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Mateo_1387 last won the day on April 6 2013

Mateo_1387 had the most liked content!

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About Mateo_1387

  • Birthday February 13

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    EMS, Language, learning new stuff

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  1. Seems like they need to go after the hospital for discharging him in an altered state. I really don't see how they security is to blame. And whoever the hospital staff is that expressed concerns.... they weren't advocating enough... I'm gonna see if I can get anymore info on this.... it happened fairly close by...
  2. Gender Uncertainty & Good Manners

    I have asked this question to a few people and I think I have two interesting answers, possibly worth using... 1st answer I liked was to just not ask, but bait the hospital staff to ask, cuz you know they will... haha 2nd answer from a friend of mine who is transgender states he don not know the best way to approach this situation. No help huh... Though he seemed to relay that just being polite and asking ought to be okay. Something along the lines of "no disrespect, are you male or female, I only ask to take your biology into consideration for a proper treatment plan". - As a side note my friend seemed to indicate he has encountered persons at work in which their gender orientation is difficult to determine. He said it is easier to avoid pronouns at times, otherwise, if you are comfortable (and maybe have to deal with persons longer than he may) to just ask their preference, respectfully of course.
  3. From Kings Mountain, North Carolina

    Welcome to the City from Eastern NC
  4. What do you do with psych patients?

    I know you are not in the United States. I've known that. Nothing new. But look, I never meant to convey you lack morals, I just thought your views on this subject were lacking in them. That make sense? I thought my counterpoints explained that, maybe I failed in that respect... I can only take what I read on here and go with that, unfortunately I do not know you on a personal level where I may have a better understanding of what you post. So much is lost in text alone when having conversations and at times I do miss the finer points of expression via text, it is a downfall of mine. Maybe we are talking about two different patients. I've only applied physical restraints once myself and chemically restrained a slew of other patients. Its just not something I take lightly, which I thought you did. Anyways, my idea of a patient possibly needing a restraint procedure is usually the patient I meet where within the first minutes of arriving on the scene we are already in a physical situation that is not deescalated by other means. I took your examples to be the patients that hint at violence, had a previous episode of abnormal/violent behavior, and the like. I guess for me I tend to try and treat on the current situation and have yet to have a patient "turn". This may be the point where we are not seeing eye to eye, different experiences... different thinking process... Anyways, try not to take it too personally, please. I've had my thoughts and viewed slammed on here more than once and I think I'm better since most of it. Hope this helps to ease tension and improve understanding. G'day
  5. What do you do with psych patients?

    Ok, I admit I did go on a rant and was not very nice about presenting some of my thoughts. I also sincerely apologize for treating you in such a manner. You deserve more respect and I should have offered it. I hope we can move forward. I also hope we can continue the conversation, as I think it is an important topic. The only patient I presented and wrote about is the example you used. I tried to make my discourse based on the ethics of restraints, but used your example to support my statements. I never accused you of only using restraints. I did try to make the point that your liberal use of restraints ought to be restrained.  Based on your reply to Captain… • • I understand there are times where involuntary commitment is necessary. No argument there. The right to autonomy is not lost though. Exercising the right may need to be restricted at times, though the goal should not be to maintain that restriction, but to restore the full use of those rights. Being able to be an active part of the treatments by being allowed to make decisions and choices would seem to be the better option than being on the sidelines without having any input. That is how we treat our animals when we carry them to the vet. It is not the way our mentally ill should be treated, if it can be helped. It could be that way. Just because there are some non-rational thoughts does not mean all thoughts are non-rational. It will be situation dependent. Maybe I was harsh with the smug comment, but, from what I read scubanurse said to musiclife “Your wording in this also makes me concerned that you really lack the skills to deal with psych patients, the bolded statement in particular.” Then you come back and claim she assumes therapeutic communication always works, she says she didn’t. Then you come back and say she did and based your argument on a few points. • One point being that she bashed a volley. • Another saying “you don’t know how to communicate” comment Neither of which happened. A concern was noted and then a suggestion made on her part. Then you tried to say that since musiclife is an EMT-B therapeutic communication was not taught in his curriculum and that he is probably not the only one lacking knowledge and then blame it on the system. So yeah, way to protect the volley from New Jersey and take a jab at everyone else… You cannot have it both ways either sir… Then you turn around and talk about willy nilly use of restraints. I quote from you “…so they get restrained or the don't travel with me "just in case". You restrain in the name of safety because you had a compliant patient bash your skull and abscond from the ambulance. It bothers me that you would cry on about his education then try and support your use of restraints on morally irrelevant previous patient contacts. I was not expecting this type of reasoning from an educated person. I digress… Now you are just reaching. Restraints may be necessary in the course of treatment, which has never been the argument. I am fairly certain you do not treat patients as you described above (ref. 16 y/o depressed kids). I will though try and answer your scenario question. The patient you describe could be an Autism patient, mental health patient, not competent, prone to violent and aggressive behavior and everything else you said. Maybe letting their family member ride to help keep the patient calm rather than restraining them could be a more appropriate treatment. Maybe talking to the caretaker about how to best handle the patient would be beneficial in altering how you approach the patient. How about using techniques the patient may have employed in the home like using music to keep the patient calm. These are a few examples. It may come to a point where physical or chemical restraint may be necessary, but if you jump to that first thing, I do not see the good that would come from it. Your posts have been riddled with your continuing support of restraints as a first resort, lacking impartiality, and based off of morally irrelevant information. You give me hell about trying to preserve civil liberties and ranting, but your views are not necessarily correct. That is why I offered my own take on the subject. I am not going to attempt anymore inflammatory remarks. It is not my ultimate goal. On the other hand I am not going to stand down for something I truly think you are wrong about until its proven otherwise.
  6. Altered LOC

