Eydawn

So did they ever figure it out? Any calls related to it that actually turned out to be something?

Wendy

CO EMT-B

MI EMT-B

"I'll bet you'd drive better with that cell phone up your arse..."

"My Redbone Coonhound is smarter than your honor student"

"Golf is a good walk- spoilt" (Mark Twain)

Ah.. I can't think of any more at the moment... but these three are some of my favorites.

Wendy

CO EMT-B

MI EMT-B

My significant other chimed in and said try a fly box for fly fishing. They are small plastic cases lined with foam (he says his dad can run over it with the car and it doesn't shatter) that come in various sizes. Sounds like you might be able to find one on any sportsman's site... but here's a link for you. The metal ones are the one that my SO is familiar with.

http://www.orvis.com/store/product_directo...ubcat%5Fid=6030

Like I said... various sizes, all foam lined... and some are metal cases. Good luck, Dust!

Wendy

CO EMT-B

MI EMT-B

Box of condoms...

Add a soup ladle, fingerpaint, nutmeg, tabasco, stretchy pants, and a Coney Island Hot Dog.

With some Icy Hot on the side... gonna be an interesting night!

Wendy

(I can't believe I posted on this thread... must be the Tylenol 5)

Drug checks on employees- for their safety and yours.

Review personnel files, make sure they're not just careless in general.

Create great big BLUE stickers to put on one of the drugs, with the drug name printed on it to avoid further confusion. Other than that, all of what has been written above. Bet they'll triple check next time.

Wendy

CO EMT-B

MI EMT-B

First off, if you want to have a few beers with your buddies and you are off duty (whether you're 21 or not, I don't really care, personally... I think Europe's got a better handle on that situation in terms of drinking culture in general, but that's another post entirely) there is no problem with that. If you are using the uniform to attempt to break the law, you are obviously not using your head and you are placing your career and the reputation of EMS on the line for no good reason at all.

We are here to serve- not to be served and worshiped.

We are not above the law (whether it's traffic laws, drinking laws etc) just because we are EMS professionals. The same rules still apply whether you put on a fancy uniform or not.

The uniform is to instill confidence and convey authority, while you are on duty. It is not to be used for personal gain. Remember that when you put on the EMS uniform, you put the reputation and livelihood of thousands of your fellow workers on your shoulders. It falls on each and every one of us- especially since we often seem to be the red-headed step child of emergency services.

If someone gives you a discount while you're on duty, it is a gift. They do not OWE it to you. You have really done nothing to warrant being rewarded in such a fashion- because you are doing your JOB. You should never try to guilt someone or solicit discounts by presenting yourself as a "hero." The uniform does not make the man or woman; the action does.

Know what this action makes you? An idiot. And it may make our jobs that much harder the next time we have to run a medical call at any of these venues- because they will view us as unprofessional due to your actions. The uniform is a symbol. Make sure you know what it stands for and how your actions may change how others perceive it.

And if you want to hang out with your family and/or friends and drink a beer, then more power to you. Don't respond to any medical calls after ingesting any alcohol and don't drink in uniform. It's that simple.

Wendy

CO EMT-B

MI EMT-B

Not a hero- just trying to do what I can.

You Can Only Type One Word

Not as easy as you might think.

