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MedicShannon

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Posts posted by MedicShannon

  1. The IV bag on the dash, in theory, is a good one. HOWEVER, I have noticed that when I do that, the bag is still cold on the side closest to the glass. A co-worker had the idea of a heating pad that runs in cycles. He put it in the action area with 2-3 bags, slightly wrapped around it. It goes on for about 10 minutes and is off for about 15-20. He keeps the back relatively warm (comfortable), so that the it doesn't get very cold in the back.

    A nurse showed me a "trick" for patients with difficult to find veins. I had always used a 2nd tourniquet with some success. He used a latex (if no allergy) glove just below the tourniquet. Helps put more pressure on the veins to promote the back-up we look for.

    And for patients on steroids or blood thinners, instead of a tourniquet use hand pressure (preferably your partner so you have both hands available) or a BP cuff inflated just above the diastolic reading. If there is too much pressure, as with a tourniquet, it can cause the veins to blow before you can even thread the cath..

    If you have the life pak 12 monitor, and use ETCO2, some of the new cannula's have a port for you to attach O2. There are 2 types. One allows you to use an unmodified supply tubing. The other type you have to cut one end of the tubing and insert it into the larger opening just below the junction. Wish I had a picture to demonstrate. Maybe tonight at work I will do that.

    Have more, but I just got home and we were busy... me going beddie bye.

    Shannon

  2. Only time I've seen someone c-spined in prone position... psych call, guy was spitting at and biting anything he could get near. Cops were having a hard time controlling him, guy was jacked up in amphetamines. Boarded him face down with collar, cops restrained with cuffs, strapped him hard to board. Collar was only to keep him from spitting and biting. :) ER got a kick out of it. My partner thought of it... I thought it was quite ingenious. When he got calmed down, PD hauled him to the clink.

    A private agency here (not the one I work at) did this a few years ago.. the patient died. I don't think he was c-spined, but he was on the stretcher prone and was restrained in some way. I have had difficult patients that needed to be in a position other than supine, but I have put them in a recumbent position. As far as the spitting, a NRB works well. Or a surgical mask with a face shield.

    Just my $0.02

  3. Anytime I respond to a call downtown on the weekend nights to pick up an unconscious/unresponsive male/female with ETOH on board... guaranteed to have at least 3-4 members of the opposite sex fawning over them telling them "I love you", "You'll be OK", "Don't die", etc. Usually have to physically pick them up and relocate them so we can do any type of assessment.

  4. Those three I've seen and I'm only a student :shock:

    My pet peeve is the know-it-all.

    We have a know-it-all in our basic class. He knows everything, has done everything, and has seen everything.

    At times, I want to punch him in the nose. I don't know how the medics maintain their composure when he starts puking his BS all over them. You can see "STFU" written all over their face and in the bulging veins in their temples.

    Every time they start to go over something, he has to interject with an "Oh yeah! That's how we did it when this one time...", Or, he'll nod his head as if he approves of what the instructors are teaching and they way they're teaching it.

    I want to give him the benefit of the doubt, but he speaks like one who's gotten just enough experience to think he knows it all, but doesn't know much at all. And with being 18 and the first time he's taken an EMT class...hmmm...

    Had a partner recently that was the exact same way. He went to class and told them that he told me how to effectively treat my resp patient - how to do my job, when in reality I had to "direct" him how to do his. A few of his classmates (who I happen to work with, as well) came up to me and told me what he was saying in class.

    So, had a very challenging cardiac call, and I asked him "OK Mr Paramedic student (1st semester), what do you want to do for this patient?" He just stood there. I told him to close the doors and drive.

    He was subsequently taken off of my truck and quit a week later. No great loss.

  5. and from same said basic on a different call--"looks like a-fib to me, but I'm not the medic"

    (no sh!t.....so shut up and let ME do MY job)

    oh, and I'm not a basic hater......just one in particular.......

    sounds exactly like someone I have worked with in the past has said. [/font:a92f7535bd]

  6. I don't think suicide is anything to laugh about :)

    I agree with you, suicide is not something to laugh about. A lot of what we see is not something to laugh about. However, we all deal with the stress of what we see and do differently. One major way is with humor. If this is the first you have seen or heard this type of humor, you haven't been in the field long enough. Give it 6 weeks you'll see. [/font:fb9c6c1d4b]

  7. A few weeks ago, up in Seminole county a guy tried to kill himself by cutting his wrists. When that was unsuccessful, he went to an I-4 overpass and jumped onto the highway. It is estimated that he was hit by more than 20 various different vehicles. Some people didn't even know that they hit a human. FHP received calls from drivers throughout the day as people heard about it on the news and then went outside to check their cars/trucks. It was pretty gruesome. [/font:277c3df680]

  8. See, now the only thing that Demerol does to me is make me sleep...and that is it. Now Dilaudid... I get Beetlejuice syndrome

    What is Beetlejuice syndrome? It is the temporary feeling of my head shrinking into my neck...its great.

