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Reddfrogg

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  • Location
    Western Colorado
  • Interests
    History, archery, embroidery,
  1. I'v been a medic for nearly 20 years, but I ran across a rhythm recently that I can't really identify. At first glance It looks like a A fib with bradycardia, rate in the 40s to 50s. But there are definite P waves, which are irregular, and seem to march through the complexes. The QRS complexes are are irregular and 0.172mm wide. Has anyone ever seen something like this?
  2. 1 I tried an IV before I went to IO 2. I love dealing with peds patients 3. We were just driving by the college sunbathing spot for driver orientation. 4. No, really, I was sick the day of the big concert/rodeo/fair/political rally 5. I'll finish that PCR first thing in the morning. 6. You'll love the night shift, everything happens during the day. 7. This is an old family recipe. 8. I always get my IVs on the first stick. 9. Sure, I'll work a shift for you if you work this Friday night for me. 10. I'll drive this time, you can drive the next call.
  3. For those who are following this, the patient I was discussing, did get D50 rectally, according to the crew that were on the call. She did improve, and signed out AMA at the hospital later that day.
  4. The person I was talking to wasn't my preceptor, just a colleague. We were discussing a recent case where the crew were unable to get an IV line on a brittle diabetic. In our service we don't carry glucagon (I'm working with the EMS director to change this, if possible) and I commented that glucagon would have been an option at that point. That's when she brought up that she had heard that glucagon could be harmful if you aren't able to get an IV after administration. That's why I brought this up to the forum. Incidentally, I'm male, not female. Mr. Dana J. Tweedy, NREMT-P
  5. The concern, as I understand it, was that if you are unable to get an IV, after giving the glucagon, that you may not be able to give any further forms of glucose. The way it was put to me didn't make a great deal of sense, as I've been doing this for a while, and I've never heard of any such concern with glucagon before.
  6. I was discussing the use of Glucagon in patients without IV access at work this morning, and I was told that there was a danger of giving glucagon to a hypoglycemic patient when one had a prolonged transport time to the hospital. According to the person I was speaking to, if you give glucagon and can't get an IV, you run the risk of depleting the person's glycogen stores, and (in her words) "Killing the patient" if you have to transport for more than a few minutes to the hospital. I've been an EMT for 26 years, and a paramedic for 12. I've never heard of any significant problems with giving glucagon to hypoglycemic patients, regardless of transport time. I realize that first choice is gaining IV access and giving D50, and all our protocols say to give D50 IV as first line. However, as everyone has seen, sometimes it's impossible to get an IV in the field on some diabetics, especially those with kidney failure, and have shunts. Is there anything to the concern this person raised? I promised that I'd check further into this matter. So far nothing I've read indicates that it's a problem with using glucagon when an IV is not possible. Any comments would be appreciated. Dana J. Tweedy, NREMT-P.
  7. in my service, in western CO, we can give Narcan IN, and Fentanyl IN. I've given Fentanyl IN, when I the patient refused to let anyone touch her before she got some pain medication (dislocated shoulder). After the IN Fentanyl, she allowed us to get an IV, and she got the second dose of Fentanyl IV.
  8. I work for a third service EMS company in western Colorado. Recently the local fire district (mostly volunteer) has been interested in taking over EMS operations. The EMS company is a paid service, with some per-diem staff, and some full time medics and EMTs. Does anyone have any experience with merging an EMS service into the fire service? I'm thinking at this point the structure of the EMS company would pretty much stay the same, but fall under the umbrella of the fire district. Presently the EMS company is funded by grants, fund raisers, and billing. Any information or stories (good or bad) would be appreciated. Thanks for your input.
  9. I was working ALS, we got a call to a doctor's office for chest pain. My partner and I walk in with the stretcher and hear from down the hall, the immistakable voice of an AED " Stand Clear, Analyzing Now" We hurry inside the exam room to find the patient sitting up, looking around apparently in no distress. Pt is alert, oriented, and obviously has a pulse. He's got an NRB mask on, with the bag not inflated. He's got AED patches on his chest, and the doc (or maybe PA, or Nurse practitioner) standing beside him. Fortunately, the machine says "No shock advised", and we take the pads off his chest. My partner asks "Why is he on the AED?" The doc replies ''Oh, just in case" In the mean time, I'm looking at the O2 flow, and I notice it's set to 2lpm! For the sake of the patient, we got him out of there. He was discharged later from the ED, with non-cardiac chest pain....
  10. As someone who has some firsthand knowledge of the case, I have to point out that it had nothing to do with "hurt feelings" on the part of the EMS crew. The crew didn't "break in" but were led in through an open door by family members. The EMS crew followed refusal protocol, and contacted med command. It was the actions of the father that raised concerns, which resulted in Social Services being called. Also, the EMS crew did not request a SWAT team. It was the local Sheriff who authorized the SWAT team, after Social Services workers, and his deputies (serving a court order) were threatened. Don't believe everything you read in the press.
  11. Find a picture of a IV training arm.
  12. picture of a sprinter ambulance
  13. Ok, how about an autographed picture of Julie London as Dixie McCall.
  14. Now find a picture of Johnny and Roy
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