BoCat9

Well, I passed Trauma with an 88. Special Considerations for a few weeks. Drug calculations test next week, so I really need to practice those, esp the Dopamine and Lidocaine drips.

Look for one with a fairly short thick tubing. I've tried a lot of different ones and I can hear the best with that kind. Also try using the "mushroom" shaped earpieces, they will fill your ears better and filter out a lot more background sounds.

No pacemakers or anything like that. According to my instructor, the guy who actually talked to the nurse, they did an ultrasound and a dopplar. The only places they saw any blood moving was in the brachial and carotid arteries. No heart sounds at all. No chest x-ray was done. They are doing an autopsy though. The guy was unresponsive, he would only sit up for a second or two before he went back down.

Initially I asked if they were checking a pulse with their thumbs, the instructor said "I hope not." Shot it the wind, but possible.

Ok, a little more info. Heart sounds were never heard. Pulse was during CPR and without CPR. No known medical hx. This is coming from the nurse at the hospital that worked on the pt. I really don't know what to think either and everyone has told me its not possible.

Please remember I was not on this case and I am giving you the facts as presented to the class.

Ok, a case was presented to us in class, actual call that took place sometime last week. We were told we could use any source to find the answer.

Ambulance service brings a mid-50 y.o.m. into the hospital. Found pt unresponsive, put pt on the monitor showing asystole. Crew checked a pulse, found a pulse in the carotid and brachial pulse. Pt cyanotic from nipple line up. HR ranged from 70-200, erratic. Pt had a BP or 110/70-200 systolic. Pupils dilated, nonreactive. Agonal resp, medics tubed the pt. Pt placed on 3 different monitors, leads and pads changed with the monitor. I monitor on the back of the ambulance, 2 monitors in the hospital. Hospital staff continued to work the pt for an hour and a half, each time they stopped to pronounce him, he would sit up, look around and then lay back down. Has anyone ever heard of this happening or have any idea what may have caused this?

Well, finally getting the hang of the IV's, so I'm happy. And I passed medical module 2 with a 100. Over the hump and now I'm feeling like I may get through this year! Woo hoo! Just thought I would give you an update. Trauma up next.

I was on a routine transport once and was taking a set of vitals and found out the cuff I was using had a broken gauge. I asked my partner to remind me to get another one before our next call, and she said "why, I'm not going to take any anyways". I lost any trust I had in her that day.

OK, I'm having problems with IV's. I can mainly get them in class and on people that let me use them as guinea pigs, but on my patients, I have a lot of problems. I got one on my first ride along day, but I have missed every one since, except the one I hit a valve on. It's really starting to irritate me. Maybe I just get nervous or something. Any advice?

Metaprolol can mask the early symptoms of hypoglycemia.

Name 2 or more uses for the KED.

I'll put it like my boss told my coworkers and me at a meeting. "I would like for you all to have a lunch break and we will try to make that happen, but sometimes it is not possible." We were also told to bring something small with us. Have a pack of nabs or even bring a sandwich with you. It will help tide you over until you can get something more substantial. Only worry I have is when my partner is a diabetic and we don't get a chance to stop.

Peace...

Found this on facebook, under paramedic tips and tricks, thought it was interesting...

Try some scenarios, esp. the things that you encounter most in your area. It may be that she freezes when she gets on scene and she just needs the practice in verbalizing what she is going to do. If you can go this far, maybe have someone play the part of a pt on a easy day. Actually have her do some things. Let her take the lead, some people just need that push. During my ride time, the medic on the truck said, on a stable pt, that both he and his partner were going to stand back and let me question the pt and do my assessment. Then the medic would ask me what I want to do, and as long as my treatment wouldn't be detrimental to the pt or totally off the wall, that is what the treatment would be. Then after the call he would ask me how I felt it went and then he would give me his feelings about it. Some people are just shy and need the push in order to get them jump started.

Also talk to your superior and see if she could ride third some in order to get her used to being on scene. If so, have the crew chief sit down with her and tell her his/her expectations. That way she knows, "OK, I will be doing this on the calls unless told otherwise." Hope this helps.

Thanks this will help me out a lot. Just because I passed cardiology I still have a long way to go.

