Hutsy

I've heard some toothpaste directly under your nostrils does wonders...

You need to upload the pictures to a website first (like say Photobucket) and then copy/paste it here, possibly with an -code.

Marc

Thanks for the great reply, Michael. That helped a lot. I have found that it is not necessarily the patient that gets to me, with one body part here and the next across the road, it's the sorrounding circumstances. How the patient's next of kin reacts to their loved one's injury/death/illness and so on. Will there come a day when I find myself laughing for no reason, or bursting out in tears?

Picture this. A young mother is at home breastfeeding her child. They came home from the hospital only four days ago. Dad just came home from work, and is standing in the hallway. Mom realizes the baby turned pale and gets worried. It is unresponsive and has stopped breathing. It's heart has stopped beating. Panic grips them both as dad rushes for the phone and mom bursts out in tears.

When I get there personell from the air ambulance are doing their very best to save the child's life. They're at it for over 90 minutes, to no avail. As they work on the baby I am put in charge of taking care of the parents. They are extremely worried and scared, obviously, and mom passes out at one point. They ask me what is going on, will their baby make it?

What do I tell them?

I've gone through this scenario probably a hundred times in my head, and yet I have no idea what to say, except, "they're doing their absolute best", or something along those lines. But that's not enough is it?

And here's the third. Torso hair is non-existant and sporting a pair of furry legs that bring all the female gorillas to the yard.

Holy shit, this thread got a lot of attention, I haven't even read it all. Looking at my own posts I now feel like an idiot. Go me.

Last week I learned that our patient did survive. It made me feel good.

I believe Stayin' Alive by the Bee Gees is the song you're looking for. This only works, however, if you take the patient's arms, move one of them down to the hip, and the other one pointing straight up...

it appears from your post you have some very valid things to contribute

This is exactly why I dont post much. I have just barely scratched the surface of EM and feel I have mostly nothing to contribute with. Baby steps... Glad to see my topic has piqued your interest though, keep it up.

Marc

Thanks a lot for your insight and for the links. My education begins tomorrow.

Ok does that make any logical sense to you ?

I have no idea, that's why I am asking. I heard some talk about it yesterday and it piqued my curiosity.

Thirty what? Mmol? Mg/dL?

mmol.

Do you know anything about whether blood sugar levels rise shortly after respiratory & circulatory failure?

Yesterday one of my supervisors said he once measured the blood sugar of a patient to 30 shortly after he went into cardiac arrest, how could this be?

Marc

I must say I don't get where you're coming from after I've looked at the sheer volume of evidence supporting the claim that Breivik is, in fact, a Christian terrorist. He fashions himself a "cultural Christian", if you're about to dispute his own claims and the facts provided from several sources including his manifesto and general policework, go ahead. As for Bill O'Reilly, it does bother me slightly that you're getting your so-called facts from a man who has repeatedly been exposed as a liar, who when confronted handles the situation by raising his voice, shouting and rambling nonsense. Plead your case.

Marc

I can try.

It's a beautiful summer day in Oslo, Norway. Out of nowhere, a massive fertilizer bomb hidden inside a van explodes outside the office of the Norwegian Prime Minister. As a result of the bomb, eight lay dead and dusins are injured. Little does anyone know, the mayhem is far from over. Just under two hours later, the bomber, later identified as Anders Behring Breivik, sets foot on the picturesque island of Utøya, and systematically guns down and kills 69 teenagers attending a youth camp for the governing labour party. Breivik was wearing a police uniform, to avoid arousing any suspicion. After waving some kids over to him, he pulled out a gun and executed them all at point blank range. Panic starts to emerge, and people are desperately trying to find a good hiding place or escape from the island. Breivik is calm and looks almost content, eye-witnessess say. He never runs, or shows any sign of remorse, as he walks up to person to person, and pulls the trigger. He views himself as a soldier, a crusading Christian - a Knight's Templar, out on a mission to cleanse Norway and Europe from Muslim immigrants. And according to him, the "necessary" attack on Utøya, is just the beginning. Behind him he leaves a rambling 1500 page manifesto, which he calls The European Declaration of Independence. It's his blueprint for a ruthless terror campaign for a muslim-free Europe, and to punish those who encourage multiculturalism, especially the governing labour party. After 90 minutes an anti-terror squad from Oslo arrives at Utøya. They find dead bodies scattered everywhere, people are screaming in agony and in shock, but as they find the killer, he meets them unarmed, both arms raised above his head. He is arrested and now sits in isolation.

