Curiosity

NRA's solution to the Sandy Hill tragedy...arm everyone in every school in America. I'm beyond sad.

JVD? Difficulty breathing? Chest pain? Breath sounds? He's in shock. No signs of bleeds, the diarrhea wasn't enough to cause hypovolemia. No signs of neuro involvement, leaves mechanical. PE would be my guess with the increasing RR.

Ill make up a pericarditis scenario for you next time. What are the physical findings? Specifically abdo. Distention, tenderness, rigidity, guarding? Any recent trauma or illness? Any weakness, numbness, tingling in extremities?

I've seen them call in cardiology and have a trans venous pacer put in place before DCing external pacing.

Agree 150% with everything the non US people are saying and I couldn't say it better without getting angry about it. As for mikes comment about knives and other potential weapons...how many innocent kids would have died had he walked into the school with a knife as opposed to a gun?

The rate may very well be the reason for the pain. What do you have on board that will control rate of a hemodynamically stable Afib pt? What cause cardiac pain? What does nitro do? Do you think the patient will benefit from nitro providing he/she remains hemodynamically stable until he/she can get the meds needed to definitively end this pain? Did your patients pain decrease after nitro administration?

I wouldn't be able to sleep at night even with the suspicion that one of my interventions with so many failsafes may have killed a patient. We're human, we makes mistakes and I understand that, but this isn't just a mistake, it's complete ignorance to the basic standards of intubation. And to admit that you think you effed up without trying everything in your power to correct the mistake is unbelievable.

Running these high energy calls can be stressful and chaotic but there is so much emphasis put on tube confirmation, reconfirmation there is no reason for this to happen. Do they have etco2? Maybe I'm obsessed with this but my tube is my baby. If I worked that hard to get it in, you can guarantee it I will be anal about keeping it in, and keeping it in the right place.

I actually cried when I heard this. I can not imagine what the families, teachers, students, friends, community are going through. I also can not imagine what the emergency workers are going through, the horrors they must have seen. I've seen some shit in my short career, I've been involved with kids but this, I know, without a doubt, would be my last day of work. My heart breaks for everyone involved.

College.

What happens when a "concerned citizen" calls for someone who didnt ask/doesnt want an ambulance? Who foots the bill then?

Are ambulances in the states really so expensive that women would rather have their babies in their cars or people would rather risk dying than call one?

Look into taking some general science classes in January. It might help steer you in the right direction

An hour and a half before they took off again?? She coulda made it to the hospital herself and had the baby in a nice warm, comfortable hospital bed.

She may have made it to the hospital had she not been forced to wait for ems to arrive It's probably in the news because a cop was there.

Any program you go to has a big anatomy portion. Changing schools won't change the fact you have to pass that course. I'm pretty sure most colleges will have anatomy I and II, mine did. If you're still wanting to go through with the paramedic program you're going to have to get through those courses. There are options available. General science classes starting in January will be a big help for you, online anatomy courses, study groups. Once you get your basics down, try again in September at the same college where you must already have some courses down. As for CTS, you're looking at an two year program condensed into one. From what ive heard it's even harder and less forgiving than two year programs. You need to decide if you want this or not. And know you're not the first, nor will you be the last to fail the anatomy course. Half my class failed, came back the next year and went on to graduate.

ER translation... Surgeon: "where do I start?" Look carefully you can see his tongue moving...this is creepy f-up shit! Word is, he died a few hours later. Happened in Lebanon in 2009. I can't imagine anyone living with those kind of wounds, the probable brain damage and the probable cspine fx.

That's still what's done around here...

I find abdo pain to be some of the hardest calls. I'd rather get a stab wound where I know what's happening and how serious it is than an abdo pain that can be just about anything.

I also was in your shoes. I was book smart, but couldn't put it all together with the patients. I struggled to make sure everything was done properly on every call. It just didn't flow for me. One day, my preceptor's regular partner called in sick. We got someone different. He took one look at me, said just a few words, and right then and there, everything clicked. It all made so much sense. From that day on, my calls flowed perfectly, I was comfortable, relaxed and confident. My preceptor was a little pissed because he had been trying to get through to me and all it took was someone else to say what he was trying to say all along. A change can do you good, someone else who will maybe explain it in a way you'll get. You'll see, one day that little light will go on in your head.

We don't use combitubes here anymore. We have kings now. One difference is, blind insertion vs visualized insertion. Blind slips in without the need to see the anatomy and sits on top of the vocal cords. It directs the air flow towards the trachea, reducing gastric insuflation. They don't however provide a definitive airway. There's a risk of aspiration if the patient vomits because the vomiting may not be visible because of the tube blocks the view. Intubation requires the anatomy to be seen and a tube passed through the vocal cords. There's more to it than just push a tube in. Landmarks, techniques, troubleshooting difficult airways. This tube completely isolates the trachea therefor in case of vomiting, the risk of aspiration is minimal. They both have pros and cons, kings are faster and much simpler to insert but don't offer the long term protection of intubation. I find monitoring with a et tube easier than a king lt. Greater risk of damaging the anatomy with an et tube (improper techniques). Et tubes also require a lot of practice and is a skill one needs to maintain in order to be proficient.

Things keep getting worse for this guy.

Just wondering, why no EJ attempt?

The article says the blood pressure was the last straw. That she had had a few other disciplinary actions against her. She could very well be in th wrong as the others stated and she's suing with no grounds.