1. Yourself: Exhausted

2. Your boyfriend/girlfriend?: Amazing

3. Your hair: longish

4. Your mother? sweet

5. Your Father? skilled

6. Your Favorite Item: ring

7. Your dream last night: frightening

8. Your favorite drink: frappucino

9. Your dream car: jag

10. The room you are in: musical

11. Your Ex: Greece!

12. Your Fears: death

13. What do you want to be in 10 years: Mom

14. Who you hung out with tonight? friends

15. What You're Not? home

16. Muffins: chocolate

17: One of Your Wish List Items: massage

18. Time: 1419

19. Last thing you did? write

20. What You Are Wearing? clothes

21. Your Favorite Weather: colorado

22. Your Favorite Book: scifi

23. The last thing you ate: pineapple

24. Your Life: insanity

25. Your Mood: patient

26. Your friends: love

27. What are you thinking about right now? home

28. Your car: aerostar

29. What are you doing at the moment?: survey

30. Your summer: lifesaver

31. Your relationship status: taken

32. What is on your tv? tv??

33. When is the last time you laughed? morning

34. last time you cried? yesterday

35. School? arrrrgh!

I thought it was fairly funny (albeit really really stupid, but come on, it's a funny idea) until they actually left the parking lot and hit the streets. And yeah... if you're gonna do something that dumb... at least reverse your jacket so you're not easily identifiable! It was kind of hard for me to gauge how fast they were going... looked like mabye 15mph? Good enough to clonk your head in a serious way if there's a rock or solid chunk of ice in that snowdrift, and good enough for some tasty road rash. Not a good thing if you're on duty. Kind of reminded me of street luge- motorized style. So where's the helmets?

Yes, we can be silly at certain events... especially if it's somewhere where playing around is acceptable, like a carnival, but you have to be able to flip that switch in a heartbeat and go into professional mode and convey to everyone around you WITHOUT A DOUBT that you are on and things are being taken care of. If you can't do that (which I'm willing to wager most of that bunch couldn't) then you shouldn't be horsing around- you should be professional 100%.

Come to think of it... maybe the best policy is to be professional 100% of the time anyway. You're not getting paid to create more patients and gunk up the backboards with street oil and mag chloride. Nor to hose down the FF's (although that's fairly harmless).

Wendy

CO EMT-B

MI EMT-B

ROFL! If I don't get off the city in the next 10 minutes I'm never getting this damn essay done. Very well done, AK!

Wendy

CO EMT-B

MI EMT-B

Why is the City such a good place to procrastinate pointless work?

Ok. Disclaimer. If you didn't know I was insane already, then you do now. Here it is: The SWAG about predicting calls, premonitions, funky feelings, and damn near everything else I could fit in!

I believe that time is fluid. That is, that time is kind of like water- it can move forwards, backwards, in different branches, it can loop around on itself and it can move at different speeds. Case in point: Many people who have been in car accidents say that time "slowed down"; that things moved a lot slower than normal, that they could see the impact approaching, etc. I think that it isn't a matter of perception; I think that time actually slows down at that point. I don't think it's completely our conscious processing that slows down- although it probably does to some extent because the event is emotionally or physically traumatizing.

I think that some people are more receptive to or aware of events where time does strange things. Kind of like some people have a really good sense of smell, or really acute hearing. Most of us perceive time as a linear sequence of events, but sometimes things don't necessarily work that way. For example... I feel like something is going to happen to my friend "Joe". I see a sequence of images of an event that I have never seen before. I call "Joe"; nothing out of the ordinary is going on. 3 hours later, "Joe" calls me and says you know it's the damndest thing, that just happened to me... and it's the sequence of events that you saw. Coincidence? Sure, it could be. Anything is possible, and lot of times it will be coincidence.

When it happens multiple times with multiple people and events, then it's not so likely to be coincidence anymore. What I think is a more likely explanation is that there are possible branches in time, downstream or ahead, if you will, of what we're perceiving right now. Sometimes our conscious thought process catches up to that point in the future, or maybe it loops back towards us, and we become aware of it. Some people are aware of it in images- for example, they see their friend getting into a car accident; some might have an auditory response- maybe they hear their friend talking to the police officer explaining how the accident happened; maybe others emotionally respond to the event without being fully aware of what it is, and get upset and worried about their friend for no apparent reason. It's different in different people.

NOW- here's the tricky part. Because of events that are happening right NOW, at this specific point that we are at in the timestream, the branch ahead of us isn't fixed. There are many branches that could happen, and each depends on a sequence of events stemming from now until that point. So, the very act of becoming aware of that possible future may change the timestream to the point where that event cannot happen anymore.

