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Thread Title calls for the day....


Date Posted: Tue Dec 06, 2005 12:55 PM
Posted By: VanHelsing (Veteran Villager)

I was thinking, instead of just posting the good calls, why not start a thread, where we post ALL the calls you did that day... ( the idea was going along nicely, until I tried to remember what our first calls was today, I just got home..... and its a blank... )

Ok Ok , im going to try harder....

call 1 : Transfer of patient post angio-gram to another facility ( boring, except for the ecg tracing... )

call 2 : 6 month pregnant woman, who fell. Has severe abdominal pain, and no fetal heart sounds present. ( we happened to be in an extremely quite back room in a shopping center )

call 3 : Male patient complaining of severe back pain, but personally I think he was exagerating, because when I offered pain meds, he said no, because he didn't want an injection... so how bad can the pain REALLY be ?? I think it may have been a kidney infection because of history and vitals, however at Hospital his urine sample came back clear.

call 4 : Transfer from the airport, french lady visisting some north african country who had an acute psychotic episode, apparently brought on by her malaria tablets ( Larium ). Then again, maybe her husband was trying to kill her ??? major language barrier as I don't speak french.

call 5 : Elderly lady, who over dosed on her sleeping tablets...

call 6 : Taxi accident. Taxi Rolled. Killing 1 passenger, leaving 6 P1's, 5 P2's and 4 P3 patients. Oddly this call upset me mildly because the dead guys brother was on scene, and he just sat by the body staring at it, saying " he's my brother " I didn't have time to talk/comfort him, because I had my hands full with the other serious patients. But it was still sad, because I could imagine how I would feel if it had been my sister. anyway moving along....



And that was it for the day... Fairly quite, but it is a tuesday day shift, so didn't expect a busy day.





Date Posted: Tue Dec 06, 2005 1:04 PM
Posted By: TRAININGATOEMS (Veteran Villager)

How the heck many people can you fit in a taxi!?!?

By my count, you have sixteen, counting the DOA. Please tell me this was a small bus or van, not a four door car like we have here in the states!

I know this doesn't fit with the thread, but I'm off duty today, being amazed by the passenger capacity of South African taxis!

Peace,
RG



Date Posted: Tue Dec 06, 2005 1:58 PM
Posted By: pbnj53 (Junior Forum Member)

Maybe it was a stretched limousine taxi.

-------------------------
Mississippi Medic



Date Posted: Tue Dec 06, 2005 2:14 PM
Posted By: p3medic (Senior Forum Member)

i've been cancelled twice today so far....



Date Posted: Tue Dec 06, 2005 2:21 PM
Posted By: Bamamedic23 (Senior Forum Member)

That's some taxi, jeez............

BTW I'm not working EMS today.

-------------------------
Do it early, do it right, do it fast, then hold on for the ride.
CCEMT-P



Date Posted: Tue Dec 06, 2005 2:38 PM
Posted By: dsjbean (Junior Forum Member)

go in at 17:00 today



Date Posted: Tue Dec 06, 2005 3:28 PM
Posted By: PARAMEDICMIKE (Senior Forum Moderator)

I'm off as well. So how about those of us not working today reply for our next shift? I'm in tomorrow so I'll post my calls here tomorrow evening after work.

-be safe

-------------------------
-be safe
Aut inveniam, aut faciam.
"There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

-Thoreau



Date Posted: Tue Dec 06, 2005 10:12 PM
Posted By: DarringtonEMT (Junior Forum Member)

Off today but yeaterday before I went to work I responded to a 24yo F with severe lower abdo pain. Transfered to Medics. Later found out she had a etopic preg with partial abruption. Yikes....



Date Posted: Wed Dec 07, 2005 1:40 AM
Posted By: VanHelsing (Veteran Villager)

The South African Taxi.....These are not taxis in the typical Western sense of the term – they won't give you a lift to your doorstep. Rather, they are small-scale minibus services, often unmarked, operating with neither timetables nor formal stops

they are the scariest thing that drives on our roads... To start with, they have zero regard for the rules of the road, the don't stop at red lights, they drive in the emergency lane, the dont know what indicators are for, they just slam on brakes anywhere they feel like, if they see a possible passenger.

Then to top it off, the vehicles are not road worthy, I have seen some that have a wheel spanner, as a steering wheel, 2 wooden blocks for brake pads ( I kid you not ), and I had the unfortunate honour of being used as a stopping device once, when driving the Ambulance, because the taxis brakes didn't work...

they are mini-vans , with a seating capactiy either 12 or 14, but yes, they squash in 16. And if the law enforcement guys try to stop or fine them, they just shoot them. ( and yes, I kid you not... again ). Different taxi associations also are at " WAR " with each other, and these gangs just open fire on ech others taxis, if they happen to be picking up in areas that they should not be. ( I've been to calls like this, with a taxi full of innocent passengers )

To end off, I go to a taxi accident a week in my area alone.....





 12/08/2005 02:23:30|U



Date Posted: Wed Dec 07, 2005 5:21 AM
Posted By: stridor (Veteran Villager)

call #1 take pt. to dialysis
call #2 pick same pt. up from dialysis
call #3 take same pt. to doctors appt.
call #4 take same pt. to nursing home

Man what a typical and boring day




-------------------------
One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
Village armourer



Date Posted: Wed Dec 07, 2005 6:59 AM
Posted By: AZCEP (Veteran Villager)

Quote

To start with, they have zero regard for the rules of the road,


So they are like taxi's in the west, only supersized. Don't let Texas hear about this or they will have to go one step bigger

-------------------------
Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

www.fieldmedics.com/forums
www.capem.org



Date Posted: Wed Dec 07, 2005 9:26 AM
Posted By: Bamamedic23 (Senior Forum Member)

Note to self, never get a taxi in South Africa.

-------------------------
Do it early, do it right, do it fast, then hold on for the ride.
CCEMT-P



Date Posted: Wed Dec 07, 2005 10:19 AM
Posted By: NSMEDIC (Senior Forum Member)

Being the only ACP truck in our town we were given a non-scheduled BLS transfer for a re-check of an ankle that has a non-healing ulcer (diabetes complication in bed ridden patient) that takes us 20 minutes out of town. Then we were posted to that same town for several minutes, beside their ACP truck while our dispatcher's neurons caught up with him and we were finally returned to our own area, which by policy we never should have left in the first place.

-------------------------
despite the rising cost of living, it remains very popular.



Date Posted: Wed Dec 07, 2005 11:36 AM
Posted By: ncmedic309 (Veteran Villager)

Started off a real busy day...I work 12 hour shifts...all 7 calls where in the first 6 hours of the shift...the second half rocked...we sat up in the north end of the county and didn't do a damn thing!

Call 1 - Choking - Infant choked on candy, fine upon arrival, parents refused tx.
Call 2 - Respiratory Distress - elderly male, asthma hx, treated as possible pneumonia
Call 3 - Abdominal Pain - elderly male, nursing facility, possible bowel obstruction
Call 4 - Fall w/ injury - cancelled enroute
Call 5 - Respiratory Distress - "asthma attack" after foot chase with PD, he went to jail...
Call 6 - Poisoning/Ingestion - infant ingested vitamins, cancelled by poison control center
Call 7 - Chest Pains - 34 year old female, treated as anxiety with a hx of the same...

This was kind of cool...might have to make this a ritual on the busy days where you have some really good calls...



Date Posted: Wed Dec 07, 2005 2:16 PM
Posted By: TRAININGATOEMS (Veteran Villager)

VanHelsing,

Thanks for clearing that up. If I ever wind up in South Africa, I'm either riding with you or walking!

Peace,
RG



Date Posted: Wed Dec 07, 2005 3:00 PM
Posted By: dsjbean (Junior Forum Member)

My calls I was on last night.....16:30-2300

1) Dispatched unconscious female later reported now conscious. ETOH
2) Generalized weakness subsequent to a fall 2 days prior (seen day of fall ar ER) facility wanted pt further checked out at a different hospital.
3) Weakness low BP - pt had procedure done in the morning following Dr orders to be seen in ER if any complications.



Date Posted: Wed Dec 07, 2005 5:30 PM
Posted By: CBEMT (Senior Forum Member)

Quote

Originally posted by: stridor
call #1 take pt. to dialysis
call #2 pick same pt. up from dialysis
call #3 take same pt. to doctors appt.
call #4 take same pt. to nursing home

Man what a typical and boring day



Thought you quit that job??




-------------------------
Village Geek



Date Posted: Wed Dec 07, 2005 7:19 PM
Posted By: rat115 (Junior Forum Member)

There are days that I wish that things were a little more active out here. I've had 3 shifts with no calls.

The last call I went on was Friday. Elderly lady passed out at the beauty salon. She remembered feeling dizzy, but not passing out. Put her on 15 L O2 via NRB and she came around by the time we went around the block to the hospital. (Literally, around the block.)

The busy 2 days were Nov 27 & 28 with the blizzard and after effects that included the power going out to the dispatch center.



Date Posted: Wed Dec 07, 2005 8:17 PM
Posted By: stridor (Veteran Villager)

I did but, the company I work for discovered that as much as you might like to do nothing but ALS and Critical care transports, the BLS dialysis patients, mri runs, nursing home runs etc. are what pay the bills. They still only have two dialysis patients and they are not really typical since they go to special dialysis clinics for folks who also have other complications as well. I usually wind up doing BLS once a week so it's not as bad as the other company, I am actually learning alot about pediatric patients in the ER at St. Christophers hospital, and getting some good training working with the medics.

Quote

Originally posted by: CBEMT
Quote

Originally posted by: stridor
call #1 take pt. to dialysis
call #2 pick same pt. up from dialysis
call #3 take same pt. to doctors appt.
call #4 take same pt. to nursing home

Man what a typical and boring day



Thought you quit that job??




-------------------------
One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
Village armourer



Date Posted: Wed Dec 07, 2005 8:56 PM
Posted By: PARAMEDICMIKE (Senior Forum Moderator)

#1: 83 YO female with left sided weakness. Hx of HTN and CVA. New onset hemiparesis within 20 minutes of our arrival. R/O CVA.

#2: Lacerations following an assault. Recalled by police prior to arrival.

#3: 15 YO female with abdominal pain. Seen by local ED earlier today and diagnosed with kidney stones. 911 call prompted by onset of nausea/vomiting.

#4: 38 YO male in PD custody complaining of pain after receiving a thumping from the security staff at the store he was trying to relieve of some Christmas gifts.

Kind of a slow day. It would have been nice to have been busier.

Other than the calls, I got a flu shot (finally), did some con-ed paperwork, finished some QA/QI paperwork and had a long, somewhat depressing conversation with my boss.

But, all in all, not a bad day.

-be safe.

-------------------------
-be safe
Aut inveniam, aut faciam.
"There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

-Thoreau



Date Posted: Thu Dec 08, 2005 12:54 AM
Posted By: niagara16 (Junior Forum Member)

1st call 84 yo female with chest pain, left arm pain and SOB
2nd call assit a 63 yr old male into his vehicle to go to a dr's appt
3rd call 76 yo female at nursing home fell off toliet and injuryed her hip
4th call 91 yo female with critically low potasium levels and is unconscience
5th call assit 63 yo male out of vehicle and into his house
6th call transfer from nursing home to Hospital

-------------------------
www.geocities.com/niagara16@sbcglobal.net



Date Posted: Thu Dec 08, 2005 1:01 AM
Posted By: pbnj53 (Junior Forum Member)

Call #1 - Code Brown, I made it to the bathroom in time though.
Call #2 - SOB, yes he was
Call #3 - Yet another Code Brown, it must have been the chili

Sorry, it's late and I've been running constant since 7:00 a.m. and I'm delirious.

-------------------------
Mississippi Medic



Date Posted: Thu Dec 08, 2005 1:24 AM
Posted By: medic12two (Junior Forum Member)

Day started @ 0800 in the north end of county (first job) on a ALS Ambulance

#1. Automatic fire alarm Cancelled
#2. MVA with rollover. Pt self extricated & amnesic to event. Transport to Trauma center

Second Job on ALS Squad in my home town started @ 1800:

#1. 400+ female who the ECF staff says “just isn’t right” & wants her checked out in ER. Turns out she’s diabetic & the Medic I relieved was there 4hrs ago & woke her with D50. Transported to ER 2 miles away.

I’m done in 9hrs, maybe I’ll get lucky & sleep all night !?!?!?!


-------------------------
Chris B, EMT-P
My Corner of the Internet

"In Lead II, you have no clue!!" -- Bob Page, CCEMT-P

Never mess with a geocacher, we know the best places to hide the body



Date Posted: Thu Dec 08, 2005 2:22 AM
Posted By: VanHelsing (Veteran Villager)

Night Shift....

Call 1: Take large Oxygen cyclinder to intercept another ambulance who was doing a P1 resus infant.

Call 2: Transfer from Krugersdorp Hospital to Johannesburg General, patient with severe pitting pedal edema, and a whole lot of cardiomyopathies, Left bundle branch block, high grade AV block and trifasicular block, very interesting ecg, regrettably our first call was at 6:45pm ( shift starts at 7pm, and as luck would have it, i hadn't yet checked the vehicle, and they was no ECG paper )
This was a long distance transfer, so it took us about 3hours.

Call 3: assisted another ambulance service with a status epilepticus, which turned out to be more like a psychotic episode, brought on by nasty drugs !! 20mg of Diazepam, and this guy was still fighting us, luckily we had the biggest ILS crew I have ever seen, holding him down.

Call 4: 02:45am, acute asthma attack, not responding to home medication, and then not responding to my medication either... about 50 amps of fenoterol and ipratropium bromide, didn't touch sides, neither did the hydrocortisol, or aminophiline.

And that was my very uneventful night shift.





Date Posted: Thu Dec 08, 2005 10:38 PM
Posted By: eagleEMT (Junior Forum Member)

I wasnt even scheduled and i ran 5 calls in just under 6 hours.

Call 1
rma old lady fall down go boom

Call 2
drunk fob wondering around in traffic at a busy intersection, transported, language barrier

Call 3
rma 5yo got hair stuck in a blender

Call 4
man in booking walked into a divider and complained of blurry vision and lightheadedness

Call 5
female with back and left abdominal pain x3 days

and that wasnt even my scheduled shift. i have to go back tomorrow for that one, and its supposed to snow, ugh

James

-------------------------
negative paitent care outcome, just a nice way to say he died
city morgue...you stab'em we slab'em



Date Posted: Fri Dec 09, 2005 4:42 PM
Posted By: MEDICSARECOOL (New Forum Member)

my average night shift(on my truck):


1st call: combative head injury with etoh..subarachnoid from a baseball bat

2nd call: heroin overdose..but denied any narcotics after narcan was given

3rd call : 31 year old male...abdominal pain times one week

4th call: building fire..hate when i am driving by and i think the candle in the window is a house on fire.

5th call: suicide attempt by hanging...a plant was found in the window(no kidding)

6th call: 42 male..with chest pain...anterior/lateral MI

7th call: dispatched for lift assist..end up being 50 male cva

8th call: co detector

9th call: cardiac arrest....end up being a man with abdominal pain(must of been a language barrier or a misunderstanding i guess).

10th call...nose fx from an assault

11th call...back pain(he calls at least three times a week)

12th call..accident w/ entrapment...vehicle into a pole..transported to local trauma center for head, chest, and too much alcohol..

-------------------------
medicsarecool



Date Posted: Fri Dec 09, 2005 8:10 PM
Posted By: PARAMEDICMIKE (Senior Forum Moderator)

Same guy with abdominal pain for one week as the guy who coded?

-------------------------
-be safe
Aut inveniam, aut faciam.
"There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

-Thoreau



Date Posted: Sat Dec 10, 2005 10:36 AM
Posted By: CarlChristiansen (Junior Forum Member)

Since were at it, I'll throw in my saturday shift in Oslo. The shift started at 07.00...

#1 - 40 y.o.m. truck driver with a seizure in the loading dock
#2 - 50 y.o.m. alchoholic with seizure in a grocery store
#3 - Interhospital transfer of a 81 y.o.f. wit a possible tia
#4 - Fire in a apartment building. Turned out to be water vapour from making food. LOL.
#5 - 70 y.o.f. slipped on the ice out side and fractured her ankle
#6 - 91 y.o.f. fell in her bath tub (empty), and has been lying there for 24 hours (turned out to be a real medical multitrauma. Everything was wrong with this old lady).
#7 - Interhospital transfer of the previous patient
#8 - An yet another transport.

15.00 - finally on my way home. A rather busy day for us today.


Carl



Date Posted: Mon Dec 12, 2005 2:28 PM
Posted By: VanHelsing (Veteran Villager)

today was fairly quiet... everybody leaves JHB during december, not exactly your prime holiday destination !!!

call 1 : Taxi ( yip, another TAXI ), vs LDV vs Toyota. I only took one pt with a sterum fracture, and a pulmonary contusion, that obviously had trouble breathing. Which is very unusual because usually with taxi accidents, you end up loading your ambulance full, with no space to treat any of the patients properly, which I really hate.

call 2 : Transfered a burns Patient from the airport to Milpark, P1, 40% burns following a airplane crash, 16year old girl, in very bad shape. ( Did anybody read about the plane crash in north africa, which killed 100 school kids ?? well they were apparently 3 survivors, she was one of them. ( long call, we were unavailable for a good 4 hours )

call 3 : Patient fell ? got to scene, and we were told the pateint was taken with private transport.

call 4 : Vague dispatch info... patient bleeding from mouth ??? also got there to find patient gone with private transport...

and that was pretty much it for the day. Got given nice jackets from the milpark hospital, in support of EMS, and in the spirit of Christams !!



Date Posted: Mon Dec 12, 2005 5:59 PM
Posted By: CBEMT (Senior Forum Member)

Don't know if I remember them all, so I won't number them. Hell, they may not even be in order...

Call 1: Wait and return methadone patient (not enough wheelchair drivers working).

Call 2: Regular methadone patient complaining of head and back pain from a fall on ice yesterday. Fully ambulatory since the event (no pain at that time). Waiting at the door with 4 bags and a half-dozen boxes she wants to take with her, because she's been staying at her mother's house (the scene) and is moving back to her apartment (near the hospital). We let her take 2 bags and that's it. Turns out the hospital she requested wasn't the one she actually wanted, but didn't realize it until she was inside. Too f@ckin bad. Afterwards, told my partner we should've done a standing takedown and immobilization just because.

Call 3: ER discharge back to the SNF.

Call 4: "Temperature and edema" at the SNF. Audible rales on arrival, insists on walking to the stretcher. Facility says she's refusing her neb treatments, which patient denies. Refuses to go to hospital requested by facility, wants to go to the trauma center, which is closer. No problem. A-fib on the monitor. Dx of CHF and pneumonia yesterday via CXR, but no script for Lasix yet. Obvious temp but she won't cooperate with the thermometer. 4LPM O2, IV, 40mg of Lasix. On arrival at the ER patient is demanding to know why we aren't in the impatient unit she always goes to- she thought that by going to this hospital, she'd go straight to a private room in one of the inpatient buildings like her last hospitalization- I figure she was probably a direct admit last time. We drop her off at a (private) ER room instead. She's annoyed but thanks us.

Post in another truck's area after getting chinese takeout.

Call 5: While posting, ER discharge back to the SNF in that truck's area. Exchange words with ER RN who feels we don't need any information on the patient. So much for being an EMS-friendly hospital. Round trip from posting location to destination and back to our area: 2 and a half hours.

Call 5:

Call 6: "Altered Mental Status with profuse drooling" at the same SNF as the last call. "I'm never on this unit" float nurse says patient has been altered since the start of second shift. 94 y/o female, DNR/DNI/DNH but the doctor says to have her evaluated. No obvious drooling, but there is a lot of secretions around the eyes, which she doesn't want to open. Pupils seem smaller than normal and sluggish. 0.4mg Narcan IV with no effect. Sinus tach in the low 100's, I'm questioning A-flutter but it's not close enough to call it. Not my call to make, either- my patner is (non-medic) ALS but I'm still waiting for my test results.

Call 7: Get a call from the supervisor while we're still at the ER on call 6, tells us one of our other trucks got into a minor MVA with a patient on board. We respond and transport their patient- urinary issues- to the ER we'd just come from.

Call 8: Meet up with the accident truck and get our stretcher back, and immediately get sent back to the same floor of the same SNF we'd been at on call 6, same facility as call 4. I think the dispatch was AMS but I don't remember. I do remember that she had a temp and absolutely no lung sounds in the lower lobes bilaterally. We bring her to the same hospital as patients 6 and 7. The ER staff can't believe we're back again. Patient 6 looks worse than when we had her, but at least they cleared the crap out of her eyes. Patient 8 gets a bed in the hallway.




-------------------------
Village Geek



Date Posted: Tue Dec 13, 2005 9:01 PM
Posted By: stridor (Veteran Villager)

I did so many runs today that the carbons would not all go through the shredder at one time when I got back to base. Man what a busy day. My second run really was tough. I picked up a 24 year old girl in right sided failure who needs a heart and lung transplant. She is not very high on the list, and she is in terrible shape. When I talked with the transplant coordinator at the hospital she told me that she would probably die before she got her transplant. I felt really bad for her mother and just in general. She was a really nice person and it seems like there is a real shortage of them in the world. Makes a person think about how good they have it sometimes.

-------------------------
One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
Village armourer



Date Posted: Tue Dec 13, 2005 9:59 PM
Posted By: PARAMEDICMIKE (Senior Forum Moderator)

We had a call with an interesting presentation today. The subject was a 60 YO male found in the bathtub by a friend stopping in to check on him. It seems that the guy hadn't been seen since last Friday. When the friend made entry to the apartment, he found his friend in the tub with the faucet running. The HOT water running. With no cold water turned on. We're not quite sure how he wound up on the bottom of the tub or how he died. No obvious signs of trauma.

