runswithneedles

Do I shoot myself in the foot when I say this but how can their be evidence a drug does or does not work when the patient is in a rhythm that carries a high morbidity and mortality rate to begin with. A drug cant work if theirs nothing viable for the drug to act on or if the underlying condition which caused the cardiac arrest (medical or trauma) is still present.

Saw this on facebook. Hope you enjoy.

I had my first OR clinical. And had no attempts at it because all of the patients are either already intubated or getting an LMA or simply not a suitable candidate for a Paramedic student (loose teeth, very anterior airway, small mouth big tongue,etc) But while I was in their I got this panicky feeling of Oh ***t this is it. And just got incredibly nervous for the process. I didnt pass out or anything and I certainly didnt shake or throw up as other nursing students had. But I realized that this is something I must have resolved before I step into that OR again. I stood back and took a breath for 5 seconds and it helped a little. But their must be something more I can do. I practiced on the dummy till I could repeat the method in my sleep. Any recommendations.

sure.

What? Uhmm.its a pneumatic device, no wires, no sensors, only the pressure cuff and the pressure hose...unless someone wants to fill me in on a peice of equipment I am unaware of.

Its a zoll m series monitor

Just though of something, here. Are we talking about "Up" being flipped to "Down", or normal "inside" being placed "outside"?

its being placed right side facing outward however the tube that runs to the monitor is flipped so goes up towards the patients shoulder where it goes to the back of the stretcher where the monitor is at.

There is no such thing a an accident!

Isnt that why we now call MVA's MVC's?

I will be certain to pay attention.

Depends on how big you want to go. My mother passed down her master cardiology stethoscope to me after passing. It also depends if hes going into 911 or ITFT. A really good pair of comfortable boots will take him a long ways in his career in 911. If hes going to get into ITFT (inter facility transfers AKA 911 my best recommendation would be a real nice backpack so he can keep all his gear on hand.

Do pardon my double post. Would admin mind removing one of them.

So just to clarify. Although atropine has been removed from ACLS with the exception of some bradycardiac rhythms. Its been left in as a beneficial drug so long as the medic uses good clinical judgement.

No epi, atropine or amiodarone looks like acls is becoming less "a" and more cls

They are always removing drugs, but will their be a time where they might be adding more?

No epi, atropine or amiodarone looks like acls is becoming less "a" and more cls

They are always removing drugs, but will their be a time where they might be adding more?

I generally do not question my preceptor and for the reason Dwayne stated. He's an arrogant hose monkey. Especially since I don't get along with him on a professional level since he had a "disagreement" with my paramedic and my partner bent him over his knee and gave him a helluva spanking in front of his captain which totally understood what he had coming to him.( metaphorically speaking of course in regards to the spanking part but you get the picture)

Usually it reads within 10 mmHg. As long as its the correct size for the patient. I have had it throw me a few curveballs every once in a while but once I re positioned it would go back to what I was trending before hand and was consistent with my manual bp. But after doing a ride along with the fire department here I got sneered at and chewed by my preceptor saying it doesnt work right if you do it that way. Figured maybe someone else have tried it here and might be able to tell me if it does.

*Edit: whenever it does throw me a curveball first I take a manual than after I re-position the cuff t see if its my cuff or monitor.*

Ever since working for med pro I have had a habit of taking one manual BP, hooking up the auto BP cuff from my cardiac monitor with 3 three lead for my long haul transfers. Ive noticed though it makes the flow of wires so much more manageable if I flip the cuff upside down so it can just flow to the back of the cot where I keep the monitor. But I never thought until recently if it could possibly change my readings. Any of you guys tried this technique before and had that happen?

Had a burn patient the other night who was on methadone at home, morphine wasn't really touching her pain but 2mg dilauded x 2 over 3 hours did well.

Until recently I never knew methadone was used for anything more than just helping a heroine junkie kick the habit. Does methadone have the similar side effects to other opioids such as N/V,depression of respiratory drive etc?

Does one have a more expanded curriculum or something?

Thats pretty cool. Not going to lie. I can see that being used for standby's at Octoberfest.

Thank you soo very much. And I have the green light from all of my classes including cardiology so I just have to get my homework done before I leave.

Oh for crying out loud people. This comment is not even worth the inflammatory responses from it. Look if it is so offensive and so tasteless that It causes problems. Please by all means remove it. As a matter of fact why don't you. I'm here to learn and acquire the wealth of knowledge the combined users of this forum has to offer. And occasionally see a funny or two to brighten a bad day at work. I have no intention to be like flaming EMT. Although I didn't see it how low his were because I filter the posts I read. And I'm shocked it's that low and he's still around . Me racist? Shit, my best friend whom I've known for 14 years is black. And he is hood black. I got no issues with it. I used to chill with his "homies" when I was in high school. I have " partners I'd trust my life with who are Mexican and my idol who is my current partner is Mexican. I don't care if they are white black or brown. I care for them the same with no pre determined judgement (even a weekly dialysis pt who has expressive aphasia and frustrates the hell out of me when I know she's hurting but I can't figure out where.

If these comments were coming from a user on a daily or regular basis or had a pattern I would believe they are possibly rascist. But to base my professional integrity off of one post is completely ridiculous.

I'm off my soap box as I've defended myself to the best of my ability.

P Mike and Dwayne. Feel free to delete it if you see fit. I don't wish to cause more fire on this post than I already have.

A recent thread about a man that died after a ski accident has brought a question to mind. The details of this call are unclear in the media and a subject to a lot of speculation.

Once a patient is in our care can the family member/bystander intervene in the patient care and treatment contrary to the attending medics running diagnosis and treatment plan?

