medic403

mailmantech82 where you at in Maine? PM me if you like. No not working under someone's name, even I know that it is illegal. :oops: It has to do with OT. Apparently miss print in my letter from the boss. Just so frustrating. I just wanted to make sure I was not doing something wrong. Take care and be safe.

Thanks for the tips. This particular service payweek is mon-sun. I'm not sure what the deal is. I work for couple different services but this service is located in Northern Somerset. No we are not Union. Sometimes people/services can be so frustrating. They want no OT and the way it was arranged that there would be no OT just straight hours. Take care and stay safe.

Hello all. I hope you are all enjoying your winter. We have here in Maine. Snowiest in over a decade. So they say. Got a quick question. A co worker is going on Vacation and wanted to work my shifts this week and Me to work hers next week. The boss is cool with it. This is to keep any and all over time down. But today the boss cops an attitude and now says that it is illegal and she can not allow this. I was wondering if this is acurate. I just not sure why it was fine last week but now it is not. I would appreciate your input. take care and be safe.

Don't lose sleep over this. Some things we just can't predict or foresee. I believe it was wrong to have that individual call you, just to tell you that you missed a femur fracture. Our med control gives us tips to help us with differiantal field diagnosis. Example; to check for a femur fracture tap bottom of the foot. If the patient cries in pain I would suspect femur fx, if not crying out in pain, I would be suspicous of bruised bone. Don't hit the foot with all your might but give it a sensable tap. In PHTLS we were taught that young children and small adults when hit by vehicle it tends to be chest and facial injuries. With adults ab, pelvis, and lower ex, injuries. 20-25 is pretty fast. Especially with car vs pedstrian (i can not spell). I am not critisizing you, I think you did your job to you fullest capability, just giving you some tips to grow off from and info to put into your already really full file cabinet. Take care and good luck. Be safe out there.

Now some of you have seen me on here once or twice. I do have a question for all seasoned ems, docs., nurses. I had a asymtomatic 58 y o male pt on New years day in V tach rate 250+. c/o n/v and stiff neck. How often does this happen. This pt did not make it. This call I can not go into much detail as of yet, has burnt me. Please don't be to hard on me I'm already going through enough and a friend would be much more appreciated at this time. thanks.

Hello all. a couple things on these stretchers. our service has recently recieved 2 loaner ferno's. I am not sure of the weight of these but there is more than a simple 30-40 pound difference in weight. I am only 5' 1" and if I have an average weight pt (180lbs), and the rig is at a slight angle, then I can not get the stretcher in. It is much to heavy for me. I do have partners that are taller and I usually try to lean on them to take the high end of the stretcher because of the height issue. I have no issue holding my own. but I think that extra weight is an issue that needs some attention, I could feel it in my back when the day was done. I like the factor that the wheels go up and down all on their own. but I can still see injuries from this type of stretcher. Is the stryker lighter then ferno. Second thing I dislike about the ferno is the handle. I realize you can adjust it to your likings but I still have to shift weight of the cot from one hand to another to reach the stinkin button. aw the stress. but some one has to have it.lol

I have a couple that come to mind. 1) called to a 21 yoF c/o cut finger can not control bleeding. On scene found a 1/4 " cut no longer bleeding. ask how long the finger was bleeding. pt stated "about an hour. I would of called sooner but we wanted to eat our lobster and corn on the cob first." wrapped and left. 2) called for a 40 y o F c/o splinter in finger. Removed and left 3) teeth are itchy. transported psyc 4) called for a 75 y o F not feeling well. on scene pt stated "my vagina feels tight". bls pt to hospital 5) my favorite ones is getting called for a 10-48 (unwittnessed death). first time I was called to a 10 48 I touched the pt and she woke up. family could not wake pt up by shouting across the room. (Can you say heart failure?) 2nd time I was called to a 10 48 in progress. I dunno how they came to that conclusion but they (dispatch) did. Lady was alive and yes we did take her for some other medical reason. I could go on and on. but those were some that stuck out. Hope you enjoy them

