mobey

I really don't think there is enough information here to comment on the treatment.

The following questions should be answered first:

1) What was the time between the initial pulse count and the arrival of the ambulance?

2) Cardiac history (including murmur), or family history of tachycardias?

3) Treatment prior to adenosine? eg, oxygen, fluid bolus, vagal stimulation?

4) Pts normal actiity level? (If this is a fit patient whom runs daily, a tach at 170 seems inappropriate)

5) Any recent history of palpitations, or tachycardias at rest or after slight excersise?

6) Current drug/alcohol use?

7) Recent lung infection?

8) Any signs of dehydration?

I will agree with the aura this thread is giving off, anxiety does cause tachycardia. It must be noted that relief of that anxiety will not nesissarily relieve the tachycardia.

All sounds very quick? What kind of school dumps a last minute paper regarding EMS terminology on thier students?

What kind of course are you taking?

On a possible related note: It is hard to undertand scanner chatter with no terminology knowledge

No, don't call me a hero. Do you know who the real heroes are? The guys who wake up every morning and go into their normal jobs, and get a distress call from the Commissioner and take off their glasses and change into capes and fly around fighting crime. Those are the real heroes.

Dwight Schrute

After reading a couple pages of RIP posts with huge posters of the star of life wrapped in banners, I left depressed.

Site sucks

Sorry guys

PS Thank You to all the people who have been nice to me on this site. You are greatly appreciated.

FYI, before I started this post. I actually spoke to management from one of the bigger companies selling the designer Medical ID jewelry. They stated that they never had any complaints about not being noticed in their 9 years of business. I don’t know if they were lying or if just no one ever bothered to complain.

I also showed 2 RNs I know at separate times a picture of the original bracelet I wanted. The both said it was fine.

I'll answer this quote and choose to ignore the drama of this thread. (FYI, you can choose to do the same) anyway...... back to the quote above

You need to cite your source here,

you came to ask Paramedics advice on a Medical ID bracelet +1 for you. Paramedics said "No" to the one you proposed.

2 RN's say it is fine.

A Med ID bracelet salesperson says it is fine.

So there you have it!

If you are looking to alert Paramedics - Don't wear one like that, Wear the ol' fasion Stainless steel

If you're looking to alert medical ID bracelet salesmen - or nurses in the hospital - by all means, get one as you posted that is not clearly identifiable.

I am quite sure I can speak for most on here when I say "Get the ol' tried and true medicalert..... switch up the band if you want, but keep the actual engraved plate a traditional design that we are used too".

This from a guy who has been cutting the cloths off unconcious people for nearly 10 years now.

Like it or leave it, that is my advice.

I will not be one too tell you it is OK to camaflauge your medalert, no matter how many ways you ask.

Take Care

Mobey

sounds like a grade 5 school repoty of an 11 year old

I took this to be directed at poor grammar/essay structure.

It really did make me laugh out loud, as I knew full well you had to be overtired or something, because your posts are usually very well written.

what type of school is it, sounds like a grade 5 school repoty of an 11 year old

not that i saying this about you but that is not what i expected

Dude, you slay me!!!

Replying to the OP about grammar, with the poorest written post I have ever seen you type!

Hilarious and genious!

BTW: Is this what U.S. Universities are expecting from students? My short essay's had to be at least 8 pages double spaced and referenced in APA format.

I am in Canada though..... and we are alot smarter.

Oh and for the record, volunteers are certainly not "joe schmoes". Where I live the people who get the most respect from the authority are the volunteers. They have to have the same qualifications as the paid staff, and they are giving their time to a charitable cause Do, for free, a job that some people rely on to feed thier families.

Just because you receive money for a service other people donate does not mean you're more qualified or more prepared, and it certainly doesn't mean you're more generous.

Nope, it means I chose a rewarding careerpath in which to provide for my family, and myself through to retirement. Volunteers do not have a place in my service area. Why don't you try going to a trade school.... say plumbing.... then volunteer to do free plumbing in the community?

I do realize I'm coming off as a prick, and I can assure you, that's only partly true.

I do want you to see the other side of the coin though. Yeah yeah volly's are noble and generous yadda yadda, but at the end of the day, I am trying to make a carrer of EMS and I don't need to compete with people in the job market who are willing to do it for free.

"If you're good at something, never do it for free"

Shortest scene time I have seen was for a young lady who had "the shakes" a day after a night of drinking. I was on practicum, my partner opened the door to the house and saw her lying on the couch. He asks "are you the patient?" She answers "yup", he says "grab your shoes, lets go"

She stands up, puts her shoes on and walks to the rig. We start moving immediatly, and I barely have time to get vitals before we are at hospital.

Hilarious 5am call.

Not the way I choose to do things..... but a good experience for me as a student.

