uglyEMT

OK, not following the reference. clue me in, please?

In one of his stand up routines he talked about how he met a women from Africa and tried keeping her at home. It was once she met girlfriends that she learned if she divorces him she gets half of everything. So anytime Eddie would "act up" she threatened him about half of everything. I bet its on boobtube somewhere.

In the imortal words of Eddie Murphy

"Half Eddie I get Half Eddie!"

2 things.

First, GET MORE SLEEP. I know sometimes you just can't but trust me you need to find a way to get it. Even if it is just a cat nap after the call while they do the paper work or on the ride back on the cot. Talk to some of the nurses and Doctors that do 24's or longer shifts. Some find that even just closing their eyes for 5 minutes revives them. Sleep depervation can lead you to nasty things. Besides feeling like your drunk (research has shown sleep deprived folks act like they have had 3 strong drinks) it can lead to real health effects. Heart Disease, Stroke, High Blood Pressure, Obisity, Mood Swings, Irritablity to name a few.

Second, it goes to show just how ingrained your training is. Without recollection of the call everyone said you acted normal which means, at least to me, you did a good job. Your knowledge is so ingrained it is now second nature to you. You can perform your duties without having to think about them. I would want you on my rig.

I have not had it happen to me in my EMS years but have had it happen before outside of my duties. I once woke up, got dressed, drove the hour to work, and finally "woke up" and wondered what the hell just happened. Freaked me out a little.

1. I think part of a best friend’s job should be to immediately clear your browser history if you die.

LOL and the photo collection and you can have my magazine collection as well LOL

2. Nothing sucks more than that moment during an argument when you realize you’re wrong.

Nope doesn't happen my wife tells me when I am wrong and apparently I always am

Okay... not to open this can of worms again. But in that scenario would anyone be glad I was there with my gear?

No not really. Wackers tend to get in the way on scene.

Deer running across the road caused the accident. He swerved to avaoid it, got into the soft shoulder and lost it. It was a pretty drastic incline off the shoulder so I could see where he wasn't able to maintain control. From what we discussed he steered into the slide once he realized what was happening to avoid rolling the car.

Concidering the bafoons we have as elected officials now are supposedly highley educated and some have law backgrounds and don't sem to be doing any good I say why not!

Have the average Joe run for office why not. I see normal everyday people be able to balance check books, keep their family on a budget, weather storms and thrive. Just like that movie where the president was gravely ill and they grab a shop owner to replace him so noone would know and he actually did some good because he was a good person and a good business man.

I think we should give it a shot. Can't be any worse then the way its done now.

Going on protocol alone in my area PD is the only people that can forceably enter a residence. The one caveat is if imminant danger is present, ie house fire w/ a pt trapped then anyone can make entry.

My squad SOP is if we can make verbal or visual contact and are requested enterence we can do what is necessary. The halagan in the rig is our master key Usually we have PD with us so normally not a big deal.

Personally I have pushed in a window A/C unit to gain entery so no damage (well cosmetic to the unit) and opened the front door for my team. The PT was spoted unresponsive on the kitchen floor with the phone near the hand through a window so we knew we HAD to get in quickly. My far to ambitious grasshopper wanted to through a chair through the back sliding doors I stopped him then used his back to reach the window.

I guess it all boils down to what is happening at that moment and what resources are available to you. Remember we are in a dynamic situation field so cut and dry answers sometimes can't be found.

Hey all. Don't know if I put this in the right forum but anyways...

Was a good samaritan yesterday and had the best providers I have ever worked with.

Driving home I notice a woman waving her arms franticly at passing motorists so I flip on my warning lights and pull over. First thoughts as I am doing this is pedi choking, husband having a heart attack, sick child, ect.. I get out and ask, "Mam I am an EMT what seems to be the problem?" I am then told she witnessed a MVA and pointed into the hollow. I look and see nothing except under brush but do notice what appear to be tire tracks leading into it. She says she witnessed a car veer off the road, hit a telephone pole and then disappear into the brush. I say, "Ok Mam stay here, let me get my bag and take a look."