And that's it, basically. There's a lot more to learn if I've piqued your curiosity. Watch the video when you can, and do some Googling.

Marc

http://www.youtube.com/watch?v=Hb0a3aG1XbI

While Glenn Beck compares the victims of Utøya to Hitler-Jugend, Bill O'Reilly claims Anders Behring Breivik is not a Christian...

85 is the official number now, there are still people missing from Uteoya, so the total death toll could be over 100. The buildings in the gov. district may have to be torn down because of structural damages. They think the bomb might have been a 500kg fertilizer bomb.

Just in: 80 confirmed dead at Utoeya.

I look forward to hear what his motives were.

http://www.bbc.co.uk...europe-14256712

Seven people confirmed dead from the bomb in Oslo, ten more severely wounded. At Utoeya at least ten people are dead, several wounded and the death toll is expected to rise as they search the island. A 32 year old Norwegian (native) has been taken into custody following the massacre at Utoeya. He had dressed up as a police officer and lured people towards him before opening fire with a rifle and a handgun. A witness claims the number of deaths could reach up to 30 at the labour party youth camp at Utoeya. There are reports that there were around 600 people on Utoeya, some as young as 11-12 years old. 38 people have been treated for gunshot wounds at Ringerrike hospital.

I've been glued to the television since the first reports came in, the gunman is also linked to the bombings.

Edit: Wrong section perhaps. Oslo's ambulance service has dispatched each and every available unit to Utoeya and where the bomb(s?) went off in the capitol.

Agreed, I find it very insightful to read about the thought process you go through regarding patient treatment and everything else, only shows how much I have yet to learn. It's things like these I try to bring with me.

Marc

You are working with your paramedic partner in a small town just outside the big city of the county you work in when you are dispatched to a moped accident. It is around 2300, and you respond lights and sirens to the intersection of a street with no traffic on it where you find the driver of a moped lying supine in the street. The moped is about twenty feet away with no major damage, however from the truck you can see that the patient's face is covered in blood. You are first on scene but can already see the BLS fire units' lights in the distance.

Go!

I'll give it a try.

Check his vitals and go from there, is he responsive? Possibly you'd need suction first and then provide respiratory assistance? Reacting/not reacting to pain? Check for cranial trauma... Put a collar on him and depending on his condition get him on a backboard.

Is that what you wanted?

Louis CK on Jay Leno talking about why he stopped smoking marijuana, made me laugh out loud so I thought I'd share.

http://www.youtube.com/watch?v=9JkbYJgW0mo&feature=related

Noticed I wrote thrombosis instead of tamponade. When I was discussing the case with one of my peers I got laughed at because I didn't realize I said trombone instead of thrombo- er, tamponade.

@Ruffems

I am no medic just yet. But thanks for the heads up, it's what I'm here for.

And for the record I am in no way supporting abandoning a patient.

What would the repercussions be for you if you had kicked her out and rushed to the other site?

If say this had happened to us we'd have gone, 'she can wait'. I asked a coworker of mine what he'd done if say we were taxiing a 90 y/o home from hospital (just an example). He said, "I'd take her with me". If there's one thing I've learned so far it's that things aren't always black and white; if rules & regulations stand in the way of patient care - screw 'em. On one of my first days I was sitting in the back as the 3rd man, we were on the highway on our way back home, the guy driving had not taken the test you need to take to be able to drive code 3. He got a bit nervous as we got a call in, but was told to, "just drive, don't worry - I'll teach you". If he had pulled over and switched sides with the other guy like he was supposed to, according to rules and regulations, that patient would probably be dead today.

I've also heard of instances where people have (successfully) "intubated" with one of these:

Thanks for your replies. Sounds like I was quite "lucky" to witness this so early in my career! I don't know whether the patient lived or not, though he was (barely) alive by the time we rolled him into the ER; Last BP measurement was at 50/30something. He was pale and a bit cyanotic. Best part is he was still awake.