The guy had his arms draped over the edge of the tub like he was trying to reach for something to help pull himself out. He was seriously scalded from the waist down. He was a black man and to give you an idea of how badly he was burned what skin he had left on his legs was white. Like gleaming, need sunglasses to look at white. The remnants of the skin that had sloughed off were on the bottom of the tub.

Like I said, we have no idea how this man died. I only hope that he was dead before the water took it's toll on his legs. I can't imagine having to go through that kind of slow and agonizingly painful death.


-be safe

-------------------------
-be safe
Aut inveniam, aut faciam.
"There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

-Thoreau



Date Posted: Wed Dec 14, 2005 1:30 AM
Posted By: rat115 (Junior Forum Member)

I got called yesterday to do a pt transfer that was a pickup at one of the hospitals in the city we transfer to/from the most. On the 2 1/2 hour drive in, my supervisor let me know that he was attendant on the pt going in. Rt hip fx and was on morphine then and had history of AMS. Arrived to get the pt and he's in bed having a full conversation with no one around and is post surgical for the hip fx. Get him into the rig and head for home and the care facility that he's going to. The first 1 1/2 hours of the ride go great. He's alert, talking to me and making sense. About this time, he askes me if his coffee was ready and starts telling me he wants it in HIS cup. He's talking to "people" like he's on the phone or someone's standing beside him, and when he's talking to me, he's asking what the buttons on the back of the passenger compartment are for. (They were the covers for the sheatmental screws holding the pad in place over the door.) By the time we're almost to town, he's trying to get me to change his foley cath by telling me that the RNs at the hospital had not changed it in 2 days and telling me he won't let me take his B/P until I do.



Date Posted: Wed Dec 14, 2005 2:48 PM
Posted By: RobbyEMT (Junior Forum Member)

Now that I don't work in the city of Buffalo, it's rare that I take more than three calls a day. After being used to taking 8 to 15 calls a day, this is boring. We work 12 hour shifts scheduled 48 hours a week. I'm working now and haven't taken a call yet today. I worked Sunday and took three calls, nothing eventful, I can't even recall one of them. Monday I took 7 calls which is a record day for the year. Like I said, we have 14 ambulances covering approx. 400,00 residential dwellings and it's really hit and miss. I gave meds twice, diabetic with BGL of 28mg/dl and Albuterol for a breather, the rest were minor MVC's and a transport for a prisoner that was on a hunger/bathing strike. Tuesday was an average day of two calls and only one transport, it was for a Parkinson's pt that had increased falls the last week, negative trauma and was CAO x 3.

Last Friday with my volly company I had a 20 yo that came over as unresponsive. Asked if there was any other info (diabetic/Od/suicide) Dispatch had nothing for me. Found an unresponsive, agonal respirations, cyanotic male that supposedly took some narcotic pain meds. Got tube line and narcan on board and the kid was blinking to answer questions within 10 minutes. His mother contacted my sis-in-law(thought she was my wife) the next day and was pouring with praise and thanks to the point she was in tears. I guess that's why we do this thankless job, cause once in a while there really is someone out there that will go the extra mile and thank us.

Rob
NYSEMT-P



Date Posted: Sun Dec 25, 2005 4:33 PM
Posted By: VanHelsing (Veteran Villager)



Christmas day shift.

mva....rain....mva....more rain.....mva.mva.mva.......home.





Date Posted: Sun Dec 25, 2005 6:19 PM
Posted By: greshmedic (Veteran Villager)

Christmas eve was

Sorry old man feeling lonely so he called ambo
Inter hospital transfer 1 yr old acute chest infection
Sorry old woman intoxicated and requiring to know if she is a bad mother
Woman fainted in night club - get up and get a taxi home
Woman arsing about pseudofitting - get up and get a taxi home
Male intoxicated asthma laying on cold wet floor floor outside nightclub phoning his girlfriend - chest sounds clear and the amount of talking he did indicated he actually wasnt having an asthma attack but c/o DIB so we had to take him in unfortunately.

Basically we had a boring 8 hours.

-------------------------
Before the war on terror, if I saw an unnatended package I used to think "I'll be having that!"



Date Posted: Mon Dec 26, 2005 3:04 AM
Posted By: Eydawn (Senior Forum Member)

This is from 'bout a week ago... did a 24 hour 3rd rider shift.

Let's see... got there at 6am... watched the medic cook his breakfast... went to sleep on the nice comfy couch... what do you mean time to go, where were the tones?! Ok, 50's ish male, German speaking only. Comes in as "chest pain", presents more like a stroke/CVA. Right sided weakness, no facial droop, can't tell if he's slurring coz it's in GERMAN. Get vitals, watch medic give aspirin (able to get across, yes, aspirin ok, I take aspirin...), try to get a phone number, nicht speak English! Resort to veterinary medicine, eg, you treat what you find! 12 lead is fine. Gets an IV. Hey, it's the ER! Put him in bed, go to lounge. Eat crackers and cheese. Meet EMT from clinicals at school. Old home week!

Go back to station, get back on couch, go back to sleep. Darn it all, no tones again, out of district call. Get sent towards wrong address! Dang! Drive down highway shoulder at 80 mph towards correct address! Whee! 50's ish male, speaks good English, very good businessman. Near syncopal episode. High bp 190/130ish, according to FF.. decreases a bit during transport. 12 lead good, feels "anxious... funny... " (gesturing at trunk area). Also gets aspirin and an IV. Gets taken to same ER.

Go back to station, find out medic is a black belt in almost any martial art you can think of, get schooled in the ambulance bay for the next 30 minutes. Learned a lot, but was I sore or what.

Shift change on the EMT at the 12 hour mark... EMT from the first half of my shift decides to hang out with the crew from the next station over. All go out for ice cream, good time. All 6 of us look up... "Oh shoot... was that an MVA?" No, it was an attempted vehicular homicide. The perp is a "no habla!" who tried to off his wife and her boyfriend. Lord, wasn't that fun. "Te dueles? Tienes heridas?" "No.. no duele... my wife!" (apparently all the English he'll spit out). Go back to station, he's not hurt, take him to JAIL.

Go to police station later to check out the wife. Head bumps and a refusal.

Go out on fire call. Stove fire, little fire... put out with 1 extinguisher.... but the new guys all show up in the full turnout gear... aww... kinda cute actually (they're all my age ish, so they're still all very cute, lol).

Go to sleep on couch. Wake up to tones. Not our tones. Darn. Go back to sleep. Wake up to phone. Never good at 3:00am to hear the phone ring... means we either missed the radio, the tones, or it's something that doesn't go OVER the radio. SWAT stakeout! Whee! Sit in parking lot of small store, watch cops sneak around in the bushes... exciting for about 20 minutes and then dead boring for the next 1.5 hours. Turns out, they went to the wrong house. The right house is all the way across town. Go back to station, go back to sleep. Drive home at 6am.

Yea, that was about it!
Wendy
NREMT-B

-------------------------
There's a fine line between genius and insanity- Guess which side I'm on! (My father)



Date Posted: Mon Dec 26, 2005 11:31 PM
Posted By: rat115 (Junior Forum Member)

Charistmas Eve here actually had some things happening.

Started off 6:15 called to police dept. for fe w/ chest pains and shortness of breath. Both of the others step back to let me lead the call since one also works dispatch and the fe was in jail a short time ago and the other perfers to let the females on the call handle the female pt. Hook her up to the heart monitor, find out pt is a breast cancer pt and her girlfriend (partner) was hauled in earler. BP was a little high, everything else looked norm. Was told to note on report that pt admitted to having ETOH on board (having drank alcohol) due to her violating a restraining order. Pt refuses transport and pd takes her home.

Get back to the shed and start typing report, and tones go off again. Dispatch reads the address and the other EMT in the back says "Hey, that's my address. It's a fall, probablly my mom or dad." We get from dispatch 40ish female. Not the parents; his sister. Tripped over the dishwasher door and dislocated her elbow.

11:30ish Called to local trailer court. Fe w/ chest pains. WOW, it was the gal from the police station. (Why didi we think we'd see her again?) Put pt on NRB at 15l/min which doesn't help the pain, but gets her SAO2 up to 99% from the 80% at room air. This time bp and heart rate are way up, EGC rythme is all over the place. Pt's girlfriend denies that pt has been drinking. Once in the amb, pt admits to ETOH again. Get her to the hospital, the doc comes in, checkes her out and gives her a shot for anxiety. Go back to have the paper work signed and pt decides to hit on me in front of her girlfriend. I got out of there quick.



Date Posted: Wed Dec 28, 2005 10:14 AM
Posted By: HFREMSMEDIC (New Forum Member)

I am at our slow post this month so I only got four emergency calls last shift.

Call 1: High BP @ Nursing Home 130/84 (love CNA's)

Call 2: False alarm fire at Drug rehab center, a mandatory daily occurance

Call 3: Nursing home transfer on a 80+ y/o man with dementia, really good for a laugh

Call 4: Second out fire alarm at Drug rehab center

also did 14 fire alarm checks, 23 extiguisher renewals and a ton of Vial-o-life updates.

Man I can't wait to get back into the city and run some adrenalizers



Date Posted: Wed Dec 28, 2005 2:37 PM
Posted By: crsemt1258 (Junior Forum Member)

Only 1, so far, today.

MVA: Truck took out street sign, 2 small trees, and finally a Big tree. Pt. was ambulatory and walking around prior to our arrival. Refusing treatment. Couldn't remember if he had his seatbelt on or not. Took a lot of talking to get him to go to ER. Couldn't c-spin him, as it was hard enough to convince him. Partner checked the vehicle and he took out the steering column with is belly. No obvious injuries though. I think he is one lucky guy!



Date Posted: Sun Jan 01, 2006 1:19 PM
Posted By: RobbyEMT (Junior Forum Member)

It's New Years Day and haven't had a call yet. 8 hours into shift, gotta love it. Although we average less than two calls on Sundays, there's usually at least 20 calls from MVC's to DOA's. Thank God because I don't know if I'm ready to smell a drunk even if it's almost time to go home. Did I mention time and a half for holiday pay??? Imagine not taking a call the entire shift and getting almost $27/hr. ?? I love this country and my job.

Rob
NYSEMT-P



Date Posted: Wed Jan 04, 2006 10:56 PM
Posted By: SnowmanMedic (New Forum Member)

Lets see 24 hr shift:
1. 37 Yr old female having a miscarriage.
2. Nursing home pt. with chest pain
3. 67 year old male who fell on the ice. Broken Ankle.
4. Box alarm. Burnt toast.
5. MVA, rear end collision, very minor, 2 refusals
6. LIttle old lady fell down. Lift assist
7. Box alarm. Burnt toast ( yes same place as call # 4) Different appt though..
8. MVA, T-bone at high speed. 2 transported to trauma center
9. Chest pain, don't recall all of the details
10. GI Bleed
11. Box alarm. Faulty smoke detector
12. Assault, transport for stitches to the head
13. Call to Police Dept. 2 for price of one special: Cops found these guys off the road. No injuries from going off the road but they both OD'ed on heroine. Both got narcan and transported to local hospital..
14. Nursing home slip and fall with hip pain
15. Dyspnea, 58 year old guy, probably has pnemonia.
16. Unresponsive male in a car on the highway. COAx3 upon arrival, + ETOH, pt refusal. Left in the custody of State Police.

Got 4 hours of sleep. I think that was it...



Date Posted: Thu Jan 05, 2006 12:53 PM
Posted By: Penguin (Junior Forum Member)

My last day shift till i come back from course- and thanks to Murphy's Law, everything that could go wrong did- Thank goodness its over:

#1: Old Age Home for 64y.o. pt with diarrhea. Whoppee! Pretty straight forward expect that:1) our control room are stupid and unprofessional and 2) We were stupid enough expect an ambulance with clean linen from Night Shift (Thanks for letting us down guys!!)

#2: Told to respond outside our area (our wonderful control room) to a collapse resulting in a response time of 35 minutes!! Pt(GCS 12) has HGT of 1.1 mmol/l ! Tried IV access 3X before deciding that the hospital was closer. Sat in back administering Glucogel orally. (Now who look like the Village Idiots on shift)

#3: Transfer from hospital to Old Age Home. Why do they build "retirement villages" with stairs (no ramps) and doors to small for stretchers??

#4: OD- pretty straightforward- wasnt to bad (except for the control room once again)

Thank goodness it was a quiet day!



Date Posted: Thu Jan 05, 2006 8:58 PM
Posted By: stxems (New Forum Member)

Well not from today but last time I worked New Years Eve.

18:00-07:00

1. at about 18:30 Assault / Stabbing - Husband claims wife stabbed him in the arm, 7 y.o. son says dad stabbed himself. Pt. refusal then Pt. goes to jail

2. 19:00 Overdose - 44 y.o. female drinks a bottle cheap wine then downs 13000 mg tylenol pm and 1000 mg benadryl. Pt responive to pain only and crying loudly. o2 @ 3l via nosehose 99%o2sat , 200/150 , upon arrival at ER pt throwing pvcs every 30 seconds and declining.
Pt was lavaged and given charchol I didnt ck up later so no idea how it turned out.

3. 22:00 Went to supervisors station for ICP tp change cardiac monitor and update Handheld Tablet.

4. 23:00 Overdose - 14 y.o. female took 2 bars xanax at 13:00 omg was B.S. Mom found out and freeked.

5. 00:10 MVA - AutoPed - 19 y.o. male walking across street hit at 30-40 mph hits hood crashes windshield roof 2 times the trunk and rolls a few times. Alot happens on scene then we go enroute to Trauma hospital. He was in bad shape, didnt stick around long due to high call volume and being 30 miles out of district.

6. 02:30 Old folks home - elderly female 26bravo1 fever 2 hours ago nothing present now.

7. 05:00 OB call - 22 weeks pregnant abd pain and spotting transport only

8. 06:45 Toothache - just what it says Needed a taxi.




Date Posted: Sat Jan 14, 2006 10:36 PM
Posted By: femmemedic75 (New Forum Member)

#1
dyspnea- dx with pnuemonia x 5 days. rhonci x5 lobes, pursed lips, tripoding, grunting
#2
"i got hit in the back with a rock" me- does it hurt- "nope" me - do u want to go to the hospital- "no but can u give me ride to get more beer"- me ummmm nope
#3
2 teenage males assaulted
+loc, vomiting, lethargic/ combative, flown out with 45 minute eta on birds
#4
4 month old male. He keeps crying. me- Did u burp him.-"no" me- burped the baby. baby- smiling/ laughing- another life saved
it is a tough job but osmeone has to do it

be safe



Date Posted: Thu Mar 02, 2006 4:24 AM
Posted By: VanHelsing (Veteran Villager)

I only worked some of the shift ( from 6pm - midnight ), but we had an interesting call.

21h05 - pt being shot.... o/a we find a 30year old male in the township, gunshot wound through neck ( from left to right, just skimming over the trachea, but lucky for him, not damaging it , then one entrance wound right chest, but again, missing everything. Then entrance and exit wounds x 8 in right arm... not missing everything.... arterial bleeding in humurous and wrist., fractured ulna and radius, and mangled hand...

The in the left arm, he had another 350773 holes, from my failed IV atempts Im embarressed to say... (External jugular was out because of the GSW), so by the time we got to hospital he still had no IV... and I hung my head in shame.... ( I felt better when the doctor also couldn't get one up )

Then at about 22h00 we had a one car MVA, with 5 patients, car spun, rolled and flew through a wall, ejecting my pt who was trapped under the car. Cheif complaint, was difficulty breathing, ( funny how having a car sitting on your chest will do that ), as to the other pts, 3x head injuries, 1x no injuries.

And then I went home....




 03/02/2006 04:27:13|U



Date Posted: Fri Mar 03, 2006 12:34 AM
Posted By: Cr-20 (Veteran Villager)

PS2 for 6 hrs, 20 mins for dinner, 10 mins bathroom breaks, and 5 mins to apply butt paste to prevent well u know what. I think I did injury my right thumb on one play.



Date Posted: Fri Mar 03, 2006 6:53 AM
Posted By: jayffemt (Veteran Villager)

Wednesday; 12 hours of trying to find ways to stay busy.

Thursday; Inventory 1 rig, hang curtains, get oil changed on 1 rig.

Thursday night: Eat and sleep, 57 channels and nothing's on.

Friday a.m.;start 12 more hours of hoping for a run, mull over getting higher paying, more exciting job, maybe long haul trucker?

-------------------------
Only 1*



Date Posted: Fri Mar 03, 2006 10:15 AM
Posted By: VanHelsing (Veteran Villager)

Today, was fairly busy.

You know it is going to be a hectic day, when as you arrive at the station, you get handed the keys, radio and call details for a P1 gun shot.

Call 1: Gunshot chest, 35year old male, trying to hijack car. no exit wound, tension pneumo-, decompressed...and all the rest.

Call 2: Got soaking wet in the rain, while extricating 3 patients from a very wrecked upside down car, driver had a massive laceration, and fractured clavicle, front passenger was P4, and backseat passenger was ejected, with flail chest, bi-lateral femur fractures.

Call 3: Medical call, hypoglycaemic coma, responded well to a whole lotta dextrose.

Call 4: Chest pain.

Call 5: MVA - bumper bashing

Call 6: " collapse " turned out to be P4, resussed anyway.

Call 7: Kid fell out tree, fractured arm

Call 8: 21year old male, stabbed with a bottle, only extremities needed suturing.

Call 9: Respiratory arrest, COPD pt. gone to the Eternal Care Unit. (ECU)

Call 10: MVA - Taxi. 13 patients. you know how those ones go....

Home....



Date Posted: Fri Mar 03, 2006 11:34 PM
Posted By: ESPARKS (Veteran Villager)


Van helsing : all i gotta say is DAMMMMMN ! you and your magic taxi crashes. the worst single vehicle crash we've had recently was 9 twenty somethings on the way home from a wedding rehearsal party. all packed into a rental lincoln town car vs very large 200 yo maple tree. we arrived on scene and took almost 5 minutes just to get a head count in the twisted wreck. You can keep your crazy SA taxis if it's all the same . Ed

ps like the transfer to the ECU :-]

-------------------------
Take care and play safe out there !!!

The dean of common sense



Date Posted: Sat Mar 04, 2006 1:00 AM
Posted By: Cr-20 (Veteran Villager)

Today was worse than yesterday. Ate breakfast, 2 hours playstation, 1 hour nap, 2 hours playstation, lunch, nap, playstation, almost ran a call but got canceled. TV 2 hrs, dinner, playstation 3 hrs, nap, finally at 2144 got a non emergency xfer, got back and went home. That was my 16 hours for the day.



Date Posted: Sun Mar 05, 2006 1:21 AM
Posted By: Cr-20 (Veteran Villager)

Nothing other than watching the Tarheels beat the Red Devils of Duke. Good game. Roy Williams is a great coach.



Date Posted: Sun Mar 05, 2006 4:08 AM
Posted By: VanHelsing (Veteran Villager)

___________________________________
Quote ESPARKS
ps like the transfer to the ECU :-]
___________________________________

I cant take full credit for that one, I borrowed it from a friend at work !




Date Posted: Mon Mar 06, 2006 1:33 AM
Posted By: Cr-20 (Veteran Villager)

actually ran a call today in my 8 hours.



Date Posted: Mon Mar 06, 2006 6:31 AM
Posted By: ncmedic309 (Veteran Villager)

Quote

Originally posted by: Cr-20
Nothing other than watching the Tarheels beat the Red Devils of Duke. Good game. Roy Williams is a great coach.


The heels are very lucky that Duke didn't bring their "A Game", if they had, the heels wouldn't have had a chance. Duke gave them that game, no question about it. I doubt it happens again though, should they meet in the ACC tourney, Duke will show them what it's all about!



Date Posted: Tue Mar 07, 2006 9:18 PM
Posted By: QuintParamedic (New Forum Member)

Hey! I am kind of new to this do i just scroll down the screen and hit submit an aritcle. That wants me to send an email. Is that how I do it? Stay safe!!
Thanks




Date Posted: Tue Mar 07, 2006 9:52 PM
Posted By: PARAMEDICMIKE (Senior Forum Moderator)

Ok, first, find the appropriate forum in which to present your question. Each thread in its respective forum has a topic. Please don't hijack a thread to ask an unrelated question.

Second, please provide a little more detail as to what you'd like to do. Are you trying to submit an article? Are you trying to post something in the forums? It's not clear from your post.

Third, do NOT post your answer here. Find the appropriate forum, create a thread and go from there.

-be safe.



-------------------------
-be safe
Aut inveniam, aut faciam.
"There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

-Thoreau



Date Posted: Wed Mar 08, 2006 2:03 AM
Posted By: Cr-20 (Veteran Villager)

QuintParamedic I agree with everything PM MIke said but if you really want someone to see something that is very important put it under current events. Everyone reads that one.



Date Posted: Wed Mar 08, 2006 3:29 AM
Posted By: VanHelsing (Veteran Villager)

Quintparamedic.

Depending on what you want to submit.

If it is just a thread like this one, go to the relevant topic file. for example " industry issues " or " student center ".

If you want to create a new thread, they is a button " New topic ", under the navigation block, ( just under the advert at the top of the page )

and obviously if you just want to reply to an already established thread, just hit the reply button under any of the posts.





Date Posted: Wed Mar 08, 2006 10:13 AM
Posted By: Cr-20 (Veteran Villager)

Again a busy day at work. I was once again forced to play PS2 and watch the Shield. Icant wait til Friday when I start my 5 day off.



Date Posted: Wed Mar 08, 2006 1:38 PM
Posted By: dsjbean (Junior Forum Member)

Last Saturday 24 hr shift:

2 transports NET
1 20 y/o with back pain

those were the calls between 0800 and 0000

2 prisoners needing decon from pepper spray - 0200 and
1 rash at a extended care facilty 0300





Date Posted: Wed Mar 08, 2006 2:40 PM
Posted By: DRIVER609 (Senior Forum Member)

Lat night shift 74 y/o female "Transport Only" from control. "What's wrong with her?" "Her doctor told her to go to hospital" "Righto"

Arrive to find pt doing some house work, car in driveway, husband watching the TV. Blood pressure rises.

