snapdragon

Any time a person starts a new medication there is the period of time where you watch for reactions, no matter what it is. How many of us have been called out to a possible allergic reaction to a new med? I have many times and it really isn't a true allergic reation but just one of the side effects.... A few years ago I finally was diagnosed with trigeminal neuralgia and was put on Neurontin (gabapentin), an antiseizure med that is also used to control pain connected with nerve damage. HOLY SH.. that stuff knocked me right off my feet. I knew that I couldn't drive let alone work during the "getting used to" period let alone work. I never did get over the horrible side effects so I stopped taking it.

For the Medics that have taken care of themselves and gotten help, there is NO shame. Thank you for being the strong one and getting the help you needed.

I have worked with medics that were taking antidepressants and I currently work with one. I have never seen any reason to doubt their judgment or treatment. You would be totally shocked at how many "normal" people take antidepressants.

Okay, I have tried to read through all 5 pages of replies with an open mind but sorry folks, many of you have shown your ignorance of mental health issues! Many if not all of mental health issues are caused by a chemical imbalance. If the antidepressent is correctly prescribed and it is a hit or miss deal, the person will not present in an "altered" state. Think about what we do, either paid or volly we are exposed to stressful situations, scenes that will be burned in our memories and many what if moments. Think about the soldiers that are coming back with PTSD. Their brain chemistry is altered from being in a constant state of flight or fight. Once they get treatment many of them are back to their pre-deploment state of mind.

I can think of one over prescribed drug that will cause a child to be a zomie, ritalin or any of its forms. If a person truly has ADHD/ADD that little pill is a life saver. For those kids that the teacher or parents think is too hyper and is medicated will present spaced out. ADHD is thought to be caused by low levels of dopamine in the frontal lobe. Medicate the problem, raise the levels and the person is "normal".

Now getting back to the original question. SSRI's, MAOIs can not be used as a prophylactic treatment. If you don't need the drug you are not going to see any benefits. It can actually make a person depressed, spacey, or a little off. I highly recommend the Physicians Desk Reference and the DSM-IV for your next reading assignment. Amazingly enlightening!!

I think what he is trying to say is that he runs alone in the back so there is no one to challenge him. He can do wahtever he wants and no one is going to tell him otherwise. I also usually run alone but its nice to have another set of hands and eyes in the back. I especially like preceptoring students. It keeps me on my toes because the info is still fresh in their minds and I have to think for a minute when they start asking questions.

I had a new volunteer with me yesterday and had a great time. She is a flight medic with the Army and a National Registered Basic. I have flown with her and now she has ridden with me in the back of a rig. She was amazed at the differences and the obsticles that we have to over come in the back. First was starting an IV and the other "odors"

I hope that everyone that was dumped on the street takes the opportunities to continue learning and never lose the compassion for thier profession, paid or volunteer.

I am sorry that you find that funny. Any good supervisor is not going to let a brand new card carrying EMT of any level hit the streets without some kind of on the job training. You can be book smart and know your regional protocols by heart but if you don't have the street skills to back you up, you are a danger to your pts and yourself.

It may be cool/fun/exciting to be tossed out there at first but when you start running into situations that you are uncomfortable with you start doing things that maybe not be in the best interest of pt. Then other things happen cause we all know that shit runs down hill. After a while you may have what could have been one of the best EMTs burned out or given up because they had their card pulled.

I am lucky that I get to do both with the department I work for. I enjoy the one on one pt contact with transports if you have a pt that talks and isn't being miserable to everyone in their path. Also, most pts don't leave the hospital until they are stable but that isn't always true. I have seen transports go south in a hurry and you are all alone to deal with everything until you can hook up with another agency or get to the hospital.

In either employment situation you won't be dumped on the street until the company feels you are ready to be on your own.

Don't take an actual "sit at a desk with other people and listen to a lecture" course. Take it online. You can do it through the National Fire Academy. Follow this link to help you:

http://www.usfa.dhs.gov/training/nfa/independent/

It'll give you the same training and certificate at the end. Plus it'll meet the Federal requirements to keep your employer/squad in compliance. Even more, it'll keep you from sleeping through what was otherwise a waste of time lecture.

Seriously, do it online. You won't be sorry. But you will be if you sit through the class!

Good luck.

-be safe.

Thanks for the link!! Now I'll have something to keep me busy for a few nights.

Not just in older male pts. Any elderly patient that has disorientation, "Just not feeling right" or some other vague complaint could be having a MI.

No JanMarie I do not believe you were out of line in talking to the medic. Just make sure when you do address an issue do not come off accusatory, it then puts someone in a defensive mode and nothing is accomplished.

As far as the pt it could have been several things.

1. Most obvious, he took too much insulin and his BS was low. Easily ruled out by a Glucometer or even a chemstrip.

2. When you said his pulse was irregular was it fast or slow. Many diabetic pts are put on Beta blockers, and you mentioned a BP medication in your scenario. Beta blockers can lead to decreased heart rates which then can lead to arrhythmia's since the heart itself is getting ischemic from lack of blood.

3. You can also get a mixture of points 1 & 2. Normally when a diabetics blood sugar decreases the heart increases to make up for poor energy use. Beta blockers will stop this increase making the pt even worse off then in a normal hypoglycemic episode. Beta blockers are your "olols" propanolol (Inderal), atenolol (Tenormin), and metoprolol (Lopressor, Toprol) in case you did not know.

So in my humble opinion he should have ran an EKG and gotten a blood sugar double quick on arrival. If he failed to do this he was out of line.

Peace,

Marty

:joker:

Marty,

You hit every thing that I would have checked as an ALS provider. Shame on the Medic that turned that patient back over to the BLS provider. A newly diagnosed diabetic with a HX of heart problems can be a ticking time bomb.

Snap

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