DFIB

Dads with daughters can fix it as well, It's cool.

Im 44 and just finshed EMT. It's good to know I'm not alone. Welcome

Thanks. I will be interested to hear what the health food professionals say. The juice was fresh so I didn't have the benefit of a label. And she has testicles.

New talent! Wonderful! Welcome

Chuck doesn't look enough like God.

Very interesting. Possibly a mild flush. I have overdone niacin before and it was very different? I thought i was going into anaphylaxis. Scared the crap out of me.

I would agree with Mobey as to giving Dex. I will let you medics and Docs hash out the Epi discussion. But if she is not presenting tachycardia why not administer Epi? I would like to know her breath sounds and labor of breathing are like. Was her tongue the only location of swelling? What was the color and texture of the tongue like? Was there any evidence of trauma to the tongue or insect bites? Scorpions can cause glossitis? Does she have a history of hyperthyroidism or symptoms suggesting undiagnosed thyroid disorder? If so, could her cardiac condition have precipitated Myxedema? Would sedation and establishing a definite airway be a consideration in this patient? Am I overthinking this scenario?

I would wonder if the patient presented any abnormal discharge, bleeding or foul vaginal odor. I would also want to know the quality and frequency of urination, Does she present hematuria? Dysuria? Has she had intercourse since the childbirth or inserted anything into her vagina? Tampons? Although unlikely it is possible. The fact that she was afebrile would be worrisome as well. Definitely a case for a good workup.

I wrote that report in the USA. My clinical supervisor had requested detailed reports. My EMS lawyer friend seems to think detail is the key to surviving potential lawsuits. Down south there isn't a narrative of the patient care. PCR reports here are just a bunch of boxes to check and fill in. Most EMT's are more concerned with detailing that they didn't steal the patients belongings than a narrative of his condition because the police will routinely pillage the patients belongings in MVC's and some EMT's do as well. My crew does not participate in pillaging because they are handpicked for honesty and professionalism and I will have their heads if I find out. I once stopped the ambulance and left the offending EMT on the side of the road to walk home because I saw him palm a ring at an accident. I was very disappointed that they only suspended him for 3 days. They didn't ask me to justify my action because I was ready to punch anybody that sided with the offender. They do act right when I am on call since then. I like your perspective and will most likely give it a whirl and see how it works for me. Thank you for your input

Sounds like this call was a nightmare from begining to end. As far as not recognizing the patient, who would know what MJ looked like when he was relaxing at home and not wearing makeup? I have an interesting anecdote and am not trying to hijack the thread but I think it illustrates my point about recognizing MJ. This is not a racial statement and I will not respond to the trolls that may try to hijack this thread. I was watching a Janet jackson video a few years back when my son (he was about 13 years old then) entered the room and asked who was singing. I told him it was MJ's sister. He responded "I didn't know Michael had a black sister" This was a normal conclusion for him because I have an adopted sister who has very dark skin. I find it inappropriate that the court would focus on a scribbled note instead of the PCR. Is a scribbled note now a legal document that can override the validity of the PCR? What will they use next, vital signs off the back of a soiled glove?

No philosophy degree but human nature and our tendency to self destruction has always been facinating to me.

Here is a narrative from my first clinical rotation on the ambulance. Vital signs re not included because they were logged on a seperate sheet that I did not retain a copy of. I remember that her BP was aprox 180/90 initially and dropped to normal ranges after 5 minutes. Spo2 98. ECG unremarcable. I try to give a good narrative because it could be years if it goes to court and I probbably wouldnt remember the details. This is not given as a example put to seek a critique. So please let me know what you think. Medic 2 is toned out at 16:57 to a unconscious female that is breathing. We arrive to a expensive ranch house where many people are gathered on the front porch. Scene is safe. We are escorted to the living room where a young, athletic female is sitting on the couch in obvious pain. Chief Complaint There is a woman sitting next to her that sais “She fell and hit her head” “They carried her to the house” History The patient was at a company party and was riding a horse when the horse spooked and she fell on her face impacting on her forehead, the ground was hard. She denies loosing consciousness. “I did not pass out, I don’t know why you were told that I passed out”. “I stood up on my own and developed neck pain almost immediately” She was carried to the house by the carrier placing his arms under her gluteus maximus and picking her up vertically. She is taking no medications and denies allergies. Ingested a hamburger and two glasses of Coca Cola two hours ago. LMP 08-31-2001 Assesment The patient is alert and well oriented. When questioned she declared “ My name is XXXXX, the president is Obama, today is Saturday and I fell from a horse. Airway Breathing and Circulation: Airway and breathing are intact. Head She presents a bruise that is forming on her forehead and across the bridge of her nose. Raccoon bruising is beginning to form. Head presents no deformities other that the bruise. There is no liquid from ears or nose. Pupils are round, equal and reactive to light. Neck Cervical spine is tender to the touch but has no deformities, contusions, abrasions or penetrations. There is no jugular vein distention and the trachea is midline. Thorax Anterior thorax shows no deformities or pain but the patient complains of pain upon palpation of the vertebrae around T4. Breath sounds are clear and bilateral with equal chest rise. Abdomen Is soft and non tender. There is no echimosis or guarding. Pelvis is stable and non tender to palpation. Extremities. Patient complains of extreme pain in her lower arms and tingling in her fingers. Pain is 8/10 on a 10/10 scale. Pain in her thumbs bilaterally. The fingers in her right hand are in a cramped position flexed over the palm. She can move her fingers with effort and pain. Pulse, motor, and sensory function are present. Radial pulse 98, strong and rythmic.Lower extremities present no abnormalities or pain. Pulse, motor, and sensory function are present Transport. C-spine is placed while patient is sitting on the couch. The patient stands and sits on the stretcher but complains of severe neck pain when we began to lay her on the backboard. The maneuver is suspended and the patient is immobilized with the KED. And transported in the Fowler position. Patient receives oxygen via a nasal canula at 4L/min and Fentanyl 100mcg intra nasal. IV is not attempted because of the extreme tenderness in her extremities. She is transported to Memorial Herman in Katy Texas. Report is given, care is transferred with patient immobilized in the KED and signatures are obtained. Medic 2 returns to service at 18:21.