It is impossible to know whether or not whatever you perceive, whether it's images, or a "feeling" about something, or something auditory, is going to actually happen or not. It's up to you to process it to the best of your ability and do whatever you think is necessary based on the idea that you might have intercepted a possible point or instance in the future, before you would have experienced it if you moved through the timestream at the same speed as everyone around you.

Now, with the pager thing... I think what might be happening (based on this theory) is that some part of his brain is receptive to that possible future- the pager going off- and he wakes up in response to it. The adrenaline and WHOA I just woke up to a call hits him about 20 seconds PRIOR to the rest of him catching up to the point in time where the pager actually goes off, because his mind was aware of it early- whether due to his consciousness moving forward or that bit of time looping back and slowing down enough for him to perceive it. So he wakes up and feels like he's about to go on call, because he is- but his alarm goes off after he becomes aware of the situation, earlier than he "should".

I've had similar experiences, especially with the waking up before the call (and this was to a camp radio that wasn't linked in to a scanner system. No chatter beforehand- just waking up and grabbing the radio and my glasses and having it go off before I realized what I was doing) You don't talk about these kinds of things much to other people, because most people go A: you're nuts B: it's coincidence or C: Really? Can you talk to my dead grandmother?

Does it help you? Does it hinder you? Depends on how you react to it. Personally I've kind of started to treat it like a patient's history... unless there's enough other pieces for it to make sense or until I discover something else that corresponds with it, it's just another possible piece of information. Might be completely bogus for all I know.

So, who thinks I need to head for the padded room? Remember, it's just a theory.... it's actually an interesting blend between philosophy and physics (the boys and gals in the physics labs are starting to play with the idea of fluid time a little bit, which is why I find it fascinating).

Who's next? More theories? Ready to stuff my theory in my ears?

Wendy

CO EMT-B

MI EMT-B

Ok, I'm really happy to learn that there's more of us freaks than I thought! Give me a few hours and I'll get back to my dorm and post my SWAG (Scientific Wild Ass Guess) pertaining to this. See if it makes sense, and let's get some discussion going on it! CJH- do you mean dreaming about a SPECIFIC job and you get that SPECIFIC job, or was that more a smartass comment about dreaming about working and lo and behold, now you have to work instead of sleep?

PS- CJH, is that a pic of you in a kilt? What clan are ya?

Stay safe out there!

Wendy

CO EMT-B

MI EMT-B

My old Gall's softpack feels unloved and shunned... it's actually quite useful though. Hasn't failed me yet (knock on wood!)

Wendy

CO EMT-B

MI EMT-B

If you are running a Windows based OS, go to the start menu in the lower left corner of your screen. Click on it. Go to All Programs; go to Accessories; now go to System Tools; finally, there should the character map. Good luck!

Spanish class had me hunting all sorts of crazy characters.

Wendy

CO EMT-B

MI EMT-B

I've woken up right before tones drop, and also right before my radio goes off in the middle of the night. I'll look at my cell phone 2 seconds before I get a text message... or just be picking it up when it'll go off... So yes, it happens to other people too. I've heard of medics who know what kind of call they're getting before they get it. I've just kind of gotten used to it.

I have a very interesting theory about this kind of thing... it has to do with time but it kind of jumps into physics a bit which I'm not really good at. If you really want to know, I'll tell you- I've explained it a few times before to friends. If not, I'm not subjecting the board to it, because it could open up a very funky can of worms!

In the meantime, don't worry about it. Just accept it, is all I can say. It's something that most folks don't talk about because yeah, it's kind of strange... but think of it this way... it gives you a jump on waking up in the middle of the night, and that extra 20 seconds could mean something someday.

Wendy

CO EMT-B

MI EMT-B

I've got to go with Anthony on this one. It's either cumulative injury from being a soccer player (which I have seen in MANY of my young male soccer playing fiends... er... friends...) OR it's Lyme disease.

