Ridryder 911

Imitrex is really a good drug for those that suffer migraines. Just like any other medications it has S/E & A/E that needs to used cautiously.Research has shown that narcotics has never really treated migraines only the symptoms. Usually, the narotics places you in a deeps leep enough for the person to "sleep" the migrain headache. One of our physician's used to use a steroid and anti-ematic and it worked just as well as the narcotic. Even some of them was on oxycontin and it worked better thatn the narcotic. I am quite aware of the severity of pain, associated with cluster headaches as well. If re-current headaches begin, you should be seen and evaluated ny a nuerologist and hopefully be treated aggressive. Good luck, RIdryder 911

I use the term " ambulance drivers" when the EMT's look like slobs or don't know hteir orifice from a hole in the ground.. but then : I would be insulting ambulance drivers then ..... Yes, it is an insult word... Be safe, Ridryder 911

WHen I first entered the field, it was a lot more common to perform IntraCardiac (IC) injections than EJ IV. Simple technique once you learned the procedure. Then in the late eighties we started placing central lines ( Femoral and sublclavian). I agree, it comes down from the same mind set ... do it right the first time, this also includes education and lab arena to train in as well. I have placed many chest tubes in and it seem a lot easier than placing a NG tube a belligerant drunk orcatheterizing a 90 year old lady. Again, it just a skill, with having an increased knowledge base, and should be closely monitored. Be safe, Ridryder 911

Well, unfortunately he is the one that is "dumb"... pain represents muscle dying, short and simple. So what if can't state the patient current c/c ... big deal! Does he not believe people when they in with a history of a fever or does he not want them taking a Tylenol before they come.... you mean he is not going to tx abdominal pain with N & V , prior to a surgeon looking ?..God forbid the surgeon not seeing the pain or N & V ... NO ! You tx the patient. Hopefully, he had a bad night, and a not true asinine idiot.. if he wants he i.m. me & I will tell him myself ! Maybe he needs a good refresher of BASIC MEDICINE ...Due the patient no further harm .... HIM! Be safe, Ridryder 911

LOL.. I was going to add that too.... & D.O. and M.S., PhD..ARNP...CNS...? Be safe, Ridryder 911

You also forgot Critical Care Paramedic and or RN, etc... as you see the list is lengthy. Be safe, Ridryder 911

I agree, nasal intubation can be & should be considered on some patients. I believe actually the number of cranial intubations may be a couple a year; but due to litigation and law suits the true number may not be ever disclosed. I do believe in nasal intubation if possible and allowable if their again is no chance of facial fractures such as La Forte or suspected basilar fxr. This is why I am big proponent of RSI. Be safe, Ridryder 911

Actually the danger lies in the soft portion of the sphenoid bone. Dr. John Shea a nuerosurgeon and very pro-EMS advocate, has attempting to eduae the dangers of C-spine and dangers of nasal intubation on potential head injury patients for years. That is why his medics performed crich in lieu of intubation on trauma patients. There are more than 2 citations of brain stem intubations as well as NG tube placement in the brain stem, this however; should not be confused with the nasalpharnygeal airway which is very soft pliable and if measured properly does not extend past the nasal/oropharyngeal vault. Again, proper insertion with lubricating jelly and proper size makes this an excellant airway device in many patients. I get very discouraged of how many EMS medics bring patients (especially CVA) without any airway device, yes, even conscious patients tolerate these well. Be safe, Ridryder 911

I suggest it if you are working for a very aggressive service, and you really want to know more emergency medicine. I found it pretty basic though. The surgical techniques, such a peritoneal lavage or belly tap are skills you will never use, however some service are going to chest tube placement in lieu of decompression. Any education can never harm you ,and may want you to strive for more. I agree though, if you are not at least up on advanced emergency care, your money might be wiser spent on field classes such as PHTLS or BTLS. There is really no difference in the didactic portion of any of these classes (PHTLS, ATLS, TNCC, etc..) trauma is trauma .. the skill portion is the only difference. Remember that this course was designed for physicians that does not practice trauma very often and was to review skills at a physician level..... good luck! Ridryder 911

Personally, I hope they do become popular.. I bought stock in this company 5 yrs ago...haven't seen a return yet... Be safe, Ridryder 911

Sorry, I cn not get the links to open. Is this the same as external prediction of C.O. and SV as well predicatble EJF index ?... I have seen these in use and thought they are a great tool, and we have one in the CCU where I occcasionaly work. But, the costs of $25K is too prohibitive at this time for it. (If this is the same device) Thanks for the info... Ridryder 911

