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Jim Squire

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    EMS Student
  1. Contraindications for morphine use include (among others): head injury, decreased mental status, multiple trauma. Why? I understand why it's respiratory depression effect would make contraindicated for patients with COPD and asthmatic attacks, and why its effect on blood pressure would make it a bad choice for a hypotensive pt. But why would multiple trauma and altered LOC/head injuries make it so? I'd think head injuries would make rise of ICP an issue, one in which morphine would, if anything, help.
  2. Thanks rock_shoes. Makes me feel like I am learning something. Although I’m a bit surprised that local protocols don’t reflect evidence based research (which is just common sense here), especially as a “critical fail” point. Well, as I said, I’m new to this.
  3. Hi all, I've done a long career in teaching/military, and thinking about what to do with my spare time in 18 months once my kids leave the house. I did a ridealong and volunteering in the local EMS unit seems like it could be really rewarding. I don't want to take the EMT course quite yet - I want to spend the remaining time I can with my kids while they're still around - but I've found a great course offered where I teach that I'll take next year once empty nest arrives, and in the meantime I'd like to poke around and see what those with experience say about the career, especially as a volunteer. I'm a bit concerned that as a 50 yo volunteer I'll never gain the patient volume to have the experience that would make me a great provider, but my local unit has some experienced people to help me along the way.
  4. I'm learning to become an EMT, so be easy on me for asking this newbie question, but it points to something about O2 adminstration that I don't understand. Virginia's health department posts a bunch of scenarios for EMT training like this one: http://www.vdh.virginia.gov/content/uploads/sites/23/2016/05/M003.pdf In it we find a young adult diabetic patient with a Rx for insulin, able to speak but not feeling well, alert and oriented x3 but "sluggish to respond" and a CC of "not feeling right". He has an O2 sat of 95 and respiratory rate of 14, no mention of cyanosis, vitals normal except for low glucose. Why does the grading criteria call it a critical fail to not provide O2? As a not-yet-certified EMT student with no field experience, I'd think this pt doesn't seem to be in any sort of respiratory distress; he just needs some glucose paste and continued monitoring enroute to the ER (and probably doesn't even need the ride, but I understand we are always supposed to transport everyone unless they sign waivers since there are problems that require more skill/equipment than we have to Dx.) Are we supposed to automatically provide O2 for everyone (except those in hypoxic drive), regardless of O2 sat? Just when I think I'm starting to get a handle on this...
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