thrutheashes

Welcome to the city. Any questions at all, feel free to ask....we don't bite, though mobey does drool a little........lol.

Thru

the BLS service I work for uses Entonox. I have found it fairly effective as a drug in quite a few cases, but in my experience you have to watch it with the 'nox as some people do not react well with it (cue vomit) and others I have witnessed the patient be complete unaffected by the gas.

And yes I did shake the cylinder so they were getting the mixed gas, lol.

Thru

I;ve been in situation myself as of late not knowing whether or not I am going too step foot on truck again due to medical issues. I definitely understand what you are saying,and am hoping to hell I get cleared back to work myself.

I am reasonably sure that it's a question that, forced medically or not, everyone in this profession faces at some point or other.All we can do to answer that question is take the time to reason it out, and not force the issue. If we go back before medically cleared, are we a help or a danger to the patient? Same question if someone is completely burned out and they are not sure if they want to do this job anymore. This job is a passion for most, and time away from our passion drives us nuts.

All that being said, if you are not medically cleared, as much as it might hurt, at least having a fall back which you can feel good about is a good thing.

I guess what I'm saying is this, everyone ponders the how long we can do this profession. Some people answer the question themselves, and others have it answered for them. Until you find out what your answer is, take it one day at a time, and let things happen as they do. It's what I'm doing.

Hope this helps

Thrutheashes

regardless of wheher you are training for Red Cross, of SJA, they are both good at supporting their instructors. Probably easier to find a school to teach for under SJA, but I personally like and stick with the Red Cross program as I find it is written for the general public with zero medical experience. There are a multitude of training centre's around, you just need to check your yellow pages.

As for being a paramedic first? Not at all. there are instructors out there whom have no EMS experience what so ever. EMS experience is definitely an asset, but by no means a requirement.

Thru

Hey Jungaree, I would in all honesty recomend teaching for another education services for awhile as a new instructor and let them absorb some of the costs. Equipment wise you will be looking at $2000 minimum for equipment and teaching aids, Also depending which agency you are teaching with (Saint John, Heart and Stroke, etc) You will have to pay $300/mos for liability and errors and omissions insurance, and with Red Cross that Insurance is mandatory. Just some food for thought.

Thrutheashes

It's emtertainment flat out, and they are pandering to the lowest common denominator. Face it. Sex sells. And despite what they get wrong, they do get a bunch right, and it does have a half-assed decent storyline. As has been mentioned, it's a drama pandering to the masses, not to those of us in the services. I enjoy it, because I take it for what it is. BS

Canadian Heart and Stroke has just changed they're guidelines as far as certs are concerned. Effective January 1, Instructors will no longer be able to issue the paper cards. Instead the student will be issued a signed letter stating that the student has completed the Health Care Provider CPR course or renewal, with offical plastic cards coming in the mail shortly afterward.

I'm alive and kicking, just busy as hell!!!

Im not endorcing a product here or being paid in any way...

5.11 ATAC Boot!!

I have booth the 8" side zip and the 6" station version

I wear the 8" as a duty boot and the 6" is my daily everyday wear.

VERY comfortable. They are oil and BBP resistant, anti slip, have a composite toe (not steel, carbon fiber), can take a shine if needed, water resistant (I never say proof unless its a yellow rain boot LOL) and comfortable.

I wear these boots as well in a non-zipper version, and absolutely love them. They are light weight, offer good support, and offer good bang for your buck!

ok. let me see if I understand this? The kid plays 96hrs of Call of Duty, then goes out with apparantly absentee mommy dearest, and then collapses? Gee, ya think?

You'd think his mom would have said something to him sooner. But wait, he was playing a video game and "I never in a million years thought that a videogame would involve his health." Gee mom, where have you been for the past 15 or so years. I've lost track of the number of reports correlating increased game play with decreased health, and that is just playing recreationally, not on a 96hr bender! And this, my fair emt city-ites is why we shall never be unemployed!

Seeing as we are talking about when/where to start IV's, I came accross this study in my research that I found interesting......http://www.ncbi.nlm.nih.gov/pubmed/21367376

Post deleted due to reconsideration of request to lock

Hey Croaker, that does help. Could you give me the name, author, and year published of your reference?

Hey guys,

I am doing an IV therapy review module for my service, and just for kicks was wanting to throw in a slide on the history of IV therapy. I've been able to get some info so far, however, the answer to one question still eludes me. Does anyone know what year IV therapy came to the pre-hospital setting? If anyone knows or can point me in the right direction I would definitely appreciate it.