"How do you feel?"
pt: "I'm ok, just a little tired"
"Why did your doctor tell you to go to hospital?"
pt: "Something about bananas"
"Riiiiiiiiiiiiight"

Check vital signs......... HR 30....... Monitor: Sinus brady, couplets, runs of rapid AF. BP remarkably 160/80

"Did the doctor mention potassium then?"
pt: "That's it! that's the banana thing!"
"Did he say what it was?"
pt: "7.4"
"Great"

Albuterol, Calcium Carbonate, D5W and insulin, all better.

Got to love our call taking system.




Date Posted: Wed Mar 08, 2006 6:13 PM
Posted By: QuintParamedic (New Forum Member)

Today we got 6 calls. All emergency

1. Full arrest.....patient died
2. MVA...2 vehicles moderate damage none transported
3. Box...upon arrival just someone who forgot their oven was on
4. Breathing difficulty...Transported code 3 to medical center..later had a arrest ...revived.(that is why it is importrant to call 911 if you havve trouble breathing)
5. Code 3 seizure...stopped by the time we arrived
6. Diabetic...administarted sugar then fine

Oh yeah... did i metion my shift ended at 7:30 am...just as the other crew arrived THEY ...got a confirmed injury MVA...HA ...we didnt have to take that


Thanks QuintParamedic.......................Stay safe and make a positive difference



Date Posted: Fri Mar 10, 2006 9:53 AM
Posted By: RobbyEMT (Junior Forum Member)

I took a call with my volly company today at a Flooring Company, a 22yo kid tried to remove a piece of wood from a machine that had the guard removed by him. The machine effieciently removed all of his fingers and half of his thumb in a fraction of a second. Two lines and 10mg of Morphine, a trip to the local trauma center and now he is Left-handed. Poor kid. The lesson here is leave the damn guard in place and don't put your hand where it don't belong.

Rob
NYSEMT-P



Date Posted: Sun Mar 12, 2006 12:46 PM
Posted By: VanHelsing (Veteran Villager)

Well just to be different, the day started off with....

A TAXI accident.
- Taxi's wheel caught fire, but the driver clearly didn't think this was important, so continued to drive, which ended up with a pancaked taxi upside down in the middle of the highway, which then proceeded to catch fire.

Luckily all 16 patients managed to get out, prior to the blasting inferno.

I transported 1xP1 ( pulmonary contusion and suspected flail chest ) and 1x P2, ( massive laceration to left patella, with suspected unlerlying fracture )

Call 2 was a 2year old boy with croup ( text book case )

Then call 3 was a taxi t-boned a lady going thru an intersection, all taxi passengers were unharmed, the driver of the car, needed to be extricated, but the entire EMS of JHB and his dog were on scene already, so I didnt do much....

fairly quiet day, except my fish all died....

Anybody know anything about koi ?? outside fish pond with lots of plants, and about 7 upside fish floating in it... Why they died I dont know, I didnt attempt resussitation, and the ones left seem to be ok ???

VH








Date Posted: Sun Mar 12, 2006 1:11 PM
Posted By: ncmedic309 (Veteran Villager)

You would think that the Koi would be more adaptive to changes but it seems the damn things start floating upside down anytime you get the slightest change in pH or ammonia. You've got to keep a close eye on that water or your looking at nothing but dead fish.



Date Posted: Sun Mar 12, 2006 1:44 PM
Posted By: VanHelsing (Veteran Villager)


Thanks NC,

However theses koi, have been fine for the +/- 10 years since I built the fish pond, with max 3 dead in that time, then 2day, i pulled out about 7 large ones.

I am surprised that it was the large ones, and not the youngsters, i would have though they would have been more susceptible to water problems.

I thought prehaps they didnt have enough O2, and died from hypoxia, but with all the water plants I have in there, I would think it should have created enough ???



Date Posted: Sun Mar 12, 2006 2:29 PM
Posted By: ncmedic309 (Veteran Villager)

Sounds odd, almost like something got in the water, but if that's the case, then why didn't they all die, especially the younger ones? Not sure man...



Date Posted: Sun Mar 12, 2006 4:03 PM
Posted By: p3medic (Senior Forum Member)

last winter we had a ton of snow, and it seemed like it was below freezing from october to april....anyhow my pond froze solid, i lost all but 1 fish....i don't have a heater, and the pump running my waterfall/filteration system failed too....i now have sunfish, frogs and bass....not as pretty but hearty as they come!



Date Posted: Mon Mar 13, 2006 10:57 AM
Posted By: VanHelsing (Veteran Villager)

Another 3 dead fish !!

Im going with the hypoxia theory. Which in my mind explains why the big fish died first.





Date Posted: Tue Mar 14, 2006 7:43 AM
Posted By: NSMEDIC (Senior Forum Member)

I had a bunch of fish go too, an aquarium though, still they were Koi and all went belly up. pH was off. Out door ponds shouldn't have that kind of pH swing though, unless you recently topped it up with hose water, or added other stuff. Are these plants releasing stuff into the water (oil of some sort)?

-------------------------
despite the rising cost of living, it remains very popular.



Date Posted: Tue Mar 14, 2006 9:26 AM
Posted By: VanHelsing (Veteran Villager)


The pond gets topped up every 3-4 days with hose water ( its borehole water straight out the ground if that makes any difference ). But this has been going on since the pond was built, so nothing I can see changed.

The plants are water lillies and stuff like that, and they have been in the pond for years.





Date Posted: Tue Mar 14, 2006 3:03 PM
Posted By: RobbyEMT (Junior Forum Member)

I had a part-time medic pick up a shift with me and he said he needed to Tech some calls cause he's 0/8 on his last attempts at starting IV's. I didn't care after yesterday. So our first run is for a CP 31 yo female. We get there and it's obvious that she's just looking to get out of work early but my partner feels the need to work her up because he needs to get an IV. The part I didn't mention was she was 5 ft. 4 in. and 265 lbs. I'm sure you can imagine the difficulty he had, not to mention he ALSO gave her a NTG. After the third stick the pt freaked on him and said your not sticking me again. As we pulled away I reminded him that he was 0 for 9.
The next two calls were for cardiac arrests. Both pt's conscious, alert and oriented. One sycope and the other seizure that signed off. I love the dispatch system they have set up here. I'm on for another three hours, I'll get back with more.

Rob
NYSEMT-P



Date Posted: Wed Mar 15, 2006 3:04 PM
Posted By: Quint7Paramedic (Junior Forum Member)

Okay.

Today we only got 4 calls, but they were fun.

1. MVA-Entrapment One patient extracted with moderate scrapes.
2. CP-Admitted to hospital
3. Oder Invest. Turned out someone was BBQ (Yum!)
4. Breathing Difficulty Patient passed out prior to our arrival. Was revived.

Stay Safe and make a positie difference. Quint7Paramedic



Date Posted: Sat Mar 18, 2006 12:57 AM
Posted By: Cr-20 (Veteran Villager)

First day back after 8 days off. Worked 16. Ran 6. Nothing big. Work 16 tomorrow then off til Wed.



Date Posted: Sun Apr 23, 2006 4:54 AM
Posted By: VanHelsing (Veteran Villager)

What a Night !

We had 9 Gun shot wound victims, ( all from different locations ). 6 stabbing incidents, and a 9 car pile up on the highway at around 4am.

The 9 car pile up... guy smashes into another car, but is unhurt... gets out the car and gets hit by another car, that then swerves out, taking along another few cars. When its your time, its your time ( the guy dies in hospital a few hours later, from a fractured pelvis, femur fracture, compound tib/fib right leg, bilateral chest drains, left drained about 500mls, the other 1.5litres.

As to the gsw, one guy died as he arrived at hospital, the entrance wounds was posterior, just below the 9th rib mid clavicular on the right hand side, and exit was anterior, in the 3rd intercostal space, mid clavicular on the left hand side of the chest. ( Guess where that bullet went ?? )

Then another guy had entrance wound right hand side just below diaphragm, also mid clavicular, and exit wound LHS, between 8th and 9th rib, left medial by 4cm from mid clavicular line. He also died, but in theatre, it was really interesting, the doc did a thoracotomy in the ER/casualty, which was very interesting to watch, the guy went into asystole just before they cracked the chest, and with a little help from a few potent drugs, some heart massage and a good dose of skill, they got a well perfusing tachycardia back ( which surprised me, I thought the guy was tickets ) anyway, then he went to theatre, where he P4'd about an hour later )

But my hat off to the doctor, I was seriously impressed, it doesnt often happen at this particular hospital !



Date Posted: Sun Apr 23, 2006 10:04 AM
Posted By: ncmedic309 (Veteran Villager)

Do you ever see anything other than trauma?



Date Posted: Sun Apr 23, 2006 3:14 PM
Posted By: stridor (Veteran Villager)

#1 transported dialysis pt. home
#2 transported post CVA discharge to nursing home
#3 transported end stage chf pt to nursing home
#4 transported pediatric trache pt. home

-------------------------
One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
Village armourer



Date Posted: Sun Apr 23, 2006 6:17 PM
Posted By: Quint7Paramedic (Junior Forum Member)

Today wasn't very busy.

    Assist PD on an assualt call
      Diabetic Emergency, administered oral glucose and finger stick. Transported priority 3

      Also in your city do you have to be trained in one or more or even none:
        ACLS
          BTLS
            PALS
              NRP



              Date Posted: Sun Apr 23, 2006 10:24 PM
              Posted By: ESPARKS (Veteran Villager)


              Well I guess I know where to go if i ever get to jonesin for some serious trauma calls. VanHelsing you gotta find a quieter place to play !! be safe ! Ed

              -------------------------
              Take care and play safe out there !!!

              The dean of common sense



              Date Posted: Mon Apr 24, 2006 12:07 AM
              Posted By: juniorxracer (Junior Forum Member)

              I want to ride with V.H. for my medic clinicals... I figure a week of SA and I'll have more serious trauma experience then any medics around. Think you can set that up V.H. LOL

              Cheers,
              steve

              -------------------------
              More houses are destroyed each year by termites on the inside than tornadoes on the outside. America faces a greater threat from moral and ethical decay than from terrorism.



              Date Posted: Mon Apr 24, 2006 6:50 PM
              Posted By: ncmedic309 (Veteran Villager)

              Quote

              Originally posted by: Quint7Paramedic
              Also in your city do you have to be trained in one or more or even none:

                ACLS
                  BTLS
                    PALS
                      NRP


                      Most areas require ACLS and PALS, some require BTLS, I'm not aware of any 911 services that require NRP but it's a great class and every paramedic should take it at least once...



                      Date Posted: Mon Apr 24, 2006 8:59 PM
                      Posted By: stridor (Veteran Villager)

                      Call #1 Post MI to cath lab, drove.
                      Call #2 Vent patient to nursing home, drove.


                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Wed Apr 26, 2006 4:34 PM
                      Posted By: Nikon (Junior Forum Member)

                      Monday the 24th
                      1. DOA guy went to sleep on the couch, dad went to sleep in his room awaken by storm 3 hours later. On scene 2 hours for the ME

                      Today the 26th
                      1. CVA w/R side weakness, slurred speech.



                      Date Posted: Fri Apr 28, 2006 12:33 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Ed, Steve, you can ride with me any day !... you do have a bullet proof vest dont you ??? just kidding !

                      Tonight is going to be mayhem again... friday night, on a public holiday... at the end of the month... its gonna rock.



                      Date Posted: Fri Apr 28, 2006 6:02 AM
                      Posted By: ESPARKS (Veteran Villager)

                      VH: keep your head down & your back to the wall . your job sounds a lot like where i started back in the early 70's , We used to call it the knife & gun club beat. then heavy duty drugs and semi- automatic weapons arrived on the scene. I certainly don't miss that place. Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense

                       04/28/2006 06:06:23|U



                      Date Posted: Wed May 03, 2006 10:04 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Well that last friday was a total dissappointment, it was really quiet. I couldnt believe it, we sat at the station and played " RISK " most the night, ( I lost, clearly not meant to rule the world ! )

                      However... this was really funny...

                      Imagine the scene, pedestrian gets hit by car in the squatter camp ( or informal settlement if you want to be politiacally correct ). The road has a fairly steep gradient....

                      Patient lying in the middle of the road, with his C-spine being held by my partner.

                      Luckily we hear the fire engine coming to secure the scene for us.... They drive up to the pedestrian and stop about 10meters before him... on the upslope of the hill....

                      Sadly this fire engine, has a bad habit of when they break, tilting out a whole lot of water onto the road...
                      Which then proceeded to flood down the road.... into my partner and the patient.

                      Although actually it shouldnt be funny... It was !




                      Date Posted: Wed May 03, 2006 5:19 PM
                      Posted By: jayffemt (Veteran Villager)

                      From the PCR: "Hasty, high volume decon of pt performed by fire dept unsure why"

                      -------------------------
                      Only 1*



                      Date Posted: Fri May 05, 2006 4:50 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Well I only worked from 3 - 11pm..

                      Call 1 : dispatched to 2 people who got thrown off the train, on arrival, found one large lady , who actually had managed to get her leg caught in the gap between the train and the platform, then somehow managed to get pulled under the train, when it started moving ( i'll never understand how a chick her size got thru the gap, but ok ). So she had a suspected tib/fib fracture, and a few puncture wounds in her arms... ( oops , that was from the failed IV attempts... she was REALLY large, so sorry for her: no morphine... ) Then we waited on scene for an hour for the ambulance to arrive....

                      Call 2 : Dispatched to an unconscious pt, who had been assaulted by a mob. on arrival find a guy that was... thrown off the train.... he has a head injury, and cant speak any off the languages that I can.... ie English ! ( only had to wait 20mins for ambo this time )

                      Call 3 : pedestrain ( child ) hit by car ..... on route we get redirected to declare a P4, which didnt make alot of sense...to summarise: redirect to a pediatric PVA, to go and declare a stiff... no logic there... so we pointed that out.... and got redirected to origional call...

                      On arrrival find 3 injured kids, that were actually travelling in the car, which was involved in an accident.... ( well atleast the kid part was right ! ), another EMS service was on scene already, so didnt do much.

                      Then pacjed up and booked off duty at 11.





                      Date Posted: Fri May 05, 2006 11:47 PM
                      Posted By: basemti99 (Junior Forum Member)

                      On duty for ambulance again...... This time Friday night 1800 till Monday at 1200..... I have no life. Had a great day of calls the other day....

                      Call #1..... 19y/o male pt single occupant of car vs large road grater..... upon arrival pt A/Ox3, LOC obvious, pt c/o R wrist pain with major deformity..... Enroute Large bore IV started, 200cc bolus given. Car was major. Passanger compartment intruded. car was passing a grater and grater turned into the car.... Actually broke the 2,500 lbs blade in half......

                      Slow day it was....

                      -------------------------
                      CALA
                      Living Life one day at a time....



                      Date Posted: Sat May 06, 2006 3:22 PM
                      Posted By: Star09 (New Forum Member)

                      Two epistaxis. That's right, two of them. We're like nosebleed central. The first guy - a clinic doctor took his BP at something like 210 systolic, she freaked out and called 911. However when we got there it was down to 130/60.
                      The second guy's nose had bled all through the night, so when he got up at 6 a.m. he decided we should come pick him up and take him to the hospital. His BP was 130/70. He had absoloutely no other complaints. It was a long ride to the hospital, he sat in the jumpseat, I gave him some 4x4s and put an ice pack on the back of his neck.

                      The only other thing we did was transport this little old lady to the city for a possible pacemaker. We hooked her up to the ECG before we left and she had the weirdest strips my partner had ever seen, so he drove hot all the way there.



                      Date Posted: Sun May 07, 2006 1:35 AM
                      Posted By: basemti99 (Junior Forum Member)

                      Call #1 0400 truck in trees roll over. Upon arrival no patient. Per dispatch after law enforcement runs plate comes back the driver was sitting at home drunk and crashed his truck and 15 minute before we arrived on scene he reported his truck stolen.... No patient.
                      Call #2 0430 car vs guardrail. Upon arrival no patient. Driver walked 3 miles to gas station and called in reporting a car vs gaurdrail down the road unknown if occupied...

                      Notice how this area is very well known for drunk drivers and ones that aren't that smart as well.

                      Call#3 0500 car in the creek. Upon arrival pt is sitting on the picnic table in park. Pt loaded and brought to hospital to find out his BA was 3.4

                      Call #4 1000. County requesting EMS to respond for a male patient that has OD on meds. Pt took 35 tablets of Effexor XR, 10 tablets of Ambien. when asked were he was heading wanted to drive his car into a tree. He only found a stop sign... Transported given, O2, large bore IV, and pt then admitted to taking Morphine PR- 15 Suppositories.... Ouch.....

                      Call #5 2245. Transfer a pt from Level 3 hosptial to Level 2... Why pt large and couldn't get into the MRI scanner and metro had a open scanner..... Plus having to be a detective found out really why pt was in the hosptial... Anyone ever go into the ED to transport a pt to a different faciltiy and not get a report from the nurse???



                      -------------------------
                      CALA
                      Living Life one day at a time....



                      Date Posted: Sun May 28, 2006 10:42 PM
                      Posted By: VanHelsing (Veteran Villager)

                      I had a busy night on friday,

                      Call 1- PVA

                      Call 2- 7 car pile up on the highway at about 10pm

                      call 3- medical pt, unconsious pt at the informal settlement fire station

                      call 4- Taxi vs LDV. Because it was late, the taxi was only half full with about 5passengers, the ldv had a lady and gent that apparently turned in front of the taxi that didnt stop at the stop street, making it roll over into a ditch, the taxi, after hitting the ldv, veered into a wall, ejecting a passenger in the back thru the front windscreen, where he hit the wall and died instantly. The driver and front seat passenger were entrapped and had to be extricated.

                      meanwhile the 2 in the ldv, the woman had a scalp deglovement DELUX. from just above her eyes, down to just above he ears, her scalp was flapped back like a pan cake, it reminded me of the mortuary that I had been at a few morning before, just before they saw the scalp open. Anyway....

                      call 5- this was an interesting one....

                      Dispatched to an assualt ( its now 04h45 ), on route the ambulance who gets there first reports that they found a dead man lying naked next to the river ( Temp outside is about 2degrees celcius )so we continue to the call anyway

                      We find the man, no pulse, no breathing, but the rhythm on the strip shows ventricular Fibrillation with intermitent runs of a very wide ventricular agonal type qrs complex.

                      So we start to resus and we get him into the ambulance ( did I mention that this was in the informal settlement again... well we drive about 10m and the ambo gets stuck... )
                      anyway, we carry on with the cpr efforts, and eventually another ambulance comes to get us out, takes us to the nearest open space, and the helicopter came and got our pt.

                      ( In hospital they registered his tempreature at 22degrees celcius...)

                      call 6- another pedestrian

                      call 7- stabbed chest



                       05/28/2006 22:44:27|U



                      Date Posted: Mon May 29, 2006 9:34 AM
                      Posted By: ESPARKS (Veteran Villager)

                      LDV?????? you have way to much fun over there VH . :-] Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Mon May 29, 2006 11:22 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Hey Ed !

                      LDV- light delivery vehicle, we actually call them bakkies here, but that probably is an even more foreign term for you !

                      and yip, we definitly have alot of fun here !



                      Date Posted: Tue May 30, 2006 7:36 AM
                      Posted By: ESPARKS (Veteran Villager)



                      hey VH;
                      "LDV- light delivery vehicle, we actually call them bakkies here, but that probably is an even more foreign term for you !"
                      ok now i understand just like a "UTE" in stralia. Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Thu Jun 01, 2006 11:03 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Yesterday
                      0810-Call to nursing home. Pt fell last evening has been getting steadily more unresponsive and lethargic, they would now like him to go to ER for evaluation...

                      0900-Transfer pt. home from hospital to nursing home that we brought in last week.

                      Our service also has wheelchair vans which the basics will be driving throughout the day when we aren't on the rigs....

                      0930- W/chair van transfer from ECF (extended care facility, nursing home) to dentist
                      0930-w/chair van transfer from ECF to neurosurgeon office

                      1000- W/chair transfer from ECF to dialysis
                      1030-W/chair transfer from home residence to dialysis

                      1010-W/chair transfer of pt back from dentist to ECF-return
                      1020-W/chair transfer of pt back from neurosurgeon office to ECF-return (of course they couldn't be done at the same time had to make two trips)

                      1110- ECF emergency call, Pt has fallen and is 'bleeding all over'. Transport to ER.

                      1200-Home residence emergency call. Daycare provider has fallen down a flight of steps. Transfer to ER

                      1230-W/chair transfer from ECF to Dr
                      1245-W/chair transfer from different ECF to different Dr

                      1300- Transport flight team to hospital to pick up pt. Transfer team and pt back out to airport. (Thank gosh they were an efficient team and didn't take long to package pt. and get him loaded. Some take forever!)

                      1350-W/chair transfer from ECF to Dr-pick up pt brought in earlier and take them back to ECF
                      1415-W/chair transfer from Dr to ECF- return
                      1430-W/chair transfer from Dr. to ECF-return
                      1445-W/chair transfer from Dr. to ECF-return

                      1530-W/chair transfer dialysis pt to home residence-return

                      1600-Emergency call-pt laying in parking lot. Overly intoxicated female needing to go to ER.

                      1630- Transport another flight team to maternity ward to pick up 26wk pregnant female. Transport team and pt. back out to airport.

                      1715- W/chair transfer of pt. who had to wait for 45mn in dialysis because of flight team back to ECF-return

                      2000- Emergency call- ECF has resident who is diabetic and unresponsive. Transport to ER.

