scubanurse
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Posts posted by scubanurse
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Happy Birthday!!!!!
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Don't count me for any discount numbers unless you need more people... my department pays for a bunch of us to go. Let me know if you need any help with the hotel situation ak I live about 30 minutes from the great charm city and can help find locations etc.
See you all there!
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Montgomery County has a Pt Bill of Rights posted but copied below:
2005 MCFRS EMS Quality Improvement
Patient’s Bill of Rights
The Patient and/or Patient’s Family has the right to expect and receive the
following from Montgomery County Fire and Rescue Service EMS Providers:
1. A clean, well-maintained, well-equipped, climate-controlled ambulance.
2. The closest available ambulance and first responder (when needed) dispatched to their
call for help with no unusual delays for any reason.
3. All responding personnel to be clean, neat, dressed in the appropriate uniforms, and
looking professional.
4. All responding personnel to be polite, compassionate, considerate, empathetic, soft-
spoken, respectful and well-mannered.
5. Transportation to the clinically-appropriate medical facility of their choice without
questions being raised regarding their ability to go by some other means, or any other
method of discouraging transport.
6. A clean stretcher with fresh sheets, blankets and a pillow and the appropriate medical
equipment brought immediately to their location; carried or wheeled as smoothly as
possible while the patient is secured with safety straps and covered with a sheet or
blanket to protect the patient’s modesty; and wheeled smoothly into the Emergency
Department.
7. To have their vital signs checked and documented in both transport and non-transport
situations.
8. To have all valuables and medications in their possession documented on the patient
care report at the time they are transported, and clearly document to whom in the
Emergency Department those valuables and medications were given.
9. To have their pertinent history, injuries, illness, vital signs, treatment, interventions and
medications adequately, thoroughly, and truthfully documented on the patient care
report.
10. To have the specifics about patient history, current situation and nature of their injury
or illness kept confidential in all respects.
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I try to take the time during my morning check out to organize all of the equipment how I like it that way I know where things are and that they are organized and perfect before I run a call... I have not heard of any commercial organizer for the zoll cables though sorry.
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That is just gross. I can't stand the food options when I'm out so I usually make my own dinners and food and bring it with me if I know i'm going to be on the road. There is really no excuse for being obese ( I know there are legit medical conditions and etc, but seriously!)! End rant
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Since no one left a follow-up question:
Explain the concept of Cushing's Triad?
Differentiate from Cushing's Reflex.
Cushing Triad is relative hypertension, bradycardia, and irregular respirations. It indicates an increase in intracranial pressure.
Cushings Reflex is the parasympathetic response to an increase in the intracranial pressure most likely due to ischemia secondary to a major bleed from a trauma or from a tumor.
This happens when mean arterial pressure (MAP=2/3 * Diastolic pressure + 1/3 * systolic pressure) is less than the intracranial pressure (ICP) they hypothalamus will stimulate a response in the heart to increase the blood pressure (because the brain is thinking it is not getting enough oxygen it increases the force of the ventricular response to get more blood to the brain).
The hypertension causes the baro-receptors in the vessels to cause the heart rate to decrease to let the pressure with in the vessel to decrease.
Next Question:
Beck's Triad
What is it, why is it important, how do we treat? -
you got it... official diagnosis was hydrocarbon poisoning.. only treatment was O2 and time
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still pigs... and a majority of fire/rescue (non-ems) males tend to be arse holes in my area...
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SP02?
96% on RA
Using Accessory Muscles?Nope
Cynosis?Nope
Since we've been outside and come inside acting weird is there any trauma? Bit/punchure marks? Wounds ect evident?No trauma no wounds of any kinda
Resp rhythm and effort?Any sign of an airway obstruction?
regular, slow, and a little labored ( in tripod position)
Pt was using spray paint outside to decorate sorority posters
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Friends have no clue... no evidence of recreational drug use...
partner reports nothing found outside.... some posters she had been working on drying on the back porch.