Grab my jump bag and start bush wacking. I come to a BMW sunk to maybe 1/4 way up the doors in muck and mire so I realize opening them will be tricky if not impossible. I notice the driver slumped over and not moving. I think to myself is he unresponsive, had a heart attack, just pissed? Get to the window and tap on it. He looks at me all doey eyed so instant relief comes over me. Apparently he was texting his wife to say he was alright. OK so I try and get the doors open, not happening. I ask him to roll the windows down so I can gain access. No good, apparently power was cut during the accident. OK I inform him I am going to break a rear window to gain entry and he says OK. Walk around to the rear passenger side and hit the window with my window punch. I enter the car and notice the airbag deployed but no spidering of the windshield or cabin intrusion. Male mid 40s moving around well no complaints or visable injuries. I ask him to remain still while I preform a rapid assesment. Quick once over and all seems wel.

I am glad for this because being in a good sam position I don't have to follow my arcaic MVA protocol from my squad and have full C-spine taken. Its at this point the "other providers" show up. Apparently while I was doing this they noticed my lights and stopped. Anyways... I look up and coming through the window was a guy in full BDU's. Army Medic!!! just coming back from the sand box and said he noticed my lights and wanted to help. I let him know what I found and he said OK let me check just to be sure. We switch positions and he does his thing. Agrees with my assesment and asks if the guy wanted help getting out of the vehicle. Guy refuses the help and all of us climb out the window. Its just then I notice another man in a suit coming twords us. I let the person know we don't need him down here we are coming up. Get to the road and the guy was still there. He tells us he is a trauma surgeon and wanted to make sure all is well.

LOL hows that for a good sam incident. You have an MVA and get an EMT, Army Medic, and a Trauma Surgeon all to stop and help, if needed this gentleman had probably the 3 best folks on scene anyone could wish for.

By this point PD is on scene and I hear in the distance the distinct noise of fire monkeys. 2 pumpers, heavy rescue and a chief show up. I do have to say this though, I don't know about your local volly fire units but this one actually had a girl (I say girl cause she looked young, maybe 18ish if that) jump out of the pumper with her turnout pants on and a bikini top! Apparently she was at the local lake and decided to come on the call. Guess a T shirt was optional or at least putting on your turn out jacket. Talk about unprofessional.

All the usual goes on and I stay and chat with the Army guy and surgeon. After a while everyone is starting to leave and I get a chance to talk with the guy in the car. After some minor chit chat the cop asks if he has a ride coming. He says no but he doesn't live far. I ask where he lives figuring it would be the right thing to do. He tells me where he lives and I am shocked, 3 blocks from MY house. This guy is a neighbor of mine and I had no idea LOL So when I tell him where I live we both start laughing. He calls his wife and at first she is reluctant to have her husband get into a strangers car. He calms her by telling her that the ride he is getting is by one of our local EMTs and if she trusted the EMTs to take care of people in the neighborhood he should be OK getting a ride from one.

I drop off the guy off to his waiting in the driveway wife and inform both of them that if anything changes or starts hurting to give 911 a call and we will come no problem.

So there you have it stop for an MVA, get provided with 2 of the best qualified other good sams, and drive the patient home personally

Yeah, no one wants you for the voice, particularly now that you've proved to be a bigger idiot that previously believed...

Dwayne

I never would believe anything that airheaded blond bimbo said period.

sorry couldn't resist.

BTW I have nothing productive to add to this thread because I have absolutely no knowledge of the disease other then knowing it is a disease. So back to your regularly scheduled thread..............

Hate to say it but it will never happen

Until we tariff the crap out of our imports we will continue to have them inudate us. I work in the import and export business and my container field is, as of today 8/3 @ 0643 EDT, 15365 exports vs 34446 imports. Almost 2 to 1. Do you know it is cheaper for a company to send raw steel to China and have a chassis made and shipped back then to have a US factory make it?

Our biggest problem is we are a cheap society, if we can have something for cheap we buy it, quality matters but price is trump. Back when "Made In The U.S.A " ment something we had both quality and a decent price. Fine you have to pay union wages and such thus driving up cost a tad but dont you think if you would be willing to shell out a few dollars more alot of our problems (economy, jobs, ect) wouldn't be?

