emtcutie

thanks guys. I have thought about talking to the family, but that isn't really something I want anyone to have to think about. Honestly I think it bothers me so much because this was right around the time my friend was preganent with my godson. It's hard to see how quickly this patient declined. She had bled out from a lacerated liver. But i think the hardest was the newborn, watching the little girl die before she even could live. I'll find some to at least talk to. I don't think I need to "overcome" anything, just share it; if that makes any sense. thanks guys

Ever had a patient(s) that was so disturbing, tragic, memorable... ect. That you can't forget. I've been plagued with the memory of a women 8 months pregnant and lifeless in the e.r as an emergency c section was performed in attempt to save the baby. I remember every detail of trying to bring mother and baby back with no sucsess. How do you forget something like that. Or recover from it. It's been the hardest thing i have ever seen as an emt. I cant get it out of my he

*head*

Anyone know of any good emt-intermediate practice test online that are free?

Why do you think it's stupid? Would you rather these people be out doing something that's really stupid? Drinking? Drinking and driving? Drugs?

What do you do for fun?

What these guys are doing is relatively harmless. Just as with any past time, do it smart and don't operate outside the realm of calculated risks that one is comfortable assuming and it's fine.

On the upside, I see your spelling has improved.

It is true, there may be more dangerous things to do in your free time. However there are definatley more productive things to do. I don't understand the concept of it, and why it is sooo fun. And yes my spelling has imrpoved, thank you.

for those of you who don't know planking is, here it is... I think its stupid

It's actually spelled "retarded".

The video was rather impressive from a gamer standpoint.

see told you, i am retarted next to that kid...... and I don't game... infact i haven't played a video game in like 10 years

i feel retarted next to this kid

O Dear... lol

without starting a religous war on here, this totally goes against everything Christ stands for :/

Snipes was much better in Passenger 57

never heard of that either :/

They made 2 of them. I saw a part of the first, didn't stay till the end, never saw the second.

that bad?

The guy in the background is Wesley Snipes, in the role of "Blade". In that movie series, he portrayed a half vampire Vampire hunter/killer.

huh..., never heard of it... sounds... different

who is that in the back ground?

I must be showing my age. I remember when Maury Povich had decent shows, that were not punctuated by shouts of "You are NOT the father", or He IS the female impersonator". An old girlfriend of mine appeared, on an "Adoptees Meet Birth Families" segment, in 1996.

haha my friends and i watch that show when we want to feel more intelligent

Perhaps she had a go with Jacob? They can go on Maury and sort out who the real baby's daddy is.

EDIT: for grammar.

OMGAHHHH think i just died... lol

To address your points:

1) What do you think you could've done better? What have you learned out of all of this?

2) This ties into number 1. Who's supposed to know better in a case like this? Should something have happened who's documentation would've been pulled? Who would've been questioned regarding a negative patient outcome? (Hint: It would've been you.)

3) Why aren't you going to question him? Are you there to learn or not? How do you expect to learn if you're not asking questions? I've refused to sign off on students and new hires I've precepted because they haven't asked any questions.

4) You say the medic in question is a great medic. What are you using as a benchmark? Everything you've outlined in this discussion regarding his behaviour shows someone who's either lazy or not interested in doing the less glamorous work required of the job.

Mind you, I'm not posting any of this as an attempt to slam you on anything. I'm trying to make/help you think about this particular call.

With regards to this being a funny call because of not noticing the transgender status of the patient in question, there is no attempt to get into a debate over the behaviour of the patient. I'm just trying to understand why you found it funny. We have to take care of everyone we encounter regardless of their status or how they're dressed. If nothing else it would've been worth a note in the chart regarding how the patient presented. But for the life of me I can't find anything funny about not noticing the fact that the patient was transgender.