You also have to remember the maternal circulation is devloping as well. With this you see sometimes a "shift" and hypotention and an increase in circulationg voulme. Be safe, Ridryder 911

I think there are Paragods.. even some who are ex's... the same as new graduate nurses that have the RN'itis syndrome. Some medics are so full of themselves to actually think they "cure" or "save" people... we just temporary postpone death. I have actually watched new Paramedics attempt to critique physicians ECG interpretation.... you mean 10 weeks ago the one you couldn't read ?..... and now your an expert ?....You got a job to do,do it well, like you are supposed to. To actually think you have grasped emergency medicine in a 16 week to 1 yr course.. geez.. Most of these so-called "Para-Gods" exposure to any medicine is the few hundred hour clinicals and watching t.v. reruns of ER and some sitcom... Yes, some were jerks before and some might been in hibernation..... Thank god they usually don't last long. Be safe, Ridryder 911

Returning back to field was some adjustment, that most rather do everything enroute..I prefer to be sure I perform an adequate assessment then perform tx. I has came from the old school of doing everything as much as possible at the scene. Due to increase weight of equipment, and number of responders at the scene etc..as well as number of responses now, I prefer to tx in my unit. Of course like each call it depends on the circumstances. I prefer to tx. hypoglycemia in the residence.. they can assist to walk to the stretcher etc.. or may even fix a high protein snack and not transport. Increasing number of responses, causes scene times to be closely monitored as well no available units. gain, each system and each patient unique. Be safe, Ridryder 911

Do as the above posts state, I would also hire an attorney to draw a letter of intent for all discussion to cease & dismiss immediately. This usually will be all that is needed and does not cost very much. If they continue then you have resources to take them to court. Good luck, Ridryder 911

If ww mandate CPR then physcians will be required to have it as well [-X LOL Be safe, Ridryder 911

Apparently the Doc doesn't know but he is about to get busted by JCAHO on pain control. He must not keep up on the new issues of controlling pain... just wait.. he will have a new attitude after review. Research has shown that pain management in ER is too low and those with perceived "drug seeking" behaviors are usually not founded. Be a patient advocate and do what is right for the patient..... Be safe, Ridryder 911

It all depends on your state..most require at least an instructor course. Some require service time at that level.. Be safe, Ridryder 911

And for us that remember Wally Cox was the voice and was a regular on Hollywood Stars with Uncle Charlie & Lonseome George Gobel... Be safe, Ridryder 911

Wow...... you had must to be bored to pull this one out from 6 months ago.... Ridryder 911

Don't know about "bad acting" but I have been on there a couple of stories...(Trauma Center & Paramedics). I guess you could say bad acting it was filmed on location and in trauma centers..... Ridryder 911

We use non latex tourniquet... I do not support the ban and here is why.. ever tried to feel intricate parts of the body with vinyl gloves ? Sorry it is not the same... yes, if you are allergic to latex use something else.. if not so be it. I think you will find it hard to see physicians and especially surgeons ever switching over... I know most thorough a fit when those kits come with vinyl gloves, nothing like trying to feel a bleeder or part of an organ with a vinyl glove on . Lot of people think plastic and latex are the same.. nasal cannulas and most catheters etc.. are made of plastic vinyl not latex... (rubber) ... Be safe, Ridryder 911

Glad you are at least discussing this. As I have posted above I believe counseling should be required for married EMT's and EMS students. It is very hard for couples as well as those with prior relationships when entering EMS. As you have pointed out " he appears jealous" that he is not able to follow his dream... etc. There appears to be more involved than just your change into profession. Again, these private matters are usually more in-depth than one realizes and good counselors are able to find them out and help couples address and work on them; hopefully before trouble arises. We wish you the best of luck, Ridryder 911

Either you are getting below local payment percentage OR watch out for the medicare insurance audit !..................... Anyone that gets that much pecentage..... hmmm .. thats great, because even professional billing companies brag on their 60-70 % Be safe, Ridryder 911

Okay, have to admit it .. when I was young I read "Emergency" magazine ... okay all you old EMT's remember the "Hare Dynasty of Dyna -Med"... and read article on Cavalier Knights.. a group of rescue/Police /Sherriff Paramedics... then the show came out about them.. 240-Robert originally starred John Bennett Perry (Matthew Perry's father), Mark Harmon and Joanna Cassidy. .... always thought their uniform was cool of orange jackets.. and orange T-shirt. Enough I went to work for a Police EMS a few years later... "the Police provided all the rescure & EMS"....like the t.v. show I cancelled out too.... Be safe, Ridryder 911