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always a possibility of pregnancy but friends deny bf or anything and she is on BC (no pills appear to be missing)... allergic to latex (no known exposure/no signs of allergic rcn)
BP 168/97 P 42 RR 18 Skin is dry and warm Pupils perrl negative JVD friends say she was outside messing around and came in acting "weird" They don't know what she was doing nor did they go and look.
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no evidence of the patient smoking... friends report she hates cigarettes and the smell.
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You're dispatched around the corner from your station for the 22YOF with an altered mental status and difficulty breathing. You arrive to find a female in tripod position sitting in living room. Presents with 2-3 word dyspnea and apparent giddiness... patient is attempting to laugh at whatever you say. Breath sounds somewhat normal they just sound a little "rough", Heart sounds reveal a somewhat loud S2, sinus brady with unifocal pvc's ~ 3 a minute. NKDA, pt on BC, No past med history/history of abusing drugs/alcohol, no one know what pt was doing prior to symptoms.
What could be wrong/ treatment...
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All of our probies are issued a navy blue t-shirt with screen printing on it with department name on the back and our logo on the front... Allowed to wear on calls. Every member is held to the highest standard when it comes to appearance (hair tied back off the face, shirt tucked in, pants ironed, composite toe black polished boots, black socks, black belt with gold belt buckle). Once they're full members they get a uniform shirt and polo shirt that they can wear. I think t-shirts so long as they're clean and not old and faded are fine for running calls.
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Welcome! Best of luck to you!!
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it makes sense, but I guess I don't have much experience and it still confuses me a little bit because I remember still hearing from the OB section that the baby is still receiving oxygenated blood from mama which is why we keep baby at level so as not to overload/underload the baby with blood?
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Keep in mind just because cord is around the neck doesn't mean that baby isn't okay.... until baby is fully delivered and cord is cut the baby is receiving oxygenated blood from mama via the placenta and umbilical cord. So if mom and baby seem stable, I would transport ASAP but any signs of deterioration on either front cut the cord and attempt delivery of the rest of the baby.
(edited part) Maybe I am wrong in this thinking though? (edited part)
Just remember...once you cut that cord, baby is on his/her own... so make damn sure it's a last resort to save baby and mama
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I said IN intermediate paramedic not to BECOME an intermediate paramedic. I was just clearly stating the name of my class that I took not the resulting certification. jeesh people.
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The course I took was titled Intermediate Paramedic which is what DC classifies their EMTs as I believe. It is the same as I/99 though.
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Didn't mean to stir so much of the pot.... UM Student... don't know who you are but you obviously know who I am... I don't think it's okay to just stop at an I certification but for some it is a stepping stone, just as Basic is a stepping stone. I agree there are too many who sit complacently and don't strive to learn more. I also happen to be a nursing student who has taken A&P so I am probably more/better trained than other EMT-I's.
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Personally I take a offense to this. I worked my ass off for over a year in Intermediate Paramedic class and feel just as qualified as anyone who took a 2 year associated degree course to become a P. Some of us don't have the opportunities to become a P as it does take 2 years to achieve. And my experience at UMBC was a horrible one at that where I experienced the gender biased department head who essentially believed the rumors of one student over the facts. But that is a different story for another time. To say that university trained paramedics are superior to those of us who take a class at our training academy or a hospital is unfair. It is fair to say that people get out of their training what they put into it. If you wander through course work at a university and do not care much for the patho/phys of diseases then you are probably worse off than the student who busted their ass in their academy class to learn as much as they could about everything related to things we see in EMS.
Just my 2 cents worth.... But I do think a paramedic board would be beneficial to the state as a whole...beyond the medivac program which seems to be under a spot light lately.
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So let's expose and check out the coloring of the legs.... Cut both pant legs and do a full assesment looking for eccymosis and the like....
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What part of the body is the band-aid on? Just throwing this out there but it could be some kind of emboli....
Do the criminal charges here make sense?
in Archives
Posted
This does seem a little tad on the insane side of the norm.... I don't think school officials have any right to go through backpacks/cell phones/personal computers because the student owns them... parent owned different story.... lockers and school owned and school property to be searched.