ericenglund

I don't put the blame on anyone but the hospital. BUT.....they could walk outside and call 911

And she'd more than likely be taken to the closest facility, right where she started.

Doc, what you just posted was well known in the fire circles and ems circles. as a matter of fact, it was pretty obvious.

be careful what you post, you might get labelled as captain obvious too.

the captain obvious thing was meant as a joke.

Eric, calling a firefighter a firemonkey is no different than calling a paramedic an ambulance driver. Both are derogatory terms to the person being called firemonkey or ambulance driver.

:wink:

They had to be complete morons to fall for that anyway..

bingo

its all good, but there IS a constant degrading of the fire service here. and it is indeed an EMS forum, not a fire one. i'm perfectly fine with it, i just don't understand why. my former paramedic instructor used to work for a large municipal fire department, then he switched to a city that is seperate fire/ems and works as an EMS only paramedic. i'm certain his credibility/quality of care have improved now that he doesn't have the title of firefighter, right?

my previous statement could very well be changed to a firefighter/paramedic has the same education as an "EMS only" medic. they just also attended a fire academy and work for a fire department rather than an ambulance service. im betting the majority of you know this and the whole "firemonkey" stemmed from one or a few individuals who thought it would be clever to consider the fire service "simple". and now six thousand of the forums EMT-Bs have hopped on the bandwagon and use the term whenever even remotely applicable.

.02

Eric

Wait, these weren't firemedics were they?

a firefighter/paramedic has the same cert as a EMS only paramedic.

always wanted to be a firefighter since i was 3 feet tall, went to paramedic school to be a bigger help to people prior to getting hired with the FD

When you come in and tell me you are allergic to motrin, toradol, tylenol, morphine, benadryl, phenergan, reglan, compazine and droperidol, complain of a migraine that is 20 out of 10 (despite the fact that you are sitting there watching TV and laughing with your friends) and the only thing that works for your migraine is 2mg IV of dilaudid then yes, you will be labeled as a seeker.

Wow thats funny you should mention that, during one of my clinicals when I was in school I was in the ER and this woman did exactly that, except her list of allergies was a few shorter and she was doing a fairly good job of moaning and covering her eyes with a washcloth. The doctor kept giving her benadryl and... I want to say Haldol(memorys kinda fuzzy..pretty sure it was).. to which she had "no relief." after 3 rounds of that the doctor straight up told her he wasn't going to give her any narcotics. She sat straight up and started bitching about a patient advocate and then TORE her IV out and said she was going to a hospital about 20 minutes away and signed out AMA.

Personally, the idea kind of rubs me the wrong way. I feel it smacks of sloppy medicine, and it shouldnt be advisable to give medications for conditions we dont clearly see. I'm not sure that it is our place in the ambulance to ever give meds "just in case."

Agreed. Although your preceptor is probably right, lots of people eat lots of Bayer every day, I dont think its my place to give meds just in case.

You've got a stable trauma patient with no deformity or swelling that just wants to get cleared physically at the ER. Do you give morphine "just in case" they have a femur fracture(or any bone for the purpose of this) that you can't detect?

Or are you gonna give your hx. of CHF pt the CHF workup to someone complaining of a headache "just in case" they're having an exacerbation somewhere in there?

Just my .02

Probably PID. NRB@15Lpm, B/L 14g with saline wide open,transport hot. Consider Narcan. Pt. may also be CVA/TIA.

The more I read this the funnier it gets

Come on, guys! This is obviously PID. O2 at 6 or 15lpm, b/l 14ga saline wide open, cardiovert at 100 or 360, and haul ass to the LZ so the critical care medics in the helo can do an immediate ORIF enroute to the Mayo Clinic.

I rarely "laugh out loud" when reading on the internet but after reading the posts you're mocking and then seeing this i got a good laugh in. Thanks.

However, does your PID protocol not mention narcan? you neglected it in your post.

Probably PID. NRB@15Lpm, B/L 14g with saline wide open,transport hot. Consider Narcan. Pt. may also be CVA/TIA.

that much oxygen and dual 14g ivs and narcan??

i know i havent been a medic for too long but sheesh

Sinus Tachycardia interpretation!

...Well I thought it was funny.

I want to say some type of seizure too but then again I don't. and it happened three times and she was alert&oriented in between them.. hmm

Was the "eye twitching" the same as you'd see on someone who'd been sedated with ketamine or how would you describe it?

How much prozac was she on/did she take? I'd want to get more into that.

50 sounds good. a 360J cardioversion on this young lady seems a bit excessive. :shock:

Defib pads on, 100 J ready, set, clear, *bam*

If converted, Amiodarone 150 mg in 100 cc of D5W over 10 min

Repeat Cardioversion if unsuccessful at 360 J

Pray to God it converted

100J or 360J? Nothing in between?

I'd call that VT 8 days out of the week. I don't see where all this SVT and adenosine talk is coming from.

Which "skills" would this be testing? :?

Sinus Tachycardia interpretation!

CNN did a video story on doctor's transplanting a beating heart off some new machine. It's late and I didn't look very hard but I couldn't find their text story on it. Interesting none the less.

CNN Video Link

Edit: For some reason the urls aren't working and I'm too tired to figure it out so copy/paste http://www.cnn.com/video/player/player.htm...transplant.wpxi

edit: i dont know how this got here

dang 90 minute edit rule.

didnt mean to say "rapid narrow complex tachycardia," on my previous post haha. Obviously a bit redundant, but hey, it was midnight.

So how do you correct HR if you don't have cardioversion in your county? I was told adenosine is what corrects the HR...if you slowed the rate down, then you don't need adenosine in the first place.

But those are just verbal explanations I've gotten...I haven't studied ALS drugs much, yet...working on EKGs still.

Right. Adenosine is indicated in rapid narrow complex tachycardias. It won't convert V-Tach as far as I know. You could try amiodarone techinically but I'd go with a good 100J synch. cardioversion.

Also, I think(but am having a midnight brain fart) the new ACLS guidelines want us to do electrical therapy without delay.

Wouldn't the decision to move her from the pole (she's not getting any more dead than lying pulseless impaled by a pole) be the same as what they're teaching now as far as if you can't get an airway with the jaw thrust just go ahead and do a head tilt/chin lift? If they're DEAD then the slight risk of actual cervical spine injury would be worth the benefit of securing the airway.

Or SWAT teams, however I don't know a ton about swat medics(haven't even been to the tactical ems forum). Probably wan't a bit of experience rather than fresh out of class...but if you get tired of the trucks I'd consider it a neat alternative.

Cruise ships!