NREMT-Basic Posted February 16, 2008 Share Posted February 16, 2008 Oh, so if a MEDIC botches it, it must obviously be some that basics should be able to attempt also. After all, it's all luck. Oh, by the way, I'm not a medic and I don't exactly remember my basic class covering the basics of hemodynamics past "blood goes round and round pushed by the heart." Keep trolling though. Well then thats a problem I would bring up with your EMT program director. Its not my fault that you went to an inferior program. Look...starting an IV is such a rudimentary skills that soldiers in combat are being given kits to do it for themselves without having to wait for a corpsman. Its not that big of a deal. We just have a bunch of medics here who are bent about the idea that there might be Basics who can and do do more than drive. Im not gonna argue with you about it. If your jealous or something, talk to your states EMS director. NREMT out. Link to comment Share on other sites More sharing options...
EMT City Administrator Posted February 16, 2008 Share Posted February 16, 2008 If you cant get this conversation back on track it will be locked. Take your personal business and attacks to PM. Link to comment Share on other sites More sharing options...
Don1977 Posted February 16, 2008 Share Posted February 16, 2008 Should have been locked a while ago. People don't know how to stop Link to comment Share on other sites More sharing options...
mobey Posted February 16, 2008 Share Posted February 16, 2008 If the standing order is for a fluid bolus via IV, its doesnt matter who starts it. Starting the IV line takes about as much skill as starting a 3.5 inch line on a fire hydrant. Its a technical skill that I have seen paragods botch time and time again. Why shouldnt we get the fun of screwing up the same things they screw up. I mean if I have seen a medic take five sticks, then there must not be much skill involved. Its must all be luck. Who's to say you are luckier than I am? Seriously, I have the basics of hemodynamics down, lets just move on. What i predicated would happen has happend which is medics whining about us taking away their toys. Alright I am not a Paramedic let me ask. You roll up on a car wreck, car vs pole @ 50mi/hr 76 y/o male pt approx 150Ib Complains of Leg pain. Obvious deformity of L femur and open fracture of right tib. Pt complains of crushing chest pain that caused him to veer off the road. BP 92/50 P 88 R 22 some quiet crackles in bases of lungs. Hx, MI x8mos ago, CHF, Smoker x 30 yrs, Enlarged heart, Hypertension. He is not sure what meds he is on or what thier for. So you have D5W, Lac Ringers, NaCl, and all sorts of needles. What size cathlon you gonna use? with what solution? and what drip rate? does this guy even warrant an IV? Please include 5 problems that may occur with this IV. Don't see this as a negative post please. Take this opportunity to show how far the EMT-B course has come since these old Paramedics were in basic school! (SORRY ADMIN I was writing this while you posted. Feel free to remove if you would like, but I am being sincere, not trying to degrade) Link to comment Share on other sites More sharing options...
NREMT-Basic Posted February 16, 2008 Share Posted February 16, 2008 Hydration IVs ONLY. (read NaCL only .9%) Everybody went berzerk which is what I said would happen. In order to get the cert in IL, its a 6 week course. The same one given to CNAs and Patient Care Techs here now. Try to understand: Im sticking a needle in a vein, asking the medic how many dpm, taping, tegaderming and getting in the front seat. I said nothing about medicated IVs, in fact I specified non-med IVs. If they were going to let us do chest decompressions, I would feel worried two, but they arent, so its not a big deal. Nothing that every Marine in Iraq hasnt been doing for more than a year. Lets just move one. Link to comment Share on other sites More sharing options...
brentoli Posted February 16, 2008 Author Share Posted February 16, 2008 Try to understand: Im sticking a needle in a vein, asking the medic how many dpm, taping, tegaderming and getting in the front seat. <snip> so its not a big deal. Nothing that every Marine in Iraq hasnt been doing for more than a year. Lets just move one. Local Complications Hematoma Phlebitis Thrombosis Thrombophlebitis Infiltration Infection Venous spasm Catheter dislodgement Nerve, tendon, ligament damage Vasovagal reaction Occulsion Systemic Complications Septicemia Circulatory overload Pulmonary edema Air embolism Speed shock Catheter embolism Link to comment Share on other sites More sharing options...
