tcripp

Whatever you choose, I will respectfully strongly recommend that nothing come between you and school.

I couldn't agree more.

Only once in my career has this happened (to one of my partners), we had extra personnel on scene to help load and he had to go badly (early morning call). He was done and ready to drive when we had the patient loaded and ready to go.

And the story I heard was of a medic who had a BM on scene.

I am not buying that for a second. Of course ladies can urinate in the back if the ambulance. you just have more clothes to go through.

Deducting 20 points on you for that one.

I should have added, more discretely. But, I'm not test driving the ability to use that urinal. I'd sooner have my partner pull over to a "facility" and go that route.

Well, just know that you aren't alone.

No one is laughing as we have all had this same concern. There are two rules I was taught in EMS. Rule #1 is to pee whenever you have a chance. I swear people think I have a constant UTI or the bladder the size of a BB, but it's the best. Rule #2 is to eat when you can but if you can't manage rule #2, always revert to rule #1.

There is something to be said for adrenaline and the adrenergic response - the urge dies down. But, it will eventually come back.

But this is where you guys have it easier than the ladies. You have the ability to use a urinal in the back of the ambulance where we can not.

Beyond that, you might mention it to your primary physician. There is a drug called Phenazopyridine which will help with increased urination among other things.

Side bar and to which I don't agree - I have heard of medics using the facilities of the patient's home...

Toni

I started to stay that the dispatchers are "exempt" but that isn't correct...they don't fall under the definition of whom the standards apply. And, as I understand it, the recording is public record and the reason it "can" be shared. Now, whether or not it "should" be shared is another topic of discussion.

Here's a good link for simplicity. http://www.hhs.gov/ocr/privacy/hipaa/understanding/training/index.html

Toni

...if I was the hiring manager and I took the time to offer you a position for a highly coveted spot, and you responded by asking about vacations, I'd go down to the next name on the list.

Don't go gung ho about the vacation - but rather accept the position and then let them know about the plans. Offer (if it's possible) to come in prior to to get as much done. Make the appearance that the job is more important but that the vacation is already scheduled/paid for.

My two cents...that information is just as private as any other personal information that they can't ask you. So, you wait until they offer the position. Then, at the point of the offer, let them know. If they decide at that point that they can't wait, then you guys part ways and they will go to the next candidate on the list. They, usually, never tell those who didn't get it until they know everyone who did has accepted.

To Mrs. T. Crippin..I believe you just kicked me out of your emt-b chatroom just now...haha.

Um, I don't think I kicked as much as you bailed as soon as I told you it was the Basic chat and not the Paramedic chat. ha ha

Seriously, I don't have an issue with you guys joining us...just make sure that the basics drive the call. FYI, it was Alex who helped my guys see that not all strokes are strokes by directing them in the right direction on diagnostic tools.

And, if I can be of assistance in your training...not that Gene isn't doing a FANTASTIC job...you know where to find me!

Toni

Glenda the good witch? Well, Dwayne, I will have to say that one is a first! I guess I'll have to post the pic of me when I was 21 and then you can tell me who I look(ed) like!

Mobey - thanks for the links. I am aware about the little old people and hypothermia and do try to use warming mechanisms (including warm saline), but now I just feel like I have another tool to remind me or to let me know if my efforts are beneficial. You know they will NEVER tell you they are cold as they don't want to be a bother.

Welcome and jump right in!

Welcome Mike! Glad to see another Texas in our midst. What part?

I am sure you will do fine. Just remember to breathe...

Snicker

Oh, hell, Kiwi. Apparently, I forgot about the group of people on this forum.

The solubility of a gas in a solvent (like carbon dioxide in blood whodathunkit?) is proportionate to temperature; so lower temperature = less soluble so there's your lower ETCO₂ .. hmm I feel like I just stated the obvious right there?

Um, yeah. I do recall that in class.

But the question was more to the readability on the monitor.

Sat in what I felt was a very good airway class on Saturday and came away with several learnings, one of which is the title of this post. Makes a lot of sense to me, but I do have a question that I didn't think to ask until, well, right now.

I've noticed that many of my frail little old ladies will show a higher ETCO2 reading for which I will now start using my warm saline and providing blankets and a warm box.

But, does anyone know if this shift in reading is proportionate to the amount of hypo/hyperthermia? By that I mean, will mild hypo/hyper show a change or is this more in moderate/severe?

Toni

1. What is the pt's code status?

2. Was there a discussion with the pt/family that led to the discharge?

In my little world, the only way we can get paid is if the transfer is medically necessary, the patient can't otherwise sit/stand without assistance OR the family has agreed to pay for the trip (which usually is done up front).