    The other thing I like about Dilaudid... I can actually have a conversation with someone and remember what was said.

  9. I got the PM, and thank you for the message. However, Rid is right. Imitrex actually keeps the migraines away, narcotics numb the pain. I explained in the PM that I usually take Imetrex PO, and have never had it IM. I did become a little hypotensive for a little while, which would explain the diaphoresis and paleness. I am feeling much better aside from some abdominal discomfort, which is a major side effect of narcotics.

    Again thanks for the warning, but my doctor and I feel this is the best for me. (hell 2 migraines a year that I have to take Imitrex for...can't complain)

    Shannon

  10. Was driven to the ED last night by my partner with the worst migraine I have ever had in my entire life. I have never vomited with a migraine - until last night.

    1st RN couldn't get a line, so they gave me IM Imitrex. Made things worse - pale, diaphoretic, more nauseous. Another RN comes in gets a 22 ga in the L hand. 2mg Dilaudid, 25mg Phenergan (over like 5 min). Total sigh of relief after about 10 minutes, except for still having that pukey feeling. Next med is Zofran (don't know how much). Gave me RX for Fioricet. Ahhh feeling better

  11. Renal Colic may be prevalent for drug seekers, but we have a lot of documented cases of renal colic - true stones. most of our seekers complain of back pain, uncontrolled abd pain (IBS, Crohns), Neuropathy, etc.

    Now correct me if I am wrong; when someone is in severe 10/10 pain, they will exhibit one or more of the following -

    elevated BP

    elevated HR

    elevated RR

    some diaphoresis

    agitation

    anxiety

    If one of these aren't present, esp in renal colic, I will start an IV but may not give pain meds. And just fyi, our transport times are 10 minutes or less (mostly less).

  12. The worst feeling as a paramedic is being unable to alleviate somebody's pain. It's worse than watching them die.

    It is the worst. We have kidney stone protocol now... very prevalent here for some reason. Certain criteria need to be met before we can admin pain meds. Right now all we carry is morphine. Would love to see other meds available, but we are lucky to have what we have.

  13. Ok I brought this up to my medical director and one of the trauma docs. And that doc that complained about giving pain meds with AMI is full of bull honky doo. From what I was told they do not want us giving any type of pain meds with ABD pain, or chest pain not cardiac related. They need to be able to assess the pain - location, severity, radiation, etc - and they can't do that if we give pain meds prehospital. So yeah that doc is full of bull.

  14. how about cannonball run? BJ and bear (always loved that red and white semi)? Rescue 911 when it first came on the air? Parachute pants? leg warmers? "We built this city" (great song for an aerobics workout). Challenger - was standing outside of my high school, looking to the north east when the explosion occurred. The wedding of the century... Princess Di, watched every second of that.

    feeling pretty old right now...

    Shannon

  15. That's exactly what I was thinking about. (For those of you who don't know I'll be a PCP student in September.) In a few years, when a pt asks me "So what did you need to do to be a paramedic?" I will be able to proudly say I have a BSc in Paramedicine and to be completely honest this is important to me because I also look much younger than I am and want to be respected and trusted by my pts.

    Respect and trust are earned, and not with a degree. I have my AS in EMS and nothing may have changed with my pay, but I feel better about MYSELF and sorry - I don't give a DAMN what anyone else thinks about me and my education..including my patients.

    I did not get into EMS for the money, for there is none.

    I did not get into EMS to be a hero, for there are none.

    I did not get into EMS to save lives, for that so seldom happens.

    I got into EMS to help the living make it through the worst day in their lives. Whether it be a shoulder to cry on or NTG under the tongue, for that is what I am there for.

    I have been reading this post today and the shallowness of that comment made me post this, so I am sorry if I have offended anyone.

    And for the record, I think if you are wanting to be a paramedic you should have a degree and not just because I have one.

    Shannon

  16. Did you guys hear about the two medics in FL (I think) that arrived on an MVA and the Fire Dept was performing CPR on a full term OB and they decided to perform a C-Section on scene.....YIKES

    They saved the mother but the newborn died.

    Mother died, was dead when they got there... baby survived... medic lost license for practicing outside his scope... not just his protocols... can understand why, but I don't recall c-sections in medic school.

  17. it also depends on who it is. there are ppl at work that dont drink so if they came in after a night of drinkin, somethin else would have to be goin on, whereas the ppl i party with on weekends, id prolly just say ok bud, slap em on the shoulder and wish em a slow day.

    I hope I never have a need for an ambulance if I ever make it to Ft Worth in my lifetime.

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