Well what i could have done better, next time i will definatley have to be more vocal to the patients about what could happen if the patients weren't treated accodingly. I already know i need to be morse assertive when i am a team leader. Also i suppose i could have asked him why we weren't doing a more focused assesment. This paramedic I think was probably trying to get everything cleared up quickly. It was rush hour after all and i don't think he wanted to stay on scene to long; not to metnion our en route time was like maybe 5 minutes since the hospital is only a couple of miles from the interstate so we didn't have much time to try and convince them or do any more thorugh exams. However I was monitering them as we went, in the seat across from the bench. They both remained stable, and the charge nurse ordered us to tot to triage. The paramedic did most of the documentation. I did the narrative if i can recall correctly. And i did put every detail in. The paramedic reviewed it and made sure it had all the key points. And what makes him a great medic he has over 30 years of experiance and he was constanlty asking (even on bls calls) if this happend what would you do, he was always teaching me ways to improve. After every call we would sit down and he would ask me, what did I do good and what could I have done better. After I answer with my opinions he tells me what he thinks. He also helped me (along with some people from here) about being more comfortable doing ivs. I have had some preceptors who i went to and they told me what to do and i did it. They didn't ask me what I would do, and never helped me learn new techniques. And as far as you trying to slam me, i don't feel that at all. I love to hear peoples opinions. It will make me a better emt, and eventualy a better paramedic. So please feel free to share them. I will never learn otherwise

You're right. There is only so much you can do. But judging from everything you've posted here you didn't even do that. You mentioned you did a "brief assessment" (later described as a "rapid assessment") because the paramedic with whom you were working couldn't be bothered to do one. Just what constitutes a "brief assessment" on two patients involved in a rollover with entrapment? How much conversing/convincing did you attempt?

Yes. Sometimes just getting them to agree to go is a victory in itself. Sometimes you're not going to be able to get the patient to agree to anything without either harassing or forcing it on him/her (both of which are unprofessional, unethical and illegal). But from everything you've written it doesn't even sound like you really tried. Between a lazy paramedic who's more interested in the potential with the entrapped patient and your "brief... rapid" assessment it just sounds like you could've done a lot more.

Also, you didn't answer my question pertaining to what, specifically, makes any of this worthy to be posted in the "Funny Stuff" forum? Do you find the issue of a transgender patient comical?

That's not what I meant, I find the mere fact that I didn't notice comical. And I really don't want to get in a whole views war on the matter either. As far as my rapid/brief assessment goes, i looked for obvious injuries, there pupils were pearl lung sounds clear and abdomen normal, and the only bleeding was from the very minor abrasions on their arms. and...1. yes i could have probably done more convinving, but I am still a little timid and shy about taking team lead; I am getting better, but as I'm sure most new emt's know its a little scary your first few times leading calls. I will consider this a learning experiance 2. they did make it quite clear that they didn't want treatment, and in the begining they didn't even want transport but they talked amongst themselves and decided they wanted to be with their grandfather 3. i wasn't about to question the man who signs my reviews. and 4. The paramedic who was teaching me is not lazy, he is a great medic and has thought me quite alot.

I have a couple thoughts:

First, why is this in "Funny stuff"? Do you find it funny that there was a question as to the gender of one of the individuals you transported?

Second, and I'd like you to really think about this, was it really smart to transport two patients from a wreck as you described without any immobilization? Do you really think that someone who's been through a wreck like what you described is capable of making a competent decision regarding not wanting to be transported? Do you think, given the excitement and adrenaline rush of having been in the accident, that there was a chance that they were so hyped that they might not feel an injury right away?

Lastly, you need to find a new preceptor.

there is only so much you can do when a petient refueses everything except transport

Good for you. Sounds like you are doing everything you can do, given the circumstances.

Good luck.

thanks so much, it means alot.

we did do a brief assement, both patients denied any head, neck, or back pain or any other pain,. and both patients did not want to be in any kind of immoblization devices,... has they were both stable. the paramedic (my preceptor) did not find the need to do a thorough search for injuries, we actually transported one on the bench and one in the airway seat. The only medical treatment we provided was irrigating the wounds and some gauze. I had asked the paramedic after we turend over the patients to triage why we hadn't done a more thorugh search and he explained to me that it wasn't neccessary due to the fact that they had no pain and nothing abnormal in the rapid assesment we did do on them. And when we did turn them over to the nurse i was telling the nurse what we had and said 2 females, because at the time i didn't know about the whole its a guy thing. Although i do think back now and maybe i shoiuld have argued the point that this was a major car accident and I do know things can be very misleading, but i am fairly new to this and figured he knew best.