22 cm ATL is also a little high for a man unless he has a short neck. Burn patients should also be measured at the teeth or gums for ET tube placement to account for swelling and fluid therapy. That lip could expand easily another 3 cm in a very quick time displacing the tube.

Ahhhh, thank you for bringing a miscommunication to light.

I read ATL as "At teeth level".

welcome to the forum

Please take a moment to introduce yourself!

Depth is good, size is OK. Lets pull all the air from the cuff, then reinflate till no leak - or 10ml of air. If it still leaks we may consider changing it for a bigger one.

Do we have a ABG?

Is he on a vent? or manual bag? Settings?

How much fluid has he had?

OKOK,,,, too many questions.

Lets get him covered with a blanket, and sterile dressings on those burns.

Can we get CBC as well? with Potassium level?

Already I am saying shut off the morphine and start fentanyl bolus PRN.

I'll wait till you get to some of the posted questions, but I would like to add; EtC02? Cuff pressure? Tube size?

Why would you raise the bitten area ABOVE the level of the heart? Shouldn't that have been below?

Since there are one-way valves in our vasculature, and it is a closed system, if blood cannot get into the limb - blood cannot get out of the limb.

Shoe tag

http://www.medicalert.ca/education/en/education/images/36183_MedicAlert-006.jpg

We carry Prednisone.

No penacillin, however rumors of ancef are out there.

On initial exam of you if you were unable to speak I would probably ignore a big leather studded wrisband like that if I didn't see the writing at first glance. However, it would get closer inspection later on a secondary exam, while disrobing you or looking for IV sites.

Luckily though, i would not be giving Pen or predisone to a person who cannot communicate initially anyway.....

Medical ID's are starting to piss me off a little because we have to search them out. I like the old school metal bracelets or necklaces, now shoe tags, tattoo's, wristbands you have to open, etc.

I am getting old though.....

Music sucks now too

In significant trauma I say

"Sir/Ma'am don't move, can you take a deep breath for me and tell me where it hurts?" Bam; I got consent, A,B, and LOC done.

In a standard approach, I also like to use humor.

"Not the best day eh?"

"Whatchya doin down there?"

"Yuup.... thats a broke leg if I ever saw one"

Although it seems, and may in fact be, unprofessional; it lightens the mood and takes the emergent nature out of the call. In nearly 10 years I have yet to have anyone offended.

Ha!

I love it!!

A thread where we can all agree!

Finally.... after all this time.

Just wish Dr. J. Kevorkian could read the article.

This post comes at a curious time for you

If I may inject a little HEMS experience here: Perhaps if the helo crew just "Load and fly" rather than sit around excersizing thier extensive adanced life support treatments on the ground, they would have better justification.

In these parts, a great way to delay transport of the patient of a critical patient, is to rendezvous with fixed wing or Helo.

**EDIT to add:

Dying trauma patients tend to die.

I am more interested to see if Helo's reduce morbidity. That I would definatly agree with!

I believe that will be the real effect in Arctic's area, not so much mortality reduction, but definatly a reduction in morbidity and increase in patient comfort.

All this TB talk the month I start on Anti-TNF therapy.

I have also transported a patient with necfesc of the hand. I kept it covered and started a line in the other one... Nothing special

Damn.... really wish I would have come into this earlier.

His LOC is decreasing?? Better recheck the vitals.

If his BP is still up (which I doubt), I want to spray 1 nitro while starting a nitro drip. *That ought to start some discussion*

If his BP is falling, start the fluids, but it is too late really.......

Maybe just some fentanyl so his last moments can be less painful?

I am looking for a protocol for the operation of the EMS after earthquake

Protocol's remain the same, triage and transport.

I suspect you are looking for a disaster plan, but I highly suspect you will not find a cookie-cutter plan that will fit your area. I suggest starting an Emergency Measures Operations committee that is composed of fire/rescure, EMS, and hospital staff. Failure to plan, is a plan for failure.

FFS. How many members have we lost on this board now? What's the count?

I don't know how feasible this is, but I'm sure Stephanie would love to have some patches or pins we could send her. That would probably mean a lot. If someone can post a physical address maybe we could send some.

What a stellar idea!

I will be watching for an addy

I suspect she took Metaclopramide for nausea?

Seems like dystonia, although could be partial complex seizure.

Just before we treat, can I get BGL, and EtCo2?

Edit: forgot to ask for temp

Does the IResQ give drops per minute?

Does not matter if it does, we have 10,15,20,60 drop sets.

App's are very useful tools, but I am not interested in one micromanaging me. I enjoy the science of medicine, and I see apps like this "dumbing it down" for me. I am not saying it is not useful, and I am sure there are lots of non-science nerds *cough FF's* who are more interested in an easy out than actually doing math and building strategies in patient management, but that is just not me.

Good luck with you're app though!

I am curious about al the ... 's in the OP "Quote"

They seem curiously placed to add emphasis on the lines that support Kiwi's standpoint.