                      2100- Respond along with rural fire dept to garage fire. Wait until we are released.

                      0300- W/chair transfer of pt from emergency room (we brought him in earlier) back to ECF.

                      0600- W/chair transfer of pt. from ECF to hospital for sleep study......think I'll just go in and lay down beside them and hope to heck no-one realizes that I'm missing in action.....

                      0750- Emergency call motor vehicle vs bicycle. Transport biker to ER.

                      0810- Go home and crawl into bed for a nap

                      1015- Get called back into work for incident report and to take an out of town transfer at 1130......and on and on and on it goes...LOL....no wonder I'm tired when I'm off rotations...didn't know I worked this hard but when I saw this thread I had to keep a daily notepad...now I'm just gonna throw it in the trash and go back to thinking I like my boring job.....
                      Take care all!!



                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Fri Jun 02, 2006 11:27 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Wow... you have a-whole-lotta wheelchairs over there !

                      sounds like you had a busy shift !

                      Thursday... Night Shift.... private service.

                      call 1- C-spine injury at rugby match...

                      call 2- sent back to same place.... c-spine injury with associated nausea and vommiting ( metaclopramide is your friend ! )

                      call 3- hematuria... 70year old male pt. ( at 5am )

                      call 4- PVA

                      call 5- MVA

                      call 6- MVA


                      Then too top things off, i got a call when I got home that one of the crews that took over from me, got hit by a car while treating a patient. Details still min, but he was getting x-rayed when I phoned him. NFI



                      Date Posted: Fri Jun 02, 2006 8:13 PM
                      Posted By: BushyFromOz (Veteran Villager)

                      Was band aid brigading at a party the other night and had a drunken suicide attempt;

                      Pt had fight with boyfriend and tried to hang herself (i freaked when i heard this, done a very nasty hanging with frncing wire once) Anyway shes so drunk she can barely walk so she sit on the ground with a rope around her neck and pulls on it - until she passess out! When she wakes up again and realises she failed, she starts yanking on the rope again, until she passes out! and the vicious cycle continues

                      stupid woman, the coppas thought it was a great joke!

                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk



                      Date Posted: Sat Jun 03, 2006 12:43 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Hey Bushy !

                      She needs a sign... too stupid to live... or else she must attend the seminar " SUICIDE : getting it right the first time. "

                      Some people ????



                      Date Posted: Mon Jun 05, 2006 4:29 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Okay... no calls... just ICU patients!

                      June 2

                      1. Post intubation patient for pneumonia.... had lung removed due to cancer a year ago... flash edema is a horrid thing!
                      2. Thrombotic CVA after recieving TPA in ER which was successful... Aggressive and confused with bp 220s/120s... lobetalol drip started... hydralazine IVP. This is the 6th stroke for this patient.... 3 time using TPA.

                      June 3

                      1. Same CVA patient... still aggressive and confused... lobetolol stopped... BP 140s/100s. Potassium low... began "bolusing" KCl.
                      2. Pt admitted with chest pain and ST elevation in one lead and then diffuse ST elevation. On nitro drip. Dx became pericarditis... Nitro weined. Fever of 38.7 degrees celcius. Tylenol used.

                      June 4

                      1. Same CVA patient... not as aggressive but still confused... BP 140s/80-90s. Oral meds started with gravol slow IVP for nausea. Potassium and Phosophate still low... KPO4 drip started.
                      2. Same pericarditis pt... fever maintained... discharged to medical floor.
                      3. Vented patient post pneumonia worsening while on medical floor. Versed drip, tube feeds, assisted with Central line insertion via sub-clavian vein, Assisted inserting arterial line situated in radial artery. Hypotensive. Bicarb to be started after I left.

                      What fun all that was!


                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Mon Jun 05, 2006 7:12 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Fun indeed ! NO primaries at all ???

                      last night:
                      # 1: MVA

                      #2: Neonatal resus... transferred to Johannesburg general hospital from Alexandra clinic.

                      Baby born, with pulse but no breathing, doctor proceeded to intubated the stomach, after many attempts, visible from the damaged around the not-so-white vocal cords.
                      We arrived, re-intubated ( this time into the lungs ), pulse when up 100 to 150, ecg had inverted T waves on lead II, what a surprise.

                      ( although I am surprised the the tube that the Doc put in didnt come out the anus, he had it in so deep, in his defence, he wasnt sure it was in, so used the BVmask, over the ET and mouth, so the baby did get some form of Oxygen, and also in his defense it was a really difficult intubation, even for the paragods !! hahaha )

                      #3: pedestrian... ( or more like road kill ), guy hit at high speed, while crossing over the 4 lane highway ( and yes, it is also illegal here to walk on the highway, nevermind cross it ), so he was smeered over a long distance.

                      # 4: Shack fire, 3 dead, dad and 2 kids, mother got out, with burns to hands, chest and severe inhalation burns.

                      # 5: shooting: Man accidentally shot 6people while cleaning his gun....
                      No just kidding, I dont know what happened, only 1 patient, but we arrived too late, and he had already been taken away by another ambulance service.




                      Date Posted: Mon Jun 05, 2006 1:19 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Those are all ICU patients... we do full head to toe on arrival and twice per shift. IVs are already started in the ER.... we add central lines and arterial lines with the internists if necessary. Somehow the patients you seem to get, VH, always seem to dwarf them........ you lucky girl.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Mon Jun 05, 2006 1:28 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Dont worry we have our problems, for today example( as I was knocking off duty ), Our station should have MIMIMUM 14 people on shift...

                      4 ( FOUR ) people came to work today....



                      Date Posted: Mon Jun 05, 2006 1:38 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      OUCH!

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Wed Jun 07, 2006 11:40 AM
                      Posted By: Penguin (Junior Forum Member)

                      VH-u must either be working in the wild west or for province. I haven't seen anything interesting in a while- Clearly I'm working in the quiet side of Jo'burg.
                      Anyway this was my shift on Saturday:

                      #1: transfer from Jo'burg International to a home in Sandton. Only handover we get from the flight steward at SA Airways is he is diabetic. 84 y.o pt 12/15, a little gray, and has one leg. In ambo, HGT normal, weak radials but BP sitting at 100/60, No other "abnormalities". Its normal for elderly pt's to be "vegetative" right?? Arrive at home and met by son who thinks his dad is in a diabetic coma. When asked why, he tells us his dad is "normally more active and can talk". After getting a proper history, pt had leg amputated 6 days previously!!! So we rushed pt off to the ED. Possible TIA??? Crappy call though....

                      #2: MVA

                      #3: Dyspnea- very cool call. 50 y.o Pt tachycardic, wheezing +++ with a rock solid abdo. Turns out pt suffers from flatulance and abdo always like that after eating Decided not to risk palpating it too hard Anyway, pt nebulised and transported to Joburg Gen

                      #4: MVA

                      #5: Lacerated hand

                      #6: MVA





                      Date Posted: Wed Jun 07, 2006 12:32 PM
                      Posted By: ncmedic309 (Veteran Villager)

                      #1 - Acute CHF - CPAP prevents another one from buying a tube!

                      #2 - Severe hypotension and AMS - Sepsis! Not sure this one is going home...

                      #3 - "I think my J-Tube is coming out..."

                      #4 - Syncope w/ hypotension, runs of V-Tach and a bout of A-Flutter...

                      #5 - "I was acting stupid and I got my ass kicked"

                      #6 - AMS w/ periods of unresponsiveness - suspected OD on something? He bought a tube...

                      I broke my crazy trauma streak today, but managed to have 3 priority one medicals in one shift, maybe the tables have turned...



                      Date Posted: Thu Jun 08, 2006 9:53 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      June 8 ICU patients I attended to

                      1. Acute renal failure with possible sepsis. On NaHCO3 drip, insulin drip, dopamine drip. All drips but insulin were discontinued at various times during my shift. Pt showing signs of improvement and may go to general medicine ward tomorrow.

                      2. Possible meningitis patient. On insulin drip, Saline with potassium. BP 200s/100s. On isolation precautions with droplet and contact precautions. Confused, large, and aggressive. Pt is like dealing with a toddler which weighs 250 lbs. Being treated with antibiotics for meningitis. No improvement during my shift. Was going to have LP done but would not lie down... had to waste 100 mcg fentanyl and 10 midazolam which was drawn and ready for the LP.

                      This was a long and intense shift.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Fri Jun 09, 2006 9:13 AM
                      Posted By: jsadin (Veteran Villager)



                      Overdose on multiple prescription meds (all mixed togther in the same bottle). Pressure tanked at the hosp and she's now in ICU.

                      MVA w/back pain. Board/collar/18ga left forearm (just because I'm 3rd riding).

                      Diabetic emergency (sugar = 28mg/dl). 18ga right AC, amp of D50, call it a night.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Jun 09, 2006 11:18 AM
                      Posted By: CBEMT (Senior Forum Member)

                      5 transfers and 3 emergencies.

                      E1: Urgent care center to the ER. Abdominal pain, bloody stool, slight SOB. Hgb 8.4, doc says she probably need a pint or two along with a workup for the GI bleed. Urgent care nurse started at 22 because... well, she even admitted she didn't know why. Says they don't have any caths bigger than 20.

                      E2: Doctor's office for syncopal episodes, updated to probable CVA enroute. Male in his late 60's with a CVA history. Family noticed sudden onset of falls, left-sided weakness, near inability to speak. Took him to his primary care MD. MD ran a 12-lead, put him on 2 liters O2, and called for a transport. Patient won't speak (occasionally starts crying), has a weak left grip, and can't hold his arms up. Response: 3 minutes (he was luck, we were close). Scene time: 8 minutes, including removal via stairchair (MD office without handicap access- fanstastic). My partner tried to climb in the back with me for vitals and whatever else he thought I was going to do. "No, no- we're leaving NOW." BP prior to arrival was 240 over something. Transport: 4 minutes. NRB and monitor enroute. Gave him the best chance for thrombylitics that we could, and he had no absolute contraindications, but there was some question of whether the symptoms started when the family came to the house or if he was already like that for who knows how long before the family went to the house. The CT results hadn't come back by the time we left. Per the family he's been non-compliant with his meds for a long time.

                      E3: Diverted from a hospital discharge to the district courthouse for a non-custody subject going for a psych eval. Never really said a word. Few hours later another of our crews transported him to a psych inpatient unit.



                      -------------------------
                      Village Geek

                       06/09/2006 11:20:19|U



                      Date Posted: Fri Jun 09, 2006 11:33 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Penguin... Yip, these calls are with province ( midrand ), so we have diepslot squatter camp, and ivory park squatter camp.

                      And to add insult to injury... on our shift, there is no ALS at sandton, so we cover that area to, and currently the ALS at fairview is on leave, which leaves us covering.... THE WHOLE OF JHB !

                      that said, the calls for today were...

                      #1- baby chocking... object dislogded by the time we got there

                      #2- MVA, car hit motorbike, had to look REALLY hard to see the dent, all RHT'ed.

                      And that was that, with a whole-lotta coffee inbetween !




                      Date Posted: Fri Jun 09, 2006 10:25 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      My Patients I was involved with in ICU.

                      1. Same acute renal failure patient. Had pulmonary edema over night. On heparin, insulin, and nitroglycerine drips. Had art line in femoral artery which the patient decided to pull out. Lost approx 300cc of blood. No chest pain, abd pain, or SOB this shift.

                      2. Cardiac patient who worsened and went into respiratory arrest on ward and brought to ICU. Was on CPAP and was in 2-1 atrial flutter. Adenosine x2 throughout morning to no real effect except making pt feel like somebody punched him in the chest. Amiodarone drip to little effect. Pt was intubated and sedated and readied for cardioversion..... then he decided to code. Asystole for about a minute. Epi and CPR brought pt back. Started on levophed, epi and norepi drips as well as amiodarone, nitro and saline. Morphine drip and versed drip started. Central line placed and art line placed. Patient vented for rest of shift. We had 5 of us nurses for 3 vented patients, and 2 confused patients. That left one nurse per patient. No admissions allowed.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Mon Jun 12, 2006 9:43 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Just 1 patient today.

                      Same as pt #2 of last post. The difference is that today he was vented on dopamine, morphine, versed, insulin and saline drips. He was getting lasix, maxeran via IVP and tube feed.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sat Jun 17, 2006 4:08 AM
                      Posted By: basemti99 (Junior Forum Member)

                      Just started my shift at 1800 on Friday and still going until 0600 on Monday....

                      #1- 1825- MVC On Interstate. All sign offs. State Patrol ( Triple A with a Gun) brought the patients to a gas station to have us sign them off......
                      #2- 2040- Care Center for a 84y/o having Chest Pain, O2 applied, ASA give, IV established, NTG x3 given. Pt has pain 10/10 Morphine Sulfate 4mg IV. pt ekg paced ventricular rhythm however on closer inspection only firing every 5 seconds....
                      #3-2345- Emergency Transfer to Cardiac Hosptial of Acute MI.... Fun I love it.. 2 nurses went with (which neither of them have any experience in a ambulance and believed that if the patient coded that they couldn't do anything until they called for orders not knowing that ambulances have standing orders for most meds.) Uneventful and stayed stable for vitals. Even with a Integrilin, Heparin and Nitro Drip....
                      #4- 0225 go help our village drunk back up into his wheelchair and then put him in bed.... Man I love doing that. 4th time this week for me.........

                      -------------------------
                      CALA
                      Living Life one day at a time....



                      Date Posted: Sun Jun 18, 2006 1:52 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Well, just so you all dont think I get ALL the fun....

                      Today I was working for a private service again...

                      Call 1 : take lady with brain tumour to hospital because she has a headache....

                      Call 2 : transfer 81year old lady with bile duct cancer back to the frail care old age home...

                      Call 3 : on route back from old age home, come across minor accident where epileptic patient had a fit while driving, and went thru a few bushed a road island , and landed up lodged on the curb, managing to miss all other cars. He signed a RHT, and we watched the tow truckers try to get the car off the curb ( Our road cones where being particularly effective, as it was just after a bend ) so we stuck around for " scene protection "

                      The most exciting thing that happened was... I found 3 hospital vouchers left in the ambulance. And because they are only valid for 24hours... the owner said we could use them. so we had breakfast....





                      Date Posted: Sun Jun 18, 2006 2:04 PM
                      Posted By: medic53226 (Junior Forum Member)

                      1200: 81 Y/O FALL WITH POSSIBLE HIP FX
                      1950: 27 Y/O SELF INFLICTED GSW TO RIGHT SHOULDER
                      2200: 53 Y/O FIGHT LAC TO TOP OF HEAD Refusal
                      0005: Transfer 27 y/o to Indy
                      0540: 23 Y/O INVERTED MVA 1 CAR PINNED





                      -------------------------
                      First Responder to Paramedic there is only one purpose. Patient Care



                      Date Posted: Mon Jun 19, 2006 9:14 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      I had 1 pt today.

                      5' 1" 300 lbs female.

                      Hx of COPD, CHF, was in atrial fib

                      Flash edema and hypotensive episode

                      Intubated on pressure control

                      IJ central line running Saline, levophed, insulin, amiodarone, versed, morphine, heparin, lasix.

                      Art line for pressure monitoring

                      Needed blood transfusion for low hematocrit

                      Also getting K-lyte (potassium), solu-medrol (methylprednisolone), pepcid, maxeran, and nystatin powder.

                      Had 9 IV lines running at one point over night.


                      I LOVE ICU

                      Oh yeah... just an aside.

                      What the books tell you is wrong about ventricular native rates. They CAN support life. We had a gentleman admitted over night whose HR was between 15-25 beats per minute on palpation and on ECG. He was concious, alert, and oriented. The patient should be shipped to get a pace maker today.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!

                       06/19/2006 09:16:48|U



                      Date Posted: Mon Jun 19, 2006 10:24 AM
                      Posted By: VanHelsing (Veteran Villager)

                      That happened to me once, minor MVA where the chap just wanted to be checked out.

                      So I slap on the Pulse Ox ( because then it looks like i am atleast partly interested, in the guy that has just has a bumper bashing where you have to look REALLY hard to see where the cars are damaged )... anyway so the pulse shows 30...

                      So I just rate, it must be a false negative reading... no hassel.

                      Take a manual pulse.... its 30. ... I get a bit concerned, but just think, i didnt feel properly...

                      Slap on the ECG.... * $!! JAYSAS MARY AND HOLY ST JOSEPH *!#@!* , this guy has a pulse of 30... I nearly gave myself an MI, never mind s#@t myself !

                      Granted it was when I was still new in the industry, and I didnt have all the toys that I now have at my disposal...

                      But this chap was totally alert/ GCS 15/15.... nothing wrong... no hypotension, no sweating, no nothing.

                      After I has assessed him, I was the one that needed to go to hospital !

                      AAAHHhhhh those were the days !
                      VH



                      Date Posted: Mon Jun 19, 2006 3:47 PM
                      Posted By: Penguin (Junior Forum Member)

                      So i went to work on Sunday thinking it would be quiet and I could get some studying done- well it wasnt too busy- but no studying done

                      #1: MVA- turns out to be a No Service

                      #2: Transfer 88 yo to another hospital to have his pacemaker checked out after fainting spell

                      #3: "Collapse"- turns out its a panic attack. Hx of everything under the sun: Hypotensive, Stroke, MI. Pt felt pain in shoulder and thought it could be something. I couldn't find anything abnormal. Went to hospital anyway.

                      #4: 26/40 week pregancy with abdominal cramps ect...

                      #5: MVA

                      So not to busy. And just to vent : I HATE going to AREA 165 at the Joburg Gen.

                       06/19/2006 15:49:38|U



                      Date Posted: Wed Jun 28, 2006 3:53 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Welcome to the WILD west of downtown...

                      at about 10:30 there was a call... what happened was, 20 heavily armed gangsters, robbed a shop in Honeydew, police chased them to there hide out in downtown johannesburg, where 4 police got shot, and 8 of the gangsters.

                      so 12 people dead on scene, and about 5 injured.

                      It was nasty...

                      I was not on scene, because I was working on the ICU vehicle for the day,and our control center said we cant go, I was rather annoyed, because I was the closest vehicle to the scene ( max 5mins ), But i chalked it down to some cosmic reason, that I was not supposed to be there !





                      Date Posted: Wed Jun 28, 2006 8:24 AM
                      Posted By: BushyFromOz (Veteran Villager)

                      Alright, though not in the same league as you guys, i think this is pretty cool...............

                      Downhill mountain bike race and asome bloke falls of at 60k/hour and pile drives into the ramp of a jump

                      Obs = GCS 0f 12, left sided weakness, RR 18, Pulse 98, pupils 2 (L) and 3 (R) non equal to light--------->02 at 8l/min (we were a long way from nowhere, and i needed to stretch the 02 out) manual spine immobilisation (we have no collars - yet), positioned right lateral and helmet removed (not that i wanted to) with nausea and vomiting-------->GCS now 10 pt became confused and agitated, almost combative -----------> it took the ambulance 1.5 hrs to reach our location. They gave maxalon, collared, boarded and left for hospital then pt flown to major trauma center

                      Why am i chuffed? first aid stretches your abilities, you got bugger all gear and when the guy started flipping out you do all you can do - talk to em

                      Now this dude had a nasty stable C4 # (So weve been told), and as agitated as he was, it wasn't aggravated any further and he shouldn't have any permanent disability

                      just thought id toot my own trumpet!

                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk



                      Date Posted: Wed Jun 28, 2006 4:00 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Nice one Bushy... limited equipment really tests our experience !

                      I hate that : " Im a paramedic, but all I can do is first aid feeling "... for a laugh I bought myself a first aider badge, that I wear on my uniform, when Im in that kind of a mood !!

                      I just got back from work... only worked from 5 - 10pm, and had one call....


                      Call #1: Pedestrian....

                      This guy was not well... he had bilateral femur fractures, a tension pneumothorax, and a massive head injury ( according to his left pupil, which was looking at something over my left shoulder... while the other was looking at my feet..HHHmmmm.... ok then.... )

                      So the Helicopter was called out... while we intubated him, and gave him Morphine in increments of LOTS.... the Midazolam, did nothing, luckily the Doctor from one of the private ambulance services arrived, and gave him some Pavalon, which we still dont have on our protocol, but it is under review.....

                      The Doctor put in a chest drain on scene... and bilateral external jugs... ( which raised my eyebrows abit... but he is the dr, so Im sure he knew what he was doing ??? )

                      Then I went to a CME on near drowning.... and Im going to find somewhere to post about that...






                      Date Posted: Wed Jun 28, 2006 5:36 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      VanHelsing:

                      You see more trauma, really BAD trauma, than anyone I know. I know things can be a little sketchy in some of those South African neighborhoods, but DAMN!

                      -be safe.

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Wed Jun 28, 2006 8:56 PM
                      Posted By: BushyFromOz (Veteran Villager)

                      THATS IT!

                      im going to south africa!

                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk



                      Date Posted: Sat Jul 08, 2006 8:56 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Had a busy night, cant remember most of it... that happens when you get old.

                      Call 1: Stabbed chest wound. Pt lying supine, no breathing or pulse but in V-fib... so he got the resus bag thrown at him... sadly... he didnt make it... and just managed to get ALL the equipment covered in blood... While we were busy there, the ambulance called us for back up with a pedestrian accident....

                      Call 2: Pedestrain... head injury... 5 mins from hospital... so he got the lateral, lets ride... treatment... sadly the receiving facility was less than appropriate, but sadly the only option... the next morning when we brought in our next pts... he was still lying in the resus bay... but miraculously had been intubated. ( that doesnt usually happen ! )

                      Call 3: 04h30 this morning.. we get dispatched to a MVA... so we drive up and down the road looking for it.. and finally get told, it is actually by the dam... IN THE CAMPING GROUND. So you can imagine... we are thinking bumper bashing, no big deal.... Only to find 4 youngster, drunk out of their brackets, hit a tree at about 100km an hour, the front 2 are entrapped... i mean REALLY entrapped, and the back to are lying in a heap on top of each other... We waited on scene for a long time for a second ambulance, with the front 2 guys... all fairly seriously hurt, but Im sure they will all make it. Alcohol + driving is bad....

