medik8

Wow...I'm glad I'm not a tall, skinny white man with a pack of Camels in my pocket that lives anywhere NEAR your guest instructor...holy crap! :shock:

It certainly sounds that way. Hmmm...you say he has performed exceptionally well in the past? It's hard to imagine a medical director "de-protocoling" someone for "lack of confidence" over one call...there must be a history with him of some sort...either that, yeah...or a personal problem. It's hard to say.... Wow... :shock: I hope I never get "de-protocoled"...lmao

It's ok Dwayne.... :wink: Thanks for your pm....I appreciate it... 8

Yup...I'm serious... :shock: I'll do it on cam..next time I'm on.

Dwayne...first off...thank you for your kind comment about me. Yes..I'd love to take care of your little one...it would be an honor. However, chances are that I won't...considering our locations. lol... But for the record, if I was, yes...I would do everything I could to ease his apprehension and protect him until he could be with you. However, keep in mind that before this, or at least along with this...comes whatever medically would be necessary for your son. That would be my first and foremost concern. Sometimes, the compassion accompanying medical care doesn't seem so compassionate at the time, especially depending on the situation. These types of situations are difficult. Most likely, I would recognize his condition after a short time with him, as I have taken care of autistic children and special needs children before. I have had 6-7 years of Peds only experience in the past, so I've seen a lot. This is a scary situation...and unfortunately you can't really prepare him as you could any other child, to not be scared, or to cooperate should this happen. First off...start with alerting your local EMS, (or the ones along his bus route) about him, and about his condition. Discuss his needs. It's important that they know. I have had parents of two different special needs kids approach me with all their info, should I ever have a call for them. I have also met these children. It doesn't mean that I'll always remember should something arise that's not at their home, but I may recognize later should it happen in this town. Also, any bracelet or necklace alerting to his condition, with your name and phone number, would be helpful. I'll do what I need to do under an implied consent blanket and my med control, however, it would be helpful if the parents could be reached before things like sedation, etc, are done. Would be very important to know his history, allergies to meds, etc...the usual stuff. God forbid this ever happens to him, but it's good that you are concerned and looking into this. I hate to tell you this, and I'm sorry to have to, but I have to be honest here. Chances are, should this happen, he will be scared and it may not be a pleasant experience...but in the end, I'm sure he will be ok. You can give yourself some piece of mind to help identify his disabilities, and to promote awareness about them. I would start there... If there's anything else I can help you with, please ask or PM me. xoxo. :wink: 8

:roll: I can almost lick the point of my elbow...I'm about an inch shy....working on tongue-stretching exercises....either that, or trying to contort my arm a little more. I'll probably end up popping it out of socket. lmao. But, I'll still try....it's amusing. ( Can you tell I'm bored...?) I can also make my tongue look like a flower... :roll: WOW....how is that for my 200th post? lmfao

:wink: OMG! :shock: Do women in Texas not have big hands? I thought everything was big in Texas? :wink:

ok...well after you look it up, I will be happy to discuss...Glad dust was quick...I almost fully explained...lmao... 8

Most often...it's due to hyperkalemia...

Jake.....I knew you would understand me, even if no one else did. LMAO. *XOXOXO* :wink: I don't get the "conservative" narcotic approach....if you have the ability to make the pain go bye bye (provided there are no reasons not to...).....then let's get on it....what are we waiting for? :roll:

:shock:

I'm pretty aggressive....I say...you hurt? I'm your Dr. Feelgood. lmao. I get a kick out of seeing their eyes roll around and their mouths go....MSedklfjasd;lkjfwepoijfalkdjfadkl;jf.... That's good stuff....right there... On a serious note though...if the patient is having pain, I say go for it. BTW...(I've had about 10 glasses of wine as I write this to dull my own pain....so.....forgive me if this makes no sense. LMAO! :shock: xoxoxo *8*

You're very welcome. :wink: 8

Holy crappies.....I didn't think of that....! You're absolutely right....pain at rest, sharp in quality or at least...bad..., history of hypertension, shock like appearance..... I think we have a winner....in fact...I would bet money on it. (as long as we're talking serious here... This certainly fits.) Good Job...flight-lp :wink: (And if it turns out to not be this (on a serious level)...then excellent guess just the same...)