Folks in Mexico drink lots of fresh vegetable juice. There are fresh juice stands everywhere. They make all kinds of combinations, carrot, orange, alfalfa, beets etc... you get the picture. They have chitlin stands also. Chitlins are a Sunday delicacy. I pass on the chitlins. Beet juice is high in iron and doesn’t taste as good as most other fresh vegetable juice but looks like fresh ground placenta will make you think you have dysentery the next morning. I guess I will pass on the red stuff next time.

Recently after drinking a large glass of raw beet juice I began to feel a little dizzy, with numbness in my lips. I can't seem to find a reason these symptoms. Could it be a drop in BP or is there some substance in beets that makes me loopy? I have heard of people having sincopal episodes after drinking consentrated beet juice. Any ideas or knowledge you could share?

I honestly dont know if I would have the guts to do what you describe in your post. Your determination gives me hope for the human race, Stay strong. Be proud. Move forward. I wish you the very best.

Bienvenido Amigo!

MJ?

I have learned valuable lessons in PCR from an istructor who is a paramedic and an EMS lawyer. His main point to me is to use as many of the patients words as you can instead of simply stating fact. It is difficult to do and I have not mastered it yet.

Spousal responsiveness is not the issue for me. It's about being a man of my word. Especially to someone that has been my friend and lover for all these years. When I give my spouse my word it is still mine but is in the care of the receiver. It is a gift, given and received. I would consider myself less of a man if I tried to take my word back or re-nig the promises delivered. Aristotle considers that men fall into ethical breaches either because they are weak and decide to do break their ethical code or impetuous and breach their ethics in an act of passion. The weak feel guilt during and after the breach where the impetuous only feel guilt after their passion has been consumed. Aristotle seems to believe that pleasures compete with each other, so that the enjoyment of one kind of activity impedes other activities that cannot be carried out at the same time. He states that although some pleasures may be good, they are not worth indulging when there are other pleasures that are far better. So, if I were going to be entirely selfish I would have to say that indulging in a passing “cheating” pleasure would negate for me the greater pleasure of faithfulness and good will towards my friend, in this case my spouse. The Bible says that laying one’s life down for a friend, we could presume negating self indulgent pleasures, is the greatest form of love. Requital is inconsequential.

Dwayne, I may be way off base on this but when we marry we agree to a certain code of conduct. This code of conduct is set by our family morays, religion, ethics and the general societal consensus of our region. I'm sure there are more but you can see where I am going. Cheating in a marital sense to me would be defrauding my spouse by giving any other person something that I have promised only to my bride. This would include emotional or sentimental non physical interactions as well. Phone sex, and telling another person you will give them emotions you promised to your spouse would constitute cheating for me.

Welcome Cheryl, Jump right in. There are a lot of very experienced and smart people that share info freely.

Thanks Dwayne. Always the encourager. I haven't been out of basic that long but I am getting on up there in age. It is an old fart camo avatar. I could change my avatar to something that is more stimulating to your areolar smooth muscle but I will leave that to the Doc and his Weiner Pics. The Avatar is kind of cute though. We were making a small first aid manual for some local classes and I needed a spacer picture for airway evaluation till my model could arrive from school. So I grabbed the mutt and took a picture. The pic with the airway model is soooo much better. Dwayne is right ERDoc. I look forward to your post. I true learning experience every time. Denny389 keep in school buddy. Basic is a good place to start but if you really like EMS keep going. The more you know the more rewarding it becomes.

Yep, Things are a little different south of the border. I just hope it doesn't become irrelevant in a forum such as this.

Old Mexico 180 km SW of Tampico.

Ruffems - I bought my pulse ox on Amazon. No Rx required. A lot of folks with COPD are using them at home now. As far as carrying extra gear in my personal vehicle, any accident I see will invariably be 25 - 30 minutes before the ambulance arrives. Some of the equipment isn't mine but the local EMT school lets me carry it when I travel (KED, Splints)My jump bag is pretty basic kind of like UglyEMT's. Local LEO always want to help but have no EMS training so it is good to have someone around that can help them "not hurt the patient" with good intentions. I don't think any of you guys are mackin' on the ones that do carry gear. Everyone’s situation is different, call times, transport times and community expectation change by region and environment. If I roll up on a MVC and someone is already "working" the scene I try to get a verbal transfer report if I am a higher level of training. If the first responder is a medic I will try to get him to hang around and help. This is highly unlikely. The closest EMT-I is probably at least 800 miles from my AO. I don't automatically think the first responder is a tool, especially if he has invested in his own gear. He may prove me wrong but I try to give the benefit of the doubt.