Take a look some years back when we decided to start importing steel rather then making it right in our own back yards. Over night practically entire TOWNS disappeared, how many American lives were destroyed as a result? Textiles were a HUGE industry here in the US but we decided to start importing due to lower cost of labor thus HIGHER PROFIT MARGINS and destroyed things yet again.

I realize I went on a rant and I appologize. Being an "insider" I see the true costs and it makes me sick. Will I pay more for a Made In The USA brand? Abosofuckinlutely. I do check labels and if I can I will do my best to by from the states. Yes i understand that alot is not made here thus I do have to purchase an import but if I can I will buy American.

Oh before I forget, if you don't think imports harm anyone and I am just being a synical bastard... In 1961 the People's Republic of China established a state-run maritime shipping company and subsequently signed shipping agreements with many countries, laying the foundation for developing the country's ocean transport. That organization developed into the present-day China Ocean Shipping (Group) Company (COSCO). Oh but wait there is more..... they have a second company, state run again, under a different name China Shipping, The company has grown rapidly: it is now the eighth largest container shipping company having recently acquired a minority interest in Asia Pacific Marine Container Lines of Canada. So all your nice imports actual fund the government of China thus funding their military-industrial complex and their government itself.

A KED is only to be used on a stable patient not requiring rapid extrication. That should be considered before "is my patient pregnant."

I don't see where pregnancy would be an issue. If the situation warranted it, I would use a KED on that patient. Having the patient lying supine is an issue, but you will most likely be placing this patient on a board once they are out of the vehicle, and just put a blanket or pillow under the one side of the board so they are lying left lateral recumbant.

I think practitioners who have not had a lot of experience or exposure to pregnant women tend to think of pregnancy as an illness or a disease, something to be worried about right away, when, unless there are signs and symptoms to tell us there is a problem, we shouldn't make that our first priority.

I'm not saying there aren't special considerations when dealing with pregnant patients... but remember that we also have special considerations for patients with physical disabilities, mental illness, head injuries, allergies... any number of things. Take a deep breath, remember what the chief complaint is, do your full assessment and history, complete your differential diagnosis, and figure out the best treatment.

Excellent response Annie!! +1

I feel the same way, what is the CC? Is this a rapid extrication or is my patient stable enough? S&S of an issue with the baby?

When all else fails.... Online Medical Control!!

I have delt with a few patients with a baby on board and didn't have issues with them. Yes special considerations were taken (ie left latral recumbant) but beyond that the human body is amazingly adapted to protect the child inutero. Baring a major trauma to the abdomen or pelvic region I wouldn't worry.

Now if there is signs of distress (water breaks, blood, severe pain, ect) then Med Control should be contacted and advised. Then roll the sleves up and get busy

Don't know much about ride alongs with film crews but I have worked on movie sets. Hasn't changed what I do as much as how I do it. Where as in the street, we do what needs to be done without much hassle. On a set besides a director, producer, and assistants asking 30 million questions you have an actor/actress basically hamming it up for whatever reason so doing things tends to be more fustrating and your action more deliberate as to minimize everything going on. If possible I like taking the person back to their trailer or somewhere more private to minimize the on lookers.

Hey folks. Well its another "feelings" post but have to get it out. I hate holding this stuff in and think maybe it may help others. So here it goes....

Well its my birthday today 11/30 and it has me thinking alot. I had a call the other day that got to me, one of those calls that just turned my insides. 20 yr old male OD Thats not what got me, been on enough of them to be "cold" to it. What got me was why! Here we are breaking a bathroom door down with the parents involved finding an unconcious boy on the floor needle still in his arm. Dad starts crying and Mom is a wreck over it. Clearly they care and are upset over this. We are bagging and getting ready to load and go. Still have a weak pulse so I am hopeful. The second the kid hits the Reeves he wakes up. Gags the OPA out and it feels like a weight lifted off my shoulders.

Now comes the emotional part. Dad starts asking the son why, why, why. Mom can't look at him but is crying in the other room. His response? I can't live with myself any more! WHAT!?! 20 years old and its so bad you try to take your life? Apparently this young man hit a rough patch and doesn't think its worth it anymore.

Dad starts balling hearing this and Mom needs to be consoled by the PD on scene, I was actually getting nervous she might be a patient pretty soon she was so upset. OK I know it doesn't sound like the worst call in the world but it started getting to me.

