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billygoatpete

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About billygoatpete

  • Birthday 03/11/1977

Previous Fields

  • Occupation
    Paramedic

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  • Gender
    Male
  • Location
    Colorado
  • Interests
    My family, Medicine, All things outdoors.

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  1. Any sign of a possible seizure? This would provided evidence explaining his sudden decreased mentation, H/R-BP a bit difficult to throw in that box thogh. There is also potential that this patient may be volume depleted and in an early stage of shock. With that, beginning treatment with 02 a line and a fluid challenge seems a prudent initial intervention (provided your respiratory assessment shows no signs of CHF). From there, ya gotta go down the drugs vs Neuro route. Despite his overall lack of apperant "tracks", addicts can be creative about getting there "fix"..this warrants some additional invesigation and prehaps a whiff of naloxone. In my earlier life, we had an entire summer of patients "foilig" Heroin mixed with Cocaine, Many of them presented in a manner very similar to the one you are discribing. If not that, strong thought needs to be given to the potential neurologic injury that may be present, Again, monitoring, providing fluids and looking for chages VS, This patient could very likely have undiagnosed cardiac issue that has not presented until the day off the call. In the bus, I'd probably run a 12lead along wth throwing in line etCo2 to gauge the effectivness his ventilatory efforts, If no changes have noted up to this point-I'd probably give him a whiff of Dextrose12.5grams, a milligram of naloxone and re-assess, From the limited information given, I'm assuming his airway is, moderatly patent. If it becomes concerning at any point in the trip---we'll go down that road when we get there. Out of curiosity, I'd want to know a good deal about the events leading up to this. My gut tells me this is either a 1, Seizure of unk etiology (possiby from piano that fell on his head two days ago) 2. An undiagnosed Cardiovscular injury Or an undisovered vessel malformation that has begun leaking, 3. Ingestion of, or exposure to both illicit and non illicit sustances. There are literally thousands of working "differentials" for this case given the minimal data provided. :fish: Just my 2 cents,,,,,looking forward to following up on this.
  2. Couple of corrections.... The crash happened at 2 PM....which is still daylight hours in Texas. The crew was a mechanic and a pilot on a test flight therefore the helicopter was not staffed for a medical response. Before we go off on what shoulda, woulda, coulda happened, lets get the facts straight. This is a tragic loss for the folks in Texas, but it dosen't need to be made any more tragic by a bunch of misinformation spread across the good ol' internet. Just my $.02 Link to article Edited x1 to add link..
  3. Nothing to add in the landmark department as I think it's been fairly well covered above... I will add a little tip that wasn't taught to me until after I had already done a couple decompression's...I have found it to make the procedure go a little smoother. Prior to doing the actual decompression, make a small "nick" in the skin at the point in which you will insert the needle. You can do this with the tip of your needle (or a scalpel if you have one and the time) it doesn't need to be very big or very deep, just enough to get into the dermis. In my experience, this small "nick" decreases resistance while inserting the needle and has made the procedure go a bit smoother. Of course, prior to doing this, make sure that the extra step is covered in your treatment guidelines, if it's not, you might have a chat with your medical oversight to consider adding it. Good luck and THANK YOU for your service to our country!
  4. From yesterdays news.... Denver Fire looking to charge for accident responses Thoughts???
  5. I had the same issue with the whole "multi quote" thing...which is why my reply reads the way it does. After 45 minutes of messing with it I decided to just post it as it was. I'm sure we can continue the conversation in the near future. Take care, JP
  6. That's a fairly incorrect statemtent. You need to speak spanish to work in Pueblo about as much as you will need it to work in W. Denver, Greeley, or any other town in Colorado. The majority of the folks in all of those areas speak english and those that don't usually can get their point across fairly easily. As to the providers in the S. Colorado areas..AMR has the contracts for both Pueblo and Canon City. C. Springs AMR has some great folks as do the Pueblo and Canon City operations, as with any place, you are going to get out of it what you put into it. If you are not opposed to looking north, look into Thompson Valley EMS, Weld County EMS and Platte Valley EMS. All are good operations. While your at it, look into Pridemark Paramedic Services as well. They have a few 911 contracts throughout the Northern front range and I have met some great folks that have come from there. Good Luck! JP
  7. D: Sorry for my delay in getting back to this topic, between work, moms day, chasing turkeys, and this wicked resp. thing I am fighting off, I haven't had much initiative to get back to the "city". As usual, you are asking great questions. Many of which I can't even begin to answer for you (remember my one promise...I will always be willing to say "I don't know") this is one of those issues where "I don't know" is even harder because I don't think the answers are easy to find.
  8. Man, sorry it took me so long to do the friend thing...until I figured out who you were it never even occurred to me to add someone named billygoatpete...what the hell??