Acute symptoms may resolve quite quickly, while the disease still progresses; a variety of neurological symptoms can be observed, including short term memory loss. These symptoms can be seen in isolation or in conjunction with other symptoms as chronic Lyme disease progresses. Also, by this point the rash from the initial tick bite should have faded, and the bull's eye pattern is not necessarily as common as a uniformly red rash (google, wikipedia and one of my old textbooks are my sources). These later symptoms can show up months after the initial exposure.

http://en.wikipedia.org/wiki/Lyme_disease

So... since the camping trip was mentioned a couple of times and we don't appear to have any STD's or cumulative soccer injury or nutritional deficiency, etc this makes the most sense.

Do we (and by we I mean Anthony) win? Is it something completely different?

Wendy

CO EMT-B

MI EMT-B

medic53226, don't quit posting. This is an invaluable site where you can learn a lot of different things. One thing I might suggest is to break up your post into several lines, instead of a solid block. I understood what you were saying- it just took me a little while to process and figure it out.

So, the gist of it is, your patient took a CRAPLOAD of drugs. You didn't realize the quantity or the spectrum of said overdose until a while in. This is the worst overdose you've ever seen.

You administered narcan, your patient woke up and threw up everywhere, while becoming extremely violent and combative. You and the doc were astounded at the magnitude of the overdose.

So now you want to know, has anyone else ever seen a patient take this much crud, react in this way, and if so, how did the medics treat said patient? Tips and ideas for future massive overdoses?

Personally, the worst overdose I've seen was dead. End of story. But I have heard of some crazy ones that got really combative. Don't know how one would take care of this; as a basic, all I can do is hand the medic things, bag the patient, take vitals or drive.

Thoughts from our upper echelon here? How would one take care of such a massive overdose? Is liquid charcoal contraindicated here?

Wendy

CO EMT-B

MI EMT-B

Mental health is as complex an issue as you can get. To begin with we don't even really know the basis for a lot of mental disorders; it is extremely difficult to tease out what is physiological, what is biological, what is situational, what is psychological etc. and all of them interplay in the realm of mental health. This makes treatment very difficult for any provider of any level, much less the prehospital care provider with 15 weeks of EMT-B training, or the paramedic with 1.5 years of education.

The deeper I get into biology and medicine, the more firmly I believe that medicine is much more important than A+B = I do C, or even critical thinking about proper treatment and interventions... It has to do with how you interact with your patient. This goes for medical, trauma, and mental health patients. If you are working with a medical patient, and you manage to establish the right connection with that patient, you can improve the outcome of your interventions. This is an idea that has been researched a few times; I'll see what I can dig up in the way of references (exam week is kind of prohibitive of that at the moment).

I think this idea is even more important to keep in mind with a mental health patient; whether it's a chronic depressive frequent flyer, a newly diagnosed paranoid schizophrenic, or someone with multiply personality syndrome, the way you interact with them will have an impact on them. Perhaps there is not a great deal that can be done prehospital, especially if you don't know what their problem is; but you can still do something for them. Talk to them. Establish a connection (albeit professionally) with them. Even though all you can do is take vitals, try to get a history and administer oxygen or sedatives (dependent on certification level) as necessary, you can still make some difference with this patient.

Mental health patients can be really difficult to deal with. They might disturb you emotionally, they might be physically combative, and you might not have the faintest idea what to do with them, but they are still YOUR patient, and need you to try your best for them. After all... many of them are suffering from an illness that they cannot control or that makes it difficult for them to mentally comply with their treatment. You don't just look at a diabetic and go "ok, shoot 'em full of d50, hi-flow O2, I'm not going to talk to them now that they're not acutely dying."

And you may never make a difference; but it is worth a shot.

My 2 pence.

Wendy

CO EMT-B

MI EMT-B

Family hx of cardiovascular or neurological problems? How about family hx of cancer?

Known allergens?

What position does he play on the soccer field (I know it's a goofy question but as a former soccer player I know it can make a difference in terms of running, maneuvers, etc)

Any noted behavior changes other than the memory loss, either by teachers, friends or parents?

