musicislife

I can ask the hubby but I'm sure he's going to laugh... Don't do this buddy! More often than not, this will be laughed at.

I live in an all volunteer area. everyone has a dash light and two grill lights at least. My little setup here is nothing compared to most members of my squad. For instance, my friend has this setup: Star High-Intensity StarBurst Phantom

Whelen Avenger Dual

(6) SNGL 3 light heads

SNDL3 Deck light

Yea, so if my dash light and two grill lights is too whackerish for y'all, then don't reply to the post in the first place.

-from my protocols and scope of practice as an EMT

history?

Pain worse on palpation? anything that worsens it or makes it better

Family history of heart problems?

Trauma?

Flight recently?

What is the pain like? Could it just be some bad heartburn? Last oral intake? Allergies?

Aspirin if on scene and not otherwise contraindicated. Nitro if it is prescribed to him and if his pressure is good.

check lung sounds just in case, although this definitely sounds more cardiac in nature.

Take vitals, give o2 2-4 lpm via nasal canula if his SpO2 is good

That is about all i would do for him, besides calling ALS

quick clot in my experience kinda burns. This is what happens when i get a paper cut at the ambulance building and we have extra quick clot laying around...

Hi, my name is Kathy, I'm currently a MA and phlebotomist, and I am looking into the EMT training classes, and then possible the paramedic training. Any one have any advice?

study hard. Im not sure what course youre taking, but the one i took in NJ was 250 hours for EMT

Okay so i just bought two SNGL3 light heads from sirennet. My plan it to wire each light into my car's fuse box with 10 amp fuse taps, connect a switch to one light, and sync the two lights using the sync wire. Would this work so that the lights will flash only when I hit the switch? Anyone wire grill lights to their POV before? If so how did you do it?

Ok. In my agency we use paper. I suppose my narrative for a 20 y/o f with ab. pain.

Bls 208 dispatched 911 for 20 y/o f. with ab pain. Upon arrival found pt in fetal position on couch being attended to and given 02 by po on scene. Pt stated "severe" pain in ab. Lung sounds assessed. Cap refill assessed. Skin color temp condition assessed. Perfusion appears normal. Focused assessment revealed 10/10 cramping pain in LLQ ab. PT states regular menstural cycle and no possibility of pregnancy. Hx and vitals assessed. Assisted pt to stretcher+secured w/ straps x3. Loaded pt into ambulance. Removed po's O2 and connected pt to main. Transported to valley ER. Pt re assessed en route and found no further problems. No noticed change in condition en route. Handed to nurse Kristen at valley ED. Assisted to pt to bed 2B. Returned to service.

What do you guys think?

What do you guys put in the narrative section? It seems that when I write a report, I cannot fit everything into the narrative section, even for simple calls. Any ideas?

curious why you didn't give the emt who responded the patient info instead of the police officer. Any reason why you bypassed the emt and went straight to the cop?

Just curious. Did the officer provide patient care or did the emt?

would the EMT on scene have done more with the patient information or would the cop have?

I am not criticising this, I'm truly asking and wanting to know why you gave the officer the patient info over the emt?

well the other two first responders (who helped the PT so i could call it in) told the emt that responded...i just told the officer on the way from his car to the PT..the emt (who was off duty) who helped the PT got the PT info from the other 2 first responders

Wondering if i did okay last night.

I was at a party and i was hanging out with my friend all night. She has an eating disorder and hadnt eaten anything but 3 pieces of cauliflower. At the end of the party she was with her other friend and she was getting really dizzy. I came over. She was barely giving me answers to my questions. I told the other friend to get the other two first responders who were at the party, as well as the PT's mother. They came over. the PT had a bounding, fast, regular pulse, and shallow breathing. No drinking at all, i was with her all night. I was holding her because she was really unstable. Once she got really dizzy, i was worried about her going unresponsive, so I put her down in the recovery position. She went totally unresponsive shortly after. I then went on the phone with 911. Right then, an EMT in the area showed up, shortly followed by a cop. I ran to the officer, told him the patient info, assisted with o2 and oral airway. After that, I gave the PT info to ALS who showed up 2 min later, followed by BLS.

Did we handle this one well?

"Are you fucking kidding me!? You actually called 911 for this!? I've got a hangover so bad I'm seeing double and you expect me to actually do some work!? Fuck you! I'm out!" <throw down kits, kick the dog/cat/child/friend/spouse and slam the door on the way out>

At least that's MY preferred opening line...

sounds like a good line

for some reason, i cant think of a good opening line to a patient besides "hi sir my name is james, Im a first responder, are you okay?"

I have always been confused on when to perform what when dealing with a multi system trauma patient. I think i have to do the rapid trauma assessment on the scene (check, head, neck, chest, abdomen, back, and extremities) and then perform the detailed physical exam in the rig (rapid trauma assessment puls a pupil check, checking the ears and nose, movement of fingers and toes if conscious, etc). Am i correct?

well, my partner tried to simultaneously ask while I was asking different questions.

but, normally i think they should be asked after the physical assessment/rapid trauma assessment, before vitals

So we did a drill today. The scenario was a 42 year old male hypoglycemic in an MVC.

I was assigned to take history, pt assessment, and vitals. My partner had the history sheet.