                      And I-Ho I-Ho... its back to work I go....

                      The we has some other MVAs thru out the night, but all were p3s, so not much to talk about.



                      Date Posted: Sun Aug 13, 2006 10:21 AM
                      Posted By: VanHelsing (Veteran Villager)

                      well, havent posted here for a while.

                      Worked yesterday day shift ( saturday )...

                      Call 1 : were dispatched to a " violent psychotic pt... " I always love these ones, lets me test out my martial arts skills... sadly, when we got there, we found a gentleman lying in bed, feeling fine, after a long nap, and slightly too many epinutin tablets... agreed to go to hospital with the ambulance crew, and that was that.

                      Call 2 : MVA, volvo hit toyota... volvo 1, toyota 0.
                      Injury to pt driving toyota, was most possibly a fratured head of femur, some morphine sorted out most his worries, and secured me a trip in the back of the ambo.

                      Call 3 : MVA... nothing found.

                      Call 4 : diaptched to a guy at the local dam, that had collapsed.... but we couldnt find him.. after a long search...

                      Call 4 : dispatched to Etwatwa fire station for a " pediatric resus " in progress.... finally got there, where the BLS crew were doing CPR... 2 month old baby in asystole, but we resused for an hour anyway...

                      which leads me to a question....

                      would you resus ??

                      my thoughts were thus....

                      a) yes, its pointless, the babys dead.

                      b) the mother was there. and I feel, it helps them to see that atleast there is effort on our part, instead of just waltzing in, stopping the CPR and declaring.... but I dont know if instead this just gives false hope ??

                      c) The crew at these outlying areas, usually dont even bother with trying to resus, however, the crew that was on duty, tried their best ( even having to use a first aider mouth piece ), and I thought that it would demotivate them, if the ALS who arrives, just terminates the resus, without doing anything. And next time, they also wont try.


                      Anyway, that was pretty much it for the day...



                       08/13/2006 10:23:37|U



                      Date Posted: Sun Aug 13, 2006 12:05 PM
                      Posted By: ncmedic309 (Veteran Villager)

                      Quote

                      would you resus ??


                      Yes! I would in most situtations if not every situation, at least attempt resuscitation, even if it just includes basic CPR and a transport to the hospital. You have family present, and your dealing with a very young pediatric patient, I think the best option is to give it a shot and transport to the closest facility. In some situations I could see where transport may be difficult. If your on scene with a pediatric that you know is dead and no amount of resusciation is going to change anything, it might not be feasable to attempt resusciation during an hour long transport. I guess ultimately, every situation is going to present differently. 9 times out of 10, we are working the code and going to the hosptial. When it's a kid, I think they deserve everything we can give them, and I think it helps us as providers deal with the death knowing that we put forth an effort to change the outcome.



                      Date Posted: Mon Aug 14, 2006 3:33 AM
                      Posted By: greshmedic (Veteran Villager)

                      I guess its a yes to the resus mainly for the benefit of the parents. I guess i could be extremely cold and say that it does make good practice and the issue of organ donation may be relevant but i don't think i'd be thinkng along those lines at the time.

                      I would question why wait at scene with a paed arrest? I must admit I would possibly question why the BLS crew didn't start running into the nearest hospital, maybe with an ALS intercept en route but then I don't know the service you work for and the basic level of provider.

                      Despite that it's never a nice job to get.

                      -------------------------
                      Before the war on terror, if I saw an unnatended package I used to think "I'll be having that!"



                      Date Posted: Tue Aug 15, 2006 9:15 PM
                      Posted By: Chadwick41311 (Junior Forum Member)

                      Tuesday (8am-4pm Shift)
                      1000: transfer from home to doctors appt. for tx. of a decubitus
                      1100: transfer from doctors appt to home.
                      1400-1555 nap time
                      1600 direct admit transfer from home to university cancer center d/t new onset pnuemonia.
                      2100 run sheets entered into computer, clocked out went home. I needed the overtime anyway.




                      Date Posted: Wed Aug 16, 2006 4:22 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      My last patient:

                      L hip dislocation (set by orthopedics)
                      In Buck's traction
                      multiple lacerations over R eye (all needing sutures)
                      R eye swollen shut
                      Severe concussion
                      Intubated due to GCS <8 in the field
                      large lac over L thigh requiring staples
                      C5 avulsion
                      maintained sedation over night with morphine and 1mg of Versed
                      No propofol as pt was for extubation the following day.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Wed Aug 16, 2006 5:42 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Quote

                      I would question why wait at scene with a paed arrest? I must admit I would possibly question why the BLS crew didn't start running into the nearest hospital, maybe with an ALS intercept en route but then I don't know the service you work for and the basic level of provider


                      Gresh... Good question.

                      The mother of the kiddie, took him to the local fire station. They are crews stationed there with fire trucks not ambulances.
                      They were BLS provides, which in this country means that they can basically do CPR and thats about it. They have no intubation/drug admin skills at all.

                      VH



                      Date Posted: Thu Aug 17, 2006 1:44 AM
                      Posted By: Chadwick41311 (Junior Forum Member)

                      Wednesday was slower than normal, two runs, one from home to the doctors office and one back home from the drs. office. I think everyones runs today were non-emergent transports. It was a slow morning, so the day shift supervisor had everyone wash their units and clean the station. We have an EMT student starting ride time this coming Tuesday. This will be interesting, at our service, they either get nothing and are bored to tears or they are a crap magnet coming out of the gate. After a few days, when they saw me coming in for my ride time they knew it was safe to kick off their shoes and relax. I had to do 60 hours of ride time to get 2 medical and 2 trauma contacts. One girl in my class got two nasty car wrecks, a full arrest and an MI. I swear I think she failed the NREMT-B on purpose.

                       08/17/2006 01:46:42|U



                      Date Posted: Thu Aug 17, 2006 5:31 PM
                      Posted By: denh1 (New Forum Member)

                      OK one call at 23:00 last night, 87 yo F. lifeline call, dif breathing, Bls (us) ALs private Co.
                      Get on sceen. lady on phone talking to kin. O2 stat 97%. talked to her, wants to go to hospital,
                      Cancled ALs. get Pt to truck get all info, Find out she is Diabetic, we are not aloud to take blood.
                      Ask her if she tested her level? She says yes it was 55. Activate Als again for intercept. They test and treat. Medic says how are you feeling? She says just fine, except for this dam heavy pressure in my chest! Off at hospital.




                      Date Posted: Thu Aug 17, 2006 7:32 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      So I'm curious. How far along into your assessment were you before you canceled ALS?


                      -be safe.

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Thu Aug 17, 2006 8:34 PM
                      Posted By: denh1 (New Forum Member)

                      O2 stat pulse. BP. lung sounds, No signs of any problems. Talking to 3 EMTs mabe 30 - 40 sec on sceen. cancled then loaded to go!




                      Date Posted: Thu Aug 17, 2006 9:21 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Did you get any history at all from her in that 30-40 seconds? A full set of vitals in 30 seconds is pretty quick. Did anyone bother to really speak to the patient?

                      I understand how patients can present fairly normally only to have underlying issues that require interventions. What bugs me about how you presented this is that you cancelled ALS only to have to request them again. It seems that had you let them continue in you could've avoided the delay in treatment. Plus, it sounds like you didn't even bother with a full assessment before calling to cancel ALS.

                      It could simply be how you're presenting this in a written format. However, based soley on what you've presented here, had I been the responding medic, you and I would've had a nice long chat about patient assessment and canceling ALS.

                      But again, that based solely on what's presented here which may or may not accurately reflect the course of events on this particular call.

                      Please don't think I'm bashing you. I'm just trying to understand what happened.

                      -be safe.

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Thu Aug 17, 2006 9:48 PM
                      Posted By: denh1 (New Forum Member)

                      I take nothing to heart. If anything yes I'm not giving enought info. I'm realy big on calling ALs
                      When the time is right, but with 2 EMTs taking vitals ( one works with me all time, see him more then my wife ) So like clock work we get a good asm. Even the medic that showed up couldn't understand How things went. she took her sugar level but not her shot aprox 1/2 HR before we got there ( what she stated ) But was as normal as we were! This one through me way off. Like I said
                      I think she was looking for company and would go to any lenth to get it ( come fly with me every
                      month ) Also my mom is diabetic, needle 3 times a day So I do have a clue!



                      Date Posted: Thu Aug 17, 2006 10:10 PM
                      Posted By: denh1 (New Forum Member)

                      one other thing not even 5 min from Hospital



                      Date Posted: Sun Sep 17, 2006 4:38 AM
                      Posted By: VanHelsing (Veteran Villager)

                      We had a busy night last night after along streak of quiet shifts...

                      call # 1 : Two woman who had been gathering wood in an old mining area, fell into a trench when the ground below them collapsed, covering them in sand, and breaking a few bones. Concerned friends then dragged them to the road, where we got sent to.
                      on arrival, one P1, and one P2. ( and a whole-lot-ta dirt )

                      call # 2 : dispatched to a PVA ( pedestrain ) who is apparently dead/ P4. Get there to find that infact, it was a poor cow that got hit and not a person... ( BBQ for dinner tonight !! )

                      call # 3 : MVA, one car... driver absconded... with just the passenger on scene. didnt want to go to hospital.

                      call # 4 : dispatched to a shooting... arrived on scene, to find a guy that had been hi-jacked... who although had lots of blood... had infact been just hit in the head with the butt of the firearm.

                      call # 5 : MVA Mini-bus head-on with a car... driver of minibus and car fine... but passenger, who had not been wearing a seatbelt... took a trip thru the windscreen, but still was only a P2.

                      call # 6 : despatched to a shooting... found patient who was P4, but hadn't been shot, had just ben assaulted with a brick...

                      call # 7 : Pedestrain... this time despatch info was fairly acccurate. A guy had clearly picked a fight with the wrong person, who then proceeded to drive over him repeatedly. Patient had multiple abbrasions ( obviously ), a fracture tib/fib, and tension pneumo on the right had side... and somewhat of a head injury.

                      call # 8 : ambulance called us for backup, for a gunshot chest. intersected ambulance... and about 1 min after I stepped into the back, the patient arrested.... full ALS resus... no luck... patient died.

                      we finally got back to teh station at about 3am, where we slept peacefull in the car until shift change...




                      VH



                      Date Posted: Sun Sep 17, 2006 6:58 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Here is one of the more interesting nights I had this week.

                      The ICU is fairly quiet with 3-4 non critical patients... ICU staff unhappy about same... long story.

                      I get a call from the ER to go down and assist with a pediatric head injury coming in.

                      I head down and prepare an area for a head injury and get my head on straight (been a while since I dealt with peds). I then get pulled to resus 2 from resus 1 to deal with an adult patient... I thought... YES... I can deal with adults.

                      The adult patient turned out to be a goodie.... One I had not seen before. He had a Grade 4 astrocytoma and had had a large hemmorrhagic stroke which was compressing his brain to the right. This man was spasmodic and semi-concious. He had L sided hemiparesis and mumbled speech. His vitals remained relatively stable. I catheterized him to prepare for an emergent transfer to a hospital who could do neuro surgery. He was then intubated when the flight team arrived and off he went.

                      Went next door to peds patient after adult left. Patient is 12yo female involved in truck versus quad accident. I hate quads. Luckily, she was wearing a helmet but her friend... not so lucky. Friend died on scene. Back to the 12yo.... She was unresponsive and had been intubated by another hospital on route to our hospital.... don't know why the paramedic didn't do it... probably had good reason. Her R side of her face was bruised and very swollen... eye didn't close fully.

                      After we stablized the girl I went and brought the family in... 15yo sister, 8yo sister and mom. Mom came in first and then I went to talk to the sisters who were in with a Victim's Assistance member in the "quiet room." The 15yo came right away in tears. I assured her that her sister could hear her and the mom and sister spoke with the pt for a while.

                      The pt went for a CT scan. We found a large contusion to the frontal lobe with a 6mm bleed. Looks like she got lucky as she could in that accident.

                      It took me 2 hours to speak with the 8yo about her sister to calm her enough that she could see her. I brought the 8yo in with the mom and 15yo. I took her to the side of the bed and talked to her about all the IVs and the ETT. Eventually she built up the courage to hold her hand and talk to the pt. I even told her it was alright to give her a kiss on the forhead if the 8yo desired. That was what the 8yo needed and a smile came to her face (that's why I do what I do). She kissed the pt on the forhead and walked back around and talked with the patient some more. The patient then started to stir and try to pull the ETT.... we sedated her some more. I assured the family that it is a good sign. The doctor seemed pleased with the CT result. Mannitol was started and she was flown to another hospital for neuro PICU.

                      I walked back up and got called again by the ER. Another pt came in with a subdural hematoma..... I never had to go for that patient.... must have been insane in the ER that night. Brains decided that the heart had been the culprit for long enough and that the brains needed their turn to hurt people.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Sep 17, 2006 10:42 AM
                      Posted By: greshmedic (Veteran Villager)

                      VH,

                      By the sounds of it Rourke's Drift was probably more like a kids tea party compared to what is going on down there nowadays!

                      If anyone is interested so far 8 hours into my shift on a response car all i have done is pick an old girl off the floor.............. Its pure mayhem here! Not so much blood but the strong smell of urine!

                      -------------------------
                      Before the war on terror, if I saw an unnatended package I used to think "I'll be having that!"



                      Date Posted: Sun Sep 17, 2006 11:24 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Grambo... Good work !! must say im envious, i am utterly useless at talking to hysterical family members... especially kids. The hijacking we went to last night, had 3 kids in the car, that I tried to talk to... not very well I must admit, but they were taking it actually very well.

                      Gresh... whats roukes drift ? sounds like a nice reprieve !

                      VH



                      Date Posted: Sun Sep 17, 2006 1:25 PM
                      Posted By: greshmedic (Veteran Villager)

                      Oh I'm suprised you never heard of that before - a couple of hundred British soldiers surrounded by thousands and thousands of Zulu warriors in South Africa 1879.

                      We won that one - thanks to the fact we had rifles and they had pointy sticks.

                      -------------------------
                      Before the war on terror, if I saw an unnatended package I used to think "I'll be having that!"



                      Date Posted: Sun Sep 17, 2006 2:45 PM
                      Posted By: jsadin (Veteran Villager)


                      03:00 - dispatched to respond ALS level for motor vehicle rollover in the next town. Yawn, scratch, drive. U.O.A. 25y/o male already backboarded by locals FD/EMTs, no obvious injuries, but the mechanism was impressive. He's a resident at a local long-term care facility (bipolar with suicidal ideations) and decided to steal the facility van so he could go kill himself. He pulled out onto the local highway and parked in the middle of it with his lights off, waiting for another car to come along so he could ram it head on (lovely). He spots said car and takes off full tilt...he never noticed it was a police officer. The officer avoids the collision and the young lad puts the hammer down. He tries to ram a telephone pole but misses and flips the van up an embankment and into the side of a building (a good 150ft roll). Drivers side crushed in, front axle ripped off, van laying on its roof, every piece of glass blown out.....and he isn't hurt one bit. Freaking amazing.

                      If I'd crashed like that, they be sucking me up with a shop vac....


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Sep 17, 2006 9:45 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Thanks VH... I pride myself in my ability to talk to kids in crisis. This is one of the only times I have had the opportunity to involve myself in that role for the family. I loved it.... maybe more than caring for the patient.

                      Okay... this occurred 2 nights later and I am back in the ICU. It is a quiet night, we have 2 patients who could go to a ward (no beds available) and one who is an ICU patient. It is 2200 hours and a nurse runs into the ICU from the OR asking for a pressure infuser. I hand her the item and ask if we should be expecting a patient.... the nurse says "probably." She runs back to the OR and I get a phone call with an anxious nurse on the other end.... she says, "I need somebody who can mix me a med FAST!" I say, "What do you need?" She replies, "Dopamine and then I need a body in here to help." I say, "I'll be there in a minute." 2205... Phone call ends and I am heading out with the dopamine running towards the OR. I get there and the patient is being rolled onto his back (had femur and lumbar spine repair). His pressure is 105/40. I look at it again... good wave form, art line intact, transducer and a good height. I spike the dopamine thinking this man is being supported by drugs and an abundance of fluid. I turn to the anesthesiologist and ask, "What do you want the dop running at?" He turns to me with a blank expression and says, "Dopamine? Why?" I inform the man that I was told to grab some dopamine and hurry over.

                      Needless to say, I spent my time there priming a line for CVP (central venous pressure). That is all I did to help. I took the dopamine back to the ICU and prepared a bed for him. I cared for him all night ventillated with fentanyl and Versed boluses. I gave him 2 units of packed RBCs and one unit of FFP on top of the 6 of RBCs and 1 of FFP he had in the OR. He was sedated but able to respond to questions and communicate with pen and paper. He was pain free too.... I was so proud!

                      He started taking huge... I mean HUGE tidal volumes.... some over 1L at a time. At 0630 we extubated because his pCO2 24, pO2 130, pH 7.66. He was blowing off his CO2 store. An RT and I talked the doc into the extubation over the phone.... never took much talking. It involved Hgb, CVP, pH, pO2, pCO2 and sedation score/GCS. The RT extubated with my help and the patient did great.... He asked if he said anything stupid and if he was taped shortly after extubation (10-20 minutes). I told him that he couldn't have talked with the tube in his mouth helping him breathe. He laughed and told me that he didn't remember a thing except waking up here just now. I thought... wow.... Versed is wonderful stuff.... and the Fentanyl did wonders as he was still in no pain!

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Mon Sep 18, 2006 12:45 AM
                      Posted By: CBEMT (Senior Forum Member)

                      Quote

                      Oh I'm suprised you never heard of that before - a couple of hundred British soldiers surrounded by thousands and thousands of Zulu warriors in South Africa 1879.


                      Wasn't there a movie about that?



                      -------------------------
                      Village Geek



                      Date Posted: Mon Sep 18, 2006 4:43 PM
                      Posted By: greshmedic (Veteran Villager)

                      Indeed there was and a very good one too CBEMT.

                      -------------------------
                      Before the war on terror, if I saw an unnatended package I used to think "I'll be having that!"



                      Date Posted: Tue Sep 19, 2006 5:00 PM
                      Posted By: CBEMT (Senior Forum Member)

                      I missed the beginning, but I've seen pretty much the rest of it.



                      -------------------------
                      Village Geek



                      Date Posted: Tue Sep 19, 2006 5:17 PM
                      Posted By: phunkymedic (Senior Forum Member)

                      Calls for the day.. Okay.

                      1. Three car MVC on intrastate. Transported one critically injured pt. Another unit transported mother/child. No need to say more on this.

                      2. Possible DOA. It turned out it was a DOA x 1 week.

                      3. Unresponsive patient. The neighbors called, because they couldn't get an answer at the door. The patient was fine.

                      4. Dispatched to a 'severe back pain' unable to get out of bed. Non emergent. Upon arrival found an elderly lady with her bags packed waiting on us to take her to the hospital. She had a hx of spinal stenosis.

                      5. Possible OD. Waited on Scene for PD. Arrived to OD premesis to find pt waiting with his bags as well..took 9 Seroquel and possibly a bottle of Xanax, because he ' wanted to hurt himself' . Past hx of suicidal tendancies. Stable to the ER.

                      6. Hypertensive attack to a nursing home. Elderly male had an elevated BP of 218/98 at it's highest point. No other complaints. RR/Rhythm, etc were WNL.

                      7. Another possible OD. Waited for 30 mins to be cancelled by PD.

                      Next day:

                      1. Vomiting, high fever, severe throat pain. Pt had strep confirmed by ER. [found out later]

                      2. 4-wheeler turn over. Back pain and right leg abrasions. Stable pt with mild discomfort.

                      3. 56 y/o male with weakness and severe pain in chest bi-laterally. Possibly homeless. Rales bilaterally w/diminished breath sounds. O2 SAT 99% on room air. Was in a sorry state of cleanliness and malnourished, dehydrated. Physical exam revealed distended abdomen/pelvis. Denies any hx of trauma. States past medical hx of prostate CA. Dx by ER 9 1/2 hours later of 'abnormal scrotal mass' admitted.

                      4. 50 y/o hypotensive male. BP was 74/36, c/o pain in his right shoulder/arm where approx 10-13 'tumors'/pustules were noted on that side, severe swelling in the R arm. Past hx of melanoma. Sinus tach rhythm ranging from 110-120 bpm. O2 Sat 98-100% on room air. 250cc Bolus, NSR. Diaphoretic, involuntary muscle spams. Alert, responsive. Found out from ER he was dx with melanoma sepsis, admitted to ICU after 2 units of PRBC, dopamine, benadryl, antibiotic drip. Besides initial IV they had to start two others in the same arm and he had a past hx of CHF, but they were still initiating IV bolus of NS. He was also in renal failure.

                      5. Chest pain x 1 week. Patient responsive, calm. Non emergent transport. No known dx.

                      6. Syncopal episode. Elderly male passed out while going to the bathroom, laceration on right forehead above eye. Known diabetic. BGL of 118. Stable transport. No known dx.

                      7. 46 y/o Female with radiating chest pain from doctor's office. BP was elevated @ 198/98. Skin cool, dry. Pain radiated down right arm and she was in visible discomfort. Edema bilaterally in feet. Moist breath sounds. NTG x 2 given. 2 ASA with some noted relief. EKG with artifact, no PVC's. Found out from ER, labs showed positive Right sided MI.