Any recent illnesses or injuries, car accidents etc? Say within the last year or so, for time reference...

How well oriented does he seem other than the memory loss? Does he respond appropriately? Does he respond within a normal time frame, and are his sentences completely coherent?

He seems embarrassed... so he is aware of what is happening, and that he should remember but can't?

Does he feel any abnormal sensations in his hands, feet, etc. that he's not used to feeling or hasn't experienced before?

Ok.. I'll let someone else play..

Wendy

CO EMT-B

MI EMT-B

One should never apply this decision based on a number. Every pregnancy, every human development within the womb is slightly different. I personally have many friends that were born at 22, 23 and 24 weeks of age; one of them had to undergo a surgery that had an 80% chance of ending his life, but if successful would ensure his normal mental development. He's a mathematical genius. My other friends have slight, if any, noticeable deficits.

This idea is absurd as a generality that could be applied incorrectly to so many specific instances. And it should never be a unilateral decision by any means. I hate numbers used in this way- life so often contradicts them.

If we are to educate parents, so suddenly thrown into this situation, we must take steps to ensure that the highest quality care is given to the newborn until the parents have reached a point where they can intellectually and emotionally make their decision. Thus, if they decide to go for broke and try, even though it's statistically unlikely that their child will survive, the correct measures have already been implemented.

This is going to be a bit of a philosophical/religious aside from this point forward, so if such things offend you, please do not continue to read.

I believe that it is *ultimately* not up to us as human beings to decide when or how a life will end or continue. We may be guided to allow life to end in certain instances, for example, a completely VERIFIABLY brain dead individual on life support, but again, these things are never clear and simple. I believe that the work we do as medical professionals is necessary and a calling, and if it is someone's time to die, then they will die despite all of your best efforts and interventions. I think it is presumptuous of me, as a person, to say "Oh, well, you were born at 22 weeks so you don't get the astronomically minimal chance you have already at life. I'm just going to let you pass away."

Why did we develop this technology in the first place, if we aren't going to utilize it? We learn more about developmental physiology on a daily basis. There may come a point where survival rates for babies born at 22 weeks increase, due to what we have learned through caring for those who didn't make it. There may never come a point where this happens But there is still a chance.

I believe that doctors have a right and the ethical obligation to inform parents that the chance of survival is minimal and that their child may struggle with deficits if the child even survives; I do not, however, believe that this devalues that life in any way, shape or form. Just because someone has deficits does not mean that their life does not have intrinsic value, nor that they lack enjoyment in that life. This strikes a nerve with me the same way that terminating a Downs or other "defective" pregnancy hits me.

I also know that despite all odds, people survive when they aren't supposed to. One of my professors has suffered blunt trauma cardiac arrest TWICE, and is still walking, talking, cussing and enjoying his life to the utmost. That's not supposed to happen. Blunt trauma asystole is supposed to be DEAD. But he isn't. Therefore, I reserve the right to respect and support those parents brave enough to tell the doctor that they want to try anyway. Because many people will just do what a doctor tells them to, and that is a scary thought.

That's enough for now; I have a workshift to get to.

Stay safe out there.

Wendy

CO EMT-B

MI EMT-B

Isn't it purely speculation to wonder why this guy was in an ambulance since you have no idea what his potential injuries were? Just saying... maybe he has a psych history well known to the cops, maybe he's a diabetic who never takes his meds, maybe the cop broke his arm or his ribs taking him down... it's all an imaginary scenario at this point. It's a moot point.

Fact: He was combative and assaulted both a police officer and an EMT.

Fact: For some reason, it was determined that he should be transported via ambulance, not squad car. Rationale: unknown at this point. Regardless, it was determined to be appropriate.

Now, let's discuss possible ways to restrain a combative patient.

