ncmedic309

Ok, so the moral of the story is... MAKE SURE YOUR EQUIPMENT IS CLEAN AND SANITARY! That's great, it sounds like we all do that and have been doing that for some time... What's next??

Here's more on the articles that GAmedic was referring to... RESTRAINT ASPHYXIA

You made the right decision, I would have done the same thing, these type incidents can not be tolerated. It's a tough call to make when it's a partner that you work with everyday, but it's the right call.

Just based on the mechanism and your transport time to the trauma center warrants flight services. The information given to you over the radio by the fire chief on scene only confirms the reason you requested it in the first place. I don't have any problem requesting them if the situation warrants it or potentially warrants it. It's much easier to cancel them once you get on scene than to request them late when they could already be enroute, you made the right call...

We also use the disposable blades, it's the way to go... EDIT: Here's a link to an article about the blades we use... Greenline

Manage it, you have the training, skills, and medications to do so, make your patients comfortable...

I just kept this simple, if someone wants to elaborate further, please do so... Vital Sign Changes in Shock 1.Initial- Changes are minimal 2. Compensation - Increased Heart Rate, BP usually remains within normal range, Increased Respiratory Rate 3. Progressive/Decompensation - Hypotension occurs along with tachycardia, getting closer to death, Respirations may initially be fast, then progressively slower 4. Refractory/Irreversible - Hypotension along with bradycardia, decrease in respirations, death Edit: Forgot to add in another topic...how about MODS (Multiple Organ Dysfunction Syndrome)?

Grey-Turner's Sign Named after the British Surgeon George Grey Turner Bruising and/or discoloration of the flanks caused by the retroperitoneal leak of blood from the pancreas in hemorrhagic pancreatitis, blunt abdominal trauma, and ruptured abdominal aortic aneurysm. http://www.fmed.ulaval.ca/med-18654/prive/Cours%2014.htm#1 ---------------------------------------------------------------------------------- Cullen's Sign

I'm not surprised of their actions... :roll:

240mg?!?!?! Damn! That's a great example of why you should NOT pull pranks on your co-workers!

If I had stopped, I would have left after first responders arrived on scene based on the scenario given. Your not on duty and have no duty to act (at least here in good ol' NC), your just acting as a good samaritan.

I agree, the initial rhythm appeared to be SVT but considering the patients history and meds you can bet it's probably going to be atrial fibrillation or atrial flutter. I would attempt to slow it down for a better diagnosis with vagal maneuvers, if no response, throw some Adenosine at her and you should be able to determine the rhythm, as you did in this case. If her BP remained where it was, I would consider this stable and go ahead and treat it with Cardizem. Let's see if we can get that rate under control, and it will probably do away with that sensation in her chest. Good scenario...

I've got the best excuse of all for not using it, we don't carry it! Even if it were on our trucks, the vast majority of our transports are less than 20 minutes in duration and that doesn't allow you a lot of time to mix up a slurry in between getting the rest of your assessment and treatment out of the way. I could see it being used in more rural settings where you have extended transport times, but in most urban EMS systems, I don't see the need for it...

Go back and re-read my first post in the thread and then take a look into where it went from there... As I previously mentioned, this thread is "useless" and I'm done wasting my time with it! Flamers and Bashers, please carry on... 8)

It doesn't need to go to that level... There hasn't been anything "productive" about this discussion...the more appropriate term would be "useless"...

It should be locked...

???

While we are talking about "flaming" towards others, isn't this thread "flaming" towards FDNY and the other responders involved in this incident? Or maybe a FDNY bash fest? :-s Nah, that couldn't be... :roll:

Or maybe he's just not a fan of bullshit?

Ace: You should of been a comedian...

I just noticed the IV bag...

The only things that should be visable to us in these pictures is this patient placed correctly in full-spinal immobilization, high-flow oxygen being applied or ventilations being assisted (which ever is more appropriate based on his presentation) and him moving very rapidly to the awaiting ambulance, at least that's how it would work on my scene. Everything else from that point on (intubation, chest decompression, IV, monitor, secondary assessment, etc.) would be done in the back of my truck and enroute to the appropriate facility. After looking at these pictures, the only thing I can see wrong after he was rescued, is no oxygen being applied to the patient as he is being moved (to the assumed awaiting ambulance?)... Edit: Just to clarify about interventions, I don't see anything wrong with someone wanting to intubate before loading the patient or with dropping a 14 ga. in the chest, but if the airway can be managed effectively with a BVM, let's get this patient into a more optimal environment and take care of business...

It just goes to show, this is about nothing more than bashing the fire services... Ace! Where you there man? If all your going off is the pictures and the media in this situation, you have no valid argument except your personal observation. And while that may mean everything to you, it may just mean diddly-squat to everyone else! My personal observation is much different, and I could give two-shits about what goes on in the fire services...please see my previous post...

First off, I'm not a firefighter, I'm paramedic all the way and have no desire to be the "Amercian Hero"... Just some observations from the picture... 1. Nobody is maintaining in-line cervical stabilization... 2. The cervical collar looks like it's been improperly placed... 3. The patient is not centered on the board and not in-line... 4. There is no care being provided for this patient, it appears he has significant burns, he's probably altered, and he doesn't even have oxygen being administered... On the other hand, I also note that there are several firefighters with their air packs and SCBA still on and in place. This tells me that they probably pulled this guy from an area with "sub-optimal conditions". The scene was probably not safe, and the main priority was to get this patient from that area as quickly and safely as possible so that he could receive the care that he needed. That sometimes means not having everything done exactly the way you would if you had optimal conditions. I wouldn't expect this patient to be packaged completely when they brought him to me, in fact, I would be surprised to see him with a cervical collar in place and on a LSB vs. just being thrown in a stokes and carried out as quickly as possible. Why is that everyone is so quick to judge the other profession and their actions, especially when you weren't present and don't know one bit more than what the media is telling/showing you? The purpose of this thread was intended nothing more than to start another fire vs EMS debate and everything else that goes along with it. Grow up people!

If it's not causing airway compromise, it's staying in place...