We have him in the back and ALS is working him up. 12 lead, Narcan, IV, the works. Well this frees me up a little and I start talking with him. Now it gets to me alot. Listening to this kid tell me all his troubles, it gets to me deeply for some reason. His buddy called him a loser the night before. Hes in trouble with the law. He's afraid his parents don't love him anymore because of it. The list went on and on. I know to a 20 year old it must have seemed like the world was against him but I am thinking to myself if thats all you are worried about you have it easy. Then I stop myself.

Wait a minute, to me its trivial, to him its the end of the world. He just tried taking his own life. Then it sets in, looking at his tears stream down his face while talking to me. I am staying strong and being a good listener without showing emotion but inside I want to break down. Here we are day before Thanksgiving and I have a person thinking life sucks bad enough to end it.

I try and tell him its not that bad. What else can I do? I try telling him it will be all right, Mom and Dad still love him, his buddy is a moron, the list went on. But all the time I was tearing up inside realizing that to this boy it was easier to try to take his life then try and fix it. Now I don't know this kids history other then what he told me, he's not a frequent flyer of mine so I don't know if he is a chronic user, all I know is that he's my patient and I "have" to "fix" him. I felt compelled this time, something inside me is screaming out to him. So I lean in and look him in the eyes. I see fear, pain, suffering. I dont see a 20 year old, I see a little boy, I see a child.

I tell him we will get him whatever help he needs. I tell him it will be better this time. I wipe his tears away. The same way a father would a child. I am trying to hold it all back. It is wierd. I dont know why this kid got to me so deeply. I have a million things going through my head, a million emotions. One thing I am glad for is he is alive. Its like an epifany, he IS alive. 15 minutes ago I was working to save this kid's life. I was fighting for his life in front of his parents. I was taking care of someones baby boy. Its the day before Thanksgiving, will it be something to be thankful for or something to be remembered? Now I am talking with him, it IS something to be thankful for.

We get him to the ED and transfer care. I finish the PCR and hand it to the charge nurse. I am told, "Happy Thanksgiving if we dont see you again." My partners ask who is driving. Not me I say.

I get in the back and a tear rolls down my face. I am a wreck, emotionally I am spent. Here was an "average" call, something I have been on before, but its hitting me so deeply. I am trying to figure out why and still I can't. Was it the day? The person? The parents? I don't know but it got to me. We get back to the station and I get to me truck and loose it. Here I am, big, strong EMT man crying like a 2 year old in my driver seat. I can't believe a 20 year old thinks life is so bad he should end it. Here a day before Thanksgiving someone though their life was worthless. Here I am letting him know it isn't worthless, we were there FOR him. I made someones Thanksgiving for them.

Now I am balling even worse. I start thinking of my family, my friends, my life. I start think of Thanksgiving. Not the commercial holiday it has become, not the turkey or stuffing, not the crandberry sauce. I start thinking of what I have to be thankful for. The real Thanksgiving, the reasons I have to give thanks for. I sit there and just let it all out.

I get home and kiss my wife and tell her I love her, my eyes are dry, I don't show what I had gone through. I stay strong in front of her, I don't like bringing it home with me. Unfortunatly it wont be long before I am needed again, another 20 something that I have to help

Thanks for letting me get it out folks, took me a while to just type it. Not knowing if I should or shouldn't but I did. I hope it helps someone else. Let it out, you can be emotional after the call. We are human, sometimes it just gets to us for some reason. I know throughout the call we are the ones folks turn too, the strong ones, the ones that "fix" things. Its after the call most don't see, the stuff some of us don't like talking about. Well I did, hehehee, guess I am just a big softy inside. No thats not it, it was just something that got to me that I needed to get out. To share this with you folks, to show we are human, to show emotions are fine and sometimes we have to let them out.

I don't know if this made any sense to anyone but I had to. Sorry if it was a waste of time but if it helped anyone your welcome in advance.

Back to your regularly scheduled program.....

Had to find one of my old threads. Besides this 9/11 would be the other.

I'll give it a go.