                      8. 3 y/o vs. car. low speed impact, when presented the toddler was screaming and alert. Scalp laceration of 6" or better. No other visible trauma besides mild abrasions to arms, legs. No evident fx or deformity/crepitus. Strong pulses bi-lat. No diminished lung sounds. Managed bleeding en route to hospital. I've never been so happy to hear a kid screaming in my life..and he did. Was still screaming at the ER hours later. No further dx on this pt.

                      9. 26 y/o female with severe headache/nausea/vomiting. Pt was stable with semi elevated BP of 187/98, which she said was normal, HR 96, RR 18. Now this one I have to make more of a basic facts comment on..when we got the IV/tubing out. She started screaming at the top of her lungs and hyperventilating, because she was 'afraid of needles'. She still got the IV with no meds to the ER. They later administered Phenegran.

                      10. 17 y/o female possible assault. Upon presentation, 17 y/o female with laceration to her right face approx 3", left arm of 6", hand 2". No other seen lacerations. She stated this had happened 3 days ago, where she went to ED and they advised to contact PD. She signed out AMA. Was afraid wounds were infected, wanted us to bandage/treat/release.

                      11. LAST ONE: 20 y/o male 'back pain'. Upon presentation, pt had a BGL of 388 and was responsive. Combative. Tachy @ 133 +, RR 16. He hadn't taken his insulin, because it was 'locked up'. The patient spent the entire time begging for water, none was given. IV administered. BP of 138/84. Family said he had a seizure and was c/o backpain. Which is why we were called. I'm not sure the outcome, because it was the last patient I saw last night. Didn't get to f/u with the ED.





                      -------------------------
                      " You have to keep the body going until the brain and heart recover enough to go on their own. "

                       09/19/2006 17:22:55|U



                      Date Posted: Tue Sep 19, 2006 8:53 PM
                      Posted By: jsadin (Veteran Villager)


                      Didja hafta say "abnormal scrotal mass"? Makes me wanna curl up in the fetal position.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Sep 19, 2006 9:17 PM
                      Posted By: coffeeachiever (Junior Forum Member)

                      Quote

                      Originally posted by: phunkymedic
                      I've never been so happy to hear a kid screaming in my life..


                      No freakin doubt.



                      -------------------------
                      Imagine whirled peas



                      Date Posted: Wed Sep 20, 2006 2:34 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      These are from my shift previous to the one that I'm just getting off of in five hours..will log current shift later after I've had some sleep and remember who I am and what it is that I like to do.... No complaints from me though, two years of head games at the old place...and seldom getting a true call....this is still "fun" again...but...give me a few months...LOL..

                      9/15/06 (reported to work at 1600) we work our 40 hours straight thru- we are short handed so sometimes we even work a 66...but that gets tooooo long....anyway..

                      1640-Called to private residence for non-responsive infant. Arrived to find baby approximately five months old laying on the floor in front of the sofa. Parent stated baby "fell off" the sofa ealier and now she won't wake up for her...scoop (taking full C-spine precautions due to the amount of bruising on arms and swelling beginning under and around eyes) and run to rig-call ALS back-up and pray they respond immediately. VS are 100% indicating not only head injury but internal trauma as well. Pulse of 88, resp of 40, cap refill +3sec, pale and clammy, unequal pupils and weakening peripheral pulses, and to top it all off now baby is beginning to seize. Insert oropharyngeal airway and pray harder....Met up with ALS unit 1700hrs and we switched places and I will repeat what I said at that moment, "Thank God for Medics!" We usually don't switch off but per phone conversation we had agreed that both medics on their truck would jump into ours and I would jump out and take their vehicle back in behind unit. I will admit that this is one call that I did NOT resent giving up control on....

                      2315-Called to private residence for person having an active seizure. Arrived to find pt in postictal state. Informed pt had run out of meds previous day, this is second seizure of the day- transported. Found out that infant brought in earlier had been stabilized as best as possible and flown out.

                      0128-Called to LEC (Law Enforcement Center) for a minor that had lacerated his hand while beating another minor over the head with a beer bottle. Minor refused transport for stitches...cleaned with water and then 100% alcohol (well, he asked for it!!) Steri-stripped it, informed of what to look for when (yep, I said when, knowing he wouldn't keep it clean) it becomes infected, got refusal signed and went back to base to bed.
                      (quick nap)
                      0210-Called to LEC for a minor that had just walked in bleeding from a gash on his forehead. (Hmm, wonder if he is the victim of the beer bottle attacker?) Got another refusal for transport for stitches, repeated above procedure and went back for another nappy poo.

                      0300-Called to LEC for inmate (whoops-patient) who has fallen out of bed and dislocated his shoulder...arrived to find that yep, it's dislocated. He asked if I couldn't just "pop" it in...umm, sure...I could try, but then again I've never done it before so maybe I could just break it for ya too....transported.

                      0424-Called to (can you guess?) LEC for inmate who is known diabetic and diagnosed with renal failure who is "getting all puffy in his face". We weren't even back to town yet from transfer of pt with dislocation!! Arrived to find hypotensive pt with pitting edema in lower extremities who related that he hadn't been taking his meds due to his "confinement"....transported.

                      1416-Called to private residence for assault victim with altered LOC. Arrived to find that pt had been assaulted on previous day and is now experiencing severe headache on movement, syncope, and is unable to turn head (or open eyes fully for that matter they were so swollen)...pt is unable to tell me who she is or where she is...has a rather large hematoma on the side of head as well as top of head...perfect imprint of a shoe on abdomen and back....applied full c-spine precautions and transported. Receiving facility informs me that this is one of the "regulars"...damn...when will she learn???

                      1538-Called to private residence for a patient that has fallen and is now bleeding profusely from head. Arrived to find pt who is clearly intoxicated and has a gash about three inches long on the side of her head...transport for stitches...clean blood and puke out of the back of the rig, change uniform, head back to bay.

                      2142-Called to private residence for pt having severe back spasms. Arrived to find pt laying in bed watching TV. Pt commences to have another "spasm" while I am doing assessment...screams so loud I almost lost my bowels...pt relates he fractured one of his vertebrae in a car accident last month and has had spasms ever since but he ran out of his meds....pt has another "spasm" before we load him on cot.....hmmm...no more spasms from that point forward...leave pt at ED to argue with nurses on when he had his pain meds re-filled last....

                      2318-Called to LEC for diabetic. Caller stated that pt has a sore on his leg that is infected and pt is now complaining that he cannot stand the pain. Arrived to find pt sitting in chair with 4x4 taped to upper thigh. Remove 4x4 to reveal nice cleanly healing ulcer w/out redness, discharge or warmth. Explain to jailer that if pt. really is in that much pain that they need to tranport him because it is non-emergent and there "appears" to be no infection and we cannot tie up our rig to transport....

                      Off at midnite...home to sleep!!! Finally!!

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Wed Sep 20, 2006 3:28 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Okay, I just HAVE to relate one of the calls we had last night...
                      I had a brand new EMT-B hang with me for 24 hours so I knew we were either going to get slammed, or get to play charades...we got slammed...BUT did have an "interesting" immediate dispatch call and had to relate it...a little background on the "newbie" was that he told the boss that he had been a first responder for five years and now just graduated from basics but feels confident that he is ready to go it alone....of course being the good boss that she is she assigned him to a few ride-a-longs first....on my shift I told him that I would hang back and let him run the calls and if he needed help to just ask me.....so here goes....

                      0255-Called by 911 Dispatcher to a private residence for a pt that had called in and stated that she took an undetermined amount of pills and now "feels like she can't breath and is dizzy." (Well, DUH!)
                      Newbie is running for the truck........ Myself and driver close behind him....travel time to residence is approximately 13 minutes. Half way enroute 911 dispatcher calls the cell phone in the rig and states that the caller called again and stated now that it was three (3) Ibuprofen that she took but now she doesn't think they are Ibuprofen because she is feeling all weird.
                      Arrived on scene and the house is pitch dark..bang on door, no response, "newbie" begins to turn and head for the truck...bang on door again and begin to open it...intoxicated male opens door...newbie returns to porch steps..ask male if they had called for ambulance and he states "No". Newbie turns to head for rig again. I ask mr. weeving back and forth if there is anyone else in the house and he replies affirmative, gives me the name of the pt that had called in and I state she called 911 may we come in and talk to her...he opens door and begins search for person we are looking for...newbie returns and enters house with us....
                      House has only one or two light bulbs that are fully functioning (yes I'm referring to the real thing here) so we cannot see clearly but we begin walk through fallowing Mr. weeve and stumble throughout the house checking bathroom, bedrooms, sofas, etc and find another passed out person but of the wrong gender (he woke up when his buddy kicked him and asked him where ---- was). Newbie is heading for door again...finally driver calls out "here she is!" and pt is located on the floor next to the kitchen table but half-way under it and against the wall so we didn't notice her right away amid all the beer cases, whiskey bottles, dogs, and garbage....newbie rushes over and stands by the kitchen table staring at pt on the floor....
                      Hmm....maybe I should take over I think to myself...
                      Ask newbie to grab me the cuff and ears while I'm controlling C-spine and driver and I are turning pt unto her back and laying her supine (at this point the pt made direct eye contact with me, then became "unresponsive" again (pt is maintaining her airway w/no difficulty, HR is regular, pupils are ERRLA) I held pt's hand directly over her face and quickly released it, it amazingly fell to the floor by her side, hmmm sternal rub produces a very loud "ouch" with spontaneous eye opening, but pt quickly becomes non responsive again....newbie grabs glucometer...then grabs correct equipment. I ask him to get a BP and pulse ox while I do a quick assessment for injury and continue questioning Mr. I've got to sit on the floor now so I don't fall over as to what she has consumed this evening "coupla beers" he replies....I finish assessment finding no obvious injury ask newbie what he got for BP and he states "maybe you better get one"... I obtain a BP of 120/80, 02 of 94%, HR 105. Since diabetes is a major problem here I asked newbie to get a BS...."maybe you better do it"...okay, poke finger and pt pulls hand away...BS within normal range....newbie still has the deer in the headlight look....
                      Driver and I pick up pt and load her unto the cot, secure her and load her into the ambulance- had newbie hook up the BP cuff from the Zoll and the pulse ox, get readings identical to the ones in the house, but now pt is fighting with newbie and yelling that she wants her babies...newbie is on the verge of hysteria right along with the pt....I get to the head of the cot and look pt directly in the eyes (she makes eye contact with me also) explain to the pt that if she continues to fight we will have to stop and let the nice policeman that is following us get in and arrest her....pt suddenly goes non-responsive....newbie is pale as a ghost....I finally explain to newbie that I don't think our pt is in any immediate danger (we aren't allowed to use the work "faking" here..lol.) I told him to grab her arm and hold it directly over her face again and drop it...amazingly enough it hit the floor at her side and not her face....newbie just stares at me like I've lost it....had him hook her up to 02 via nasal cannula. The ride to town is uneventfull, when we are approximately three blocks from hospital pt comes around again and when I question her as to the use of street drugs she replies "I don't do that stuff but we did smoke a joint and I think there was something in it"...I thank her for being honest with me and she promptly becomes unresponsive again.......until the nurse stuck her with the first I.V.... pt suddenly became oriented to person, place and time....
                      The newbie thinks I am a Goddess and I should be a medic.....hehehehe.....hope I get to work with him again...

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Wed Sep 20, 2006 7:42 PM
                      Posted By: CBEMT (Senior Forum Member)

                      Two emergencies, ER discharge, and a cancelled dialysis.

                      1) Not even done checking the truck yet. Dispatched to the SNF for PNA. Per the nurse, 84 y/o male recent dx of PNA, returned to the facility yesterday, on Levaquin. Extensive cardiac hx- HTN, CHF, CAD, CABG, valve replacement, cardiomyopathy.... Per the nurse pt was found cyanotic an hour ago, SPO2 70% RA, wheezing, rales, the whole bit. Afebrile, 146/something. She started him on 12lpm via NRB (my jaw hit the floor at that point), and gave Albuterol x2 prior to calling. Said proudly that his sat was 97% and he was no longer wheezing. "Yeah, but he's still drowning..." Resps 44 and labored with accessory use. Discovered at this point that I didn't have enough electrodes for a 12-lead. Fark. Rate is 75. Hmm... rhythm looks farked up.... maybe some STE in II.... Is that a pacing spike? No, can't be, nothing in the paperwork, I woulda SEEN it when I slapped the lead on him... Bump him up to 15lpm and it's off to the truck. 172/68, 75, 44, 99%. Rales up to 3/4. Slightly diapheretic. Abd unremarkable. I'm leaning towards CHF but with the recent PNA dx I'm not convinced... Suddenly he sounds like he's got phlegm in his throat, nods when asked if he needs to spit, produces a small amount of red-tinged mucus. Bingo. IV attempt, nothing. Second attempt, nothing. "Strap him back up and let's go." Let's try the other hand, bingo! Hmm, not advancing well... Hey look at that, I forgot to put the tournequet on- wonder if that was how I got the stick? NTG and 80mg Lasix. He doesn't look like he knows what I'm talking about to keep the tab under his tongue so I decide to skip the ASA. I'm on a roll, no sense killing him now. Trying to call the ER and push the Lasix isn't working well- Triage nurse is getting aggravated. Finally lose her in a dead zone. Repeat the BP, 154/72, looks like he's not working as hard, rate hasn't changed much though. We're pulling in. Resident's impressed, orders another NTG and 2 of Morphine. Turns out he DOES have a pacer- former CCU nurse picks up on the spikes, and finds the scar- no bump, just a scar. Son of a gun.

                      2) Usually they leave us alone for the last 2 hours of our shift once the early morning trucks come on. Not today. SNF for the high temp. Found her an hour ago shivering. 104 rectally. They gave her wet towels in the armpits and on the head- apparently the PRN Tylenol order got by them somehow. 100/60, 86, 18, 80% RA, NSR. 4 liters nasal, IV, start a small bolus, and we're there. Takes 3 nurses to get a Foley into her.



                      -------------------------
                      Village Geek



                      Date Posted: Thu Sep 21, 2006 2:52 AM
                      Posted By: phunkymedic (Senior Forum Member)

                      Didja hafta say "abnormal scrotal mass"? Makes me wanna curl up in the fetal position.

                      Aha! Sorry. It doesn't sound pleasant.. does it? It didn't look it either.. I'd be interested in finding out what else they found on this pt. I may follow up, because the way he was screaming with his ribs/chest hurting him and his abdominal region. I'm wondering if there wasn't an assault he wasn't telling us about.

                      Then again, it's speculation. I may never know.


                      As for the toddler vs. Car... Yeah, it was a beautiful sound. I had thoughts of insanity of where the heck the parents were when it happened, but ...let's let CPS ask those tough questions.



                      -------------------------
                      " You have to keep the body going until the brain and heart recover enough to go on their own. "



                      Date Posted: Thu Sep 21, 2006 9:04 PM
                      Posted By: coffeeachiever (Junior Forum Member)

                      Quote

                      Originally posted by: clutzycowgirlEMT
                      (we aren't allowed to use the work "faking" here..lol.) I told him to grab her arm and hold it directly over her face again and drop it...amazingly enough it hit the floor at her side and not her face...


                      I really like that trick.

                      Recently I was shown the eyeball thump. You want to see someone faking jump to their feet in a hurry? They will curse you like the devil, but they are so busted.



                      -------------------------
                      Imagine whirled peas



                      Date Posted: Fri Sep 22, 2006 10:09 AM
                      Posted By: jsadin (Veteran Villager)


                      Eyeball thump? I assume you're just "percussing" the eyeball through the closed eyelid? Sounds like fun...



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Sep 22, 2006 12:07 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Um...yeah. Don't EVER, under ANY circumstances, thump someone's eyeball.

                      Talk about a way to make someone lose their eyesight.

                      Not to mention it's stupid, dumb, idiotic, negligent, unprofessional...did I mention stupid?

                      I don't care what anyone tells you. DO NOT THUMP EYEBALLS! I'm just completely dumbfounded that some idiot out there would do this...much less teach someone else.

                      How stupid! If you even consider doing this you don't deserve to be able to practice.

                      -be safe and don't be stupid!



                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Fri Sep 22, 2006 7:30 PM
                      Posted By: coffeeachiever (Junior Forum Member)

                      Quote

                      Originally posted by: jsadin
                      Eyeball thump? I assume you're just "percussing" the eyeball through the closed eyelid? Sounds like fun...


                      That's exactly what I'm talking about.

                      Mike, I'm not talking about a knuckle buster, orb popping, rear back and let it fly thump. I'm not talking about popping eyeballs and detaching retinas. I'm talking about a sudden, unexpected discomfort that will suprise an attention starved person out of poorly acted syncope. And yes, it's fun. You should try it.

                      I understand you feel strongly about it, but it is a taught and accepted practice here. It works. To date, no one has lost their eyesight from it, just their perception of their own importance.

                      Peace

                      -------------------------
                      Imagine whirled peas



                      Date Posted: Fri Sep 22, 2006 9:09 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Quote

                      Originally posted by: coffeeachiever
                      Mike, I'm not talking about a knuckle buster, orb popping, rear back and let it fly thump. I'm not talking about popping eyeballs and detaching retinas.


                      Then what are you talking about? Because this...

                      Quote

                      I'm talking about a sudden, unexpected discomfort that will suprise an attention starved person out of poorly acted syncope.


                      doesn't cut it.

                      Quote

                      And yes, it's fun. You should try it.


                      Yeah. I think not. I'm the first to admit I'm not the smartest guy in the world. But I'm not a dumbass either.

                      Quote

                      I understand you feel strongly about it


                      Whatever gave you that idea? Oh wait! That's right! Stupidity on behalf of EMS providers really does make my blood boil.

                      Quote

                      but it is a taught and accepted practice here.


                      By whom? On what grounds are they using this as an accepted practice? Do you have some sort of medical literature backing this procedure? Produce it for review.

                      Quote

                      It works. To date, no one has lost their eyesight from it, just their perception of their own importance.

                      Peace


                      Just because it hasn't happened yet makes you think it won't? That leads you to believe it's safe? Who are you kidding?

                      I stand by my original comments. If you do this you're a moron. If you enjoy inflicting pain or "sudden discomfort" on your patients because you think they're faking then you're a moron. Whether or not they really are faking is not the issue.

                      There are other ways to determine if someone is faking. Most of them do not require you, as a prehospital healthcare PROFESSIONAL to inflict pain on a patient. Certainly doing it because it's "fun" (as quoted by two of you) is certainly worthy of having your ability to work in the field revoked...if not be charged with assault. And as you are intentionally inflicting pain/discomfort on a patient, I'd prefer to see the assault charges applied.

                      You want to change my mind? Produce evidence that the "eyeball thump" is an accepted practice in medicine. Produce evidence that you're doing it based on sound medical teaching and not, as you've stated twice now, because it's fun.

                      And when you can't do it, tell me where you live so I can avoid visiting. If you're doing stupid stuff like this and laughing about it, I don't even want to think about what other kind of negligent, crappy care you and your fellow whackers are attempting.

                      DON'T BE STUPID!



                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Fri Sep 22, 2006 9:48 PM
                      Posted By: jsadin (Veteran Villager)

                      I would have to agree that there are easier (and less painful) ways of judging whether someone is "faking" or not (I usually just use the eyelash trick or the hand drop from a safe height). I've never heard of the "eyeball thump" technique until this thread. Is there anyone else out there that uses this method? I'm sure whatever service coffee works for picked this up somewhere.

                      As for my statement of "sounds like fun", I was joking around. I don't get off hurting my patients (I don't do sternal rubs for the same reason). Now lets all take a deep breath and shake hands....



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum

                       09/22/2006 21:51:49|U



                      Date Posted: Sat Sep 23, 2006 2:17 AM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Just had to get this off my chest......I know I'm not a poet...but it's the best that I could do...no other words to describe this call..........


                      I held your lifeless baby in my hand,
                      As you sat and screamed “I don’t understand!”
                      “We just had her party, she just turned three!
                      We’re on our way home, my baby and me!”

                      I shook my head and said I did all I could,
                      But my heart was so heavy it felt like wood.
                      As we stood in the darkness and the rain,
                      I cried along with you and felt your pain.

                      Then your alcohol laden breathe reached my nose,
                      And I felt the anger clear down to my toes.
                      It was your choice to drink and drive,
                      Because of your choice your baby has died.

                      Now we will both live with the memory,
                      Of a rain laden night and a life that wasn’t to be.




                      Dangit......when will they ever learn.............





                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       09/23/2006 02:18:59|U



                      Date Posted: Sat Sep 23, 2006 10:05 PM
                      Posted By: jsadin (Veteran Villager)


                      So sorry to hear that. Some will never learn...



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Sep 23, 2006 10:19 PM
                      Posted By: EMTGirl21 (Junior Forum Member)

                      okay here goes...if i can remember.


                      #1- standby at lil kid football.
                      #2- elderly fall with minor trauma.
                      #3- Back to standby.....lil kid fell from bleachers, transport POV.
                      #4- MVA no transport
                      #5- MVA...mutial aid no transport.....but it was a kick ass wreck


                      Hopefully it will stay at that. My unit is next up and I only had three hours of sleep last night due to tornado's. So hopefully I will get to go nite nite really soon.




                      -------------------------
                      God bless, stay safe, don't get dead



                      Date Posted: Sat Sep 23, 2006 10:20 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      ClutzyCowGirl,

                      Those words describe the call rather well...

                      On to other business.....

                      As for the "eyeball thump".... never heard of it. I am, however, sure it is not accepted or even acceptable practice. Anybody who does this should have their privileges revoked on the spot.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Sep 24, 2006 3:21 PM
                      Posted By: MJMC4404 (Senior Forum Member)

                      jsadin... just because phunkymedic had to say "abnormal scrotal mass" doesn't mean that you have to repeat "abnormal scrotal mass" ya know!

