct to challenge them to their face. For example, you felt they were in atrial flutter but what if the Medic said 'no, it's a-fib' and he has a history of this based on his medications (first clue is he is on blood thinners). As for going around behind their back, it sounds to me like the guy admitted he made a mistake and attributed it to work load. Can you tell me you have never taken a short cut or not done something for a patient for personal or selfish reasons? We are only human. To be specific, there is nothing with the first patient that screams out at me that this needs ALS intervention. Weak and dizzy is a very common complaint amongst the elderly and the majority of times it is very benign. Could also explain him being pale, 'shaky' and the elevated BP, due to the catecholamine response. The second patient sounds very vague. In the end, what is it you expect? So if they were wrong not putting O2 on, why didn't you? Something else to consider is, what are the ALS resources like in your area? For example, what is his train of thought to tax resources that don't absolutely require ALS in the event a cardiac arrest comes in or an MI? It's also about triaging and prioritizing.

Our system here utilizes a pilot and a co-pilot. No if's, and's or butts.

The only sure fire way to know if a seizure is real or fake, is to perform an EEG during the said seizure activity. Sure prolactin levels might be elevated, but what is it's specificity?

First of, if it walks like a duck and talks like a duck, it's a duck. Sounds more like they were a wolf in sheeps clothing. I've found that a few properly dropped medical terms get their spidey senses tingling if I want to play the 'I'm a Paramedic card' while off duty (which, is few and VERY far between). Secondly, if you can't verify your credentials and licensure, GET THE HELL OFF MY SCENE. And even then, GET THE HELL OFF MY SCENE. It's called common courtesy and professional limitations. Thirdly, know your place, of which, this is not theirs.

Two words, "YOU'RE CANCELLED"

Anone notice the feeble attempt last game in Raleigh? They tried to sing O'Canadia (and they did brodcast the words on the screen there, however they do NOT at Rexall) 3-1 Oilers tomorrow night. Atta go boys.

How about a PE?

That would suck. No TCP?

Okay, then going back to your original comment Try a Class IIA ballistic vest, plus the dark poly clothing. That's farking hot. By the way, your kind of cute, in a non-homosexual kind of way :shock: :wink: LMAO!

If you think it is a simple question, then my answer is no. If you can tell me why and how Glucagon affects cyclic AMP and why it is important in your patient (and prove it is tought in the program that affords you to utilize this medication), then I might say yes.

I agree. Those are the intimate moments that I thoroughly enjoy about our job, the things they don't tell you about or teach you about in school. Those are the reasons I do what I do today. Not to save people, or 'help people', but rather to feel lucky enough to be invited into their home, workplace, whatever in their time of need. Then, in my brief moment with the patient, I enjoy getting to know them (not that it happens with the majority of our patients). These are the things called soft skills, and these are the things out patients remember. Not that starting the IV only took one attempt and only 'hurt a little', or how well we splinted their fracture, or the fact that we stratified them straight to the cath lab. They don't care that you carried a 97% average through school and can recite the Krebs cycle. They remember that we took the time to get to know them, we remember their name and took an interest in what they had to say. Empathy, it's a wonderful thing. I just wish more people in this industry and medicine in general had it.

I assume you're talking Celcius as opposed to Fahrenheit?

If they placed a 6.0 ETT, either it was an error of equipment selection or an error of judgement. Realistically, if all they could pass was a 6.0 due to edema, that's fine. If they were properly prepared, they would have had ETT's of all sizes available. Yes with inhallation burns, aggressive airway management through ETI is important, but you don't need to truly rush and make errors. It is better to plan, prepare and pass (the tube). While doing the laryngoscopy, there is no reason you can't say "hey, I think I can actually pass a 8.0" instead of arbitraily placing a 6.0. Even if they are edematous, you can probably pass 0.5-1.0 size larger than you visualize due to soft edema - provided you can visualize cords.

Actually, he couldn't cut the mustard in Alberta registering with ACP so went to Ontario instead! :twisted:

Actually, the funny thing is, he wishes he were like us Canadians :wink:

So, I take it your passing on visiting us out west this time around?

What's with all the gold stripes? LMAO 8)

It's a problem with the linear thought process that 'I can give drug X to RULE out agent Y' that's the problem. First of all, are you familiar with the narcotic triad? If so, why do you want to rule out CNS depression when that isn't even remotely what the problem is? Did you know that there are lay people here that give Narcan in the inner city? Without re-hashing this tiresome and stupid debate, don't bring a knife to a gun fight. This stuffed shirt thinks it's assanine for people to assume they can do anything. I know the indications and contraindications inside and out as well as the procedure for inserting a chest tube. The education in me tells me to leave it to the 'stuffed shirts' that know what they are doing. Therein my friend is the difference between knowledge and training.

Edmonton. WooHoo! Working for the City of Edmonton EMS. (EMT-P, ACP, whatever)

Well, isn't that SPECIAL. It's funny because most airlines won't release their medical kits to an EMT or Paramedic so how is this going to 'save lives'?

Hey, don't make fun of Joey Moss. In case you couldn't tell, he has Downs Syndrome and is part of the Oilers locker room staff. He's been around since the early/mid 80's. Do any of you remember when Gretzky dated Vicky Moss? Well Jeoy is her younger brother. What was cool was there were players and coaching staff from Anaheim that said this made the hair on the back of their neck stand up, as well as a bunch of the media types.

Hemorrhagic shock is easier to remember as a form of hypovolemic shock. Hemorrhagic shock is generally the result of hypovolemia, whereas as has been stated, hypovolemia can be caused by a number of other causes.

I would agree, but from an experience perspective, I've done both on patients and found the difference in most cases to be quite negligible.

I agree that it doesn't mean you have to run fluids through at all let alone wide open. I would think the thought process would be something to the effect that it's better to get a peripheral line while they have circulating volume before they go flat due to hypovolemia. Spock, why are you guys pulling the prehospital IV's?? And, do you not subscribe to a targeted MAP of 90 mmHg in TBI to maintain proper CPP (without knowing what the exact ICP is)?