So, what was the reason for your transporting her to her home? Certainly not for a higher level of care.

Two-three times a year, a local group puts on a cool event called "Thunderdrome" in Northwest Detroit. The basic gist of the event is a bunch of people gathering at an abandoned velodrome (1000' concrete banked oval race track) and racing pit bikes, minibikes, mopeds, scooters, mountain bikes, "fixies", and commuter bikes. It's a legal event, with insurance and permits and such. However, over the last couple of events, I've noticed a disturbing lack of medical coverage. They have a small plastic case with neosporin and band-aids, but that is the extent of first aid available on scene.

My questions to the city dwellers are:

1. Would you, as a licensed but off-duty EMT, volunteer to provide any on-scene medical care, limited obviously to your provider level, but also with the stipulation that 911 will still be called, as needed?

In Texas, we can only work at a first aid level unless you are covered by a medical director which usually requires a First Responder company to be responsible. Ultimately, you are there to do bandaids and call EMS if needed.

2. What type of equipment would you bring with you? I'm really interested in doing this, but I have nothing aside from a small first-aid kit in my trunk, and my school gear (shears, stetho, BP cuff, CPR mask, and pen light). I don't want to feel like I'm carrying a portable trauma unit to this event, and I don't know if I can justify buying a wacker-kit just for 2-3 events per year.

Pretty much a first aid kit - holler at me for more specifics if you need them.

3. The obvious one; liability. All racers have to sign a release form before being allowed to compete. However, if someone were to get hurt, and I was to provide care, what sort of liability does that open me up to? Does it open the organizers up to any liability if they allow me to provide care?

In Texas, you'd fall under the Good Samaritan Laws...

...see comments above.

I've worked a number of events like this, but as a first aider and then under the umbrella of a FRO group so that I could work at my level as authorized by that group (usually paid at that point).

They are both fun and rewarding!

DFIB, I so TOTALLY forgot about the uniform - clean/pressed and boots shined. Again, I am amazed at how some people show up. FYI - bright whites are usually much more professional than dingy whites. Don't wash your whites with your blues or reds.

As a new EMT-B Student, I'm starting my clinicals in a little under a month. What should I expect from the FD ride along and the Hospital setting? Is there anything I should ask or shouldn't ask?

Thank you for your help,

Chris

Mike is right about timing. Definitely saving your questions until after patient contact is the best way to go.

I am preparing myself for the same thing as well, Just out of curiosity how long is the ride-along/ hospital time for?

This question is best saved for your clinical coordinator. Each program may be different.

But, for you both. I've noticed, lately, some students aren't taking their clinicals and/or ride outs seriously. So, this is just a heads up for you.

1. Understand exactly when and where your clinical is supposed to be and double confirm it. Then, plan to show up at least 10 minutes prior to that start time. Learn now that 10 minutes early = on time and on time = late.
   
2. Understand what components are considered a part of your uniform and ensure you have all components with you. Please...this does include a watch, a black pen and, possibly, a stethoscope. You are entering the world of medicine and these are tools you need to do the job.
   
3. When you go on your ride out, bring with you some snacks/food AND money. You don't know your crew so the expectation of when and where you will get to eat will not be yours. It will be left up to the crew.
   
4. Bring a book with you for potential down time. And, by that, I don't mean a love story or mystery novel. Bring with you your text book or other homework. And, it's okay to ask questions about your text/homework. It shows your FTO that you are serious about the business.
   
5. Remember - you are in their "home" and you should treat it as such. Keep your feet off the coffee table. Get up and help with chores. You aren't a guest...you are there to work and learn. Learn these words, "What can I do to help?"
   
6. And, my biggest pet peeve...GET A GOOD NIGHTS SLEEP BEFORE YOU GET ON SHIFT. I am horrified at the number of people who come in and decide that a nap is appropriate. If your crew isn't sleeping, then neither should you be. And, even then, it's questionable. Your aren't familiar with the tones and they are not expected to wake your happy ass for a call.
   

Okay - off my soap box. Now, make us proud!

Think of it this way. You can stand up and walk to the door while holding your breath...but you can't do the same while having your heart NOT beat.

I like to think our SOCs are pretty progressive and we only carry 4 narcs (fentanyl, morphine, diazepam, midazolam) + 37 other drugs and that includes our NS and O2.

Since when is nipple tweaking an appropriate exchange for the sternal rub? I must have missed class that day...

Just wish Memphis was closer to Austin.

Fantastic! And, you know where to find me...

Congrats to you both! Dfib...you ready for the next steps???