sirduke

Now that I have been properly chastised by the previous post, I'll get back to the discussion, I've been researching it on the internet, lots of discussion by doctors and nurses alike in regards to the desirability of starting bevel down. Most notably on dehydrated children and dialysis patients when sticking in fistulas. As for my esteemed whipsman in the prior post, my instructor teaches us bevel down for the type patients I first described. As for anyone else who wants to chastise me. Just send me a PM, we all know how smart and superior you are, so you don't have to flaunt for everyone on the post.

It is funny to see the doc's reactions when you request Torodol, really freaks them out.

I regularly use a heat pack to raise viens on those with deep hidden veins, brings them up wonderfully, also on unresponsive patients or the extrememly obese when you absolutly have to have a line, the underside of the wrist works great.

I love the ones who are allergic to torodol, yet take an asprin for their heart everyday. I have frequent kidney stones, and am deathly allergic to codiene, so invaribly when I stagger into the ER begging for Torodol, they look at me like I've lost my mind. One doctors reaction was to ask, "You know you can't get high on that don't you?" Talwin NX works pretty good for me as well, no high, no hives, no difficulty breathing, just pain relief. Did have a patient tell me she was deathly allergic to normal saline, but that's another story.

We use the Autoguard as well, but it works with the Jelcos as well. I have no idea why it works, just know it does. Sort of like the trick carpenters use to drive a nail in a two by four without splitting it, they can't explain it, but it works. The old medic who taught me this couldn't explain it either, but he said he was taught that way by his instructor years ago, my current instructor was as well, but her husband who has been a medic since ambulances had stone wheels, never heard of it. The ratio locally seems to be about fifty fifty, as to who knows about it and who never heard of it.

THIS IS NOT A DISCUSSION ABOUT CLINICALS OR THE WAY TO GO ABOUT THEM IV techniques

Understanding how I may have sounded, I take no offense to the onslaught. Let me rephrase the statement, she and I had a disagreement as to the effectiveness and justification of my technique. As for giving her a bad impression of EMS as a whole, she is married to the only Paramedic who isn't a complete idiot, just ask her. There are 6 counties that transport patients to this hospital, our local trauma center, we are talking about 85 medics, and she criticizes each and every one of them. So I doubt my comment had much effect at all. That said, you are right, I'm there to learn, not change beds, clean rooms, and fetch water for patients, and get pushed to the side when it comes to treatment. I pointed this out to the nurse supervisor, got a different preceptor and eventually started swinging from nurse to nurse as patients arrived. I was invited to come work anytime, so I think I aquitted myself well. The main point of my post was NOT to draw fire about my behavior or as you feel, lack of proper behavior during clinicals, but rather find out if anyone else has tried this technique, and perhaps hear of other tricks that would help in providing better care for my patients. The nurse in question does in fact have some great skills, abiet a shitty attitude, which she was glad to share, and I have used in several occasions with good results. As for the Rural EMS statement, I have mine, you got yours, Nuff Said?

Recently I got into a pissing contest with a RN during a clinical rotation at the ER. I've been a EMT for 3 years, must have stuck several thousand times. I was taught, after school, by an old medic who is one of the best I've met, that with a severely dehydrated patient, or elderly person with crappy veins, that you could start the IV with the bevel down to reduce the chance of blowing the vein. I of course had to try this, and to my surprise, it worked. I have used this many times since, and the ratio of sucessful sticks on these patients has increased. But, of course, a paramedic student is the lowest form of life in the ER, and she ripped my testicles off in front of the patient for causing them undue pain. Has anyone else ever heard of doing this, or am I just crazy? By the way, I got the line and she blew two attempts and gave the old lady a couple of beautiful hematomas. Even the old lady preferred my method as she only got stuck once by me. Anyway, your thoughts and other tricks are welcome. Rural EMS, a lifestyle not a job

[/font:6770b60613] Even here in rural Georgia, we deal with the same issue, cameras flashing as you try to work on your patient. And it never fails that they catch you in the worst moment, or the patients worst moment. What really chaps me is when they want you to comment on the patient's condition, and ask what their chances are. I understand that we need freedom of the press, but we also need decency and tact within the press.

[/font:5a8ec6753e] Goes in spells here in south Georgia, you get your runs of Seizures, or as we usually hear it Skeezurs, then they will switch out to Lifting Assistance at 3 am, full moon you have Domestics, Cuttings, Shootings, etc. With the lovely roadways we have in our county, we have a good number of wrecks, especially when the ETOH begins to flow on a Saddidy nite. The we all know Codes come in threes, so we'll see a spell of those as well. Then there are the ones that make you want to cry or cuss. Toothache at 4 am, Constipation, Rectal Pain, we've all been there. We have one dear lady who calls fairly regular thinking she has an earring stuck in her ear canal, but fortunantly of late, her family has taken over care of her and we haven't had to look for the non existent earring. Then there is Sammy, but that is another story all together.

[/font:6176020702] [/font:6176020702] Greetings one and all, my name is Michael, I am an EMT I and currently a Paramaybe... December will tell. Formerly a First Responder, and prior to that a Combat Life Saver with Uncle Sugar. Working rural EMS in Georgia, swattin gnats and soaking up that good old southern sunshine.