IMHO I think it has to do with the type of person in the different areas. Most rural folks are resiliant and don't see doctors for minor things or will drive themselves so if there is a 911 call its usually for something serious (to them at least) or which they have no other choice but to go by ambulance due to an immediate medical intervention need. Whereas most urban areas folks are less resiliant and or don't drive thus the higher call volume for the medical taxis.

BTW this in no means is ment as an insult to anyone just an observation.

Oh and Ruff quit the thinking, I can smell the smoke from here

debit celing crisis is easy balance the damn budget, go ask Clinton how he did it and gave us a surplus.

I get you Vorenus maybe my example was poor, my meds have my brain foggy lately.

Still though even in an ED setting having more hands to do CPR always helps. As engine stated she was exausted thus wouldn't provide good proper compressions thus the need to have someone else jump in. Again I am not saying the medic was wrong just that the excuse was just that an excuse.

OK here goes..... personal opinion the medic was a dick. No gloves? In a trauma room? Come on even a civilian could come up with a better excuse. And it is just that an excuse.

Off duty? Another excuse. Would you, as a medical professional, not do CPR at a resturant, ball game, shopping mall because you were off duty?

Helping out in the ER, yea it sucks, but as a trained medical technician you are qualified. I have assisted in Level 1 Trauma Centers when asked. Sometimes even they get overwhelemed. On duty or Off if your in a uniform and asked you should assist. Sorry that doing compressions isn't heroic enough or sexy enough or challenging enough for your paramagic skills.

Would I report him/her? No, unfortunatly he/she didn't do anything wrong.

Sorry if I am coming off as a dick myself, call it early AM, lack of sleep, being under the weather, whatever but after reading the OP I got pissed to hear yet again one of our own doesn't live up to their responsabilities.

We are SO BAD

LOL

Sorry early AM lack of sleep and still under the weather but this thread made me laugh.

We go from something simple to "trauma shears and crevats in the bedroom"

I digress.... If your looking for something special for your special lady and keeping in the EMS side of things I agree with others... Trauma Shears. If you want to make it "special" you can have a local jewler engrave them. My wife gave me my pair with my initials on them after graduation and they never leave my side.

Another thing you can look into is a Saint Michael pendant for her. I don't know your faith, if any, but he is the Patron Saint of EMT's. I have mine stiched into the pocket of my BDU's (again from my wife)

Ok no collar around? Grab a towel make a roll and tape, instant neck collar. Also works well with obese patients and large neck patients that a collar wont fit properly. Then everything else is still the same. If no towel around have one provider hold spinal precaution while the other does the suction, again if possible keep the patient on their side to let gravity aid in keeping the airway clear.

As for the new CAB stuff yes you are correct the pumping is now more important and needs to be done first. Have the second provider try and get the OPA in. If it doesn't go in quickly forget it and hope ALS is close by so they can drop a tube. A secure airway is still important thats where ALS comes in so they can drop an endotracial tube not the little OPAs that just help keep the tongue from blocking the airway. The new CAB is for the everyday folks doing CPR where an OPA might not even be around. Just like they are pushing compression only CPR on the TV PSAs now, it gets folks to help until the rig arrives especially when they know they don't have to do mouth to mouth. Plus it helps when civilians dont have to think about number of compression to so many breaths, just pump away until help arrives.

Ruff gave a great example of a 3am stubbed toe so I wont elaborate further. Most folks use it as a metaphore for the late night call that doesn't seem to warrent an ambulance yet we are there.

As far as pronouncement at the scene check your local laws and SOPs most places I know of you need to be a paramedic or higher to legally pronounce unless clear signs of death are present (decapitation, lividity, rigor, decomposition). Dont want you to do something bad young grasshopper.

Also keep the questions coming. None are stupid except the one not asked.

Matthew if your worried about the C-spine due to the MOI (mechanism of injury) then collar and backboard the patient. Then as other have said let gravity do the work just tilt the backboard on its side and let the blood run out. I have been in this situation before and we did just that, backboard on the side with a few pillows holding it in that position while on the cot. Suction at the ready incase the blood blocked the airway. Thankfully we had ALS close by and got the patient tubed before long so suction wasn't an issue any longer.