What would you do if the accompanying family member attempted to take over the care and treatment of your patient while in the ambulance?

Dwayne, would you put a question mark after the thread title? Thanks.

Edited for spelling and to ask Dwayne to include a question mark after the thread title.

As far as our protocols are concerned it must be a physician that shows proper Identification and licensing. And also agree that he takes full responsibility and liability to the outcome of the patient regardless of what it may be.

However, when it involves the family member of the patient as being a trained healthcare professional. If I have no pertinent medical reason for that person to be in the back of my box (which in inter facility pretty much narrows those reasons down to if it is a child/ opposite sex adolescent or the family member is bi lingual and my patient is spanish speaking only) I tell them for insurance purposes they must ride in the front and Ill keep them posted on how they are doing.

And in the god awful event that it hits the fan and that family member tries to intervene we will have him/her taken off the box and leave her on the side of the road.

I saw this post as an opportunity to add a few as well. Although my post hit home far more than the others. I do now understand that this is not always the case in some ghettos such as what bullets stated where gangs and its officials had a respect for the EMS that worked their streets. Which I do wish to say that's a big step in the right direction as far as scene safety and being able to provide quality patient care.

But I didn't believe my post belonged in the funnies of the forum as I wasn't trying too be cutesy and those comments are extremely close to home and are difficult to take in a lighthearted manner.

*Note: I re-read through the entire post and realized it was moved from another post. I did not realize it was posted somewhere else and moved. So I can now partially understand why my post definitely didnt float well here. And It seems I might have made a bad judgement call in placing that post here rather than the funnies.*

Or am I still missing something

Understood. Ill keep the cynical comments to myself. Apologies to the elder members of the forum.

But might I ask what makes my post different from flamingemt2011

http://www.emtcity.com/topic/20985-you-might-be-ghetto-if/

I realized it is in the funnies but from my own general perspective the same principals are in both. (Which if I was trying to be cute I wouldve posted it here)

Enlighten me so I dont upset the balance of the order and keep my growing pains to a minimum.

Im terribly sorry to have offended you. But heres a bit of background. Source of each and every one of these was from my mom was a paramedic working for Kansas city, Kansas and Missouri. Over her ten year career there she had a man put a gun to her and her partners face while only trying to help his child.

She lost a friend of hers due a crazy gunman that went into her station and killed her and her partner.

Another of her friends almost killed by a raging lunatic who blew up two houses; opened fire with a rifle on all of the police,ambulances, and firetrucks below where her co worker was shot. A ballsy firemen ran out in the gunfire to scoop her up and get her out of the what was standby zone that was supposed to be safe.

Paramedicmike have you ever seen a rig cut up like swiss cheese from bullet holes in the back of your shop. Try seeing that when your 13 and you know your mom is doing that and it couldve been her truck. Ive also rode with her on the trucks as the EMS service at the time had a ride along program. And only being a teen and hearing gunshots on a scene that was thought to be safe and was "secured" because the shooter didnt leave; It tends to leave a lasting memory.

Police don't patrol certain parts of Kansas city, KS/MO because they are so bad and MAST (ems service used at that time) were backed up by MO Police because KS Police wouldn't.

I'm not talking out my ass when I post here;their is simply no room for it because Dwayne would give me one helluva spanking if I did.

In regards to the narcan remark

I do see what you mean with that and i'll correct it promptly.

I have yet to be a urban EMT. But I will say I have been inside urban ems. Even as a fly on the wall or the person squeezing the ambu bag every 5 seconds on a Intubated GSW patient. Its shows a side of society that makes me question if ethics and morals exist anymore.

And no. I don't think im cool for writing this. This was a very humorless/cynical post. Those you might be urban ems if.......are reasons why I dont work the ghettos.

In KCMO/KCKS the inner city african american population had a entirely unique language. The I done fell out was just one of the unique phrases that the newbies had trouble with.

I would like to make it clear to everyone on this post.I love my job. If it wasn't for those ride along's and my mom I wouldn't be a EMT/ paramedic student. I do love people and I love having the honor of lending a hand to someone whom I have the opportunity to truly make a difference in ones life. And on the holy day I get a thank you Im gratified. And if I don't i'm happy and content that knowing deep in my heart that they are.

I just hate the ghettos. Especially KCK,KCMO

heres the links to the shootings

http://forums.studen...ad.php?t=113548

http://www.kmbc.com/...094/detail.html

Okay take that back. It seems I cannot edit it to correct at this present time

you might be in urban ems if your patient says "he done fell out" when he just simply passed out

you might be in urban ems if police cringe when they hear your requesting back up at your location

you might be in urban ems if your wearing kevlar as part of your uniform

you might be in urban ems if you have ever considered inventing a auto eject narcan pen.

you might be in urban ems if you believe hysterical black woman is a actual syndrome.

you might be in urban ems if you have to learn a whole new language in order to care for your patients

Any others i'm missing?

O_O That is amazing. That woman is on her way to american Idol.

I got the email from AMS head quarters. They have invited me for orientation. So long inter-facility and helllo 911. Ive been reading around and several other forum sites mention during the orientation also involves taking a EVOC course. Is this a set company policy? And what should I expect from the orientation.

That just tickled my humerus and made my day.

They cynical part of me knows from prior experience with virtually any healthcare provider is that everyone seems to think they know better than the medics, and that they have the right to tell them what to do, being that EMS is apparently at the bottom of the medical food chain.

Could it be possible that this is caused by the small percentage of medics that are so hard headed they dont want to admit they make mistakes and further take the initiatives to correct and prevent another mistake.

Or perhaps it reverts back to lack of recognition as a healthcare profession because not too long ago EMS was simply a hearse car rented from the funeral home?