Jeepluv77

This one I should be able to remember pretty well. Not too long ago there was a major fertilizer spill in a neighboring city. Entire storage tank blew and flooded a neighborhood. Thankfully no one was seriously sickened.

Thank you. It helps a little, but it's still kind of not sticking. I've read it several times now in two different books. The visual in my ECG Made Easy book just confused me more! I think when I go to class tonight I might see if one of the proctors might be able to help, too. They are more for skills training but you never know. This is so frustrating. I've never had to work this hard to learn something. Class is way past the phases now and I'm getting everything fine, but I've got the sneaking suspicion it's all going to tie in.

First off, congratulations! He's absolutely beautiful! Given the time of his birth, I vote for something along the lines of Mr. Impatient or Early Riser.

I'm actually kind of surprise this hasn't popped up yet, but what does her skin look like? Breathing sound like? Is she perfusing well? As long as she isn't becoming cyanotic or showing other signs that she's not handling this well, I'd say go with the family's instructions. Personally, I'd be much more concerned if she'd been having these seizures this often (for any length of time) and had not been seen by her md and neuro. If you really want to be sure she's receiving proper evaluation/treatment maybe ask what tests have been run. That should give you a pretty good indication as to whether or not things are in order.

Thank you for the advice everyone. I had mentioned on another thread that I had been told not to stop, but only given the reason of not having to repeat my clinicals which I wouldn't mind doing. These are much better reasons. My program is a two year(not including my basic) program, with the option of adding a semester or two and getting my associate's. I intend on getting my a.a.s. and taking a&p as my health elective and biology or better as my science elective. In fact, I'm going to make all of my general studies relate in some way to my eventual work as a paramedic. I've actually considered starting another thread to get advice on what would be good courses to take. I don't want to hijack this thread, through, so I'll leave it at that. Again, thank you.

Absolutely, no doubt about it. Even at the basic level, though, we were taught at least a little about what's normal versus what's not. And since I'm a visual learner, I've checked out every single photo I can find. I really believe though that if there is something major going on as far as seeing/feeling I'd have a pretty good idea it's not normal. I didn't know exactly what it was I'd have no problem calling med control/my charge nurse(if I decide to work in a hospital for awhile) and getting their input. I do feel I'd know "It's not supposed to look/feel like that" even if I don't know what's causing it, and it'd probably still give me more time to treat for shock, etc. before they are actually circling the drain. Hearing, maybe not so much with some things(heart sounds?) but things like wheezing and rhonchi...definitely not normal. I'm still trying to figure out what a split s1 sounds like(told I have one) but I listen to the heart/lung sounds of myself and everyone else I know to at least get an idea of what I'm supposed to be hearing. However, you are completely correct in that I still have a ways to go in my training/experience, which is exactly why I'm considering working as an emt-i for a while before continuing.

I'm not agency affiliated yet, so a lot of it(maybe even all of it) will depend on my agency's policies. That being said, I really think I'd have to look at it on a case by case basis. A teddy bear from the sweet elderly couple would be a great item to place in the crew room to remind everyone of why they are there when the going gets tough. However, a cash amount from a woman/man with a known propensity for faking because they hope it will soften you up to them and further their cause would be a whole different ballpark. No way. Then you have the gray area in between. I feel a lot factors would have to be considered. As for Dustdevil's statement to report it to your employer and keep it completely above board, absolutely. As my dad always said, c.y.a!

Yeah, this is getting pretty confusing isn't it? The long and short of it, however, seems to be that everyone agrees we need to expose an area for assessment. There are just some disagreements as to why. Am I on the right track here? Also, I don't feel why is as important(not saying it's not important though!) as just the fact that it's done. If you stayed awake in class and read your book every now and then, you'll probably know trouble when you see/feel it.

I'm still thinking it's hemorrhagic stroke. Can I assume it's been five minutes and get a repeat on vitals, including bp, hr, rr, pupils, and skin? edit- also assuming we're already in the truck and gone, btw

pupils? skin?

I just started acls, so although I see his p waves are tiny, at least one lead shows depressed st segment, and another shows tented t waves, that's about as far as I can go with ekg. Only had one lecture on ekg so far. Sorry, y'all. However, Henderson's is a facility for thrombosis and vascular disease. Do we know when/why he was there and if he's had any treatment? And do we know yet what meds he's on? Sorry if I missed them. edit-bp shows a wide pulse pressure, but apparently we haven't gotten there in class yet either.

Facial droop? Arm drift? Do we have any past history for him? Actually, let me get a full sample. The nurse said he was staring of and not speaking, but now he's speaking, just not making sense. How long has he been speaking again? Any slurring? Also, any signs of trauma?

Just noticed this. Sorry, I'm a little late. Do you know how you did yet?

