Lucky~13

For anyone who's taken or is current on the pediatric IO station for NR....

On the step to "inject saline to assure placement", do you still have to drawback to get a bloody return to assure placement, or do you just inject the saline? And how much saline do you have to inject?

Thank god for the NR. They fixed so many problems that plaqued EMS that the most pressing concern is a name change! And its a good thing too, otherwise someone might think this was a pretty assinine idea.

When your battling zombies, it pays to be prepared. Or vampires, whatever comes first

Bringing it back from the dead

Games out, $15 to play. Some hoops you gotta jump thru if you want those 6 CE's.

How does it play? Would'nt know since 64 bit puters aren't supported. Something they neglected to mention before I plopped down 15 bucks

Tazer her + shoot the bird = all problems solved!

I will allow it to stay.

Admin

The overlord hath spoken.

So was she supposed to stand there and watch the driver burn to death?

According to some of the fire departments I worked with, yes.

But kudo's to her. The driver is alive and [presumably] well today because she made a heroic choice in a horrific situation.

From what I have seen and experienced, many of the "overseas" positions require the provider to work in a very independent role with little supervision and guidance. No, I am not talking about running a code and pushing your protocol medications. I am talking about caring for patients with complaints that require care beyond IV, O2, Monitor, Symptom Relief, and Transport.

You need to have a good understanding of family medicine, ambulatory care, internal medicine, and preventative medicine. I just had a guy with pneumonia. Or what I suspect is pneumonia based on the history, vital signs, and physical examination. This guy will not see a doctor for two days. I had to decide what X-ray he will receive tomorrow, what antibiotic to load him with tonight, what medications to send him home on, and I had to decide that he was stable enough to go home and have follow up on an outpatient basis. I also had to ensure he was well educated and able to follow the proposed plan of care. While it may seem mundane, these are very big decisions and if something goes wrong, I am totally responsible.

Take care,

chbare.

Yeash, tougher then I thought!

Generally speaking, who does one work for over there?

Any Updates?

Last I heard, development was stalled and we won't see it again for at least another year. If we're lucky.

ummm......... PD?

I think it's because cops aren't sure under what authority to do it. When called to a scene, they've seen confused/hesitant due to know knowing under what authority to hold them (provided they aren't on a psych hold).

That's their job to know. EMS knows medicine, PD knows the law, and the monkey's know how to put water on fire and cut stuff with robo scissors. If I showed up on scene and didn't treat the pt because I didn't know my meds or drug dosages, I don't think I'll be working much longer.

Patient may not be A&Ox3, but if he/she is uncooperative and COMBATIVE, the patient is not your problem. But rather the problem of your fine local, county, or state PD.

But if they should insist the problem rests with you, they metal clipboard solution usually works.

EDIT: To clarify

Will you utilize PD to take them to hospital by force? What authority would PD use to do that if he's in his own home drunk, not having violated any crimes.

Protective custody can be implemented if its in the patients/publics best interest. Even if no crime was committed. Good luck ever getting them to do it though.

Obviously, if it's a known altered diabetic, we're more likely to go hands-on, restrain, and give dextrose/glucogon, but what about not so clear-cut cases, like drunks?

Drunk doesn't mean squat. If they are altered, they are altered. The causes don't mean much if your trying to restrain the patient.

And get out of the thinking that one type of patient is more worthy of you then another. Drunks require your care just as much as diabetics.

Anyone ever get dispatched non-emergent for a general weakness on one side of the body only? :shock:

Do they have the tinglies?

Disp: "Bravo XXX respond priority 1 (lights and sirens) to the meijer parking lot for a, per store security, marijuana overdose."

Bravo XXX: "Are you serious?"

Did a 24 hour shift yesterday, and the first call of the shift we were sent Lights and Sirens to an MVA nearly 10 miles away (average miles for us are around 2-4 max), so it was a bit of a haul. Our PT had a seizure and struck another oncoming car. Speeds were about 45-55 MPH for both cars. Decreased LOC, multiple lacerations, a gigantic LAC on his right foot that I could clearly see muscle and bone thru, and an increasing distended abdomen. Assessment and vitals pointed towards massive internal bleeding.

Incident 1: We arrive, pulled in where we flagged too. Me and my partner get out, start to pull our gear out of the rig when the local firefighters decide to shove both of us aside and grab our stuff for us. Needless to say, I wasn't to pleased with that but went along with it since there was more important stuff happening, like the patient dying. I reported this incident to my boss but was basically told I need to learn how to deal with the firefighters.