In the second case, suction like hell, get a tube in all the while pumping like crazy. If the cardiac was during the accident then get him out as quickly as possible, have one provider pump like hell while a second gets the collar on and gets an airway.

Don't worry about thinking of worst case scenarios, we all do it. I actually think it makes you a better provider because if you can think of the worst and plan for it you can handle the day to day without much issue. In my case I always thought of the worst MCI I could which was a bus crash, one day I actually had it. School bus with 30 children plus 2 motor vehicles involved one with a mother with a 3 day old infant. Ran the call like I imagined and came out the other side feeling good, sometimes the worst does happen but usually its a stubbed toe at 3am

Good luck in school.

On Duty:

Belt:

Mini Flashlight w. strobe safety feature (great for disorientation)

Mini Multi-tool (never know when its needed)

Pager

Radio when out of the rig

Pants:

Spare nitrile gloves (usually 2 or 3 pair)

Wallet

Knife (never know when needed)

Shears

Pen Light

Mechanic Gloves (blue and white helps in MVAs)

Pens (usually 2 Bics)

Pocket Reference

VICS Vapo Rub mini

Steth

Pocket Mask

Off Duty:

In vehicle:

Radio (portable unit like we carry on duty)

Personal Jump Bag (same as what we carry on the rigs)

Neck Collar (just one)

Jumper Cables

Mag Light

Flares

Fire Extinguisher

Emergency Blanket

Folding Camping Shovel

Tie Down Straps

(in winter I add a bag of sand)

In my center consol I carry a window punch and seat belt cutter (same in wifes truck)

On person:

MDI microshield with a pair of gloves attached to my key chain

Pager

Wallet

OK I know it looks like I am a wacker with my vehicle I AM NOT. Being a line officer my squad requires me to carry a few essentials in case I need to respond to a scene before a rig gets there or if I need to be on scene during an MCI or fire standby thus the jump bag and radio (we dont have cheif/captain cars or trucks so its our POVs). As far as my other stuff in my truck, I think they are just basic safety equipment everyone should carry

I also do alot of driving (110 mile commute daily) and come across a few MVAs so it is nice to have a few things if need be but thats just me

Ok so my last post was bullsh!t and I blame the person on the other end of the line for my misinformation.Thus I have deleted it as not to spread disinformation

I was looking around the site and found the PP presentation. You use your fingers to hold the nose closed!! OK NOW it makes sense. Can't wait to test this out.

North Carolina not Romania LOL

My link

Still cool name though for a county. Ya'll a wierd bunch

Welcome to the City. Pull up a chair and join in. Don't be afraid to post!!!

ok, some answers for you all.

BSR should be NSR (normal sinnus rhythm) Fat fingers, cant type and apparently i cant proof read either

Hx- hypertension, paroxsysmal Af, type2 diabetes, had a DVT a few years back, depression and being treated for a chest infection

ECG = Sinus Rhythm in 1,2,3 AVF, AVL, AVR and V1

GCS = E1, V2, M3

Pupils = 2mm, very sluggish to respond.

Temp = is 35.5 celcius

No evidence of trauma or drop bear marks kiwi

Ate a roast chicken sandwich for lunch.

No evidence of inflammatory response

Wife states that he suffers from depression, but has gotten quite a bit worse in the past few weeks, states he has been becoming increasingly withdrawn, often muttering under his breath and quick to temper.

Ok a few things I noticed...

Temp down 1.3 C what is the weather outside?

Also the GCS has droped from 6 to 5. I can't tube but ALS would be on this one (less then 8 intubate LOL)

Bushy what was the time between the inital assesment and these current findings? Just so I can figure out how fast he is decompinsating.

Being he has NSR I am not thinking cardiac. 130/90 w/ a hx of hypertension isn't too concerning at this point. You say he ate for lunch, when was that from this time? Did he take his insulin properly or is he on a pump?

The hx of depression is a flag for me especially with the eyes, could he have overdosed? did he have an interaction with any other meds? Being she stated his syptoms have gotten worse recently and the only new hx would be the infection are we looking at interaction vs overdose?

I will wait for some of those answers.

Having said that, i have no idea how many county's you blokes have over there.

There are 3,143 counties & county-equivalent administrative units in total