scubanurse

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....

What part of the body is the band-aid on? Just throwing this out there but it could be some kind of emboli....

What are pupils like...

lovely... we have doc's okaying procedures they aren't familiar with and medics using slang over the radio.... just super.

ahhh... i couldn't figure out how y'all were reading it ... i feel blond ... and i must have had another blond moment reading the BP, but I think I was proposing the dopamine as an alternative to the fluid bolus to maintain pressure since it is a long flight and bladder control is an issue/i hadnt gotten a response on lung sounds. If they had been wet... could we use dopamine to keep pressure since a fluid bolus is contraindicated? j/w since i'm still learning.

NTG in an inferior MI will completely bottom out their pressure if I remember correctly... I have very very very little experience reading 12 leads and so I wouldn't recognize an inferior MI if it smacked me in the face.... I can't wait to learn more about them this spring.

What is GTN???

Looks like some ST-elevation? hard to tell from the small pic though so I can't count it out to see how elevated... Try some dopamine too to help the pressure, NTG once the pressure is up and some fluids running, MS PRN, and high flow O2. Agree with the others on the 12 lead q1 hr and continuous 3 lead monitoring. Treat acute symptoms as needed. as far as transport... having never done inter facility this is a new area for me to think about, but like others said- enough meds/fluids for the transport, pt would be getting a cath before we leave if possible, food, water, a good book, blankets to keep her warm and comfortable. A working communications set for orders etc... telemetry if available so doc can check strips simultaneously and advise on treatment plan. Long Term thinking: warmth/comfort of crew nutrition resources/supplies bladder control thinking ahead for possible problems in the air such as: pt coding, loosing an airway (appropriate room/resources for intubation)

This seems like either a sink or swim situation... you either just learn to deal with it and get over it, or you let it control you and you switch jobs. Either way I hope you find some peace soon in whatever you decide.

in Maryland you can become an EMT-B at 16 with parental permission and ride under the supervision of a senior member until you are 18 and can take your written and practical aid-man tests. I started EMT-I at 19, graduated and took NR at 20 and have been in the field "blessed" for about 3 months (which was following a lengthy internship which I have chosen to extend). Even at 21, I hardly feel prepared enough to be out there alone which is why I have extended my time as a 3rd for another few months which would equal about a year in total of internship before I am alone on a medic unit. I believe this is the best so you get experience working under a seasoned preceptor until you are comfortable enough to be on your own. No one can tell you when you will be ready or at what age you will be ready because it is far too individualized. I have met some extremely mature, responsible, and intelligent 16 year olds in classes and I have met some 40 year olds who shouldn't be given a CPR card let alone a medic card. In any situation there needs to be an SOP in place to insure that medics are not released too soon... a required internship, oral boards, and preceptor evaluations are just a few ways we overcome the insecurities of allowing paramedics at age 18. A good friend of mine started her medic class while still in high school (but 18), and most people pre-judged her and said she was far too young and inexperienced to perform the duties, and she happened to graduate top of the class and had the best field knowledge of anyone out of her year.... so I guess age is just a number and really it is up to the individual maturity level of the provider which should be assessed through checkpoints built into the system.

me? I'm in Maryland near D.C. but I'm mostly doing nursing school and picking up medic shifts as often as I can.

We have a "family" dinner at the station where family members are invited and it is really nice. We always decorate the fire house too with a tree, menorah, lights, and stockings with each of the members names on them. We also ride around our first due with santa on the wagon for four nights before Christmas. The corporation pays for the shifts dinner on both Christmas and Thanksgiving where family is invited and it is a big fun event.

Welcome to the city!!

haha dust... i think they were more concerned about the clots traveling to the lungs or brain silly

I have the Littmann Lightweight II SE Stethoscope with an oblong diaphragm which comes in handy to slide under the BP cuff and you need an extra hand. I also have the Littmann Classic II Infant for my nursing rotations in the NICU (I want to be a NICU RN someday ). Both are great and good quality. The adult has lasted 5 years or so and I just got the infant one this spring. They were both gifts so I don't much know/care about the price, just as long as it works well enough to hear heart sounds accurately in a busy ED.

