Eydawn

Perhaps it is that he functions well, but is barred by military screenings... however, I find that difficult to believe, as I know of someone who is on mood stabilizers and who is in active service... maybe it's a case by case basis or something, but I would have thought for sure this person would have been disqualified and yet, there they are! Wendy CO EMT-B RN-ADN Student

Yeah... you had a 1am funny. CO binds to the same binding site as O2, thereby showing the RBC as "saturated" (increasing pigmentation) and causing a false high reading. CO2 binds to hemoglobin and doesn't affect saturation, thereby having no effect on SpO2 reading. Hence why you can have someone who has plenty O2 but is retaining CO2 and thereby in deep doo-doo as far as their acidosis/alkalosis balance goes... Wendy CO EMT-B RN-ADN Student

Stitches- Why tactical EMS? What is it that you REALLY want (other than adrenaline)? Why EMS at all? I want to see your thinking, then I'll give you more... Wendy CO EMT-B RN-ADN Student

You and me both, brother! So far, my area's been pretty on board with the NO BURN idea. All the smoke in the air has something to do with it prolly. Wendy CO EMT-B RN-ADN Student

Simple to mix in that format, yes, but counting drops is in no way, in my opinion, an accurate way to titrate a correct dose. It changes enough on a patient in a non-moving hospital bed... I agree with Chbare that a pump is vital, and it is far preferable to go with the IM route in a moving vehicle. I'm curious as to what the post-fluid bolus care is... do people end up in fluid overload once the anaphylactic shock has been mitigated? Do we ever see rebound pulmonary edema, especially in those clients already in heart failure? I honestly haven't seen enough anaphylaxis nor the followup care to know... but 4 litres is a LOT of fluid to be positive on! Wendy CO EMT-B RN-ADN Student

Speaking as someone who's been an EMT for 6, going on 7 years now, and who is currently in nursing school... I am still looking to get my paramedic after I get my BSN. I can't speak to your particular geographical area, but if the passion is there, half of the experience in the workplace is what you bring to the job... you can't fix stupid people around you, but you can kick ass and take satisfaction from doing so... Wendy CO EMT-B RN-ADN Student

I think this may push us towards non-pharmacologic and alternative pain interventions... we have to think outside the box here. I'm concerned about adequate pain control on my floor, with post-op orthopedic surgery... my floor is known for its pain control, so I'm sure we'll figure something out. I bet we'll see a lot more neuraxial analgesia used (oh Jesus, great, more Q1x8 postop vitals, FML...) but there's risks with that too... Are you dancing for joy because you don't dig Dilaudid? Because you think it'll cut down on seekers? Or some other, weird, Doc-ish reason? I also am not sure if Arctikat is being highly sarcastic, or letting you have it! ?? Anyone care to clue me in? Wendy CO EMT-B RN-ADN Student

I don't know how many of you follow "The Most Interesting Ambulance Crew In The World" on Facebook, but I've been perusing their posts and I've come to the startling conclusion that we're screwed as a profession unless we manage to get past the "hero, guts'n'glory, RNs (and anyone else for that matter) suck!" mentality. (I know. We knew that, here on the City. Right? But, I was surprised, as I'm so used to our intelligent discourse, to see what happens on the other side...) It's interesting. Post anything challenging any part of what's posted, and people begin calling you all sorts of names... I won't link to it, as I don't want to advertise, but if you get the chance, search for it and take a look at some of the posts. There's almost a slavish "yeah, that's right!" attitude towards anything said... lots of jokes, (which are great) and now tons of RIP posts. Desperate for heroes? Indeed... seems some people are. Just because someone happened to be a paramedic/EMT/FF and they died doesn't mean they were a hero, nor that they should be massively, publicly mourned.... I like what we do here on the City, where someone who knows them posts, and we send each other some love and good thoughts and prayers, and then we move on... Anyone else? Thoughts? Seems like we're going to need a HUGE culture change if we want anything to change in our lifetime... Wendy CO EMT-B RN-ADN Student