  9. Hello!! Welcome, feel free to speak up. ;)

  10. Thank you all for the kind welcome... Dwayne, Seriously man, thanks. You are way too kind. Tell Babs I ate my breakfast in my underwear this morning while standing in front of the kitchen window staring aimlessly at the neighbors strolling by (freaking coffee pot takes FOREVER). As long as she can keep it to about that level of social inappropriateness...we should be good to go:-) Really though, you are welcome anytime.
  11. Hi all. Long time lurker, 1st time poster. I figured it was time that I finally posted something up if for no other reason than to annoy Dwayne :-) Anyway...I suppose this is the "about me" post section. So here goes. My name is Jason....I live in wonderful Colorado and have been here all my life. Paramedic x 10 years this October, started as an explorer at 17, fell in love with EMS and haven't looked back. I am married to the kindest, most understanding, and coolest woman on the face of the earth. We have a 3 y/o daughter who did, in fact, hang the moon. My off time is spent in one of two places. Wherever my family is or out enjoying all that Colorado has to offer. Thanks for having me. JP (Oh..the username....Billygoatpete is a LONG story and I tried to change it after I entered it but couldn't get it done. So, I guess I'm stuck with it!:-)
  12. Funny that this post pulls me out of lurkerdom. As usual, I take some issue with Dr. Bledsoe. There seems to be no "grey" area with him on most matters (Pre hospital intubation My link, HEMS, ETC:). The problem I see with this is that he makes generalized statements about an entire industry and, in turn, makes the whole industry look bad. Has there been a huge increase in the # of HEMS programs in the last 10 years? Absolutely! However, if you look at the majority of those programs, they are privately ran enterprises that approach a hospital and ask " would you like a helicopter based here??" of course the hospital agrees..what do they have to lose?? The program pays the staff, pilots and mechanics..why wouldn't a hospital want a helicopter to call "theirs"? If the hospital says "no" and the program still thinks they can eek their way into the system in the area they simply station it at the nearest airport and PR the hell out of the thing. If it works, great, if not, they pack up and head to the next area they think they can make a profit in. THAT--IMO is what needs regulated, that type of business plan is dangerous in any industry..but it is super dangerous in the HEMS world. It's pretty hard to maintain a "3 to go 1 to say no" attitude when you know your base is needing numbers to stay afloat. The feeling of competition leads to folks pushing things like weather minimums or trying to take flights that have already been turned down. Additionally, what does the program have invested in it's employees? As said earlier lots of folks want to be flight medics/nurses right? So, in the above business model, why not hire somebody with less experience who will take a lower salary to call themselves a "Flight medic/nurse". Is regulation needed? Sure it is, we have waaay to many helicopters killing folks. Where does it start though. Even more, where does it end. Dual pilot IFR ships are a great idea, but they are by no means practical in some areas of the US. Do you have any idea what type of AC would be needed to meet that requirement and still be able to function in the altitudes of Alaska, Montana, Colorado or Utah?? Sorry folks, its just not gonna happen. What Bledsoe fails to look at is that there ARE great HEMS programs out there. Just like there ARE great Paramedics and EMT's out there that need to be looked at as the model for where EMS and HEMS SHOULD be going..rather than breaking down the entire industry to a nice, easy to understand, black and white box. Again, just my .02¢. Thanks for having me.
  13. I have no idea what the message you left on my profile mean..

  14. Send me some bidness will ya??

  15. Welcome to the CITY!

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