Tiff...honey....I love Dust too...but what have you just done? :shock: You have created a very large monster....lmao... :wink:

Any previous history of this or anything like this happening before? What about a temp? Do we have one of those? Warmth or erythema at site? Hmm...pressure is a little high, but that could be due to his hx of hypertension...but with tach...hmm..What has he been doing the day or two before this happened? Any recent illnesses at all? Has he ridden a bike lately? Any abdominal pain with this? How about low back pain (kidney). Is the pain worse/better if he sits or stands? I already said thoughts of torsion or testicular ca are in the mind. Umm..could be simple testicular inflammation (orchitis), maybe has developed an abscess....but....I'll wait for your reply on the above...before I comment further... :wink: 8

Quite a pleasure, Dwayne. :wink: lol.

I own this book....it's great. :wink: Also, it may be a little beyond what you are looking for, but Mosby's Paramedic Refresher and Review (A Case Studies Approach) by Alice Dalton and Richard Allen Walker, M.D. is excellent, as well. It has great scenarios, and then walks you through step by step giving you the scenario, assessment results/findings, and asks a multitude of questions about the scenario, questioning you about things you may have forgotten, and then explaining why you need to be thinking this way or looking for this stuff. It's been a good refresher to pick up and read from time to time. I've recommended it a lot...it's about $35-40. Well worth it.

Doc...I don't know this guy personally, but I'M thinking that HE'S hoping that YOU are NOT thinking he has Fournier's Gangrene.... :shock: lmao. YIIIKKKIESSS!!! Ummm....yeah....patient history, recent injuries to the balls/groin area...(pissed his wife off lately?), how long has he had pain? Was it sudden or been going on a while?....testicular pain could be a number of things...some that come to mind... Torsion, CA, oh...and then there's that Fournier's Gangrene thingamajig... :roll: lol. Interested to follow this one...Can you give us his history and let us go from there....anything significant? :wink: 8

see...that is funny...right there... Can you say, idiot?

LMAO...I'm reading all this crap as I'm munching on a yummy cheeseburger and fries for lunch. MMMmmmmmmmmmmmmm.....:dontknow: It's amazing how some things bother you, and others don't. Guess ya get hardened after a while. Depends on the situation. Like I said earlier in this thread.....those were my bad ones. BLECH. :pukeleft: The vicks thingie....I use it ALL the time. Every time I have stinky situation...I use it. It works great!!! And, if you can smell the stinkiness through the vicks...you KNOW you have yourself a real winner! :wink:

Pt has the right to decide what they want. If I suspect spinal injury...will try my darndest to talk them into the full package. If they refuse...document. That's all you can do. If they "need" the c-collar.....they are getting the board...and that's exactly how I put it to them. "These two things go together. It's not an option with me, to pick just one. If I let you do that...then I'm not doing my job to protect you. Do you understand what I'm saying?" 95% of the patients sit there a minute looking dazed.....think....and opt for the full treatment. Sometimes it just takes a moment to get them to see the whole picture. Patience is a good thing sometimes. xoxoxo 8

We all deal with things in our own way. There is no "right" or "wrong" way to deal with your feelings. Some find comfort in laughing. It doesn't mean we are an insensitive or bad person. It is a sort of sick humor, but if it works and helps you cope, then so be it. There are times that if I didn't laugh, I wouldn't be in a job anymore. This profession is not easy on any of us at times, but you have to cope, and whatever helps you do that is right, even if only for that person. I won't go out of my way to make comments to hurt anyone's feelings, and would never do so intentionally. But, there is also the reality that people don't know what is in your mind, or what you are overly sensitive about, or what turns your life has taken. Most of the time, we have no idea what each other has been through. So, you can't hold it against them if something is said that rubs you the wrong way. It's happened to me on here...tough time for me...someone said something...brought back bad feelings... I had to get over it. That's life. :roll: Meh...I cope with whatever way works for me. If it means to cry and then 5 minutes later to laugh my ass off....so be it. I wont judge others for how they deal....don't judge me. xoxo 8

LMAO @ Asys....Those are excellent! Unfortunately, I can't use them if I want to keep my job. However, close to retirement, and the more agitated I get by these people, will probably let one fly at some point. I'll think of you when I do. I give one warning...then have the police remove the person from my sight, before I kick them. I hate interruptions, distractions and unnecessary crap going on around me. Just like I've learned...if there are a ton of friends, people, or family members, and certain things have to be done on-scene, will get the patient to the back of the ambulance, if possible, close the doors, and let them knock all they want.