Incident 2: We load up, and start to move out hot to the hospital. I got my lights and sirens going. We get down the road a ways when some idiot decides to stand in front of my rig about a 1/8 mile up. I go left, he went left. I go right, he went right. He did everything possible to stay right in my rigs path. A last second swerve managed to avoid him completely. Pretty damn lucky, considering my speed was about 70 mph at the time.

Incident 3: While on scene still, I was helping my partner and the medic assess and treat the PT. The whole time everyone kept saying we were going to Hospital A. So naturally I went towards there. Sometime during transport, we decided to go to Hospital B. Would've been nice if someone told the driver (me) before we got a 1/2 mile to Hospital A.

So after all that we finally get to the right hospital. It took us about an hour to write the reports and clean the rig. A lot to happen one one call, yet this post only gives you a glimpse of what all really went on. The only bright side to this whole ordeal is, I did some checking, and it looks like our PT's gonna pull through. I guess that's all that matters in the end.

Can we get back on topic please?

Ok, I am in no way mechanically educated however I was under the impression that idling saves more fuel than starting and stopping.

From the email:

"Letting an engine idle actually does more damage to the engine than

starting and stopping. Running an engine at low speed (idling) causes twice

the wear on internal parts compared to driving at regular highway speeds,

which can increase maintenance costs and shorten the life of the engine.

Please check your owner's manual to find out specific warm-up guidelines for

your vehicle."

According to the emails, a truck idling for an hour consumes about a gallon of fuel. And starting the rig only consumes about 30 seconds of 'idle time' fuel.

As for post call volume, we can average 5-6 calls for a 8-9 hour shift. Or we might only get one or two calls for the same time frame.

With the painfully high cost of diesel, my companies really getting on us about idling. We're getting tons of emails, notes posted all over, and I even got busted for letting my rig idle while doing the morning checkout. The message is clear, if you not on a call, NO IDLING! I can kinda see their point though from a cost perspective. Cutting all unnecessary idling can save the company around 10 grand a year. But sometimes not idling is just unrealistic.

At my company, the emergency cars get a nice air conditioned base. So yeah, they'll shut their rigs off. But the transfer cars (which make up half our shifts) don't get a base, they have to post. And the only way to keep from roasting inside the rig is to keep the air conditioning on. Which means the engine stays running, the cost goes up, and we're in violation of company policy.

Anyone else run into problems like this? Anyone come up with novel solutions? I'd like to help the company but I'm willing to go only so far. And I draw the line at becoming a dehydrated, shriveled up EMT.

Our medical director is an employee of the hospital. He oversees all EMS for the County and you must pass his oral boards to function. He answers to no one when it comes to the delivery of Medical services to the citizens.

Same as ours. But god help you if you cross him, no matter what service your in!

I am sorry guys but I am gonna win this one.......from the other side of the coin though...I had to call 911 for a resident to wanted to go to ER because God was meeting her there.

"Sorry to burst your bubble ma'am, but god isn't meeting you at the hospital. His real name's mike and he's on the ALS intercept coming to meet us." - ZING!

And I guess you win! Oh well, my career's still young. I'll win this contest someday. 8)

Got dispatched last week priority 1 (lights and sirens) to a 73 y/o female with difficulty breathing.

Arrived to find pt at a group home, where the pt had ZERO signs of difficulty breathing but the group home "attendants" were unable to obtain a temperature. Apparently this malady required ambulance transport to the hospital.

So, do I win the award for dumbest reason to transport ever?

Bravo, Richard!

If one is going to resort to the ceremonies of the civilized, one must also abide by the protocols thereof.

I say we get drunk, kick their ass, make fun of their mommas, set flaming bags of dog doo on their porch, and pee on their lawn!

I don't remember if it actually happened, or is just an urban legend or whatever, but I remember a discussion in emt school about the local pd using an ambulance for a sting operation. EMS still takes potshots for that one...and I don't meed good natured flack from coworkers...I'm talking actual lead bullets

That actually did happen. I'll see if I can't find the story.

**EDIT** found it

Linky

OMG, where the heck do I start. I would be honored to report anyone trying to engage in terroristic activities. What a great idea. They don't give a shit about us, so why should we give a shit about them. They killed 3000 Americans that day. @#$%EM, They can be sneaky, so can we. CIVIL RIGHTS go out the window when it comes to terrorism. !!!!

And they can kill 3,000 more, but that's not gonna effect your patient care. Hell, you can have bin laden himself in the back of your rig and your STILL gonna give your best to provide the best possible patient care.

They're not hezbollah, they're not al-qaeda, they're not serial murders, they're not rapists, they're not child molesters, they are YOUR PATIENT and your gonna give them your best. If you have a huge problem with that, then maybe this isn't the job for you.