I wish for everyone to get along on this site and contribute to the education and advancement of our fellow EMS providers

In Montgomery County, MD there is a LOSAP program. You get 1 point per standby and you need 50 LOSAP points to qualify as an active member. You can receive other points for collateral duties such as BINGO organization, map work, etc... and you get training point. 1 point for every 2 hour drill involving 2 or more people. If you get 50 LOSAP points the next year you get a $200 check. After 5 years of active service you get other benefits like a tax deduction and after 10 years I believe you might get a monthly stipend or something of the sort. you can find more information at mcvfra.org

WASHINGTON -- Until more testing can be done, Army medics are being told to stop using a new product just sent to the war front to help control bleeding among wounded troops. Officials were in the process of distributing some 17,000 packets of WoundStat, granules that are poured into wounds when special bandages, tourniquets or other efforts won't work. But a recent study showed that, if used directly on injured blood vessels, the granules may lead to harmful blood clots, officials said Tuesday. The Army Medical Command will continue its research and work with the manufacturer in hopes of figuring out in the next few months whether to resume use of WoundStat, said Col. Paul Cordts, head of Army health policy and services. WoundStat manufacturer TraumaCure, Inc., of Bethesda, Md., had no immediate comment. The product, which was developed at Virginia Commonwealth University, had been approved by the U.S. Food and Drug Administration. It was one of the latest in a series of Army efforts to improve survival rates on the battlefield. Today, 90 percent of injured troops survive their wounds, the highest rate of any war, Cordts said in an interview. He credited better training of combat medics, better body armor the troops wear and better tactics they use on the battlefield, as well improved bandages, tourniquets and so on. Defense Department figures show that as of this month, more than 4,800 troops have been killed in Iraq and the global war on terror. The latter category counts casualties mostly from Afghanistan. Some 34,000 troops have been wounded in the wars, where insurgents have made wide use of roadside bombs and other explosives. Excessive blood loss is the number one killer on the battlefield, and the Army announced in October that it was sending two potential lifesavers -- the WoundStat packets and a bandage called Combat Gauze -- to replace older other products that had been in use at the time. A committee of Army medics, Navy corpsmen, surgeons and others recommended the Combat Gauze bandage -- which has an agent that triggers blood clotting -- should be the first-line treatment for life-threatening hemorrhaging in cases where a tourniquet could not be placed, such as the armpit or groin area. The WoundStat granules were to be used if the bandage failed to work. Cordts said the Army put out a message on Dec. 18, directing the temporary halt in use of WoundStat. Though it has arrived at the war zones, officials are unclear on how widely it has been distributed so far. They're working to identify any soldiers who got the treatment, study their cases and examine them for any problems with blood clotting, Cordts said. He said he didn't know whether it had been used on any soldiers and thus had no reports back from the field -- positive or negative -- on how effective it might have been. Cordts said that after an additional few months of study, officials will likely determine whether they should discontinue its use altogether or perhaps redistribute it with warnings for how it is to be used. More Information: Army Medical Command TraumaCure, Inc. Copyright Associated Press Any thoughts/experiences with Wound Stat that resulted in a clot?

A guy I worked with a few times did accidentally stab a patient in the crotch area cutting too fast he just pushed right into the family jewels :/ no good.... at least we knew the pt was responsive to pain.

I'll be there. Not like anyone from here would even care.

irresponsible

gun

crash

we call PD since they have the authority of the Coroner...we wait till PD gets there and then we go....i always make sure i ask the family members if there is anything i can do for them, sometimes a hug or glass of water can help them. We carry a list of counselors as well and i have called before in the case of SIDS. I called a certified counselor to come in and be with the family since i wasn't qualified. Just remember when you are there you are the first person that these people will associate with the loss of their loved one, be polite and understanding and they will remember that for a long time.

I am not but know of quite a few who have been. Georgetown University has one GERMS (Georgetown Emergency Respons Management System) they have their own ambulance and do their own training in house....from what i hear a pretty well run organization. They also help out DC Fire for the surrounding areas of the campus. UMBC supposedly has one but from what I hear their EHS LLC and response team my not be happening you can check it out though UMBC EHS. Tufts has one from what I know of that is okay I believe they have a chase care type response vehicle those are the ones I know about im sure you can do some research and i am sure there is an association out there for collegiate EMS if you have further questions....you can also PM me and ill look into it and ask around for ya. k