I don't know if anyone watched the other clips but my dog is either very concerned for or very afraid of "bizkit the sleepwalking barking dog". He may need some doggie counseling now. But really, that was hilarious! He'll make tiny little running foot motions sometimes but nothing like that. He does yip(more like a muffled bark) and cry a lot in his sleep. I can only guess he's hearing a strange car in the driveway because it's the only time he barks when he's awake and even then it's only one quick(but loud!) bark.

It's just sad that this type of thing still exists in this world. I don't even know what else to say. My heart goes out to her and I hope she wins her appeal. This is just barbaric. All for letting in two men(one of whom she apparently had a major part in raising) that were bringing her bread?

I won't even ask where her parents are. They apparently are either not around much or are pretty...umm...bad parents themselves. Yeah, you may not see the first baby coming at, what, not more than 14? But 3? And another on the way? Her parents should be taken out back and shot. I went to high school with a 16 y/o girl having her third baby. She confided in me that her grandmother, who had custody of her as mom was in jail and dad was absent, was making her do it to so she could stay on welfare. I think anytime a teen is on baby number two, cps should be stepping in. One could be an accident brought about by simple ignorance(giving the benefit of the doubt here). After that, it's pure negligence or in the above stated case of grandma outright abuse. For that matter, any teen having a child should be made to take parenting classes if they intend to keep the baby. Period, across the board, no exceptions. No teen has enough life experience to be a good parent. I wonder if this girl has any idea that she has destroyed her life before she really ever got started. Even if it's expunged from her record when she reaches adulthood, it's all over the internet and will haunt her(and her offspring) for life. Also, it makes me wonder what else her children could have been exposed to. If cps took the previous two, why was this one still in her custody? I just don't understand that.

Thank you, spenac. I was also taught that there could be visual differences in the skin/muscle tone(overly rigid or "squishy"), color, etc that you may or may not be able to feel through something like jeans. And that, when in doubt, you can document/mark the swelling(much like you might with something like an insect or snake bite) and you may notice if it is changing too much or too rapidly. I haven't seen it in practice yet, but I know when I do my chances of having that gut instinct that tells me something isn't right will probably be a lot more on point if I have a visual baseline. Of the injury, not just a monitor. Especially with kids as I know they can compensate until it's almost too late then just bottom out.

I've just started acls. I'm having trouble remembering the phases. I'm a visual learner and as yet have not been able to find any visual aids. Does anyone know of a web site that may have an animation or still pictures? Even a mneumonic(sp?) may help. I'd greatly appreciate any help you can offer.

I know here(in Virginia) if you do not expose on your states you fail automatically, regardless of what else you may do "perfectly". I haven't taken the NREMT-B(decided to keep going through school) but was lead to believe it was the same way. If that's so, then it leads me to believe it's pure out laziness. And to not expose when assessing a trauma? To me, that sounds like it could be edging on negligence. How can you do an appropriate trauma assessment without looking at the injury?? Ex- You have a fractured femur. You splint it, finish your "assessment" on scene, and go at a nice leisurely pace. But since you didn't look at it, you didn't know that it had severed the femoral artery was pouring blood into the closed injury. Your pt has serious complications(or even dies) because by the time you realized he was going into shock and prepared to treat it was too late. Maybe that's a little extreme an example, but it hopefully illustrates the damage that can be done by not taking those few extra seconds to cut away clothing.

It's interesting for me watching this unfold. I'm 26 so I don't really fall into the "younger paramedic" grouping. But the topic of how much time should be taken as an emt-b before starting paramedic school was touched on earlier. Any chance of getting some more input on that? I started my schooling last August and got my emt-b in Dec 2008. January 12th is started als. I've been thinking of stopping at intermediate for awhile and returning to school when life calms down a little. Also, I'm just not sure I'm ready to have that type of responsibility on my hands knowledge wise. I want to know for a fact that I know what I'm doing inside and out before I start doling out orders to everyone else, even if that means I spend a year to two running as an intermediate and taking orders. However, a lot of my proctors have said this is not a good idea and to go straight through. The best response I've gotten as to why is because if I'm out more than a semester I have to repeat all my clinicals from this semester and last. Which I really wouldn't mind. I already think the 32 hours this semester and 98 hours next semester(for intermediate level) is not nearly enough. At least not for me, as I am in no rush to have someone's life solely in my hands until I've had plenty of time working under the guidance of others. Any thoughts?

Mmmm...sounds good. Hope you enjoyed! Just let me know if you need anymore help. I'm always willing to talk food!

Thank you! It was mentioned in passing in class, but I get the sneaking suspicion that could be useful on down the road.

Okay, so help a newbie out here. I know I've heard this before but cannot quite recall in reference to what.

So, I have to know...what kind of deli sandwich did you get. Oh, and thanks for sub!

Just wanted to say hi. I'm new to ems(just finished b in dec and started als in jan) but I am addicted to both the ems world and this site. I like the way you think! Decided early on I don't just want to memorize the info and be a cookbook medic, but rather learn it and utilize it to give my pts the best outcome. I've learned alot here so far that I don't think I could have picked up from a book. Hopefully, I'll learn a lot from you, too!