Ok... Wow. Sorry to hear your life sucks. However, I have to agree with Mobey... the original purpose of you coming here has been satisfied. Nobody's trying to be mean, we're trying to discourage fake drama-vomit in our forum. Makes the place kind of stanky. Sounds like you have some legit drama. News flash for you: There are many of us here who have gone through LOTS in recent history. Some still dealing with ongoing issues. You don't see us writhing (and writing) in agony all over the place... You want something to change in your life? Change something. Look for creative solutions. Ask for help. We'll give you all the advice we can, but you have to give us somewhere to start. Best of luck to you... Wendy CO EMT-B RN-ADN Student

I need to know a LOT of information about your setup before I can offer anything specific. I am a Venturing adult leader, and have been a camp medic at a large BSA camp. I have a lot of good tips, but I need more info from you before I can say anything useful. How big is this camp? How are you handling campers with medications? Do y'all have radios? Do you have a water area? Does that water area have certified lifeguards? Do you do climbing? Horseback riding? Are you just a dedicated medic, or do you have another role as well? How will you manage both roles if you've got more than just the medic stuff? How many staffers do you have? How many campers do you have? How long do they stay? What altitude are you at? Are they sleeping in tents or cabins? Is there heat in those cabins for cold nights? Do they cook their own food, or is it a dining hall setup? How are you documenting care you will be providing? What level are you expected to practice at? What's your support like- who's your transporting agency? Do you have a medical director? Are you actually practicing under your licensure? I'd say you've got a good start with "don't do anything stupid and please find me" but I'd like to know more. Wendy CO EMT-B RN-ADN Student

It's always different to be on the other side of the patient care relationship, no joke. The personal side forum is exactly the place for stuff like this. So, have you considered seeing a psychologist to help deal with the post-traumatic stress (reaction, if it's recent, disorder if it's been going on for a while) that is messing with your sleep and such? This was a pretty significantly crazy event that happened to you! Do you know what caused it/feel comfortable sharing? Welcome to the City... may your next ambulance be one you are driving or providing care from, not riding in! Wendy CO EMT-B RN-ADN Student

I'm actually trying to figure out if PERCOM will allow me to become a CO paramedic. I like the online learning environment and much prefer a hybrid course to a traditional "in class" course. I also feel more comfortable now with taking an online course or bridge than I did back before I started nursing school- I feel like I've gotten a lot of complementary education that would allow me to be more successful with this kind of approach (not academically, but as a practitioner). Yeah, I know. Finish nursing school first... Wendy CO EMT-B RN-ADN Student

So, those of us who do event standby aren't real EMT folks, eh? I'll tell you that I've seen quite a bit of useful calls working event standby. Someone's gotta hold the fort until the ambulance gets there.... My suggestion was going to be along the lines of looking into event standby, Boy Scout groups, etc... but since that's beneath you and only ambulance time will do, then you're SOL as others have stated. Also, if you don't have a car, what makes you think you can be a volunteer? Volunteers in EMS need to be quickly and readily available. Most volly rural/suburban groups will need you to be able to respond AS A CALL COMES IN. Good luck doing that with the train system. What magic "skills" can you only hone in an ambulance? I can package a patient, take vitals, get a history, and hand other people shit just fine working in a non-rig environment... I happen to have a wee bit more assessment ability than some, but that's because of my other jobs/learning experiences... so what is it about 911 that MUST BE IT for you? If it's that important, TRANSFER. Go to an area that allows you both. What are you in school for? Just saying. Wendy CO EMT-B RN-ADN Student

Hey Dwayne... From what I've heard there's not really need so far. A lot of stuff is being handled up here at the High Park fire by a mobile clinic, as what folks need is refills on prescriptions they can't get to (or that got destroyed) and minor medical attention for injuries sustained during evacuation. I don't know about down south yet, but up here responders have been able to work their shifts once their families are settled in a safe place and I haven't heard about any critical staffing shortages due to folks having been evacuated. What's really needed is infrastructure rebuild. Roads, utilities, homes.... all damaged or destroyed in many areas... Wendy CO EMT-B RN-ADN Student