At the place I work for now it really all depends on if there is a free crew for lifting assistance. I know our policy states both crew members need to be able to lift up to 150 pounds, but some are stronger and some are weaker. They also try to send two men for the heavier patients. Depends on the day and dispatcher.

It'll be rough, but you just need to budget carefully. Maybe get a roommate if you have enough room. I'm getting it done, and I may be the worst budgeter of all time. If you work for an ambulance service they may offer tuition assistance and they will most likely work around your school schedule since you are going for a higher cert level, just ask a supervisor.

I passed the Cardiology Module Exam today. I was pleasantly surprised, made an 80 on it. Thanks for the websites and tips. Now onto the 2nd Medical module. My brain is fried

Ok-

Check for signs of unsafe scene, i.e. fluids leaking, smoke coming from under either or both hoods, etc.

Check windshields for star bursts, lift airbags to check for bending of the steering wheel.

Triage-

Priority 1-

-Passenger of car due to severe pain. Did his legs hit the dash on impact? Pt will be transported in first BLS unit. Attempt to find translator.

-Driver of SUV due to Abd cramping and pregnancy. Pt's c-spine will be secured and transported slightly tilted to the left side. Pt will be transported in ILS unit to the hospital.

Priority 2-

-Driver of car, c-spine controlled with rapid take-down, transported on 2nd unit out due to elevated BP and complaint of head pain.

-Passenger of SUV, c-spine controlled due to complaint of neck, back pain. Pt transported on 2nd unit out

Priority 3-

-Infant transported in car seat with towel rolls on either side of head until c-spine injury ruled out. Transported with driver of SUV.

While waiting for back-up units I would check vitals and responsiveness again and depending on results order of transport may be changed. Also contact online medical control for orders for the passenger of the car.

All we were told in our class was that you could not be paid for any of the time you put down for "ride time" and you had to do clinicals at a facility that they had a contract with.

Ok, we're doing this in class right now, so I'm going to attempt this. I didn't look past the scenario, so I'm not just going but other peoples answers. Let me know if I'm right or wrong, please.

Ok, PVC's...

O2 first to try to knock out the PVC's.

Place the pt on a monitor, if the occurrence of the PVC's is less than 6 per min, no couplets, monitor the pt closely. Get IV access to give meds if necessary.

If PVC's are occurring over 6 times a minute or I see runs of PVC's I would look at the actual heart rate, if knocking out the PVC's would make the pt bradycardic, maybe try TCP? I'm not really sure. Don't want to administer Lidocaine due to possibility of additional bradycardia.

I don't know where to go from there, sorry.

Ok, I'm in my 3rd month of medic school and I've passed everything so far. We are in the Cardiac module now. Does anyone know of a good website or book that I can sit down and study with? I would esp. like some scenarios because I tend to understand things better when I have a way of applying what I learn to a situation. Any comments would be appreciated. Thanks.

Ok, I'm in paramedic class and we just started calculations. I need some suggestions on doing these, esp the dimensional analysis. Any websites or suggestions will be greatly appreciated.

Well, I've finally done it. I have passed A&P and have started paramedic school. It's gonna be a long year. It feels like just yesterday I was in Basic class in the chat room asking all of you for your help for the complicated stuff at that level. You'll see me on here a lot more often. See ya later.

Well I guess I should check things here more regularly. Congrats to all who won. Merry Christmas and be safe.

I had a rough call yesterday. A 5 y/o female was shot in the face, left upper lip. I just can't get the little girls image out of my mind. I need to stop second guessing myself, but I can't help but wonder what if I had done something differently. I feel like I froze up, couldn't remember what to do. Family as working her when we got there, but she was already gone, but we had to work her all the way to the hospital. How can I deal with this? This was my first bad pedi call. :sad11:

If this post is in the wrong place, feel free to move it. Any comments would be greatly appreciated.

Well, to answer the question, we've had a 450+ lb pt, 2 people to lift the f/w. That was really fun. Then we had a 350+ lbs regular pt where we usually had 2 people to lift.

I am morbidly obese, which I am embarrassed about, but I am not letting that keep me in the house. I love my job and I do it well, and as long as I can still get around without hurting someone or something, I will keep it up.