Para-Medic

Hi everyone, I usually have no problem putting on EKG pads. I know where they go and how to put them on EXCEPT on the patients that really need it. I'm talking about the obvious signs of AMI and that incredibly diaphoretic moment. Usually I just wipe the area clean and re-apply pads but they just keep coming off (seriously I could go through like 3 bags of those pads). From what I've heard it's a common problem. So, I wanted to know if anyone here has tips or tricks on how to make this fast and effective. Someone told me that hospitals actually have some special pads for these types of situations but I never got the name of them. Maybe someone here knows. Well, if anyone has any advice or opinions please post. THANKS

I don't really know so much about medicine but what you could give a person in liquid could be measured and noted. I mean ANY liquid inserted into the body would be urinated (including salene by IV) sooner or later, right? Plus, I would doubt that someone wouldn't be able to hold their bowls (I pray they do) during a transport (which really aren't long).

well, I really wouldn't bother giving someone water to drink who is havings some sort of airway problem or pretty much like you stated a compromised airways. I mean, those patients that really don't have an exact "emergency" and are having a sad or intense moment. Usually these patients get that dry itchy throat. These are the ones who ask for water the most. So why not give them some?

I always wondered about this. Besides for reason of OD and ingested poisons and compromised airways and such. Why is it that we aren't allowed to give people a drink of water? Not only in EMS but in hospitals too.

Just had an idea. What about if these machines had some sort of output that allowed you to hear it when the machine is taking the B/P. As the machine starts to lower the air pressure you would have a visual on the numbers (most already do). Anyways, as the machine starts to deflate the cuff you could listen for the proper sounds. This way you could have some security on what you heard. When the machine gets the reading you could compare what you got to what the machine got. If there is any suspicion you could continue to take a manual B/P. One other thing I notice is when the machine takes a low B/P or high B/P none of the nurses or doctors bother to take one manually. They automatically start to take give meds for something that could of been an error. : S

That's exactly what I was always thinking. I mean, of course a person would trust what they heard when taking a B/P rather than letting a machine do it and not being able to verify if it's right. So, with that in mind, why would doctors and nurses allow the machine to do this and allow these readings to determine what meds/interventions to take? Seeing as how the machine use pulsations to get a B/P and a manual B/P (which is suppose to be more accurate) involved auscultation. The main reason I ask this is because I remember I was dropping off a patient (c.c. was she couldn't stop vomiting) and when we got to the ER they had to take their vitals (using the machine of course). So I thought ok I got stable vitals the whole way here so it should be fine. Suddenly their machine reads 90/56 and they were going to start a line on her. I thought, that can't be right. So I repositioned her arm placed the cuff firmly on and tada 110/88. Took it again and got the same thing. So basically, I'm just questioning the reliability of these machines.

Hi all, I always wondered on why sometimes the needle on the sphygmometer will move before and/or after hearing the beat? The reason I ask is because sometimes (not always) I will see the needle move and later hear the beat. Well, curious on whether I got it right or not I test it again in the hospital with their machines. I notice sometimes the monitor will show the B/P to be basically where the needle would be moving and not exactly to where I heard the beat. I know their B/P might of changed a bit, but sometimes the machine will say I was about 5-10 off (pretty much where the needle started moving). Still though, I wonder if the needle would be sensing something earlier than we would in auscultating. I know the rule on not using the needles movement as a guide just the auscultation, but wouldn't it be something to be taking into consideration. Obviously, I'm not any medical expert on this and don't know much. Still, I'm just curious on what it could mean. If anyone has any input on this please post. THANKS

ok, that's what I thought. Here are some situations I imagined though. What about? Obvious spinal deformity protruding posterior? just someone who has too much pain to lay on back?

Hello, I was reading a couple of the scenarios and have a small question. For what type of "situation"or "injury" would you c-spine immobilize someone face down on a board? I really haven't come to any scene where I would have to do that. So, I would want to be prepared to face it if I have to.

I thought committing harm against ones self is a crime. Plus, wouldn't a person who is threatening to harm themselves be more likely to harm others too?

what I would like to know is whos call is it? who would be able to say this person will go by amb. or SO? I like it when our sheriff take them but they fight to send the patient with us. I don't blame them but I think it should be done because they have more units than us and they can actually get there faster.

Hello, Well, around here we have a pretty substantial amount of psych calls. Some are suicidal, homicidal and others are just odd. So i had this one run where guy was suicidal. The story was he was in a confrontation with his cousin and family stated he grabbed a knife to try and end his life, but the patient stated he grabbed a knife to protect himself. So this is the second time we go out there and our MD states that we should take him. So, OK we take him against his will whatever. We get there and the hospital (which is not a psych facility BTW) basically ask him a couple of questions and get him to sign a release. Our paramedic hears the story and states how dumb it is that they ask him a couple of questions (like do you want to kill yourself/others) and all he has to do is say no to leave. Then again I think to myself, but don't we always take psych patients to this hospital just because it's the closest facility? If he really did try to harm himself shouldn't the police officers of escorted him instead? Not long ago we had the same thing happen and police officers heard the guy say he wanted to kill himself and took the patient himself. Our closest psych facility is about 45 minutes away and they feel it's inconvenient to put a ambulance out of service for so long. Still, sometimes our captain states when to take someone to a psych facility or just a normal hospital. I just don't understand why we would take someone who would require a psychiatric evaluation to a normal hospital when the hospital really can't do anything. Our closest hospital is sometimes constantly on diversion for no rooms and they put a suicidal/homicidal patient out in the waiting room. Does it really make sense for the department to do this though? I would like to hear some inputs and procedures you all take for these type of calls. Please if you have any thoughts, opinions or advice please post. THANKS

I know I haven't been around EMS but I really think it would be a great idea. I mean, we really wouldn't be able to do much even if we find something with the x-ray but it would take some time off of getting a patient rapid treatment.