Eydawn

2nd graders have short attention spans, so keep things simple and interesting. Use humor and demonstrations as much as possible. Bring in your radio (or *A* radio), a simple first aid kit with some roller gauze in it, and a C-collar. You can always get them to help you with C-collaring the teacher, or you can C-collar a volunteer kid; show them how to do simple splints with whatever you have at hand, let them play with the cheap walkie after you show them how you do it, and explain when to call the ambulance and what you guys do. And what you guys do NOT do. Also explain to them what they should do if they hear an ambulance coming (stay on the sidewalk and cover your ears 'till it goes by). You can use some really simple props to get their attention, and if you do something goofy to the teacher they will love you. If you have a personal steth, play with that too. Just give them a general idea of who you are, and what you do, and keep it fun. Good luck! Wendy CO EMT-B

Brady does some very good study guides. Go to the local Barnes and Noble or Borders, ask them where the EMT study guides are, and browse through a few. Buy one or two and practice with them. Good luck! Wendy CO EMT-B

Unless you have a system where someone goes to get the rig while someone else responds in their POV to optimize response time to the scene you have no need for lights whatsoever. Really, you don't. This reminds me slightly of a quote from a Heinlein novel (one of the greatest scifi writers of all time). I believe it is from Tunnel in the Sky, and to paraphrase: "When I send one of my girls out on a mission, I don't arm her to the teeth. I send her out with nothing more than a pair of shorts and one knife. That way she comes back alive and with her goal accomplished." Don't arm to the teeth. Use your hazard flashers and headlights if need be; a single strobe to alert people as to your presence should be fine. You're not trying to beat every light and make it around as many people as possible; you're trying to reach the scene safely and efficiently so you can help your patient. The goal is for everyone to get to their destination alive and in the same or better condition than when you started the shift. Lights will make you overconfident and feed into the adrenaline trap, because they're yet another stimulus. No lights will make you drive much more defensively because you know not everyone is paying attention to you. If you must put a light in, Galls sells some little LED bars that stick to the windshield with suction cups, so you don't have to have it in all the time. I don't doubt that you're probably a very good provider... but do a search here in the forums on the term "whacker" and all of the debate it's caused. Be careful of appearing whackerish; many will judge you instantly and make a ton of assumptions about your competency based on a few careless or arrogant remarks. Not saying you've made those, but just an FYI. Welcome to the City! Lurk around a bit and try to get a feel for the place, and take everything with a grain of salt till you get the hang of things here. Wendy CO EMT-B

You notice how it said <tits> at the top of her chest (hard to see, but there) and then at the bottom of her bust it said </tits>? Basically <whatever> is HTML code for beginning of -whatever- in this case, TITS then, the </> operator means "end of" whatever you're coding. Again, in this case, TITS. Get it now? Wendy CO EMT-B

Oh lord, even I understood what the HTML meant... Wendy CO EMT-B

ROFL!!!!!! Wow.... that was hilarious! Dyin over here... (and my apostrophe key is broken, sorry!) Wendy CO EMT-B

Michael writes haiku Brent is ever lamenting Be lonely no more! Wendy

Dust? Did you mean me, or WendyT? I try not to ramble! Wendy CO-EMT-B

Speaking as a fellow Colorado basic, unless you plan to work part time or volley somewhere out in the boonies (AKA Elbert County) then just skip the intermediate and go for your paramedic. Really. It's not that much more schooling than the I99 would be and I85 is the one that many people are phasing out or have phased out already. If you want to work ALS at all, really and truly just spend the little extra time and money and go through a good paramedic program. Just work as a basic until you can get into one, and start your process by taking an A and P course in the meanwhile. Where'd you get your EMT-B through? Wendy CO EMT-B

mountains

tones

Well, per your last scenario's response I sure hope you restocked the nonrebreathers.... because that's the first thing I want on this guy. I also want to know his max epi dose and whether the 2nd one is helping much. Does he take benadryl ever for this? If so, as an adult he can choose to grab your benadryl bottle and take some.... does he have any other medical history or other medications? Have you removed him from the ant nest and ensured your own safety? Can you start an IV on him? Can you possibly ship him out with a BLS responding agency and have them rendezvous with ALS, to speed things up a touch? Give more epi if online med control or his maximum dose indicate that he can receive more, and if he doesn't show improvement from the prior doses. Possibly benadryl per online medical control or patient's normal routine, 12-15L via the nonrebreather, monitor vitals. Watch for airway compromise. Wait for ALS, or start him going with BLS if he's not improving... Wendy CO EMT-B

In CO we had to submit that info ourselves plus a state registration fee.... you may want to double check to make sure they do it automatically for ya! Wendy CO EMT-B

