tcripp

As a new first responder (back in 2004), I found myself stopping more often than not providing what aid that I could. Of course, I kept a BLS bag including O2 because I was a volunteer and had that equipment at my disposal. Now that I'm a paramedic and not carrying a jump bag of any kind, I find I can watch and wait. I'm always watching. If it's serious, I will act otherwise I stay out of it. And, if I do stop to offer aid, as soon as EMS arrives, I'm outta there.

So, for grins, I thought I'd go and surf the web. Never know how accurate the info is, so I pulled up my locale to get a good feel. Good news is, it posts the salary for a full time paramedic prior to our raises this past January. I also looked at two other counties near me where I also know the salary range. So, I'm gonna say it's fairly decent representation...for me. Check out www.indeed.com.

Apparently I have a stutter and it won't let me delete. So, I've edited to remove the repeated comment.

Made me go review our guidelines...and nothing specific to a head trauma / seizing patient. But, I'd expect RSI in the near future depending on the details which would allow for lidocaine to help with potential ICP rise.

ERDoc is right, on both accounts. But, in the grand scheme, you'd most likely fall under a Good Samaritan law (you aren't on duty and therefore don't have a duty to act). You are using equipment in good faith as per your training and you did not intend any harm. And, since the dude(ette) is already dead, you didn't make the situation any worse. **disclaimer is that this has occurred in a state that honors the Good Samaritan Law.

It's good to know I am not alone. Watching the horrors on TV turned my stomach to the point that I found Hallmark channel to be the best offer I could get. I can't even imagine being a New Yorker much less one who lost a friend/loved one and then being given not much more than the reviews over and over again on TV. (When Katrina hit, I worked in the Austin Convention Center where we housed for weeks many evacuees. In an effort to make things pleasant, someone decided to put TVs with CNN running...everywhere. I know news is good...but reruns of "olds" can't be good for the soul.) My 48 began yesterday morning and I too remembered while I drove in to work past the 35,000 acres of land/1500 homes that have been devastated here in Texas. No, I don't think that is more significant than 9-11 and am not comparing the two, but it does bring home that we have atrocities all around us and how lucky I am.

Very good point. In school, it became part of any scenario. Not only did we have to state the drug we were given, but how to mix the drip if indicated. Lido/Dopa/Epi were drilled in to us!

Dwayne, we are hanging in there. Thanks for asking. Last night made for a fun call. We had an AMS pt that we decided needed a larger hospital for skills our local hospital couldn't handle (no ICU). We had to detour around the fires to make that happen. Took nearly 6 hours from tone to bed and that didn't include the report writing. Yes, both fun AND exciting! Grady, I keep thinking if we could herd the loose cattle in to the fires, then we could have the outdoor BBQs after all. ha ha The surrounding counties have banned smoking outdoors, BBQing, and welding.

Me too, Richard. Me too.

The patient wanted relief if it meant going to the hospital. We also returned the patient after the call and the serenity on his face was priceless. I know I did right. But...I'm wondering if we should have called hospice back to advise that we were transporting. Or, do we advise the patient/family that this "could" affect payment so they can make an informed decision. (I don't like that the gov't has this separated...it sucks.). That's why I'm trying to find out just "what is". Not sure I understood why either.

Because of your age?

Any of my fellow posters being affected by the fires?

My solution is to breathe through your mouth and not your nose. Downside is that after a while you forget to use your nose when you really need to "smell" on a call. I've been doing it for so long that I once ran a call on a decomp and didn't even recognize it (the smell) until afterwards...when I could smell me. ha ha

This thread is specifically for US as it relates to medicare payments for hospice. I ran a pt the other day for abdominal discomfort - it was clearly indicated that the pt was under hospice care. The discomfort was coming from zero BM x 8 days and had nothing to do with the reason for being on hospice in the first place. Time of day was late in the evening and when the spouse spoke to hospice, was advised to give the pt stool softeners/pain meds and to call in the morning; obviously this wasn't an acceptable option. Based on the presentation of the pt, we transported to the closest available facility. Pt got relief and returned home the next morning. Based on your knowledge/experience, did we jeopardize the pt's hospice payments/program because of this trip to the ER? Does it negate hospice as far as medicare is concerned? I'm trying to do some reading, but am hoping someone has some insight... Toni

I apparently have a short attention span (hence the reason EMS is a good medical field for me). I'd have gotten bored with it way too early.

Quick side note...if you haven't already done it, make sure you are studying the latest/greatest in the NR skills sheets. They've recently made some changes and if you've not dowloanded them lately, it would be a good idea to do so.

Very cool and something I needed. Dealing with the death of a loved one and, well, the timing was just good. Thank you, Ruff.

Welcome my friend! Jump in with both feet!!! The water is just fine here...

Um...yeah! and...wow! LOL - I've already had to change my question from "do you drink" to "do you drink alcohol". I guess my new line of questioning will change from "do you drink" to do you in any way/shape/form/fashion have alcohol enter your body?

Okay - so let me start out by saying that I have led a very sheltered life. I'd also like to emphasize the word "very". Off shift with a episode of Law and Order SVU on in the background and I just learned about something they called an alcohol vaporizer. Interesting concept and one of which I had not heard. It's illegal in the state of Texas as well as many others. However, has anyone ever come across this device with a patient in the field? Any insight for one who might come across this device with a patient in the field? Toni

Ditto on the ability to shave what you need with the cheap razor. My two cents is to get a single blade. Twice now, we've been lucky enough to have a pt go down in a salon and we just used their shears to get the job done!

Met a man not too long ago, former FBI profiler James Reese. Funny guy who gave a motivation speech on Staying Bitter or Getting Better. Of of his final statements that I would like to share... wake up with an attitude of gratitude create a challenge if one doesn't already exist reinvent yourself every day don't take everything personally reduce your expectations of people continue to make good choices Crotchity has it right...only you get to decide how others can make you feel. That includes your stupid partner, that pissy patient that called you at 1:15 with knee pain, or your crappy commander who knows so much less than you do you still aren't show how (s)he got the job. Refer to #5. Toni

I took the online course through Percom as well. The final scared the crap out of me, but it's a necessary evil. And, as stated by usalsfyre, you no longer have to sit for the state exam if you successfully pass the course through Percom. Of course, that didn't occur until AFTER I got mine. UGH! If you have more specific questions, I'd be more than happy to answer them. **Disclaimer, I teach for Percom. ***edited for grammar. I need to go back to my nap.

Excellent question, Dwayne. And the best answer I can give you is that that is what my Clinical Manager would want to see happen. If I've gone to the trouble of taking away the breathing for my patient, why not provide all that I can in return? As I wrote in the earlier post, I'm presuming that I've taken the patient's airway because of the hyperventilation...so I would BVM to control the breathing. Kind of a crappy scenario when you are told "this is what you did" now justify it. Guess that is what I get for biting. I guess I need to go back and see what I wrote because I thought I had written that nothing we do is black and white and I most likely wouldn't even have RSI'd that patient. OH, wait...I had that patient the other day. Well, no 30 RR, but rather unconscious/unresponsive with a GCS of 3 with a possibility that the patient OD - no proof either way. BP was pretty much 120/80, HR was 72, RR 22, ETCO2 was 40 and SPO2 on room air was 98%. I BLSd the airway. The patient came to...and was later discharged without being admitted. Had I taken her airway, that is not how that scenario would have ended.