medicgirl05

It is not only the guns that are alarming, it is also the alcohol consumption and the PTSD book. These combined make for a possibly dangerous scene. If the police are 1 minute out that shouldn't make much difference in patient care...better to be safe than sorry. Yes we have lots of people with guns, however they are not usually in clear sight. When they are in sight we ensure that the patient isn't within reach of them, either by removing the gun from their reach or removing the patient from the scene.

At this point I'd definetely back out until police arrived to ensure the patient was unarmed. There is obvious potential for things to accelerate to a point I'm not comfortable with.

If the scene is safe, attempt to locate the patient... What do you find? Conscious? Alert? Oriented? Position of patient? Complaint? Vitals? That should get us started...

I've been taking classes at the local community college for years now and the time has come that I HAVE to choose a degree path. Here is the problem...I love my job as a paramedic, so I want a degree that will enable me to go further in this profession. I thought I wanted a degree in literature...but that just seems like a waste of time. There is an on-line B.S. in emergency health sciences that looks really interesting, but I'm not sure it would be beneficial in the long run. Here's my question-What degree do you have and how has it helped you in EMS? If you don't have a degree what would you suggest? Thanks!

Interesting 1C. No, he wasn't stuck between anything. He had just kind of slid forward off the toilet and his arms and head were propped on the tub.

Ah. No I didn't look at his eyes to be honest. I walked in enough to inspect the scene but since he was obviously dead I didn't inspect as much as I maybe should have. He smelled a little if you know what I mean. ;-)

No evidence of foul play...nobody had been in the room...no blood in the ears, definitely not Battle sign. At the risk of sounding like an idiot I'm going to ask...what's hifema? Scatrat-very possible that the carotids were occluded due to positioning. Thanks everyone for the input!

That policy doesn't sound like it has patient care in mind. Our policy is that we leave any equipment necessary with the patient...the nursing staff puts it in the EMS area and we retrieve it on the next run. If we are flying a patient we use a RAC backboard and disposable air splints when necessary. If we have equipment at a hospital we don't usually go to a neighboring EMS service usually drops it off at our office on their way through town.

For starters.... Is she alert and oriented? What are her vitals?(pulse ox, pulse, BP, respirations, BS level?) Lung sounds? Medical history? Complaining of pain anywhere?

The man's head was level with the edge of the bathtub. The rest of him was lower. Usually the blood settles in the lower part of the body, that's why I'm confused. As for the autopsy results, it's hit or miss wether they will give me that information. I plan on calling in a week or so, but sometimes they say it is irrelevant for me. The call came in from the manager of the hotel and I'm thinking she called 911 not knowing what to do. We were the first to arrive on scene. It happens pretty regularly that we are called to a very obvious DOA. I think it is just that the public doesn't know what to do, and the dispatchers don't either.

I recently had a call and felt a little stumped. Call came out for unconscious patient at a local hotel. We arrived and found the patient DOA in the bathroom. No medical history, no meds in the room, and no family present. Patient hadn't been seen or talked to in almost a week so also an unknown down time. So we found him on the floor between the tub and toilet. It looked as though he had been sitting on the toilet(though there was nothing in it) and fallen off to hit his head on the bathtub faucet. There was about an inch of blood/water in the tub presumably from a small lac to his head. The wierd part is that his face was BLACK and swollen. His legs weren't black, just purple tinged at places. My partner thought maybe he was electrocuted but I didn't see any evidence of that. My only idea is that maybe he had a PE, but would that cause him to be black? I've seen people who had recent PE's and were cyanotic from the neck up, but never black. Any idea?

Great thread with great advice. The only thing I have to add is that I agree with others saying you should do clinicals. That may help you realize that other college courses may help you to better interact with people. English is a good idea as well as a medical terminology and A&P. With clinicals you will better understand the job itself, that's something that just can't be taught in a classroom. At my basic course the paramedics that taught us all talked about their "saves" and bad calls. I was completely unprepared for all the hand holding I'd have to do until clinicals start. For me, I have more calls that dictate the use of people skills rather than EMS skills.

I just looked into the prerequisites at the local college. They require a medical terminology class and strongly advise taking anatomy prior to enrolling in the paramedic program. I'd have to agree. I have taken both those classes and wish I'd taken A&P before my paramedic program. I remember sitting in A&P and making connections to why we do things as paramedics. I didn't know that colleges had any prerequisites for the paramedic program. I think that's definetely a step in the right direction!

Believe me we have ALL tried. We have tried to get several different pain meds approved with no luck. We had Toradol in the protocols for a while but never actually carried it. When I started as a paramdic we carried a non-narcotic pain med that I can not remember the name of...but it was taken off because the ER docs didn't approve of it. IDK why I can't recall the name of it...having a very DUH moment.

Morphine is the only thing we carry for pain management. We have run into patients who are allergic and I have called medical control for permission to give enough Valium so they don't care as much about the pain.

That sounds almost exactly like my first call. I am curious to know where you're headed with your story. My personal opinion-I wouldn't pay to read someone elses diary of exactly the same calls I have been on. There would have to be more content than just your experience stories. Again that is just my personal opinion.

In addition to the A&P book I'd recommend a medical terminology textbook, not an essential but it couldn't hurt. Good luck to you!

I give more pain meds than most people I work with. Pain is one of the few things I can actually fix, so when I can, I try. I don't have a set dose, it varies with the type of injury and other things going on with the patient. I usually start with 2-4mg of Morphine and give more as needed. Our protocols do not allow us to medicate undiagnosed abdominal pain. If I think the patient is seeking and is a patient of our medical director, (they usually are as there is only one dr in the county) then I call the dr and ask for advice. I think it is best as prehospital providers that we err on the side of the patient.

I think everyone starts out that way, but then reality sets in. Sometimes I have the best job in the world, but sometimes I am very frustrated with patients and I think a career change may be in order. The positive attitude is great, but the frustrations will come. You will be aggravated by the people who buy cigarettes but won't pay for their kids medication. You will have people who fall out of bed and call 2-3 times a day for help getting back in. You will have people who are ungrateful or are rude. When you get frustrated or are feeling like you aren't making a difference you have to hold onto the good times and remember the patients who are appreciative. Yesterday I was transporting a patient who I felt wasn't exactly friendly, but my nature is to kill them with kindness...so when we got to the ER after a 45 minute transport the patient thanked me for being so kind and putting her in a better mood. Those are the things you have to try and keep with you. They make the bad times a little less bad.

I also had a problem with the oral stations. The first advice I would give is to right down the info they give you and continue to refer to it. Scene safety is a big thing that you need to address. It was hard for me to treat without being able to see a patient. Lots of scenario practice helped me. Good luck!

I have run into this scenario multiple times. As the last option we would load the kids up i the ambulance if we had car seats to secure them. Yes, its less than ideal but if it is the only way to get the patient treated then it has to be done.