Lol... speaking as a BSA camp medic, first off I'd ensure that this patient got a full trauma exam... airway and breathing as our number one priority, of course. Medical hx on the kiddo from either their class 1 form or the scoutmaster's files or knowledge? Previous injuries? Patient is AAOX? Baseline vitals (pulse, respiration, BP, O2 sats) please. I want a better description of how he fell and what he landed on, and how the scoutmaster moved him. What do you see in your exam? As soon as you've checked his back, including exposing the guy, backboard and extricate the kiddo, don't forget to pad the voids... have the ranger help you with extrication if he will since he has experience. Send the camp director to call the kiddo's folks as listed on the class 1 form to advise them of what's going on and the actions you're taking. Finding any other deficits? How about visual bruising? Treat the kid with as much TLC as possible... if he's a tenderfoot or first class, just out of webs range, he's going to be really scared. Ensure airway, adequate oxygenation and try to learn as much as you can so you can hand him off to ALS with more than "kid done fell down..." in your report. None of the above meds would be appropriate as far as I'm concerned... if he's in severe pain, ALS can establish a line and use far more effective painkillers. You guys have authorization to hand out benadryl, ibuprofen, tylenol etc. to adults on your ranch? We had it written in under our doc's orders this summer where I worked in CO. How'd it really go? What was the patient's condition? Wendy CO EMT-B Venture Crew 911, DAC BSA

I have the solution, ladies and gentlemen.... something VERY distinct that would definitely set us apart in the medical field! I can guarantee you no other EMS is wearing this... http://www.utilikilts.com/index.php?page_id=46 Wendy CO EMT-B

Dust, I wasn't equating the two courses. On the contrary... I know the two are vastly different levels of education. What I was trying to convey is that perhaps what is at fault here is not mastery or understanding of the material. There are many individuals who simply do not test well, especially when it comes to standardized testing, regardless of what the subject matter is. I happen to have very high standardized test-taking intelligence. Multiple choice tests make a lot of sense to me and cause me very little undue stress. Huzzah for a killer SAT and ACT score ( :roll: ). Short answer tests are the devil and I never seem to get what the professor is looking for, exactly. Hence my GPA coming out of Kalamazoo College... under 3.0, unfortunately. Now, there are many people who do fail to study and don't put forth enough effort and then WHINE about their problems. That's not the same as knowing the material and being able to use it in every other area *except* for testing. Hence my example of myself and a lot of my undergraduate biology classes in Michigan... I'm hoping the different testing style of a large state university will work better for me, and that's part of why I transferred. What I was trying to show is that some people test well in some subjects and don't in others. And did you notice that the original poster only failed by 2 points? That indicates to me potential for problems with certain question wordings, rather than insufficient mastery. Review is good for the soul, however.... and I think try #2 will treat this guy much better than his first attempt. Wendy CO EMT-B

So you put the KED on them to make it easier to transfer them to a board just prior to putting them in the arriving ambulance... equally valid. From how the scene was described, I don't envision a patient out on a board sitting for 10 minutes being safer or that being more beneficial to their well being as opposed to remaining in the shade of a vehicle with open doors. I might also add that yes, rapid extrication is *best* utilized for those patients with critical injuries, life over limb... but a patient who is panicking as you're placing a KED is going to put themselves in danger as well. You removing them in a rapid, controlled fashion would seem preferable to me, because either way minimizing movement of the spine is our goal. I guess I envisioned the scene as a hysterical woman with some painful injuries panicking and not necessarily being entirely cooperative with or receptive to the actions being taken by the responders... perhaps I didn't see it right. If so, mea culpa. If no, I still might have gone with this route... quicker and less conducive to further panicking the patient. PS, dusty, of course you don't use it as a "whups, I've been on scene for..." technique. DURH. Wendy CO EMT-B

Doing research: The act of looking for published journal articles indicating the efficacy of the device in question. Also may constitute setting up a response trial in which medics from around the country (in large quantities) are invited to comment upon the efficacy of an EZ-IO as documented in their PCR's. Your personal experience may have shown it to be ineffective, doesn't mean it's a widespread phenomenon. My personal experience is that moleskin absolutely sucks for the treatment of blisters... I hate the stuff and refuse to treat anybody with it. Moleskin is proven to be a highly effective treatment for many blisters.... get where this is going? Your experience with the EZ-IO may be an anomaly... you might have just had tricky patients or a poor access point. I don't know what my problem is with moleskin though, haha! General question for those who use the EZ-IO... why is it used in pediatric trauma so much? Why not something like a more central IV access? I've never been able to figure that one out. Wendy CO EMT-B

