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ORmedic65

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About ORmedic65

  • Birthday 02/16/1990

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  • Occupation
    Paramedic

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  • Gender
    Male
  • Location
    Oregon

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  1. It makes absolutely no sense to me to tube a patient and not provide some sort of sedation afterwards, especially to those that need it. In my opinion, it's cruel, inhumane and just plain negligent to intubate a patient without providing the appropriate sedation/paralysis before and after, especially if they're already fighting the tube. The whole worry about "wiping out their respiratory drive" is ridiculous to me; I mean, once you've intubated them, you're already at the end of the protocol so to speak. You've intubated the patient because they weren't ventilating well enough for themselves, so why be worried about wiping out an already insufficient respiratory drive? If you're going to be taking over someone's airway then you must be prepared to take it over completely, or not at all. At least that's my opinion on the matter. I'm not going to begin to critique your last call, as I was not there, however, I will say that it sounds as though you have the right idea about airway management. Good post.
  2. In this situation I would have taken the most critical on the stretcher, and the other would be on a backboard, strapped down to the bench. I've taken two patients in one ambulance multiple times during my short time in EMS so far, it's not all that uncommon around these parts. We actually had a car wreck last week with 6 patients, only one critical, where our backup unit was able to take 2 patients, we took the most critical, and fire transported the rest in their rigs.
  3. Huh, I remember seeing something about this on the NREMT's website the other day, but I wasn't real sure what it was talking about. I would really love to find some more detail on what the transition courses will entail. EDIT: If anyone is interested, I found this video that gives a little detail about what some of the changes for the different levels will be. Click
  4. I can only somewhat relate to what you saw Mike, as I haven't been in the field that long. However, I must say that acts such as these disgust me; these are the people that our patients and other healthcare providers remember when they think about EMS, they don't remember the ones who took the time to take care of their appearance, or who were courteous and polite, no, they remember the filthy, cocky, poor excuse for a "paramedic". I just don't understand how someone can come into work and somehow believe that it's alright to be unkempt and rude, if you're not going to even make an effort to take care of yourself, how can your patient trust that you are going to take care of them?
  5. I've never seen it done, and I've never done it myself. Our patients deserve the same quality of care across the board, and that includes fresh linens. It's that crews responsibility to make sure their rig is stocked, which includes linens. Now I can kind of understand if they've been running back to back calls and ran out of fresh linens, but really, they should have at least picked up some fresh linens after they dropped their last patient off.
  6. I guess I'll try to add to the discussion a bit. I must say that at this point in career (the very beginning) I'm kind of neutral to my systems RSI protocol, I don't really have enough experience to thoroughly critique it just yet. That being said, my systems protocol for RSI gives us the option of using either Versed or droperidol for pre-sedation, and of course we have the usual options of atropine for peds or lidocaine for ICP. Then we just recently replaced Vec with Roc and no longer have the option of a defasiculating dose. We use succinylcholine for induction of paralysis, and then Roc for continued paralysis with a maintenance dose of Versed for continued sedation. Our backup airways are the King and we also carry Per-trachs (which seem to just overly complicate what should be a somewhat simple task). Unfortunately we don't carry bougies. We do have waveform capnography. I would like to see our medical director bring fentanyl and Etomidate into the mix, but it seems that we've been trying for while and he just won't budge. Like I said though, with my limited experience I'm not really in the position to make a push for any changes in our system, especially only have a few RSI's to compare. Question, does anyone else have a protocol for doing RSI via the IM route?
  7. Yup, you were in fact judging by implying we don't care enough...however that is not the issue here. The problem is that you gave someone a medication that was not indicated at the time, and you did so without considering the implications of said action. There was a very high suspicion that he had a chest injury that caused the SOB and chest pain, however you gave him his nitro without considering that the chest pain and SOB were caused by the trauma he just suffered. You're not an EMT and you acted outside of your scope of practice, there's no two ways about it. It's great that you want to help and that you want to learn everything you can, but you need to take it one step at a time. Focus on reading your EMT-B book and put down the paramedic book, turn off the scanner and appreciate your down time, if you get employed in EMS you'll find it to be a rare commodity. You asked what you did wrong and we told you, we're not trying to be dicks, we're just critiquing you, learn to accept criticism in all its forms or your time in EMS will be short-lived.
  8. I'll second that, this is not the day for either of those two. First of all, it's legal to assist someone in taking their medication if you're an EMTB, which you are not. Ergo, your point is invalid. Second, don't try to make assumptions about the kind of people we are, it's rather arrogant and reflects poorly on you.
  9. I would imagine that there are places a lot closer to him where he could run through the skills stations, rather than flying all the way across the country. I just took my practical at NCTI in Roseville and I personally found the review day to be pretty useless as far as tips/tricks went, they seemed to spend more time giving my classmates and I a hard time about being from Oregon, than they did actually instructing us. That being said, some of the instructors were pretty cool and it was nice to run through the skills stations one more time, but there are probably places a lot closer to Florida that will prep him to retake the practical. For my practical I had bleeding control and shock management as the random BLS station. I imagine the other stations haven't changed a whole lot since you last took it, but definitely look over the skills sheets from the NREMT and make sure you know them. Honestly, as long as you can run through the skills sheets you should be perfectly fine, the only stations that require a little more thought are of course static, dynamic, oral, and trauma. For static and dynamic, make sure you know the current ACLS guidelines by heart and can run through the algorithms confidently. For oral, verbalize everything you can, delegate duties, treat all life threats first, and don't focus so much on nailing down the exact diagnosis, but rather what the general pathology is. If that makes sense? Then for trauma, it's really pretty straight forward, just do a manage life threats, do a RTA, transport and finish everything else up there; keep your on scene time short for trauma. That's the best advice I can give to ya.
  10. That was my initial thought as well, I mean it has all the workings of a good whacker story. However, if that's not the case then I think everyone else summed up what you did wrong, and I'm not really one to be redundant.
  11. Hahaha, you did a nice job on that JPINFV
  12. Eh, the billboards might be a little too much, and like someone else said it's almost like Georgia has crossed that bullying line. However, it is rather obvious that childhood obesity needs to be addressed, whether or not this is the way to do it remains to be seen. Removing the pictures from the billboards seems like it might be a good idea, because this campaign does have the potential to increase bullying, and hopefully that risk might be reduced a little bit by removing the pictures.
  13. You might be over thinking this a bit too much. I understand your desire to want to be "perfect" when you start, but your partner should understand if you are a little slow at mapping to begin with. Are you working for a BLS company or ALS? If it's ALS then I would imagine that you would be driving and your partner would be mapping, in which case you have a little less to worry about.
  14. My favorite snack? It's got to be between Nutella on a banana, or dried fruit
  15. Thanks! Yeah, as a general rule I try to stick with an opinion that I can justify lol
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