scubanurse

He took the constructive advice people gave him... not the insensitive and non supportive advice. Way to be super passive aggressive and an ass. If the OP has control over their anxiety, what is your issue? There are plenty of providers who practice out there with PTSD and various other mental health disorders and do just fine.

If you actually read the rest of the thread you would see that the difference between certification and licensure has been discussed at great lengths and I expanded on that original post, but if you just want to single me out and every post I make to show me that I'm wrong... Go for it. And I believe I can reply with whatever opinion I want, as this is a public forum, please don't tell me what I can and cannot do. I'm really not in the mood for your posts anymore.

Would NPA or OPA be a feasible option to help control the airway?

congrats!

Old school but maybe a NPA? And we can bag him as well... I feel hesitant to RSI since he's likely a difficult tube and he's tanking so fast... Large bore IV's, fluid bolus, EKG continuous monitoring, capnography if we have it, keep patient calm and alert receiving facility...

Medicgirl-- I am so sorry you went through this. It must not have been a good call and for that I am so deeply sorry. Ignore Miscusi or whatever that jerkoff's name is... Showing emotion is what makes us all human, it makes you a better provider, and a better member of society. If we never let anything get to us, what's the point of anything. For reasons of my own, I have been feeling everything this past month, every emotion possible, I have felt it. It is lonely and awful. No one should feel this. And because I am going through this, that does not make me less of a provider, it does not make me less of an asset to medicine. I think those who lack the ability to empathize with a patient is not an asset but rather a disadvantage to medicine. Having the ability to provide compassionate care, means you have helped a patient in one of their worst times. Helping the mother who lost their daughter by holding her hand, getting her tissues, makes you a better provider. EMS is more than just transport. This isn't the days of the hurst providing transport, where you load and go. EMS is medicine, and with where EMS is going, you would do well Miscusi to change your view. EMS is moving towards being more of a primary provider in some communities, with diagnosing abilities, and having the ability to critically think through a patient's problems. Being a mindless, emotionless robot is not helping this profession. If death does not bother you, you need to leave EMS and do so very quickly. I do not know of a single provider I have ever encountered, save for trolls and you, that feels death is a non-issue. Yes death happens, it happens a lot. A 90 year old passing away in their sleep is not as sad as an infant passing away d/t SIDS, but it is sad. It is sad for those who loved them, it is sad for those who cared. Do you think you show more machismo or are more of a man for saying death is not upsetting? What are you trying to prove? I really hope this is just machismo and an act, because if not, that makes me sad for you.

So because I don't want my patients to die, I'm emotional and incompetent??? Not wanting people to die is a very basic human desire. Being sad when someone dies is a very basic human emotion...what are you? a robot? I hope you never have to feel the emotions that come with loosing someone very close to you, or loosing a child. You sound like a heartless bastard and that would make you a very incompetent and piss poor EMS provider.

Never getting sick when this dude is on duty... If he even works for NYEMS

I agree with this. Giving the parents false hope is not good. Just be open and honest. Let them grieve, don't get them worked up thinking they grey, quiet, dead baby has a chance, it does no good.

What do you think? and see the plethora of other threads currently on this topic.

Do you actually work in EMS????????? For real? You MIGHT call ahead? Dear lord. The point of scenarios is to talk through patient care actions and critically think about the presenting patient, not just say well transport and maybe give the receiving hospital they are about to get a very critical patient that will likely need an OR prepped and ready.... Seriously dude.

If you had actually read the replies made by seasoned EMS providers, many of which are instructors or have been instructors, you would have known NREMT is required by states to get certification.

I'm good with just a beta blocker and see how it does, I'm good with adding a nitro drip and seeing how that goes. I'm really thinking this is more cardio/respiratory than neurological at this point. I'm hesitant I address the lung sounds because everything we have in our arsenal can increase HR and BP. There may be a small bleed in the brain from the tPA that could have started this sequelae but we also might never know since I don't think this buddy had a very favorable outcome given all the obstacles to his care.

Ahhh... careful dissing on floor nurses. So you would just ditch them and not continue to offer help? Neat. Yeah, but if we don't do anything about the BP, seeing as he's missed his morning anti-hypertensive AND B-blocker, it's just going to keep going up and make the situation worse. I know hydralazine can cause tachycardia, but it also is very effective at lowering BP.

It could be a crime scene as well, so you much make a decision as to how to proceed based on the individual situation. Some shaken baby cases are played off as SIDS and you should always be analyzing the scene for suspicions and make a decision from there.

I guess it does depend on what Chris said... if the state has a scope of practice set or not...

Can we get an ABG w/o a respiratory therapist?

So, he didnt get his am meds? IV hydralazine for the pressure IV furosemide Stats cxr Does this hospital have an ICU? Respiratory therapists? Respiratory status likely due to not receiving his asthma, copd/asthma and chf. BP/HR likely d/t missing his AM beta blocker/antihypertensives. Probably totally off on this, but it may stabilize him long enough to get a bird available or get a critical care team to ground transport to a ct hospital.

I just applied for my CO nursing license not that long ago. On it, I did not report my EMT-I/99 certification I had held in Maryland. This is because the question asked for a list of any previously held licenses in other states. I did not have a license, I had a certification. They are very different. The link Mike posted is very helpful but here's a brief on the difference... EMS has a scope of practice defined by their medical director. There is no legal scope defined for EMS providers, just that of what the medical director approves of under their license. The nurse practice act, a legal document in every state, defines the legal scope of practice a nurse can have.

Uhh...except the states that require NREMT for initial certification... EMT's also aren't licensed I believe, they are certified.

The only thing in common was a similar diagnosis....

You have no idea how much I wish I couldn't drink now. I would give up ever drinking alcohol again, or Jimmy Johns, or sushi just to have my baby back in my tummy instead of in the ground. You have no idea. The only way to get through this right now is drinking and drinking is what I know I can't fuck up. At least I know I can stay drunk and not mess that up. A good base level of etoh is what I need, so ill take those beers and fuck root beer.

Very nice!

I guess my question would be what steps are you taking to manage your OCD and anxiety? How does your OCD manifest its self?

When I was in Australia, I never even saw a Fosters...quite disappointing! I did fall in love with cider poured over ice and now I get crazy looks at bars when I ask for it that way.