Thrutheashes

This is a touchy subject no matter which way you look at it. I am for the most part in agreement with the decision that was made. However I don't feel it should be yielded as a broad brush stroke and applied to every single person. I believe that this needs to be looked at on a case by case basis, or the risk for abuse becomes high. If people are trapped in failing bodies, better they should be able to end it on their own terms, and properly.The alternative is some will attempt on their own. We all know how some suicide attempts end up. They end up alive, angry, bitter, and with more problems than they initially had due to live, kidney, etc damage. And that is a further cost to themselves emotionally,physically, and to the health care system.

People should be counseled on their choice, and help offered. If in the end they chose to end it, on their terms, because of some malicious disease, I see no reason why they should not be allowed, and to have someone assist them to get it "right".

And before anyone says anything, I have personally felt the bite of suicide. My first wife attempted suicide a number of times before finally succeding in the fall of 2004. I know how touchy this subject can be.

The biggest question to come out of the debate for pro/con assisted suicde is this, what is in the best interest of our patients? I know if I was severely ill with little to no chance of recovery I would reach for the shot gun and do it myself, while I could.

Sorry about the rambling.

I think it's going to be dicey, but I think enough people are pissed off enough to come out and vote and give the PC's a hurting. I think the main factor will be people getting out to vote. If the numbers are like like election I don't think there will be a change. If everyone else gets convinced to use their rights.....it will be another story.

To say that that was a crapper of a call doesn't begin to describe it. I feel for you, my friend. The job we do has us facing some of life's worst moments. I am glad you have found. Outlet where you can vent And not keep things bottled up. And to echo someone elaes's comment.....it is good this call bothers you, because it means you care. I'd be more worried about you of something like this didn't bother you!

On another note, great job on the save! We cN't save them all, but the ones we do, it sure feels good, doesn't it. Keep on touch.

All are excellent points, and I get exactly what you're saying.

I think that this thread, and your previous post particularly where you mention withholding tPA without a 12 lead, is painting a perfect picture of the complete provider. That we can't be what we maybe should be if we lean to heavily on our tools, but certainly would be relatively crippled without them.

Pretty cool...

Dwayne

That is the point I was attempting to make, but missed the mark. Thanks for someing it up so well.

thrutheashes

Would love for you to head over to my resp senario and apply your logic. I'll think you will find your assessment skills are only as good as your educational background and FUNCTIONAL experience. That is why we use machines.

fair enough!

My treatment would vary based on pt. particulars, but as presented I'd go low flow o2 and see if the sat were to go up. That said, as long as color,resps, v/s are stable I would not go any more aggressive than low flow. Conversely, I have someone who has sats reading high, yet they are struggling for breath, showing cyanosis, I am going to treat more aggresively. I'm not trying to say that the tools are irrelevant. I will always side with pt. safety. But sometimes you have to rely on what you see, not what the gizmo's tell you.

Hope I'm never in your remote area when I'm in a perfusing v-tach, or silent MI, or,or,or.......

Hey, contrary to what the lifepack says, if I'm chatting with someone, and I can palpate a pulse, I'm going to have a hard time believing the patient is in asystole if it's showing on the monitor. Just saying.

Our tools are nice, they help us do our job, however it is possible to be too reliant on them. That's all I'm saying. The tools are half of it. The practioner's experience and intuition are the other half. such as the case in the op's original post. Does this SPO2 reading make sense? Does BGL reading make sense with patient presentation? Or what if your equipment dies and you have to assess the old fashioned hands on way, using auscultation, palpation, and vision? I've seen newer EMS practioner's who, quite frankly, don't have the problem solving abilities to assess without those toys.

The toys are nice, but not without the basic understanding behind them.

This topic takes me back to something that I have believed for quite some time. As providers we need to rely loess on our toys, and rely more on our training, education, and instincts. The old mantra says "treat the patient, not the equipment" and I believe that 100%. We as a profession need to put EMPHASIS on our assessments, and use our technology as a backup, and not the other way around. I know it's an easy trap to fall into , and I've been there myself, though it is something Iconsistently try to work on.

Awesome rules to live by.

Seeing as I have found myself in a similiar situation lately, I feel I have something to add here. As the op presents, I would likely stage myself, however there is a multitude of information missing.

MY partners and I have always run by the two person rule, which is we either both agree to go into a scene, or we don't go in. If we are told to stage, we stage for police. No questions. Otherwise it is our discretion. We read the scene the best we can, make our decisions accordingly, and if we have any "bad feelings" we stay out. I know not everyone will agree with this line of thinking. But that's ok. We rely on our instincts and try not to do something stupid, while helping someone in need.

Thoughts and prayers to the crew and to the patient.