    Scene presentation - safety, weather, whats in the shopping cart? If its relevant Patient presentation- Level of consciousness, obvious injuries, signs of distress? Airway, Breathing, Skin color, temp, radial pulse qualities? If she is talking then "Hi, I'm Matt with the ambulance, how are you?"
  7. What do you do with psych patients?

    "Just in case"... I'm shocked that with your smug attitude of lacking U.S. EMS training and education that you spout off crap like this. The moral and legal issues of restraining another person are more profound and farther reaching than "just in case". Morally speaking, the willingness to restrict a patient's freedom willy nilly, because you had one patient become violent towards you, surely lacks a moral basis of preserving a patient's right to autonomy and right to refuse. The previous sentence speaks to your impartiality of applying restraints and is morally irrelevant in dealing with your next patient. I'd like to think you want to provide good care for your patients, but automatic restraint of psych patient's "just in case" will systematically violate personal freedoms in order provide care and prevent harm. Sure, a utilitarian view of protecting others is a consideration to be taken, but there is still one person who is not "most benefited" by the procedure. Tell me, how is restraining a patient therapeutic? Or is it just containment? Do you think your patients see restraints as treatment to getting better, or more as punishment? It seems these considerations matter when deciding to restrain a patient. With your better psychiatric education, do you even try to use less restrictive measures in your 5 hours ago raging storm but now compliant paranoid schizophrenic patient? It makes about as much sense as putting you in handcuffs because you were royally pissed off with road rage 5 hours ago.... wouldn't want you running down and hurting someone... Legally speaking, committing acts of battery come to mind first. I'm not the most legally savvy person, but restraining patients based on previous patient's or "just in case" situations, would seem to be a form of battery. The schizophrenic patient that previously exhibited a "raging storm" extreme of behavior doesn't mean that five hours later, while being compliant, deserve to be battered. Again, this type of systematic use of restraints violates a persons right to refuse medical care. Now, this is a double edged sword, I agree, but the point I'm trying to make is that systematic use of restraints can leave one liable in violating another person's rights. In no way am I saying that restraints should be banished, but rather the decision to restrain should be carefully considered in regards to moral, legal, therapeutic, and safety aspects. Its not an issue to take lightly and very much should be a last resort when other less restrictive ways of behavior modification have been exhausted. In regards to safety, I realize two persons on an ambulance certainly raises concern when dealing with an acutely violent psychiatric patient. Placing patients and personnel in situations that are dangerous and make the requirement of the most extreme measures necessary as the primary intervention in lieu of not being the most appropriate treatment.....system error much...???
  8. Reaction to Platelets

    As far as Benadryl goes, it could be an allergy due to the dye of oral Benadryl, not necessarily to IV Benadryl. Also, remember Phenergan is also an antihistamine that could possibly be used.
  9. Switching to hospital pacer after transport