Yeah... Mike's a lil' paranoid. That's a good thing though. We've been burned by bullshitters before who are "just sick and looking for advice" on various stuff. No offense, man. Mike, you did see the posts where this person did explain what they went through, why they're asking, and that they're looking for "Goth-acceptable" medic alert bracelets, right? Or is that what triggered you- too MUCH info, too fast? Just curious. Truthisone- are you male or female? I'm a mite confused on that point. Wendy CO EMT-B RN-ADN Student

Welcome to the madhouse! If you're looking for a group of professional folks who like to argue and hold each other to great standards, and you enjoy learning and discussing, you'll love it here. Wendy CO EMT-B RN-ADN Student

Try this company. I wore a bracelet from them for a while back when I had a few new allergies pop up and my asthma was wicked out of control. I wore a simple steel chain link bracelet and it didn't offend my fashion sensibilities a bit... http://www.americanmedical-id.com/marketplace/category_viewall.php?shopby=10 Based on your previous posts, I would suggest the leather flex or silicone flex bands. They blend with your style pretty easily. Sorry it happened, now don't be an idiot and make sure you take good care of you. Suck it up, buttercup! And good on you for asking to see what we'll notice. Not everyone thinks of that. ;-) Wendy CO EMT-B RN-ADN Student

So, in a recently popular thread, we were discussing whether or not it is appropriate for individuals to take the law into their own hands, even to the point of using violence. It appears that a grand jury in Texas sides with the use of force when protecting the helpless and innocent. http://www.cbc.ca/news/world/story/2012/06/20/texas-dad-beats-molester.html What do you guys think? Especially JPINFV- I know you side with the law... and this was deemed to be a legal use of lethal force. Ethical perspectives? Anyone disagree with the father's actions? Wendy CO EMT-B RN-ADN Student

Ask the FTO to sit back and just observe you on a few calls unless you're missing something VITAL or about to kill the patient. Ask him to let you just fumble through and think through without having to think about what he's doing/wanting you to do so you can improve your sequencing, and then ask for feedback AFTER the call is done. Also, just slow yourself down. Take a couple breaths to think, and plan your next few actions. Rushing will make you jittery and forget things. I speak from experience with this, as I really struggle with being interrupted mid-stream. Back off, and leave me alone until AFTER unless I was about to kill someone or do some serious damage. If you have a "better" way of doing something or want me to think about something, tell me right afterwards so I have time to process it and don't forget everything else I'm supposed to be doing. Hope this helps! Keep your chin up. Be confident in what you know you can do!! Good luck. Wendy CO EMT-B RN-ADN Student

Yes, but we're not in a "should we all be vegan?" debate here. I do know that for me, sentience tips the value scale. If I can rescue only one life in a burning house, and one is a sentient human being and the other is a cat, the cat's on his own... We don't know, unfortunately. Once dogs learn to speak, they can be afforded the right of self advocacy. We are guardians of the animals we choose to live with; we must make decisions that we feel are in their best interest. And, it is interesting to me that you assume that the dog might fight for SURVIVAL, when the issue at hand is individuals fighting AGAINST survival (under very specific circumstances). Ack... you got me there. I did not mean to imply that dogs have no soul (I am one who very firmly believes that our dogs wait for us... after all, isn't Heaven all the best of existence? And dogs surely qualify there...) and therefore that point is null to the argument. I can't argue the value of the dog soul vs the human soul, as we even poorly understand the existence of a soul at all ourselves... it was my religious thinking pulling into the argument some, but not fully fleshing out. If you'd like to have a religious debate, we'll start another thread (as I have a very specific religious component to my conviction, but realize that not everyone shares that common ground and have no desire to step on more toes.) But should I be forced to accept legislation that I find morally repugnant without expressing the contrary viewpoint? Currently, society sees murder as illegal and abhorrent. (In general). If we were to suddenly find legislation justifying murder, wouldn't you see people argue against it? In this instance, I think suicide, assisted or not, is very wrong. Therefore, I find its sanction incorrect, and choose to argue against it. Take another example... late term abortions. I may not be carrying a baby, nor choose to abort that baby (we're talking past the age of viability here), so it does not affect me personally, and yet I find such abortions (for the sake of birth control alone) to be morally and ethically incorrect. I am not quite sure if we are on the same page? Because if you are referring to the Nazi euthanasia and sterilization movements, you're bolstering MY point... What were you trying to say (as I'm sure I've got it wrong, lol!) I do respect yours, though I disagree with it; however, as it comes to policy-making and laws, we must each advocate for that which we find most correct, no? Ok, you MUST know you're off in the ditch here. We're talking end stage hospice care for those who are suffering. I could shoot back with "So you think it's bad to give pain relief, but you're OK with killing them?" and it would sound equally as ridiculous. I believe you can die with dignity without hastening that end intentionally, and treading onto ethically shaky ground. The benefits of using benzos and narcs for those heading for those pearly gates far outweigh the downsides, and we all KNOW that giving pain control like that shortens the body's coping and hastens, to some extent, death... but it would be inhumane and cruel to withhold that kind of pain control. Wendy CO EMT-B RN-ADN Student