NREMT-Basic Posted February 16, 2008 Share Posted February 16, 2008 Local Complications Hematoma Phlebitis Thrombosis Thrombophlebitis Infiltration Infection Venous spasm Catheter dislodgement Nerve, tendon, ligament damage Vasovagal reaction Occulsion Systemic Complications Septicemia Circulatory overload Pulmonary edema Air embolism Speed shock Catheter embolism Oh youre right. Now that you put it like that, I see. Because of course none of these are a concern when a medic does it..... Septicemia...in a 10 minute ride to the ER? Hematoma? You mean they might get a bruise? Infiltrate....oh God...I went through the vein!!! Catheter dislodgement? For the love of God man...where were you when the Illinois College of EMergency Physicians and IDPH created this new protocol. You mean the needle might not stay in? Good God Jim!!! Infection? How common is infection from an EMS intiated IV? I do commend you for your use of Taber's through. NEXT! Link to comment Share on other sites More sharing options...
brentoli Posted February 16, 2008 Author Share Posted February 16, 2008 You're right it could happen to a medic. You missed the point, that I didn't expect someone of your caliber to get anyways. You said, "it's not a big deal." The point is, it is a big deal. Belive it or not, you can kill someone with an IV line, and I would venture to say its more likely to happen with someone who has had 6 hours of training on IV's than someone who has had 2 years of training on the human body. Link to comment Share on other sites More sharing options...
DwayneEMTP Posted February 16, 2008 Share Posted February 16, 2008 Hydration IVs ONLY. (read NaCL only .9%) Everybody went berzerk which is what I said would happen. In order to get the cert in IL, its a 6 week course. The same one given to CNAs and Patient Care Techs here now. Try to understand: Im sticking a needle in a vein, asking the medic how many dpm, taping, tegaderming and getting in the front seat. I said nothing about medicated IVs, in fact I specified non-med IVs. If they were going to let us do chest decompressions, I would feel worried two, but they arent, so its not a big deal. Nothing that every Marine in Iraq hasnt been doing for more than a year. Lets just move one. Hey! I recognize you again in this post! Welcome back. I don't think we're talking apples to apples on this topic. Do you run all medic/basic trucks NR? If so, I don't see the issue either. All of the basics here start IVs...as you've said, it aint exactly rocket science. When this comes up I think most of us start thinking unsupervised basics with access to fluid therapy. As was mentioned before, it's uncommon in my limited experience to start an IV on someone that isn't pretty dang sick. And if they are really sick, I'm not trusting anyone with the management of my fluids. Fluids are really pretty dangerous to many people. Also, I don't think many of us think supervised basics are "to dumb" to start an IV, it's simply a slippery slope. From your past posting history (the last few weeks excluded) it seems obvious to me your intelligent, committed, and as capable as any basic out there. But my experience has shown me that you are the exception, not the rule. Unfortunately we must argue based on the rule. It does hurt my heart a little bit to hear you make the "every marine can do it" argument, as I believe you to be smarter than that. In all honesty, how many well conditioned 20 y/o patients are you going to run on next month that are going to need fluids? Yeah, not many. It's pretty hard to screw up fluids in this group, far from impossible, just much more difficult. If the average marine was likely to be 60-100 years old, suffer from CHF, MI, renal disease, or dozens of other health issues...then I'd take this away from them as well. I'd like to see us all get back on the same page. As a 'near' medic, I don't have issues with basics starting IVs because it makes me feel less important. It is a very dangerous, though at times very beneficial skill. When done with the aid of someone versed in A&P and common disease processes, I don't see the problem. It's not the IV start many of us are arguing against, it's the incorrect use of fluid that makes me wary. Dwayne Link to comment Share on other sites More sharing options...
ccmedoc Posted February 16, 2008 Share Posted February 16, 2008 It's not the IV start many of us are arguing against, it's the incorrect use of fluid that makes me wary. I agree. Unsupervised IV initiation and fluid administration is WAYpast the Basic scope. If they are with a medic, it is supervised, and the paramedic trusts them to perform the task correctly...I have no problem. It is a plus to have a partner that can assist in this area...kinda brings us back to the "why don't we just have medic medic ambulances" or "no basics on emergency response ambulances" arguments. Both, by the way, I agree with...but I digress. :roll: Link to comment Share on other sites More sharing options...
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