so I was doing a field shift for my class yesterday. Started off the same with chest pains and breathing difficulties. my shift ended at 7 and it was 6:30 when we got a call to assist another medic at a motor vehicle accident on the interstate. When we arrived on scene the other medic was cutting an older gentlman out of the car (which had flipped.) The 2 passengers were standing agaist the barrier, pretty much unscathed. We were instructed to take vitals and transport if patient didn't refuse. So, we took the 2 ladies (around my age actually) into the medic and i assign a emt-b to get vitals on the younger one, while i got them on the older girl. The paramedic was assting with extracation of the grampa. Appparently Grampa had been driving and got dizzy and passed out and flipped the car. I figured just another normal traffic accident. All the vitals check out and both patients only have mild abrasions on the arms. They wanted to be transported though because they wanted to be with their grandfather the hospital. We were just about to leave when a cop walks up with a silver purse and asks "whose purse is this" the older girl said it was hers. Then the cop kinda smiled and said "oh really' because there is weed in this" the girl immediatly starts denying its not her weed (even though it was found in a closed wallet). Then the cop asks "who was driving" and they both respond 'my grandfather" again the cop smirks and goes "really because your grandfather said you were driving (to the younger girl) and we found him in the passengar seat." The younger girl was like " my grandpa and i switched plces during the rollover." I am sitting here thinking this story is unbelivable. Anyways on the way to the hospital we were making small talk about fashion and whats "in style". We tot the triage nurse and i went to go do my paperwork. As I am about to leave the cop walks up and says "I need to speek with the young man and the young women in the car" 'I'm like sir it was 2 young women, the only man was the grandfather, and he can't be seen right now because they are trying to stabilize him. cop says" no no there was a man his name was (fake name) tyler. I was like HER name was (again fake name) taylor. And he shows me the i.d and indeed she was a he. I was like omgah, i didnt even notice. Anyways i show the cop where they are in triage and i get them to sign the hippa form, as they are signing i am watching more closely and i see a wig on, and what looks like a sock coming out of the bra. then when he spoke i was like omgah how did i not catch in on this. Anyways thats my story... it turned out to be a rather intresting day.

I stopped by the other day with some food for him because i knew he want making any food himself; He had reluctanlty excepted buy wouldnt eat it. He was sleeping (even though it was 3pm) so i didnt stay long because i could tell he didnt want me to. I was able to talk to him a little and maybe that is what he needs. I try to reassure him and convince him that his wife wouldn't want him to give up. That seemed to get a little bit father I guess. I am just worried about him. I have informed the wellness center at the retirment community; they are in charge of overseeing all health related issues and concerns with the residents. Unfortunatly they told me there is little they can do because he is in the right state of mind and if he chooses not to eat or takes his medicine he is allowed. They are only allowed to intervene if the patient CAN'T eat or take his meds, due to a medical condition. So at this point I will just try or make frequent visits, and try and just listen, because you guys may be right in that that is what he needs.

HIPAA is designed so that you aren't telling the world about your patient as it relates to their care as provided by you or their personal information obtained by you.

If you have a legitimate concern that your patient/friend isn't doing well and is depressed...that is continuity of care. If your plan is to notify his/her doctor/nurse or to contact a family member, then you are doing it for the betterment of your patient. Of course, what I'd be curious to understand is the health condition of your patient. Is he terminal? Is he so old that he's just tired and really ready to let go of this world? Maybe it's just time and he knows that it is coming?

You aren't violating any laws by letting someone know that he is depressed and potentially suicidal. Not to mention...you are visiting this person now as a friend...not his medic.

But I go back to my questions...

he isn't that old, and no he isn't terminal. He lost his wife a few years back. He has been treated for depression before, but hasn't been taking any of his meds for that or any of his other medical conditions. I don't want to blow this out of proportion but i don't want to take it lightly either. There is a wellness center located in the retirment community that i could possibly get in touch with. Another person told me to conact adult protective services. Unfortunatley i don't know much about his family and wheter they are involved with him or not so i don't know if anyone else is aware of the current circumstances.

i did better yesterday and hit all my ivs!!!

So i had a patient in the e.r the other day who was a family friend. The patient had a stomach virus and was dehyrdrated. The patient also told me and the nurses he/she was depressed. He/she had stopped taking their medications including some very important heart meds. Since i knew them i told them i would stop by later to see how they were doing after they were relased. I did that today. When i arrived at the retirment community were he/she lived at with a plate of cookies, they told me "i don't feel like doing anything, i don't want to eat or drink, i'm not going to make it much longer, i just want to go back to sleep., I am not ok" Of course this concerned me. The patiant apparently had not eaten anything in a few days, I want to help him/her but i don't know how. I know you can share informtation if you believe the patient is a danger to him/herself or others, but this is a very gray area... what do i do?