You'll be ok. Take a look at the breakdown of where your areas of trouble were. Where did you miss points? Look back over your practice exams book and re-read your textbook before the next shot. Talk over questions with others from your class or post some here (or PM me, I don't mind tutoring). As for those who decree that someone who fails the NREMT-B written must be an ignoramus with no capacity for medicine, I dare you to tell that to one of the men I personally trust with my life and well being... he failed it twice before finally passing. Test anxiety, poor test taking intelligence, lack of sleep, etc. can all be factors in failing an exam. Just because you don't look good on paper doesn't mean you know your stuff. Conversely, if you want to do this, you have to overcome your problems with exams. If you have severe test anxiety, you need to find a counselor at your community college or other school and get some resources. Who in here hasn't failed a test or class yet? Life's gonna come at you fast when you finally do fail something. Luckily I learned early on that failing a single class or exam isn't the end of your world. Hell, I think I've failed or gotten low C's or D's on many of my biology exams. I'm a biology major. Does this mean I don't understand biology or that I'm unintelligent? Wendy CO EMT-B

Aortic tears secondary to trauma are tricky buggers and no mistake. One of my friends is an extraordinary lucky girl... survived an aortic tear. Her truck vs. a mini cooper. She did end up losing the lower part of her right leg due to venous clotting post-op... but she's alive! That said... there isn't a whole lot you can do to help an aortic tear. I don't think there's any one action that will help save that particular class of patient. A lot of it is definitely luck. Or grace. Who knows? Wendy CO EMT-B

My favorite... "Wow, that sounds like an amazing product... oh oh... OH GROSS! OH ICK! I'm really sorry, hang on a second, my dog is throwing up..." Leave phone sitting for 5 minutes... come back "Jeeze, I'm really sorry about that, are you still there? WHups! Hard to hang onto the phone, my hands are kind of slippery.... I think she was eating cat crap again..." This is usually followed by a "click", but for the even more persistent, I just set the dogs off and let the girls howl into the phone. "CATS" works quite well to get them going.... Wendy CO EMT-B

Hand holding isn't pointless... it's all about knowing how and when to make that kind of connection, albeit carefully, with your patient. Do I ever give tough love? Well, if you count lecturing drunken classmates and making fun of them and making it absolutely miserable for their friends by assigning them to drunk-watch shifts, then yes, I give tough love. Do I judge the situation first? You bet. If someone asks me to stop or back down, I do so immediately. It's all about knowing your situation, and if something works for you and seems to benefit your patient, then by all means continue with it. Just make sure you perform the physical care first, since that is your first priority as EMS. Wendy CO EMT-B

I think you made the right decision. How long does it take to do a rapid extrication? Maybe 2 minutes at most if it's tricky? What was the guy's hurry? In my opinion, you are safer inside of the vehicle as long as you don't notice anything that would compromise that safety. I know I wouldn't want to be lying exposed in the middle of an accident scene on the blacktop; if a lookee-loo lost control of their vehicle, and ended up in the scene, it would be far better to be inside a steel cage (albeit an already crunchy one). As long as there were no factors indicating that immediate removal was in the patient's best interests, I think you acted wisely in waiting for the unit to get there. She didn't seem to need any advanced maneuvers ASAP and was stable... so, why pull her out and let her freak out more? Ick. What do YOU think? Wendy CO EMT-B

Brentoli, you must have been a boy scout... what rank did you get to? I think EMS personnel should learn all sorts of rescue techniques... helps you to appraise a scene better if you're trained in tricky rescues and it helps you to think outside of the box as far as I'm concerned. If nothing else, you can be used in a pinch if it turns out that the rescue team needs more hands than they thought they did. Besides, it would probably help you safeguard your own well being on a scene like that... since you would have been trained in how to handle those scenes... Wendy CO EMT-B

I think we've got some terminology confusion here. Bulemia is defined as periods of binge eating followed by subsequent purging, via vomiting, laxatives, and/or heavy exercise (or any combination of the three). It can exist on its own, without intermittent periods of decreased food intake. Anorexia is defined as purposeful abstinence from food to achieve an ideal body appearance or weight. It may include strict calorie counting, abstinence from certain food types or groups altogether, eating only lettuce, and various other manifestations. It can also include cessation of food intake- period. Anorexia may also exist on its own, without intermittent binging periods. Often, anorexia and bulemia will manifest together; a person will cycle from one of these behaviors to another. Binge eating is a behavior in which people will spontaneously overeat a certain food item or a large number of items. It is not followed by purging. If it is, it is bulemia. Many people will go on diets and not eat dessert, and then relapse and binge on nothing but desserts. Binge eating periods vary from a few hours to weeks, and are often accompanied by significant weight gain. These behaviors often have psychological causes. If you are experiencing some of these behaviors, seeing a qualified professional would be beneficial to you. It's not about the weight, or the body image... it's usually about control. Hence why you get girls literally dying of starvation with lanugo (fine downy yellowish hairs) all over their bodies... that isn't the image they're going for, it's about controlling something... Until you get help for the underlying psychological issue, you will probably not get the behavior under control. Support groups can also be useful. Google is your friend... there are many forums and groups on these issues. WARNING- there are forums out there in cyberland that are pro-anorexia groups and promote the anorexic lifestyle. Please, don't stay there too long... it won't help you. Knew that my psych class would come in handy at some point... Wendy CO EMT-B