Looks like the EMS gods still favor my presence in certification land... I am active until June 2015 as a Colorado EMT-B! WOOHOO! Lol. Guess I couldn't let it go after all...

We don't all agree... sorry to burst the bubble chaps, but I disagree with this decision. I think it is not ethical to initiate the intentional termination of life, under any circumstances. There is something unique about human life that makes it different. Yes, we put our animals down out of compassion... but an animal is not a human being. The sentience that comes with being human, and in my opinion, the existence of the soul, makes suicide (whether assisted via a physician or not) an act that I feel to be very wrong. I also would caution that there is another group of individuals who feel that euthanizing non-functional human beings is appropriate, and that is a very difficult and pitfall-ridden path to be walking along. Human life is invaluable. It is precious. While I empathize with those suffering from chronic, debilitating, progressive diseases, I do not feel that opting to intentionally end your life is an appropriate intervention, nor should it be sanctioned by the medical community. I know many disagree with me on this, but this is something I am very firmly convicted of. I would like to add that I do not make this statement out of ignorance, or lack of exposure to what individuals and families go through as someone deteriorates from an incurable disease. I have provided care to many of these individuals, suffering from a range of conditions and possessing a range of cognitive functions. It is that experience that sets me so firmly against euthanasia and assisted suicide. I do agree that it is ethical to control pain, alleviate suffering, and through those measures perhaps shorten the span of a life that otherwise might have gone on for longer. For example, I have no problem in the administration of benzodiazepines and narcotic pain relievers in hospice care, where you know full well that said administration will shorten the person's life. I also agree that it is ethical to remove the artificial prolongation of life via medical interventions such as feeding tubes, artificial ventilation, intra-aortic balloon pumps, etc. Especially when the individual in question has created advanced directives indicating their preference with regard to this sort of care. Yes, you are removing an intervention that is directly supporting the individual's life... but you are not intentionally administering something to end that life. There is a very discrete ethical difference here. Make of it what you will.... Wendy CO EMT-B RN-ADN Student

Hell, better than MY chemistry teacher who decided since it was raining that the rooftop BBQ could easily become the fume hood BBQ... offering a hot dog to a firefighter in full bunker gear who just came up 4 flights of stairs is not a wise choice.... They were NOT amused and neither was the principal (considering my high school had a 5 alarm, several million dollars worth of damage fire caused by unlicensed welders my freshman year...) Wendy CO RN-ADN

Ruh roh! I wonder what they looked like all deflated and icky... probably like the sheep's lungs we used to play with in high school bio. I bet they were not human. That, or Mr. Canadian Porn Fugitive found a way to drop some spare parts in LA, too.... Wendy CO RN-ADN Student

My employer REQUIRES us to have the AHA BLS for Healthcare Professionals. There is no other option. You must get it, or you don't work. We actually had an issue and lost a nurse off the floor the other day because she expired and didn't realize it.... I don't, however, know of anywhere that DOESN'T accept AHA in my area. Anyone heard of AHA not being acceptable anywhere? Wendy CO RN-ADN