He started asking him the SAMPLE questions while i was doing a rapid trauma assessment.

Should i have done all of the asking, while having my partner write the info down?

I dunno Kiwi. I was once transporting a client to a tertiary facility over 2 hours away. Being a little hungry on the way I ate a few pieces of saltwater toffee. After we dropped off our patient we drove to a restaurant for supper. On the way i was overcome by a sensation of weakness, vertigo, and mild nausea. When we arrived at the restaurant I thought I'd check my BGL and it was 3.2 mmol/L, 58 mg/dl for you yankees. I've since added granola bars and fruit juices to the snack compartment in the ambulances.

As to Craig, I would believe her to be dehydrated to a certain extent. Her skin was moist, yes, but that doesn't tell us much about how much is left in her body. We don't know what her oral cavity was like. As to her skin being flushed, agreed that it would be reasonable to consider her exertion to be the cause, but we can't rule out mild dehydration either. I compare it to someone who has a heart attack in the shower, is he diaphoretic, or just wet from the shower? We don't know, so lean toward diaphoretic and err on the side of caution.

She was alert, orientated, and quite capable of being placed into her mother's care. Oral fluids and complex sugars resolved her condition. I'll stick with my original determination. Mild hypoglycemia from a sugar rush compounded by the added caloric requirements for the triathlon. As well as mild dehydration from the exertion. Although the cause of a side stitch like hers isn't known, many theorize that it could be caused by a lack of fluids.

i agree with that..aslo being that she certainly knew nothing about proper training and diet for this sort of thing, considering that she was 8 years old..as far as the cramp, could be an electrolyte disturbance from the exertion (i find that my cramps from running go away with some gatorade or something like that)

yea the sugary drink helped her greatly, so did the ice pack and water

That was the direction I was heading with your information. Sounds like she was coming down from a sugar high.

wait were you thinking it was hypoglycemia or dehydration?

also thinking this could have been dehydration or hypoglycemia.(maybe not due to the sugary cereal, and her appropriate and normal responses to my person, place, time, and event questions)..what do you guys think?

If you are holding c-spine with a jaw thrust...how are you going to do a physical exam? Once you take control of c- spine with a jaw thrust, you can't let go.

good point

her mom was kinda freaked out so we wanted to at least chek her...had a normal BP anyway...it really was just a really anxious little girl who ran a bit too hard

Ok so we were standing by for a children's triathlon

Patient was dizzy, and felt like she would puke (she had just finished)

outside temp was 60

A+O times 4...quite nervous, crying-had her cramp in her left side-9 yrs old female

Airway: unremarkable,

Breathing: Fast, shallow

Circulation: Pulse bounding, regular, and fast. skin condition very flushed in the face, hot, and moist

pupils: PEARL

Ate a sugary cereal this morning

No medications, medical history or allergies reported

Vitals: BP: 118/80 didnt get rest, because by the time i took the BP, the mother RMA for the child

Treatment: we gave her an Ice pack...parents gave her some juice and an orange to suck on...and some water....no adverse reactions to that

other than that, kept my hand on the patients shoulder, talked to her, ect

This is all the info my partner and I got prior to the RMA (RMA was prior to rig's arrival)

patient was a lot better when we checked up 10 min later

this was the first time I got to treat someone

thank you...would it be acceptable to perform a physical exam (minus any exposure) /SAMPLE if this patient were conscious? Would a physical exam without exposing do any good? I am guessing it could do some good, but i could be wrong.

Very good. You have identified your index of suspicion and opened the airway. Are you going to hold the jaw thrust maneuver until the ambulance arrives? If you use the modified version you can stabilize her cervical spine as well, since that is your suspicion.

yes, that is exactly what I would do

I would say that the index of suspicion comes from the fact that she collapsed and hit her head, without anyone catching her. I would use the jaw thrust due to this index of suspicion. Another possibliliy is the recovery position, but I am not inclined to do that due to my index of suspicion. Also, the age of the woman, indicating a possibly more brittle bone structure, also raises my suspicion of head neck or back trauma.

According to my book, unconscious patients often have their airways obstructed by their tongue, and the jaw thrust (among others as well) will alleviate this.

Frist three things are Airway, Breathing, and Circulation (C-Spine is also there, as part of the scene size up)

By performing some simple exploratory procedures you might can find some clues that can help you, Are there any DCAP- BLT on her head? What do her pupils look like? Are they PEARL? Skin tugor? Color and condition of mucosa? Is the mucosa moist and pink? Is it pale? Dry?Are there any signs of hemiplegia or hemiparesis? Did anyone see what exactly happened? Does she have JVD? Edema in arms or legs? Among a ton of other stuff you can look for.

All of these things are can lead you to clues as to what this lady has but without diagnostic tools you will not be able to really know what is going on.

By maintaining her airway and waiting for the Ambulance you are ahead of the game.

EDIT: If you are doing the jaw thrust maneuver you will know when she wakes up from the moaning. Left lateral recumbent might be a better position while waiting

thought you werent supposed to do that for suspected trauma? And cant an unresponsive patients tounge end up obstructing the airway?

i dont know..in all of the cases I have heard, fractures and breaks are not ALS here. maybe im wrong Ill chek with my captain