                      My day was pretty calm until a few hours ago. MVC single occupant, unrestrained, wrapped her car around a BIG treetrunk. Midly difficult extrication, short transport to LZ, pupils dilated & non-reactive, VR 18 reg, P 110s reg, BP 140/90s, I don't have RSI, so had to wait for Flight crew to secure the airway (trismus). Still waiting to hear about her. Also waiting to see what the night will bring.

                      -------------------------
                      I'm NOT short, I'm INSEAM CHALLENGED

                      Village Sanitation Engineer



                      Date Posted: Sun Sep 24, 2006 8:14 PM
                      Posted By: jsadin (Veteran Villager)


                      Ahhhhh...he said "abnormal scrotal mass" again!

                      Quiet night/day. One transfer and then up to the local "troubled youth" school for a 1/2hr presentation on EMS that turned into an hour (actually kept their attention!). Got the call at 7:30am this morning and it went something like this, "Hey, ummm, can you swing up here at 11am and do a presentation on EMS? Just make something up." Great. I love improv.... The headmaster was suitably impressed and mentioned something about a donation. That should keep the boss happy.





                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Sep 24, 2006 8:40 PM
                      Posted By: coffeeachiever (Junior Forum Member)

                      Quote

                      Originally posted by: grambograham

                      As for the "eyeball thump".... never heard of it. I am, however, sure it is not accepted or even acceptable practice. Anybody who does this should have their privileges revoked on the spot.


                      I will relay the opinions here to the preceptors and get back to you with their response.

                      -------------------------
                      Imagine whirled peas



                      Date Posted: Sun Sep 24, 2006 11:32 PM
                      Posted By: phunkymedic (Senior Forum Member)

                      I've never heard of the eyeball thing either... but.. why would you want someone flipping your eye?

                      Calls for the day...let me set the scene.. it frigging poured the rain aaaallll day long..like 6-8" so it was soggy wet.

                      1. 13 y/o injured on football field. Definite deformed fx of left lower leg. The flesh was distended and the bone was nearly through it. I felt sorry for the kid, but it was a text book fx..would have made a great picture for it.

                      2. Dispatched to an unresponsive female at a local hotel. While enroute dispatch notified pt was bleeding. We get to the place..after having to carry everything up three flights of stairs....she was bleeding.. a lot.
                      Blood all over her, about a liter of blood on the bed, walls, door. Possible attempted suicide. She had a 2" gash on her wrist about 1 1/2" deep. Pt had no palp BP, no radial/pedial pulses.
                      She was semi conscious to verbal stimuli. Unable to establish an IV due to heavy scar tissue in arms, legs, neck. Pupils dilated.

                      3. Cardiac arrest at dialysis center. From Dispatch to Scene arrival approx time 3 minutes. When we arrived on scene we found a convalescent van sitting out front with a 78 y/o pt in cardiac arrest. They hadn't initiated CPR, but instead the nurses were ' holding her head up'. She was still sitting in her wheel chair.
                      Total on scene time 4 minutes. Loaded and went. CPR en route, tubed with 7.0, ventilated. Asystole.

                      4. 46 y/o female fall down a flight of stairs at a local motel. c/o severe lower back pain. Non-emergent transfer.

                      5. Dispatched to a MVA with possible leg injuries, both patients waiting inside food City. FD ran first response and cancelled us, because there were no patients to be found.
                      [something funny on this one. While running lights and sirens, we went through a bit of water across the road.. it didn't look deep, but it was deep enough it came over the hood of the ambulance and drowned out the sirens. They started working again..but it was a first. ]

                      6. Dispatched to a possible assault. Male lying in the middle of the road covered in a blanket. We get there to just that. A 40-ish year old male laying in the middle of the road, covered with a blanket. He had about 2-3" of water running over him at this point and was soaked through and through. Witnesses said an 18 wheeler had either thrown him out or he jumped out, but they said the truck stopped and the driver got out and kicked him several times. He got up and staggered into another car and the truck driver drove off onto the intrastate.
                      When we got this guy in the ambulance he evidently reeked of ETOH and was severely combative. Strapped to a board and the stretcher his only visible injury was a 3" laceration to the outside of his ear and being soaked to the bone. He wasn't cooperative to verbal stimuli. He would groan and lift his arms to try to grab onto you and hold on or try to get free of the straps. We had him trauma packaged with C-Collar, blocks, and those nifty velcro/glue tape laerdal straps on the head that, by the way, don't hold very well in the rain. He had a total of 8 straps on him and was still pulling free to hit at us. We didn't have a blood pressure, IV access or anything yet and he was being combative as we tried to place leads on us. Two people in the back, one driver. He was still combative when we got to the hospital, although..he did calm down when he was informed that if he touched either of us again he'd go directly to jail. His BP was good, HR was good, NSR, O2 was 98% on NRB.

                      Thankfully... that was our last call of the day...after the flat tire and broken stretcher.

                      -------------------------
                      " You have to keep the body going until the brain and heart recover enough to go on their own. "



                      Date Posted: Mon Sep 25, 2006 7:31 AM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Quote

                      Originally posted by: coffeeachiever

                      I will relay the opinions here to the preceptors and get back to you with their response.



                      Why not relay what you're doing to your medical director and see what response you get from him/her?

                      If your preceptors are the ones doing this I'm not sure I'd trust their opinion.

                      -be safe.


                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Mon Sep 25, 2006 10:11 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      It's scenerio time. A person has a hidden brain bleed applying pressure to the eyeball. The paramoron in charge figures that since this person is seizing and has no apparent injury, that this person is faking. Out comes the idiot with the eyeball thump which causes further damage to the eye and causes further injury. Explain how that eyeball thump is harmless?

                      Kinda like saying that if a person just finished having open heart surgery involving a sternal incision who goes unconcious or seizes. I guess the solution to that problem would be a sternal rub to see if they're faking it?

                      If the part is injured (sz usually means brain) don't play with that part of the body to see if they're faking it!

                      I hope whoever tries that, tells the physician in the ER that they tried percussing the eyeball to see if the patient was faking the seizure. That is the same as shaking the person's head to see if they really do have a spinal injury... or are they just faking it.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Mon Sep 25, 2006 10:16 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      I'm very interested to hear what the preceptors have to say. Did you ask their medical director about that practice?

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Mon Sep 25, 2006 11:17 AM
                      Posted By: VanHelsing (Veteran Villager)

                      I have to say, im also against the "eye-ball test".

                      Over here, I dont care if people are faking or not,if they want to go to hospital, then I take them, whatever the reason. I would rather let the doctor have the decision, as to wether he wants to admit them or not.

                      There is NO way I plan on losing my right to practise, over some brain donor, who just wanted to get out the house for a while.

                      so off to hospital they go.

                      If I think for whatever reason they are faking, I'll take them to an appropriate facility, which will be so awful, they wont ever want to go to hospital again. That way I cover my own A$$, and patient gets what he wanted.

                      NOTE : only the patient can refuse hospital treatment... not the medic !



                      Date Posted: Mon Sep 25, 2006 8:51 PM
                      Posted By: coffeeachiever (Junior Forum Member)

                      They have never refused transport or treatment.

                      Keep in mind folks that I'm an EMT IV doing clinicals for paramedic class, so pull those punches a bit and choose your targets. I come here to take from your knowledge and experience, so if you have something to say, try a jab before throwing the haymaker.

                      Your comments are duly noted and said comments will most definitely be passed to each of my educators. If they do have a retort it would be very interesting to be the messenger/mediator between you. The collective brain of everyone on this site is quite formidable and I kind of want to see what happens if they challenge what you all have said. Keep in mind that I personally wouldn't challenge any of you on a medical issue at this point.

                      Again, when I see a preceptor or instructor next, I will certainly bring this up before we part. It may be this weekend, but I promise I will post the response as soon as humanly possible.

                      Coffee

                      -------------------------
                      Imagine whirled peas



                      Date Posted: Mon Sep 25, 2006 9:53 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Thank you for being willing to follow up with your instructors regarding this issue.

                      There are two things which, at least from my standing, need to be addressed...

                      First, I would not have responded so angrily if you hadn't expressed such joy in inflicting pain on a patient. If you hadn't said it was fun you might not have gotten the responses you received.

                      This leads me to:

                      Second, the "...I'm an EMT IV doing clinicals for paramedic class..." isn't an excuse and shame on you for using it as such. This is something you should've learned from growing up. It is immoral to purposefully inflict pain on people for your enjoyment. You should know this as a human being much less as a health care provider.

                      And if you want to know the truth, I pulled my punches quite a bit. You really don't want to see what I wrote initially.

                      I'll hold on further comments until you post here the results of your conversations with your preceptors and instructors.

                      -be safe

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Tue Sep 26, 2006 1:23 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      I agree that being an EMT IV should not be used as an excuse. However, I do think that bringing this up to your educators/preceptors shows that you have the intellegence and fortitude to be a good medic. Please note that I threw no punches aimed at you... just the morons dumb enough to attempt that stunt and your preceptors. Them: I threw a few good shots at.

                      I also pulled my punches a bit.... I wrote a much more cynical and snide post and decided to just stick to sarcastic with the second post.

                      Respectfully,
                      Graham

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Wed Sep 27, 2006 8:22 PM
                      Posted By: coffeeachiever (Junior Forum Member)

                      Literally nine out of ten 911 calls here are people calling the orange and white taxi to come screaming for them with lights and sirens. They want a ride downtown or they are putting on a show. Many times a unit has to be called from another district to respond to a true emergency while time is wasted on nincompoops that need a ride somewhere close to the hospital. Moreover, the unit is rolling 23 out of 24 hours giving medics no time to eat, rest, or use the restroom.

                      The frustration with the local attitude toward 911 services is about to come to a head here. While it sometimes heads in a negative direction, I find myself being caught up in it sometimes. There are no fines for misuse of 911, medics are overworked and burning out at a record pace, and our state insurance is paying for the misuse of our services thereby increasing our taxes and decreasing the pay.

                      As much as I love this field, and I do, I will not be able to continue to do it in this city after a few more years. Most of this city is a war zone where most medics can tell you about the time(s) they were shot at. The police dept. has used city ambulances for drug stings, so there is no more trust. The paramedic burnout rate here is now 3 to 7 years.

                      You can see how it only takes a short time for bad ideas to start to look like good ones. Make fifteen emergency calls and only one being someone that was sick or hurt. The rest were wanting a free taxi ride or attention from their friends. Now do that every day. Frustration builds quickly. Reasoning goes just as quickly.

                      I'm not justifying anything, just explaining how the mentality comes about here. We have become unwilling participants in a circus we didn't want to go to. We really want to help people. We resent being fuc*ed with day in and day out though.

                      I can see moving to a rural area with a hospital based EMS very soon. In the meantime, thanks for keeping me grounded.

                      Coffee

                      -------------------------
                      Imagine whirled peas



                      Date Posted: Fri Sep 29, 2006 9:34 PM
                      Posted By: nyemt2005 (Junior Forum Member)

                      this shift occured about a week ago. It was a Friday overnight from 8:00 PM Friday into 11:00 AM Saturday. This particular agency I was working with is a BLS college ambulance on a good sized urban campus. We do about 700 calls during the school year.

                      Call 1: Approximately 0130. Priority 1 Chest Pains outside one of the Residence halls. Young male, no cardiac history, no SOB, no radiation and also c/o of cold-like symptoms for a few days before the chest pain started. ALS shows up, determines it is BLS and we transport to the hospital. Back in service at around 0200.

                      Call 2: Approximately 0400 for a broken finger on one of the residence halls. Kid got angry, hit a wall and now c/o of severe pain in the middle finger. Splinted with ice pack, transported to hospital. Back in Service at around 0430ish.

                      Call 3: Approximately 0930 for a laceration to the hand on one of the residence halls. pt states he fell getting out of the cab and scraped his hand on the curb about 5 hours ago. Two small lacerations on the hand, each a couple of centimeters long. Wound cleaned, and wrapped with a clean bandage and dressing. Transported to hospital. Back in Service around 1000.

                      Call 4: Approximately 1015 priority 1 for a pregnant woman going in and out of consciousness in one of the residence hall kitchens. upon arrival find patient A and O times 3 but weak and lethargic as well as hypotensive. pt c/o of flu-like symptoms. ALS arrives and determines it is BLS. Would like to take a blood sugar but glucometers aren't in service yet. Transported to Hospital, back in service at 1100. Day Shift takes over.



                      I just wanted to post this so you guys can see the kind of calls we get doing college EMS. It's not all drunks.



                      Date Posted: Tue Oct 03, 2006 1:06 AM
                      Posted By: systemlord (Junior Forum Member)


                      Hey Van Helsing!

                      You allude to working in SA if I am correct? If so....all these questions are based on the fact that you do live there and work there! Um.... I am interested in working in SA for a year or so. I am dutch but live in Canada and I am a first year medic student. Is it possible to work there by just doing the exam and registration process???? Just curious! I know a SA DR who said he could set me up working in a hospital! Anyways just seeing what my possibilites are! Thanks for the info!



                      Date Posted: Tue Oct 03, 2006 3:34 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Systemlord..

                      Do you want to work pre-hospital with the paramedics, or in hospital with the doctors ?

                      as a paramedic... you cant just write the exams, and register... I wish it was that easy.
                      We practise in an entirely different way to the US, ( thats casue people dont keep sueing us ! ).

                      We are independant practitioners, so we make the judgement calls, without any backup doctors on call. Hence, our training is different to what I expect yours is. I dont profess to saying our system is better, in fact, I dont think it is.

                      If you want to work in hospital, I dont know what needs to be done, but I thinkit would be easier to get accreditation as a doctor, that as a paramedic.

                      VH

                      p.s. If you want voluntary shifts in johannesburg... you can ride with me !



                      Date Posted: Tue Oct 03, 2006 5:12 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      I only had one call yesterday. It even made the national news.

                      -be safer

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau

                       10/03/2006 17:17:09|U



                      Date Posted: Tue Oct 03, 2006 6:23 PM
                      Posted By: jsadin (Veteran Villager)


                      You're not in Lancaster PA are you?


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Oct 03, 2006 11:29 PM
                      Posted By: phunkymedic (Senior Forum Member)

                      We have become unwilling participants in a circus we didn't want to go to. We really want to help people. We resent being fuc*ed with day in and day out though.

                      You know.. I feel the pain on this. Being in a metropolis sort of gets all kinds of calls.. but let me say this too..

                      You are helping people..you're taking them to the hospital, because they need to go. Sure.. we've all gotten the 'taxi service' calls, the non emergent, non life threatening calls.
                      They're still patients. They're still calls. Remember too.. the non emergent ones are the ones that are most likely to remember how they were treated and cared for, which here can effect the way you are paid and which truck you run on.

                      Run them like you would the traumas, because you can't see everything going on inside the patient.

                      They could be calm, c/o abdominal pain, unable to eat, difficulty swallowing, dx with bronchitis a week before, or allergic rhinitis and you think it's no big deal ...until you find out later on one of your fourteen runs that night that he has been flown out cuz he has a AAA.

                      You just never know. That's the point. Treat them like you would your family. Man, I know all about eating fast on the way to calls, having to go through 2 dispatches before you can take a bathroom break, and maybe a five minute catnap while your partner is driving. You take turns doing it. That's the nature of the beast..you're not alone in that.

                      When you get tired of running calls, it's time to take a few days off.. cuz I've done rural too and you're still going to get called out at 3 am to help Mamaw back into bed when she falls out. Maybe even take her to the hospital, because her arthritis is flaring up.

                      You have just as much of a chance in the big city [if not more due to population] of running trauma on an ALS truck then you do in the country.

                      Good luck. Be safe.

                      -------------------------
                      " You have to keep the body going until the brain and heart recover enough to go on their own. "



                      Date Posted: Wed Oct 11, 2006 4:31 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      And another 40 hrs goes down in the journals.....

                      Sunday 2345 check in for shift, get the lowdown from outgoing shift that it's been Quiet on the home front...woohoo...
                      0022---Tones go off....damn.....
                      Respond to rural residence for 23 yr old female who is 7.5 months pregnant and has been assaulted by two men. (double damn) Suspects have left the house...yeah right....arrive to find four PD vehicles, two fights going on in the yard, dive, duck and dodge with two BIA officers to the house to treat the first pt who is lying fetal position on the floor in the living room with this funny looking fluid leaking from her ear....oh yeah boys, we're gonna have a quiet shift...thank the man upstairs she's maintaining her own airway...get ALS enroute, C-collar LSB pt, load up momma and dive, duck and dodge the WWE matches going on in the front yard again....throw on the 02 and NRB, vacu-splint her very obvious ulnar fracture, put pressure on the 6" laceration on her thigh, pressure dress it as best I can, control bleeding on non-fractured arm (at least I don't think it's fractured) continue with trauma assessment....intercept with ALS just as momma is beginning to fight c-collar, me, etc...turn pt care over to paramedic, spike IV, call ED and get trauma team on standby (which means at this hospital that the doc, two nurses and RT will be on hand--they lost their level I trauma status eons ago)as well as asking them to alert LifeFlight....yep...all quiet on the home front....(IlovemyjobIlovemyjobIlovemy...) try and help keep pt's arm down for medic to stab IV...try to keep pt from beating up herself and medic and I...try and dodge vomit....unload pt at ED and head out to clean up the disaster area once known as Unit 62

                      Get a major dressing down from the paramedic of the ALS unit in the ER garage because I asked him in the rig why he didn't jump in with a spiked IV bag....jeesh, I thought it was an innocent question and made sense he would have had one ready since they had a fifteen minute drive to intercept and when I called them I told him EXACTLY what I was seeing in blood loss, head trauma, etc.......silly me.....
                      (maybe it was an uncalled for comment....)

                      0159--on return to base paged out to a rural residence for an assault...hmmm...is it gonna be one of the WWE fighters? Yep....trash the rig again enroute to ED with pt who has various lacerations to the head and arms, hematomas, severe attitude problem (he wasn't happy with the BIA officer babysitting him) and broken ankle.....(hmm..should I vacu-splint it or let it dangle since he's the one that beat momma)..dangit...better splint it no matter how I feel about him...oh and I threw a NRB on him to keep him from spitting blood on me....but dang that tube of super glue looked like a better option....

                      0300--shower and change uniforms

                      0328--paged to rural residence for pt complaining of severe abdominal pain, weakness and dizziness with n/v...pt is coming off a five day drunk...has BS value of 39, spits out the insta-glucose...pukes on the floor of the rig instead of pretty little white baggy I gave him...what is it with ppl puking and spitting on me today??????? transport

                      0645--get a call from man asking who he calls to get a ride to hospital for stitches. Ask nature of injury, amount of blood, etc...explain it doesn't sound life threatening and he needs to call CHR (ppl who are supposed to be on call 24/7 to transport non-life threatening pt's w/out transportation to ED or Doc appts)

                      0710--female rings doorbell to station--asks me to evaluate her boyfriend and his friend who are sitting in her car. One has 1" laceration over right eyebrow (Hmm...could he be the previous caller?) the other has a blown out knee....they were "scuffling" and fell down....try and explain that neither are life threatening injuries and they really need to call CHR or she needs to drive them in herself...no...CHR is not answering the phone and she can't drive..she's been drinking....(IlovemyjobIlovemy) transport.....

                      1015--lay down for nap

                      1145--toned out for 22 yr old complaining of hemorrhaging in her second month of pregnancy.....tranport

                      1411--toned out for standby on vehicle fire/unknown if occupied...arrive to find PD on scene, search ditches and surrounding area, find no-one...find footprints in gravel heading to farm house....follow PD to farm house...driver sitting on front steps...assess for injuries...none except for strong ETOH smell...watch PD put on cuffs...return to base.

                      1924--toned out for uncouncious post seizure butt breeder--hehe...dispatch has a lisp..transport pt who is now conscious and had another seizure during assessment..ran out of seizure meds....

                      2200--shower and bed

                      0219--toned out for youth who fell in a fire pit...16 yr old male with 2nd and 3rd degree burns on upper half of left side..transport with ALS intercept due to airway difficulty....
                      (hehe..medic got in rig with spiked IV bag...)


                      06something--toned to Manufacturing plant for unknown medical--pt with BP 175/122 accompanied by tingling in arms, dizziness....okay Grambo, Doc and Kat...need your opinion on this one...
                      no Hx of hypertension, diabetes, anything....guy keeps going up with BP...I administer what I'm allowed in protocols meaning 02, 4 babies...three shots of nitro (in appropriate intervals) and it continues to rise.. called ALS and they responded that they did not feel intercept was warranted....we transport Code 3....by the time we get to ED pt is severely diaphoretic and in severe pain with a BP of 232/136...
                      was I wrong in thinking that I was dealing with a dude who was fixing to have if not having an MI and needing ALS meds????? I'm too tired right now to try and figure this one out..so would like your input....

                      0900--meeting at HQ

                      0944--toned out to 34 yr old female with difficulty breeding...dispatcher with lisp is back on duty...pt has Hx of CHF, Lupus and seizures...transport

                      1129--toned out for MVA...driver is standing beside rolled over smashed car..dazed and confused (just like me)...apply C-collar do standing LSB takedown...treat cuts and bruises during transport..

                      1321--Mama brings six yr old to bay for bad tummy ache...ride over must have jostled her tummy enough, she uses our bathroom, relieves the tummy ache...cutey pie gets a teddy bear, tour of the rig and they go home....

                      1529--toned out to PD for inmate having a seizure...nasoairway, move chairs, wait, apply 02, assess....releif EMT read shift log book and came up to PD to relieve me...dang gotta buy her a beer....

                      Pick up my little man at babysitters, go home and drool on my pillow....


                      Doc, Grambo, Kat and my other astute back up medics here in my EMS Village family...when you get a chance please respond to me on the BP dude...I'd really like to know what I'm missing....why ALS refused...etc...I appreciate you input more than you know...good or bad...my favorite phrase is when you feel you know it all...you may as well die...I enjoy learning from all of you....