Hello paramedic mike. thanks for your opinions and questions. Here is some answers to your questions. This was a trip on the Dead River (no phun intended) located in Northern Maine. This was the end of the season for rafting so many came from far and away to raft. I am not as familiar with the Dead River as I am with the Kennebec River. I pick up to many people to raft or white water kayak. I do flat water or minimal moving water for kayaking. There was some where around 500 rafters on this particular river this day. This rafter was in a private raft with friends and a professional guide from another rafting company. In Maine you need a licensed guide on any rafting trips. The dams were open so the river was higher than normal. Not sure of the flow that day. The one thing i am sure of is the reason it had taken the rafters so long to get the pt to the ambulance was because the accident happened early in the trip. There were many whirl pools do to the water being higher. The rescue was done by a rafting company that saw the accident. Yes you are very right. Time flies by and no one person will be the same as another. But he did receive immediate care, because they were there. Otherwise who knows what would of happened. The pt color tells me he was under water for a time. The CPR and rescue breathing was done by the rafting guides that pulled him from the river and was the one to tell me that pulse was not assessed. The gentlemen told me it was two rescue breaths and approx. 30 chest compressions and pt started breathing. (2 person CPR). End result the pt made a 100% recovery. Physically any way. Unknown mentally, he may be scared of the river now. I know I would be a little nervous. On a separate note I had Life flight training this past weekend and the same crew that was on this call was doing our training. So I asked about more info on this pt. The flight nurse stated pt had some kidney problems at first from being hypoxic and poss from being hypothermic. But after a couple days and plenty of fluids he showed no signs of failure. thank goodness. Pt was very appreciable that he was still alive. Went home to Ma. 2 days later. Lucky man. I do appreciate your input. It helps me get another medic perspective on the situation. Anything else I can answer please ask or any comments please add I do read them. Thanks once again.

I have one for all of you. Please give me your opinion. I work in a very rural area. Nearest hospital (from the time of pt. contact) is approx. 1 hour away by land. I was called to an area approx 20 mins. away for a MVC that sounds serious. Unknown how many PI. Dispatch tones out vol. fire/rescue that would be there much sooner than our rig would be. Vol. Rescue put life flight on stand by and headed for the scene. Once off at the scene rescue found no mvc. rescue went and talked to the business the call came from. The business did not know much except for a gentlemen with a life vest ran in and said to call for an ambulance there has been an accident. So now the accident may be a boating accident. Still nothing further to go on. Life flight is still on stand-by. Well before we have any pt contact or knowledge of what is going on life flight chooses to head to a designated LZ. They have an ETA of 28 min. Once I show up on scene pt still has not came off the river and no one has any idea what or if we have a pt. The guy with the life jacket left before any one was on scene. So now lets reflect. We have an officer (MVA?), game warden (poss. boating acc.), vol. rescue crew (extrication and 2nd pair of hands), ambulance (transport and treatment), and now a life flight helicopter (transport to a trauma center) and still no patient. No one could stand down because we still did not have no idea what we were dealing with. Soon some rafters come off the river and can not tell us anything except we are looking for a blue rafting boat. Still no pt update. after of sitting on scene for approx. 45 minutes a doctor comes off the river and says "the pt may have a broken jaw or neck, but other wise is stable. Pt will be walking off." I shook my head and said, "I don't think he'll be walking off the raft." Then I walked away. OK, so now we have a pt condition maybe. So I relay what i know to life flight. They continue to the LZ. Now approx. 10 mins out. Pt finally arrives lying on bottom of raft. Obvious injuries: Hypothermic and a 1" lac on chin. Pt AxOx4. While cutting wet gear off I am receiving report. This pt. raft flipped on one of the whirl pools and was pinned under water for approx 2 mins. Another raft came through pulled him out and did 15 secs. CPR. and rescue breathing. Then pt just started breathing. Pt color was reported as very blue. Pt remained unresponsive for approx 15 mins. I asked if he had no pulse. Answer was: that was never assesed. Pt was wearing a full helmet w/ face shield. Placed pt on 10L of O2 via NRB. Skin: Pink-cold Vitals: B/P 140/78, HR 72, RR18, B/G 97 Examination of systems: HEENT: pt complains of vision disturbances, unable to see. Pupils: sluggish but react with light, lac on chin, bleeding controlled, other wise clear. Neck: no JVD, no trachea deviation, no pain on palp, placed collar on pt Chest: lung sounds clear, no crepitus felt, symmetrical, no pain on palpation Ab: soft and non tender, no bruising or discoloration, ab slightly distended, pt complains he needs to relieve himself, have male help him with that. 500cc's of slightly yellow urine, no blood presant. Plevis/hips: clear Ex: clear, good csm in all ex. Back: clear, no pain on palp. Boarded the pt. Iniated rapid rewarming, wrapped pt with blankets, placed hot packs on back of neck, arm pits, and on ab, started 2 large bore IV running w warm normal saline solution. Placed pt on life flight and was taken to trauma hospital. I felt the hospital I would of taken pt to would of been sufficient. TIME is the only reason why I felt it was necessary to go with life flight plus they were already there. How ever couple things bothered me. Waste of valuable resources had taken place and I question the pt was not breathing. I believe CPR was contraindicated in this situation. I believe pt was alive but had water in his airway at first. I believe some one was anxious because we have had 2 deaths on the river in the past two years. The reason I believe this is because pt had to urinate. So what do the critics think? Any advice on doing anything different? Pt outcome: Pt was observed for two days with a concussion and released without complications. Do not have any more information than that.