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akroeze

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Posts posted by akroeze

    Noloxone...should EMT-I's be able to administer?

    in General EMS Discussion

    Posted

    Hammer, I think you just proved exactly why BLS personnel should not have access to ALS meds ... If 2 mg of Narcan hasn't shown a response, either every potential receptor is already occupied, or there's something much more serious going on. If that's the case, securing the airway and maintaining adequate ventilations is now my top priority. Not that it wasn't before, but as I previously stated, if I can eliminate the problem, I will. The line of thinking of "well if 2 mg isn't enough, I'll just call for more" is a little skewed. And yes, I do know of patients who've received much more, but that was in-hospital with a lot more resources available.

    Yes, narcan has a shorter half-life then opiates. However, it is an antagonist, meaning, it will compete for receptor sites. If there's still sites available, it will bind to them, lessening the effects of whatever the patient took essentially by having less receptors for it to bind to and letting the others already bound wear off.

    Sorry if I'm not making things clear ...

    peace

    I think the point was... you give 2mg and they come around good... it starts to wear off and they go down hill yet you wouldn't call to get them out of it again?

    Noloxone...should EMT-I's be able to administer?

    in General EMS Discussion

    Posted

    Depends on their local system. But no, the standard scope for most EMT-B's in this country does not include any injection except for an Epi-Pen, and even then, usually only if it is prescribed to the patient.

    As for hypoxia, yes they can correct it, but they are not given adequate education to assess and evaluate it utilising pulse oximetry. And the use of a pulse ox only encourages them to treat the machine instead of the patient. Their patients should be getting oxygen regardless of what a pulse ox says, so the expense of the machine and the time expended dicking around with it on a scene is too costly.

    What do you expect out of 110 to a maximum 250 hours of training?

    I can see your arguement for the pulse ox and conceed the point

    The other though... what if you have someone who is slightly confused, part of your "routine work up" is to do a BS on this pt. You find them to by hypoglycemic so get them something sweet to drink thus correcting it.

    Noloxone...should EMT-I's be able to administer?

    in General EMS Discussion

    Posted

    They can't treat it. Why should they be encouraged to sit on a scene with a patient and hook him up to machines that do not treat him? The hospital is going to run it all over again. Hell, why don't we just do MRI's and CAT scans in the ambulance? Sure, we can't treat anything we find, but hey, since when did that ever matter to EMT's?

    I'm sorry but are you saying that your EMT-Bs can't even correct Hypoxia and Hypoglycemia??

    I need help for a project

    in General EMS Discussion

    Posted

    Maybe if 'flash' pulmonary edema is discussed in more depth I might start seeing more EMT-Bs covering CHF patients up when its cold outside.

    After having a pt that experienced flash PE I attempted to do as much reading on it as I could. Maybe I'm not looking in the right places, but I can't find any info on the net relating specifically to flash PE as we would be concerned about it. Lots about with liver and kidney problems but nothing about simple C/P that turns into flash PE.

    Can anyone help me?

    Commercial showing EMS as thieves

    in General EMS Discussion

    Posted

    You people are over-reacting to this. It reminds me of a commercial that was on a while ago (don't know if it is anymore) in which a radio controlled airplane goes out of control in a park and these people have to keep ducking so they don't get hit.

    My dad is in a RC club and the members were up in arms about this because it implied that RC airplanes are unsafe. In reality, it was just a commercial and that's all!

    Stupid things you've said on calls

    in Funny Stuff

    Posted

    Not me that was involved...heard it through the grapevine yesterday. Seems to have a better effect if read out loud.

    Crew while on an emerg call had this conversation with (I'm assuming) an RPN:

    RPN: (while giving history) "Now why would they write that the patient has roadside assistance on her chart?"

    Crew: "huh?, what do you mean?"

    RPM: "Yeah, it says right here that she has triple A."

    LOL....The medic telling this story swears that it happened.

    Just out of curiosity, why are you assuming it's an RPN?

    follow up question on ontario paramedic schools

    in Education and Training

    Posted

    Unfortunately, learning to 'assist' ALS skills is a complete waste of your education. A proficient ACP or CCP would not require assistance with such things.

    The best PCPs are those who can think independently and do the menial 'no-glory' grunt work on calls. Setting up the stretcher, applying the cardiac monitor, getting a COMPLETE and ACCURATE set of vitals and their parameters (BP, pulse, respirations, skin temp, pupils, GCS and CBG). Even better is the PCP who can do their own complete assessment quietly, interpret the findings and talk to me about what they think is going on. If the patient is genuinely ill, you can bet that I will be the one asking most of the questions, but if you're listening, there's no reason why you can't be thinking about what's going on. I honestly really like it when PCPs take the initiative to do physical assessments (lung sounds, neuro exams etc), because it shows you really want to be a part of what's going on without overstepping your bounds. Trust me, I've been doing this for a while, and I really don't need help with cutting pieces of tape for the IV.

    If you want to assist with ALS skills, goto ACP school and learn to do them properly, not through a crash course. You're only cheating yourself by thinking your helping the ACP on scene rather then perfecting your own assessments and scene management.

    peace

    Or what's even better is a PCP who can run an entire call because there is no ALS... sure the guy is in cardiogenic shock and his lungs are filling.... deal with it.

    Looking for suggestions for kids education

    in General EMS Discussion

    Posted

    Have them all pile in the ambulance and sling and swath each other.

    I figure that's about as useful as anything an EMT-B learns and a skill that they can take home with them without any fear of them hurting anybody. And next time you see an EMT who can't figure out how to properly apply a sling, you can laugh at him and tell him you taught 7 year olds to do it in fifteen minutes. :|

    Wow.... you manage to find a way to insult Basics in almost every post you make, don't you?

    Well is the teacher going to be there? Collar/board the teacher... what kid that age doesn't want to see their teacher tied up??

    Long shift = much satisfaction...

    in General EMS Discussion

    Posted

    Well I worked a marathon shift over the past weekend. Went in at 07:00 Friday and left at 23:00 Sunday! I put 2 kids on the helicopter in 2 days. One was a 3 YOM who got mauled by a big German Shepherd cross dog. MAJOR damage to the head. Then a 12 YOM who rode his motorcycle into the side of a car. Broke his left leg in the mid-shaft femur and the-fib. What made this weekend really satisfying is that I was running my own truck as an EMT-I. I had some good calls and good outcomes and actually helped a few people. Making the step up from EMT-B has made a great difference in my satisfaction level in EMS. Does anybody else feel that moving up in level has made the job better for YOU?

    Well two days ago we had a lady who fell down a flight of stairs and landed on a cement floor in the basement. We figure she was there about an hour before she was found. She was semi-conscious, lethargic, GCS 11 (E1V4M6) and had crackles throughout with a sat of mid-80's on NRB@15lpm.

    It was good for me in that I am a student and I was able to run the call with no problem. It showed me that I can handle myself even with critical pts.

    Turned out she had a subdural bleed and the stated her to a neuro-capable facility. Don't know if she is sitll alive or not. We were only on scene somewhere around 15 mins which is really good considering having to extricate her from the house etc.

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