ncmedic309

Our tubing has both ports on them. The majority of our medications can be given in the needleless port but some still require the use of the needle port.

Your department should accept the online training format, of the agencies and departments I know of here in NC, they all are allowing their members/employees to do the online courses...

It sounds like your response was too quick! It sounds like you managed the situation just fine, he still had signs of life in the field and you guys attempted to get him to the ED alive. We know before hand that our efforts are not going to make a difference, this kids dead and there's nothing anybody can do to change that. You have a shockable rhythm, regardless if it's medical or traumatic etiology, you still treat it the same. I know some departments are going away from doing ACLS on traumatic arrests, mainly because it doesn't make a difference. So here's another question, if your not going to throw ACLS drugs at the patient, would you opt out of electrical treatment as well?

I agree with the above comments. The arrest was coming, it just happened at the same time they were knocking this guy down. It seems more like a timing event than a procedure that precipitated the arrest.

And to think some of the situations we face on the streets are tough? I would hate more than anything to be in that position in that particular situation. What do you do? If you give him a heads-up, your likely violating the department policy that's in place for drug testing purposes. If you don't, he might lose his job, his career, and everything else. If you have reason to suspect drug use, it would be more than appropriate to refer that person to EAP. I wish I had better advice...

1. Apologize to the patient for breaking her personal property 2. Notify the staff that we accidently broke a personal item 3. Notify my supervisor of the incident As minor as it might seem to some, it might not be so minor to the patient or family. I do this, I know I cover myself either way, and I won't feel as bad about the whole situation...

Yep, same thing here, exact same set-up, on each and every call. I might opt to take in the portable sucition unit as well, we carry a manual one in our airway bag on every call, but if I know I'm going to need suction, I go ahead and take the other unit as well. I would like to be able to carry in our CPAP on every call, but the damn toolbox that it's kept in is freaking huge (which makes little sense due to the CPAP unit being rather compact?)

I'll send you a PM...

I think your right, they don't happen that often. I've yet to see one in my career. I can't really say for sure until I'm in that situation and have to immobilize that patient. AZCEP brought up a good possibility, I'll add Kyphosis and Lordosis to that list, I'm sure they would make maintaining inline much more difficult..

We actually have a cadaver lab at our EMS headquarters. We are going to begin working with human cadavers as part of our continuing education in house. It should be interesting, I'm looking forward to the opportunity...

I keep these things on me at all times... - Radio w/ Mic - Alpha Pager - 5 1/2" Trauma Shears - Penlight - Pens (one for the uniform shirt, one that I can contaminate and throw out) - Critical Care Field Guide - Gloves - Note Pad - Pocket Calculator - Stethoscope - S&W Pocket Knife - Wrist Watch - Wallet with Certs and other important items I keep the following in my duty bag in case I need them: - Palm TlX Handheld - LED Flashlight - Stinger XT Flashlight - Gerber Multi-Plier Tool - Copy of Protocols - Rapid Rescue Spanish Field Guide (excellent for translating) - Eye Protection I keep a rescue bag on the truck as well: - Bunker Pants/Coat - Fire Boots - Extrication Gloves - Helmet - HEPA Mask - Traffic Vest

I would attempt to do inline stabilization. If you can't put the patient in an inline position, just immobilize them the best you can and document the situation.

Keep in mind, most cardiac patients present initially with normal EKGs (over 50% of them)... If it sounds like it's cardiac, then it's probably cardiac...

Check out this topic... Would you stick that laryngoscope blade in your mouth ????

I'm right there with you brother! I never had the oppurtunity to work for AMR, but at the same time, it sounds like I didn't miss out on much...

I think we've already covered Grey-Turner's and Cullen's sign earlier in the thread...

Take a look at the "Botched Executions" section... :shock: After reading all those, I can't imagine anyone would want to be the person administering that execution. Talk about needing a little EAP afterwards... Check out the very last entry of this year...