    Not sure about how the LP 12 handles, but I believe the Zoll's we have, and the hospital too, can have pacing set up without the pads. So take the hospital machine, match the settings to your machine, then switch the pads. I'd try and make it a timely and coordinated operation. Speaking of this, anyone have the 4:1 button on their Zoll to take a look at the underlying rhythm? I tried it to see the underlying rhythm, because I couldn't believe it would show the underlying rhythm while pacing. How it works I have no clue, but it showed me a nice slow rhythm So, I just went to the ambulance to test it, for the Zoll, you can disconnect the pads and set up the pacer. Just to let y'all know...
  10. NC college EMS

    So what are your findings of the EMS system's response to your college campus? Forsyth County EMS is one of the more highly regarded one's in NC. You sure there is no reinvention of the wheel? With the system and local hospital, its a good place to get hurt. Besides, how often are there injuries necessitating EMS services? Not trying to bust your bubble, as you seem to be intelligent, trying to write proper proposals with financial constraints and statistical analysis included, but, I get the impression that you are looking for an outlet to play EMT, so those skillz won't depreciate and become stale. With such an obvious intelligence about yourself, as well as your interest in EMS, are you sure set lighting is your calling?
  11. New Member, Quick Question

    Welcome to the City ! Although age may disqualify you from working for a fire department, I say piss on them. I think your age/life experience would be a great asset to you being a paramedic, along with your customer service experience (as a lot of what we do is public interaction). Market yourself well stick around the City, you can learn a lot, and we will do our best to steer you in the right direction. Matt
  12. To Expose or Not To Expose, That is the Question.

    Spenac, time for you to go back to the basics... It'd be a good idea for basics to sit a patient up that has a high blood pressure, and lay a patient down for low blood pressure. There, that was simple. -5 for a stupid question. If you don't know how a cat scan can change the treatment, then go get a book. -1, for simple ignorance. Spenac, this could be such a great topic, but, being such a poser, you sure can run it into the ground. The sad thing is, I agree with a lot of what you say, but you're merely an echo, IMO. You have also echoed yourself, multiple times. Please, let me reference everyone to these posts, by none other than Spenac. This fetish of your's about exposing patients is really starting to be an old tune... You first posted about this subject on 06 May 2007 Here is a link. On 21 Jan 2008, you brought up the subject again. Reading through, its not a bad thread at all. Its title is "Did You Look And Feel? Hands and eyes on?". But, after your last post on 7 April 2008, why, I guess you just love talking about exposure so much, you bumped it on 22 Oct 2008. If you would like the link, Click Here. Oh, I almost forgot ! -5 for not using the search feature and duplicating a topic. But that just was not enough. On 17 March 2009, you just had to revisit the topic. And by the way, I just loooove the name of this thread "Proper Exam Technique - Expose or Fail". So, you apologized earlier for what seems to others to be an attacking delivery message. With a topic title like Expose or Fail, what makes you think we'd take it as attacking... Anyways, I'm sure everyone would like to see a link. Click Here -10 for not using the search feature and duplicating a topic, twice now. Also, another -5 for being hypocritical towards others about using the search function. Then there is the current thread. Here. The 4th time now that you have discussed it. Except now, as I have observed over the years, you have become much more pompous about your position. So, I guess -20 for a triplicate post and not using the search function, another -10 for being a hypocrite again, and another -5 for not using spell check, and other -5 for just being egotistical about this topic. Folks, honestly, this is a good topic to discuss, if you read some of the older topics, you'll see some posters from back in the day with some good things to say. Again, all Spenac is doing is echoing others, and then himself. I just hope people can see it for what it is.
  13. To Expose or Not To Expose, That is the Question.

    Good ol’ classic Spenac post, pose a question that seems to ask for opinion, yet he already knows what the correct answer is (at least by his viewpoint). If you’re answer agrees even halfway with his, then you are still completely wrong… and furthermore are deemed scared, unprofessional, bashful, and therefore must obviously be incapable of saying penis and vagina without giggling, so you must surely call them private parts and no no’s… I digress… So, what was the point of this post Spenac? Did you’re post from the past covering this topic get deleted or something? Felt enough time went by that you could duplicate it without many noticing? I take it you also expose and palpate the vagina and anus of all the rape victims you encounter? How do they feel about your ‘professional exam’? I guess you do the same for the child victims too? Do you also prefer to do prostate exams on all males over 40? I bet that one goes over real well...
  14. International Lawsuit

    I thought it was pretty funny !
  15. Versed in the drug Box.

    I have used it once, in two years now as a paramedic. We use it for seizures and sedation.