wrmedic82

Was the bottom of the pot/pan coated with teflon??? I know it sounds crazy. I read in a studyway back when ( sorry this is the fireman in me coming out) that a pot/pan coated with teflon left on a heating element with nothing cooking inside the pot/pan the teflon begins to form a colorless, odor less gas that can cause asphyxiation. I will have to re-research to recall the actual form of gas created. So its possible that the reason for AMS is hypoxia. Of course I havent read the vitals so Im not saying that this is what it is. However just throwing out a possibility.

I would have to say 1. PPE 2. Oxygen 3. BVM 4. Monitor / Defib 5. Manual BP cuff 6. Stethoscope

Congratulations on your new bundle of joy.

Just remember the basic's. Start with personal safety, and the ABC's. Correct any problems that you come across that involve the ABC's. and go from there. Everything else will come with time and experience.

Ok I gotta hear about this

wish granted but now your stuck with a partner who is a dyslexic agnostic paranoid schizophrenic who thinks the dog is out to get them. I wish for more a lottery jackpot win

Wish granted you are done with your senior year but now you have been solicited by your parents to babysit the neighbors screaming 2 year old. I wish that we no longer run nursing home calls or renal round up

These are our protocols Psychiatric Emergencies (including Excited/Hyperactive Delirium) Basic Life Support 1. Maintain scene safety. If scene is unsafe, leave and stage for the police department. 2. Consider requesting law enforcement assistance 1. Advise against the utilization of a Taser if Excited Delirium, especially multiple Taser use. 3. ABCs 4. Oxygen (as indicated) 5. NPO 6. History & physical, vital signs, secondary assessment 7. Measure blood glucose as indicated 8. Provide protection and maintain body temperature or cool patient as needed 9. Reassurance and position of comfort, if hypotensive, elevate feet 10. If patient is spitting, apply an approved spit hood. Intermediate 1. Airway management as indicated 2. Intravenous access (if possible) ALS First Responder 1. Cardiac monitor FRO Advanced / Lead Secondary Paramedic 1. If the patient is violent and a danger to himself/herself or others: a. Soft, four point physical restraints – utilize properly manufactured soft restraints on upper and lower extremities b. Midazolam 5 mg deep IM/slow IVP/IN if needed to protect the patient and/or crew; i. As a last resort, you may administer IM through the pants on the lateral thigh c. 250ml normal saline IVB, may repeat if necessary 2. 12-lead ECG acquisition and transmission (if available) as indicated Conditional Primary Paramedic / Primary Paramedic 1. If it is probable that the patient is in full cardiac arrest from a Excited Delirium, refer to the appropriate ACLS protocol and administer first round of ACLS medicines first, then administer Sodium Bicarbonate 1 meq/kg IVP. BSP Orders 1. Additional Midazolam 2. Haloperidol (Haldol) 5-10 mg IM only 3. Benadryl 25 mg IVP/IM for dystonia 4. Further therapy orders

when in doubt, shock the person into a rhythm you can treat. j/k I think you will do find. you probably have seen how to do the skills a million times. You can do it. I have faith in ya.

I run my tired butt all day with very little downtime. I work 16hr shifts and its not uncommon for us to run 15 people to the hospital.(this is minus release at scenes, and AMA's) The company runs as a whole anywhere from 300-400+ calls a day. Sometimes we get to sit for some time but thats a crapshoot.

I have never heard of anyone having any type of problems other than being disgusted by the smell of flatulence in the air. Its not like he ( the bus driver) never ripped one and the kids behind him were left to suffer. And come on its not like they were lighting a bag of poo on fire for him to step on. (sorry been watching billy madison)

Was the bystander a health care provider or someone who took a heartstart coarse ? That would explain that. If they were health care providers...then they just dont know any better. But anywho, about ACLS. I guess you cant ding EMS or say that's the day EMS died as much as healthcare as a whole.(going off the main topic not the quote above) MD's RN's EMTP's and so forth take the same class, same tests, and everything for the class. If Im getting this wrong feel free to let me know. Ive been known to put my foot in my mouth a time or two. Spenac can testify to that. But is there really any data out there that suggests true competency or incompetency with ACLS providers?

I was making a generalized statement, nothing towards the person on topic. I guess I was somewhat still hinging on my last post as when a patient that is fully informed that they could die or be a vegetable, and they choose to take chances. In that case you cant help stupid.

judge 3....weak

cant help stupid...that is a preexisting condition

Only thing I can say to this sad story is always advise patient's of the risks of not being evaluated. Im not saying they all have to be evaluated in the ER, but by a physician. Whether that be primary care, or a doc in a box. (not that I think highly of doc in a box places) After you have given the patient enough information to make an informed decision, mindful that they are legally competent to make a rational decision. If they still want to take their chances and go on their own. Then its on them.

Cant help on my lunch break

DE DE DE

What I tell everyone who bitches about fire/ems. Its not the service, its the attitude of the provider. If the medics attitude is not towards the well-being of the patient, patient care ultimately suffers. This can also be seen in private ambulance services as well. I know in the state of Texas, Firefighters are only required 20 hrs CE per year to renew certification. It also is the firefighter's responsibility to maintain their EMS cert. (72 hrs EMTB, 104 hrs EMTI, 142 EMTP). I do agree that more focus should be on education per year vs every 4 years. I am also for 1 uniform certification for all EMS providers. I am also for designated drivers trained only to drive the ambulance to and from calls. I also think there should be legislation on the books that give certain criteria for lawsuits concerning health care providers. (not just EMS). I also think there should be a law making it a class B misdemeanor for abuse of the 911 system. I have cast my 2 cents there. take care, be safe.

Whats even worse you can now do EMT, EMT-I, and EMT-P online. Welcome to the new information age of EMS Ive also seen a 15 day EMT-B Boot Camp, as well as 3 month accelerated paramedic program. Hope your a fast learner.

My belief on that is, its not necessarily the occupation (i.e. Fire/EMS) but rather the attitude of the medic on the truck. If someone wants to be there to help people then that's what they will do. If all they want to do is fight fire, then they will suck at their job. I don't think its completely fair to say all fire medics perform crappy patient care. But there are a lot of them that don't want to be on a ambulance. Which sucks because I foresee lot of municipalities moving faster towards fire based EMS in order to cut costs. I do think running BLS only would be a big mistake for Columbus though. That is my opinion care to disagree if you like.

3 words -Soft Restraints -Versed

We use priority dispatch in our system. I have never been too fond of it. One draw back to it is that people are getting "smart" and learning what to say to get a ambulance to them quick. So they know what to say to get a P1 or P2 response (L&S). I have noticed that in our system there has been more critical patient's with P3 response (no L&S) in which we have run to the hospital P2. So I do think that is hinders the system to a certain point. Also our dispatchers rarely use discretion so that may also play a part in it as well. Some that have played in the field do. But for the most part its all scripted.