The "Blue Baby Syndrome" is actually present in many different congenital heart defects... - Ebstein's Anomaly - Tetralogy of Fallot - Ventricular Septal Defect - Pulmonary Stenosis - Transposition of the Great Arteries - Truncus Arteriosus - Tricuspid Atresia - Coarctation of the Aorta Nitroglycerin Drip (Tridil Drip) - Angina, Reduces Preload, Etc. Let's see if I can make a little sense of this... 50 mg of NTG in 250 mL of D5W yeilds you a concentration of 200 mcg/mL Most drips are usually started at 5-10 mcg/min and titrated to effect... Mix up your med, do the math, and go to town... Now we should be in line, on with the next one...

That would be Adenosine (Adenocard)... Stevens-Johnson Syndrome

If there is going to be a doctor present, why not just let him do it? I think it's pretty messed up that they are looking for somebody else to come in and "do the dirty work". What's that say for us as professionals? We're trained to save lives day in and day out, but take them? It's not our place to do so and we shouldn't be involved in this type of situation. It's nothing more than another kick in the balls to the profession, and that's something that we all can do without.

Definitive treatment for Trazodone overdose is Activated Charcoal and/or Gastric Lavage, and treatment for symptomatic hypotension should it occur... Treatment for a Vistaril overdose is supportive...

HELLP Syndrome H – Hemolytic Anemia (abnormal breakdown of red blood cells) EL – Elevated Liver Enzymes LP – Low Platelet Count HELLP Syndrome occurs during pregnancy with patients who have pre-eclampsia and eclampsia. The syndrome is typically an early warning sign of pre-eclampsia. Common signs and symptoms of the syndrome include abdominal pain (usually in upper quadrants), headache, and worsening nausea and vomiting. Lab work will reveal elevated liver enzymes along with low red blood cell and platelet counts. The most significant complication of HELLP syndrome is liver damage. Care is mainly supportive in the pre-hospital environment and treating the signs and symptoms of eclampsia should they present. Definitive treatment in the hospital setting is delivery of the child in the most severe cases. Differences between Fetal Circulation and Newborn/Neonatal Circulation

GAmedic1506: That's an excellent list of accomplishments! Congrats on a job well done!

Ok, since nobody wants to put anything in on this one... MODS (Multiple Organ Dysfunction Syndrome) As defined in Brady's Essentials of Paramedic Care, MODS is defined as a progressive impairment of two or more organ systems resulting from an uncontrolled inflammatory response to a severe illness or injury. The most common causes of MODS are sepsis and septic shock. Sepsis will initially be present and it will progress into a septic shock and then ultimately into MODS or a systemic inflammatory response syndrome. The mortality rate for MODS is 60-90%. MODS also results from diseases and injury such as: -Trauma -Burns -Surgery -Hemorrhagic and Cardiogenic Shock -Acute Pancreatitis -Acute Renal Failure Risk Factors for MODS are: -Age > 65 years -Malnutrition -Pre-existing Chronic Disease (DM and Cancer) Clinical Presentation of MODS: Within 24 hours - Low grade fever, tachycardia, dyspnea, AMS, and hypermetabolic states are present. At 24-72 hours - Pulmonary failure is present At 7-10 days - Liver failure, intestinal failure, and renal failure begins At 14-21 days - Renal and Liver failure become more significant, GI collapse, and Immune collapse occurs Past 21 days - Hematolgic and Cardiogenic failure begins, AMS secondary to encephalopathy, and death occurs Source: Brady's Essentials of Paramedic Care, 2003. Next Topic - The Cranial Nerves (Function and Assessment)

Sorry, I must have missed that question. Yes, I have found dirty blades and other equipment that was contaminated more times than I can remember. It still tends to happen to this day, but it's much less likely to be a dirty blade, because we use disposables now. You might find a dirty handle from time to time. If you want to make a discussion, let's look at the entire ambulance and see just how clean it is. I can take a clean white towel on most occasions, and wipe off nothing but the seats in the cab and the steering wheel, and afterwards, the towel is brown. I haven't even touched the patient module yet. There's something in each one of our ambulances now that's contaminated. Somewhere in that bus, there's something sitting that we missed. I'm sure some people don't think that's possible, but even when you practice good cleaning habits, your not always going to get everything, mainly because everyone else does not practice those same habits. It would be nice to have a perfectly clean and sterile environment each day, but it's just not possible...