BlueSkies

Welcome friend! Let me be the first to say congrats on being a new EMT! Its an awesome feeling and an even greater responsibility to be able to help someone in their time of crisis and need. Not all of these times will be emergent of course and for the most part they aren't but just remember its an emergnecy to them so be as compassionate as possible and treat them as if they were family. Stay safe and welcome to the ranks!

I developed a few Pt relationships over the course of my career. I have carried them to their Md appts. dialysis appts, the ER and in one case to the grave. We had a very nice younger lady on dialysis. She was great to be around, always funny and up beat. She nor her family had much money so my entire EMS division put together a fund and raised enough money to build a wheelchair ramp at her house. She also had diabetes and had lost her right foot due to that horrible disease. She passed about 6 months after that and I was honored to be asked by her husband to take a place at his side as a pallbearer. After becoming a Paramedic the convalescent calls were significantly reduced and pretty much non existant. I found myself missing the companionship that you can form with this type of patient. Later when I was on the aircraft full time I had no contact with this type of patient and I felt like a reason that I loved EMS so much had been taken from me. Now that I am doing Remote Medicine it is like being in the Military again. Out here you develop friendships and dread the day you here the words. "WE NEED A MEDIC!" They do happen and fortunately they are few and far between but again I am honored to be the one they all rely on here. Greater love hath no man than this.....that he lay down his life for his brothers...John 15:13

Bieber I personally think you are on the right track. Sounds to me that you are progressing well as a young practitioner. I always wanted my students and new medics to ask these types of questions. Why do we do this and why do we do that? If we only follow what is written and never quesion the rationale then we are doomed to only be mediocre at best and mediocre in this field is absolutely unacceptable. I agree with the others who have voiced their opinions about the Captain's decision to withhold sedation after the airway has already been secured. That to me is pretty counterproductive. You also have to consider the fact that her gagging on the ETT will cause her ICP to rise. With all of her health issues I am sure that HTN is in the mix and if it isn't it soon will be. I understand that this isn't a head injury case but knowing that she has health issues why take the chance on something else going wrong in the process. I come from a service where RSI was a key aspect of our care. Coming from a flight service we were encouraged to RSI anyone that may put up any kind of fight due to the close proximity of the Pt's feet to the pilot. In this case, RSI would have been a strong option in my head. Sounds again like you're on the right track, keep your head up, always keep asking what if and be a strong patient advocate always. As an after thought I will throw this out there for you and anyone else who is reading this post. What are you director's and your medical director's thoughts on RSI? Do they not like the idea of someone being paralyzed and then not being able to intubate? If that is the case, try looking up Suggamadex. It is the antidote to neuromuscular blockades. If Norcuron is used and you're unable to intubate. Suggamadex will reverse the effects and the patient will recover their own respiratory drive. Just a thought for you to consider. You first few intubations sounded good to me accept your "Semi". Look up all the ways to confirm ETT placement. You will see that the ones that are known to fail due to inexperienced practitioners are the ones you were talking about. Visualizing the chords, Breath sounds and chest rise and fall. The can be deceiving to you in such a chaotic environment. Try relying on others as well like a good capnography waveform, no epigastric sounds, condensation on the tube, things like that. I hope some of this helps! Take care and best of luck to you my friend you are doing well!

Thanks guys for the warm welcome! I look forward to posting my humble opinion and silly insights on here. Don't let Dwayne fool you though, he was one of the best paramedics we had working for us on the spill. He is truly commited to being a compassionate practitioner and he also quickly became a great friend to me and others. I actually am offshore right now. I just came back on tower this past Tuesday. Got another 12 days to go before I finally get a 14 day break. It has been crazy here. I have worked a couple of 21/7 hitches lately due to my relief taking classes and working extra to help out during our annual shut in. Its been an absolute blast out here and you know me good sir, I will take the lemons that life gives me, borrow some Patron and steal someone's salt shaker....THEN ITS A PARTY!!!

Ahhhh good sir how dare you not know who this is just by the title of the post. Geesh...the food so bad in Mongolia that you're brain is malnurished lol its Eric from the SMS silly silly boy...I had to find some way to keep up with brother!!

Hello boys and girls I have been here prior but its been so long I couldn't even figure out what old email address I used!!! Dwayne, you know who you are lol, I am assuming they have internet connections in Mongolia. We need to take a vacation to the Rockies when you get back over to the real world. So I am a paramedic and I am working offshore in the Gulf of Mexico. I have worked as a Flight Paramedic for the University of Tennessee and also on the ground as a Street Medic, Rescue Technician. I have always specialized in Techical Rope Rescue. High angle rescue is where my heart truly lies. I have been in this business since I was 17 years old and I recently turned the ripe old age of 36. I am still young at heart and 40 is the new 30 so I am really 26!!! I don't have much knowledge and very little craft but I can BS with the best of them and I am a Google Expert so feel free to ask me anything you want! If I can't tell you the truth at least I can Google an interesting lie! Take care my brothers/sisters in arms! Gulfmedic9538

I asked the same question many many moons ago before I started school. I will give you the best piece of advice I never used. DO NOTHING but relax. Paramedic school when it starts will consume your life for roughly two years so why start early? I wish I would have listened but I didn't of course because I am a nerd!!! So look at the awesome list that Kiwimedic threw up there and have fun!