A: Physical restraint that does not compromise the airway. This includes full immobilization to a long spine board, with hand and foot restraints to keep the patient from flailing/striking anyone in the patient compartment. The "oreo LSB sandwich" is a lawsuit waiting to happen. Ask a partner to sandwich you when you've got some down time and then wiggle around. Think about how your respiratory capacity is diminished, and how an agitated state with an already elevated respiratory rate might make this situation deteriorate rapidly. Also, it would probaby be better to place a dust mask or N-95 on a spitter than an NRB with no O2 flowing through it. Just a thought.

B: Psychological restraint via the presence of an LEO. This LEO, remember, must conform to his operating procedures. He's in there to keep himself, you, and the patient safe (pretty much in that order) and will use whatever force is necessary to accomplish this goal. Usually this will involve psychological force in numbers, as well as helping you tie Mr. Incarceritis (Help! I'm going to jail! I have CHEST PAIN!) down, and/or utilizing further physical force as necessary.

C: Chemical restraint. Subdue the patient physically long enough to make chemical sedation a possibility. Then further physically and/or psychologically restrain as necessary after sedative administration.

Moving on... any other thoughts or ideas on dealing with combative patients, criminal or not?

Wendy

CO EMT-B

MI EMT-B

No, lol... you can do it any way you want to I guess as long as you don't end up with a really stupid answer like 124... OBVIOUSLY our instructor was not breathing that fast. Personally I prefer the 30 seconds x 2 method. We were taught 15 seconds X 4... and somehow my classmate got screwed up and ended up with a realllly odd number that should have registered with me before I relayed it. He got yelled at because he counted for 15 seconds and didn't multiply by 4. Or maybe he got reamed because he got an illogical answer and didn't double check. I wasn't there for all of his chastisement.

That answer the question?

Wendy

CO EMT-B

MI EMT-B

mediccjh, absolutely amazing on the scene time on your rough one. And even though it seems frustrating that all you could do was maintain airway and C-spine, think about it this way.. if you hadn't done that, she might not have had a chance at all!

Take it easy, if I were over 21 I'd buy you a Guinness!

Hang in there.

Wendy

Fortunately this was only during training but it was dumb enough that I should have caught it. 3 of us were working in the simulation lab and I was the comm officer; they start hollering vitals at me (respiratory distress- our "patient" was a local medic from the FD playing along with us) and I relay them to "medical control" (my instructor) to get an authorization for something, I don't remember what it was for exactly, I think it was the "patient's" nitro.

"Yes, we have a 46 y/o male, c/o dyspnea and crushing chest pain; hx of cardiac problems, has a prescription for nitroglycerin and I am calling for authorization to administer"

"Could I have some more information please?"

"Yes, patient is AAOX4, no allergies, no other meds, BP is 140/90, pulse is 88, respirations are 124"

"Could you quit talking to me and start bagging your patient? What do you mean resps are 124?"

Look at my partner... "hey, "Bob"... what are his respirations? "

"ONE HUNDRED AND TWENTY FOUR AND HE JUST FELL OVER"

At this point we just ran it like a code, but I got reamed for not thinking about that respiration number and my "partner" got reamed for multiplying by a number other than 4. I don't know what he multiplied by... 8 or something. He just wanted to be a FF anyway (really and truly, he was only in the basic course because he had to be- great guy, he's going to be a really nice FF someday!)

So far, that's the outright dumbest thing I've said... *knocks on wood*

Wendy

CO EMT-B

MI EMT-B

Improvisation is the key. When I have my 'druthers, a SAM with some nice bulky kerlex and padding. Next preference- a pillow and a LOT of kerlex and cravats.

Vacuum splints are counterintuitive in the mountains.. you come down in elevation and guess what, pressure changes... and so does the shape of your splint...

Just a thought!

Wendy

CO EMT-B

MI EMT-B

Definitely always have the little memo pad in the back pocket. They're cheap, so if they get gunky well, out they go! Good for writing hx, things you thought looked funny, vitals, drunken quotes... you name it.. and don't worry about the pen. Wash your hands. The handle on the bathroom faucet in the Arby's is a much, much scarier thing to touch.

Wendy

CO EMT-B

MI EMT-B