                      Tami

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Wed Oct 11, 2006 7:08 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      How far were you from the hospital and how long would it take ALS to get to you? Which would be faster.
                      How old is the patient? How quickly did the BP rise?
                      Any headache?
                      Drug use?
                      What was his heart rate?
                      Did you do a rhythm strip or 12 lead?

                      Just want some info before drawing any assumptions/conclusions.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Wed Oct 11, 2006 7:40 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      How far were you from the hospital and how long would it take ALS to get to you? Which would be faster.
                      We were 37 miles out when I called. Intercept would most likely have occurred within 10 to fifteen minutes. It may have been just as fast to continue as we did.

                      How old is the patient?
                      Pt was 42

                      How quickly did the BP rise?
                      Continued to rise with every blood pressure taken, five minute intervals..due to using the nitro I was taking it every five minutes.

                      Any headache?
                      Pt complained of "slight headache but more "fuzziness" (in his words).

                      Drug use?
                      I would say no as he is top man at Manufacturing plant and they undergo drug tests every 3 months.

                      What was his heart rate?
                      Started at 96 and was at 130 if I remember right when we got to ED.

                      Did you do a rhythm strip or 12 lead?
                      No, my manager will not allow us to use the Zoll due to the fact that if we hook it up, we MUST know how to interpret ALL the strip possibilities. Which i understand and agree with.

                      And the only med he was on is Potassium

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       10/11/2006 19:47:56|U



                      Date Posted: Thu Oct 12, 2006 10:28 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Does he take the potassium regularly? Could be hypokalemia causing the tachycardia. More likely a TIA or unstable angina. I'm tired now.... just came off shift... I will maul this around in my brain but I think ALS needed to respond to this.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Thu Oct 12, 2006 4:18 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Thanks Grambo,
                      I'm not so much worried about the fact that ALS didn't intercept...although I was shocked at the time, and I'm sure my jaw dropped to the floor....but I just keep thinking back to the pt and wondering what could have been going on with him...some of these calls just stick in my mind and I wonder what I could have done differently to improve care...this was one of them....thanks again!!
                      Tami


                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       10/12/2006 16:20:00|U



                      Date Posted: Thu Oct 12, 2006 7:39 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Sounds like you did what you could. What he needs is beta-blockers IV to control the pulse and BP.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Oct 29, 2006 11:15 AM
                      Posted By: VanHelsing (Veteran Villager)

                      havent been here for a while...

                      last night.... I was expecting it to be really busy, what with the end of the month and all, but it was fairly quiet, even though it felt busy, because I was really tired.

                      call 1 : Pedestrian ( on bicycle ) hit by taxi, and killed fairly instantaneously. ( and if he wasnt, then the following few cars that ran him over, would have done him in for sure ! )... so he just needed to be declared.

                      call 2 : MVA... drunk guy, hit tree that jumped into the middle of the road.

                      call 3 : Gunshot abdo and pelvis. point blank range with a 9mm. The ambo crew had done a pretty good job, when we arrived, so I just drove with them to hospital, incase the pt crashed, but actually didnt do anything, except put on an ECG and pulse ox.

                      call 4 : this wasnt really a call.... I had just dropped the above mention patient at a really bad hospital... and I was sitting in the response car having a break... when a taxi drives up to the entrance, and about 10 guys, all fairly drunk, attempt to pull a very dead looking guy out the back... ( i really wanted to just look the other way, because I had just lit up )... but alas, I went to help. Initially It looked like he had been stabbed in his chest, and beaten up fairly badly around the head, So we got him into the resus room, the only doctor ( who was still trying to sort the gunshot patient out, just couldnt help us... so we continued treatment )...

                      He didnt have a patent airway, far from it actually, so I asked the doc if he wanted us to intubate him... " yes, thanks.... but can you use your laryngoscope, because we dont have one that works... "

                      And we dont have any ventilators, so if you tube, you will have to bag him.... prehaps just leave him lateral ( we thought that was a bad idea ).... the pateint needed to be sedated, and the doc came and gave a 10mg IVI slam of dormicum, then wondered why the patient stopped breathing....

                      But anyway... he then went to the X-ray department... and I thought that was my queue to leave ! which I did, it was 4am... and definitly time for a nap.

                      I really feel for this Doc... he had an ER filled to the brim with bleeding screaming patients... and he was the only Doc there... If i was him... I would have cracked. But hat off to him, he did a magic job, with the resources available. Its hard for me to describe to people in a 1st world country the state of our provincial hospital... but trust me when I say... you wouldnt want to end up there !

                      we had another mva call, but were cancelled on route, because there was no serious injuries.



                      Date Posted: Sun Oct 29, 2006 3:43 PM
                      Posted By: bgrondahl (Junior Forum Member)

                      Clutzycowgirl...you and I work on the same EMS squad...cool, huh. Well, at least I am pretty sure. Anyway, those are some pretty cool calls, and yes SLEMS is a pretty fun place to work. You would be relieving me tonight, but you switched shifts. Anyway, on to the calls.
                      I am not done with my 40 hours yet, so I am probably going to "jinx" myself.
                      Call #1--called to PD for 21 yo male inmate/patient involved in an assualt, punched in the face, 3 cm laceration below left eye. Pt. very intoxicated, ok, pt. smelled heavily of ETOH and showed signs of intoxication. Cleaned up eye with saline, H2O2, told patient he needed stiches. Ruled out head injury, C-spine. Pt. informed me he would like me to be his boyfriend...OK, but no thanks.
                      Call #2--Severe asthma, pt. unable to speak, audible wheezing, taken rescue inhaler of albuterol X 5, with at-home neb X 4. Gave pt. O2, loaded, left, started .085% albuterol neb enroute, epi injection. Pt. started to recover.
                      Call #3--Severe asthma, pt. is located 30 miles from our base, in the middle of nowhere. Directions from dispatch were crap. 38 minutes later we arrived. Found 78 pt. on bedroom floor, alert, good perfusion, audible wheezes. First-responder claimed to have lost the pulse, and had performed CPR with chest compressions and assisted ventilation for approx. 9 minutes with a sporatic return of pulse and breathing...yeah, ok. Gave neb treatment, pt. talking well, no epi this time. Monitored heart on cardiac monitor, NSR to a 1st degree block. Hx/o everything...hypertension, diabetes, high cholesterol, COPD. Gave O2 with care.
                      Call #4--22 yo female pt., fell while walking down stairs, thinks she twisted her knee. No deformity, no swelling, pt. stable and not in much pain. Able to move leg, etc. Called CHR--no answer (what else is new) Called CHR manager, CHR called back in 2 minutes, transport with CHR...I think.
                      Call #5---Possible house fire, was really grass on fire around house, cancelled

                      That's it for now, but still about 12 hours to go...we'll see what happens!

                      P.S. Clutzycowgirl...on the issue of ALS...in our area, it sucks. Although it would be ideal to have an ALS provider on some, ok well most, of the calls, it isn't going to happen. I have learned to only call the ALS intercept when in dire straights, ie a code, major trauma., MI when transporting a long distance. They are nice to have around for the extra set of hands, and once in a while the meds. I hesitate calling other times and think I have only utilized their services 3 times in the last year and a half. So, I am thinking that you too will probably not be using them much anymore after another experience like the one you described above. Plus, they meet us on the road and putz around for about 15 minutes, by which time you would have the pt. in the ER being treated by the doc (in the perfect world anyway). But, use your best judgement, usually if you call they will come.

                       10/29/2006 15:52:32|U



                      Date Posted: Sun Oct 29, 2006 6:03 PM
                      Posted By: ALTAZANSW (Junior Forum Member)

                      Here's my last 12 Hours:


                      On Duty: 1830

                      1832- 17 y/o f with Worst headache ever for 2 weeks and couldn't hear. Funny, could hear evertything we were saying......Vitals WNL, CBG ok, EKG ok. Straight to Triage

                      2300- MVA T-bone, 20 y/o f wanted Eval, No Haul

                      0200- 80 y/o f w/resp distress......MDT keeps popping up with "Pt wheezing", "may need to be intubated". Pt sitting bolt upright on edge of bed w/some kind of stridor in the throat and moving no air, but 100% on SP02.....HX of CHF, COPD, IDDM, HTN. Family says last time this happened she had to be tubed, 2+ edema, hypertensive.......Nebbed 1 Albuterol, opened her up enough to hear the rales and get her the "CHF Cocktail" - Lasix, NTG Spray, NTG Paste, Morphine. We got a line in her last good vein....She almost got an EJ or adult IO......Code 3 to the hospital.

                      0330- Asthma attack going on since noon, out of her meds, audible wheezes, got 2 albuterol en route

                      0430- New parent syndrome: 5 day old "breathing too fast", baby was asleep and apparently dreaming

                      0630- off duty- Not HARDLY. 21 y/o w/ chest pain at PD Precinct. 10-22 upon arrival, pt going with LEO.

                      0700-Finally OFF

                      Now, in the midlle of all this, we were doing laps around the city to standby posts, we were short a truck and our Supervisors that usually run the Sprint suburbans were off! Didn't see the station until about 0400!

                      Almost time for another 12!!!



                      Date Posted: Sun Oct 29, 2006 11:31 PM
                      Posted By: greshmedic (Veteran Villager)

                      Quote

                      we had another mva call, but were cancelled on route, because there was no serious injuries.


                      Judging by the calls you get VH "no serious injuries" in SA probably relates to multiple trauma in my neck of the woods.

                      -------------------------
                      Before the war on terror, if I saw an unnatended package I used to think "I'll be having that!"



                      Date Posted: Mon Oct 30, 2006 7:52 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Ah sorry gresh... let me rephrase " no serious injuries " to...

                      " the ambulance crews didnt sh!t themselves when they got on scene.... "

                      VH



                      Date Posted: Mon Oct 30, 2006 12:29 PM
                      Posted By: jsadin (Veteran Villager)


                      My 16hrs went something like this:

                      22:00 - punch in
                      Sleep
                      01:30 - diabetic gone way low. D-50, sandwich, OJ, back to stn w/refusal of transport.
                      Sleep
                      06:45 - PD calls to see if we want breakfast
                      07:00 - breakfast w/PD
                      10:00 - call dispatch at state PD and see if they want coffee
                      10:30 - have coffee w/dispatch
                      13:00 - back to stn
                      14:00 - punch out

                      There's something to be said about working in a rural system.


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Oct 31, 2006 2:24 AM
                      Posted By: phunkymedic (Senior Forum Member)

                      There's something to be said about working in a rural system.

                      Ugh! Been there.. done that.. got the fuggin' t-shirt.

                      No thanks

                      -------------------------
                      " You have to keep the body going until the brain and heart recover enough to go on their own. "



                      Date Posted: Tue Oct 31, 2006 10:21 AM
                      Posted By: jsadin (Veteran Villager)


                      I dunno, I've done the busy metro system and the rural. If you work for a GOOD metro system, I can see the attraction, but work for a bad one and it brings suck to a new level. I rather enjoy the leisurely pace of my little towns.

                      Most medics I speak with that worked high volume systems for more than 5 years are complaining of burn out. Would you feel that's generally the case or no?



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Oct 31, 2006 11:37 PM
                      Posted By: phunkymedic (Senior Forum Member)

                      Most medics I speak with that worked high volume systems for more than 5 years are complaining of burn out. Would you feel that's generally the case or no?

                      Well... that's a double edged sword.. I mean. I can see if you run 8-13 calls on day on a 16 hour shift for 5 years it's going to get super old, super fast...

                      As opposed to the 4-5 in a busy rural system. Though if you do anything for 5 years you're going to be down in the mouth about it at the end of the 5th cycle.

                      The thing I can tell you, from personal opinion/experience..the big difference is this:

                      In a rural system you see more in depth patient care than you do in a metro system. You have that critical patient in the back for 30+ minutes on the way to the hospital. You also see more things the City doesn't see.. like auger accidents and other farm emergencies.

                      In a metro system you have a higher call volume and you're constantly on the move. Stationed in your ambulance. My first three rides in the metro system I saw more shock/OD's/violent incidents than my first two years in the rural system.

                      What I like better about the metro system is you get to fine tune your skills. Sure you have that patient for 10-20 minutes tops, but you have -more- patients and let's face it..you can pick your schedule from a mixture of 8, 12, 16, or 24 hour shifts..you get to fine tune your skills. I don't know.

                      I've worked the rural system that in a 24 hour shift we never turned lights and sirens once. I mean.. the ambulance was in the bay the entire time.. except on trips to the store.

                      After a year or two of metro I may get burnt out and wish I was back on the quiet rural system.. we'll see.. but for now, I'm enjoying the change of pace. I think we all need it now and then.

                      -------------------------
                      " You have to keep the body going until the brain and heart recover enough to go on their own. "



                      Date Posted: Wed Nov 01, 2006 1:10 PM
                      Posted By: jsadin (Veteran Villager)

                      Hi Phunky,

                      I understand what you're saying. There are shifts where I don't see a patient and sometimes that can be a boring day (one big reason I didn't go for my medic...not enough patient contact to keep the skills up to snuff). You absolutely see more patients in the metro systems and I agree that your skills can become razor sharp after just a short time due to the increased pt contact. I did my ride time for my intermediate in a system that logs around 20,000 calls per year with 5 trucks. Most medics that had been there any length of time were complaining of burn out with a few planning to leave EMS all together within a year or two. A typical 8hr shift had at least 5 calls with no chance for sleep during the night hours. I worked a 24hr shift with them once and ended up running 16 calls: not feeling so fresh by the end of that one. I can't imagine keeping that pace up every day.

                      In the end, to each his own. I'm 38yrs old and working 7 days a week...I'd probably crack in a high volume system. I don't need an extended stay in the rubber room.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Nov 01, 2006 4:48 PM
                      Posted By: NSMEDIC (Senior Forum Member)

                      Had a symptomatic VT patient yesterday. Weak, nausea/vomiting, SOB.

                      65mg Lidocaine later, felt much better and back to her normal a-fib @ 74bpm.

                      First tachy call I've ever been able to treat.

                      -------------------------
                      despite the rising cost of living, it remains very popular.



                      Date Posted: Wed Nov 01, 2006 7:28 PM
                      Posted By: jsadin (Veteran Villager)


                      Strong work NS....



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Nov 01, 2006 8:55 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Hey jsadin!! LOL...don't knock my rubber room until you've tried it!!
                      Ya gotta love all the "alone" time you get to spend with yourself....gives me time to crack the old "Brady" book once a week and "brush up" on my skills....

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Thu Nov 02, 2006 12:29 PM
                      Posted By: jsadin (Veteran Villager)


                      Too funny clutzy. I do review stuff when I'm just hanging out, plus I'll sometimes cannulate a couple of veins just for fun. It iggs one of my partners out when I walk up to her with three or four 22ga caths hanging out of my forearms...



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Nov 03, 2006 4:52 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      I only had 2 patients last shift which were my own. I was called in to work.

                      1. Atrial fib with controlled ventricular response. BP 100 systolic and patient shows no symptoms. Did a TEE to check for blood clots in the heart and never cardioverted. He was placed on a beta blocker instead to help control the ventricular response.

                      2. Atrial fib with rapid ventricular response. Pt symptomatic. TEE to check for clots and then cardioversion at 150 joules after amiodarone bolus and gtt initiated. Pt converted to NSR and then stayed that way. Left on the amio gtt for 1 hour and sent home with perscription for amio oral dosages.

                      Then home. I was in at 1130 and out by 1630.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Nov 05, 2006 12:31 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Hey Grambo.

                      Can I ask a dumb question....

                      What tests and scans do you use to test for clots ? and with the first patient you mentioned, did the beta blockers help with the atrial fib ?

                      And with the second pateint, if he keeps reverting back to Atrail fib, what is the next line of treatment before you operate ??



                      Date Posted: Sun Nov 05, 2006 12:49 AM
                      Posted By: VanHelsing (Veteran Villager)

                      well, I worked a 24 hours shift ( stupid me ), Friday night was at a private service.... and we had a quiet night...

                      call 1: woman vomitted, fainted, and called us. ( her BP was 80/40, HR 72, Hx of Hiatus hernia and hypotension.... daughter said she had bood dripping out her right eye.... )

                      call 2: MVA, cancelled on route by ambo, no serious injuries.

                      call 3: PVA, cancelled on route, another ambo and ALS already on scene.

                      call 4: Stabbed head.

                      call 5: MVA, This was an interesting scene... a oil tanker type truck veered off the highway, just before a bridge ( under highway ), and managed to go down the embankment, jump over 6 massive water mains piping, drive across the road , up the other side, and hit a tree.... a big tree. Besides the shock, he also had a massive swelling over his lumbar spine, which looked darn painful, but he was moving all extremities and Im guessing he has a number of compression fractures from looking at the mechanism of injury.
                      --------------------------

                      Then I went to work day shift at the government service...

                      call 1: Ambo called for back up, for a patient that was continuously fitting... however, we somehow missed them, and they got to hospital before we met up.

                      call 2: Chest pain ! I havent done one of those for ages ! classic Angina.

                      call 3: Gunshot. In calf, our femur, in humurus, lodged in shoulder. One bullet, 9mm at close range.

                      call 4: Stabbed chest

                      call 5: Stabbed back

                      Call 4 and 5 were from the same fight....










                      Date Posted: Mon Nov 06, 2006 9:18 PM
                      Posted By: jsadin (Veteran Villager)


                      I always feel slightly inadequate when replying after VH; nothing quite compares to a shift in SA.


                      11pm - evaluate family for carbon monoxide exposure.

                      3am - domestic assault involving 21y/o female, 27weeks pregnant (high risk).

                      11am - 23 y/o female thrown from horse. Perseverating during transport.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Nov 07, 2006 3:52 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Nothing dumb about those questions VH. Here are some answers.

                      To check for clots we use a TEE (transesophageal echocardiogram). In short we do an outpatient procedure in the ICU. We lay them on their left side, place a nasal cannula on them at 6L. Next I sedate them with fentanyl and versed. Then the Internal Medicine Specialist passes an ultrasound probe down the esophagus to the level of the heart and looks at the heart from as many angles as possible. Close attention is paid to the atria... specifically the R atria as clots are more common there. A regular echo (done externally over the chest) is generally not diagnostic for clots. They are generally released within an hour or two of the procedure.

                      If the person keeps going back into a-fib, we try managing them medically. Generally, we use beta-blockers to control the rate and they seem to have a good effect on keeping A-fib from returning. Next, we go a step further and give them an anti-arrhythmic such as amiodarone. We may load them with amiodarone before cardioversion and then shock them. They can then be placed on oral amiodarone (cordarone). This also has a good success rate.

                      Finally, if nothing else works, we send them to another facility (larger hospital than what we have) and they can do EP (electrophysiology) studies on the heart and do ablation via cardiac catheterization. In the worst case scenerio the patient's atria is enlarged (hypertrophied) too far for meds to handle things, and a heart transplant is needed.

                      Hopefully that answers your questions.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Fri Nov 10, 2006 8:05 PM
                      Posted By: NSMEDIC (Senior Forum Member)

                      Dispatched for 86 year old female not feeling good.

                      On arrival 86 year old female not looking good either. Grey/cyanotic, cool, dry and breathing appears a little extra effort is needed, but just a bit. Patient states she feels fine at present.

                      Family was concerned because she had been throwing up (was just getting the green bile cleaned off her as we arrived) and due to pre-existing back pain is unable to make it to bathroom.

                      She was switched from Atenolol to Tiazac 2 days ago, is being treated with a sulfa for kidney infection, and had a recent pneumonia.

                      At arrival patient states no symptoms. Legs their normal size (double what they should be) scattered crackles throughout both lungs while patient supine (heard primarily end inspiratory).

                      Vitals BP 110/70, SpO2 98% room air, RR 20 and a HR of ...... 30!

                      O2 nasal cannula (SpO2 up to 100% and colour much better) and a lock put in (cause a line would have been lost getting out of that place). Pt stood and turned onto stairchair with assist, and again to go from chair to stretcher. HR 60 during transport, no other changes. We get to ER and her rate is back down to 30, until the Dr. went in to see her. 6 seconds of asystole! - she got a little sleepy. That's all.

                      -------------------------
                      despite the rising cost of living, it remains very popular.



                      Date Posted: Sat Nov 11, 2006 7:04 PM
                      Posted By: jsadin (Veteran Villager)


                      Had a patient like that once...baseline HR under 40bpm all the time. CAOX3, but it did give me pause in the back of the truck.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Nov 11, 2006 8:37 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Finally getting a couple days off from my paid EMS job I took over the pager for a fellow EMT here in a small town, ND.....mistake #1

                      0113--paged to a local residence for a youth unconscious and barely breathing- dangit I HATE calls like that. Enroute I'm thinking ETOH-buddies-party-alcohol poisoning...arrive on scene and it's a 14 or 15 yr old female who is cyanotic, is lying in vomit and currently breathing at approximately 6 breaths per minute with a HR in the middle to upper 40's.
                      Don't get me wrong here, I'm not being arrogant, but I know the family, and their lifestyle (they are a close knit family that is often seen together dining out or shopping) and honestly did not think drugs immediately....

                      As we were packaging said pt up and ripping open BVM masks, etc. the officer that was there with us got another page for a teenager at another residence in the same town that is extremely agitated, very confused and unmanageable at this time and the parents are requesting EMS and Law Enforcement....since we are the only rig in town the volunteer service from the next over is paged to respond....

                      I alerted ALS to meet us enroute....as they were piling into our rig they got a call from the other ambulance hoping to intercept with them because when they got on scene the 'agitated' pt was unconcious and in the same condition as my pt....they were then told to turn around and head for another hospital 45 miles east of here and intercept with their ALS unit....

                      By the time the night was over we had the first two pt's as described above, another male that wasn't as bad as the girls and a final girl that was air lifted out to Fargo....

                      And THAT boys and girls was my introduction to "Georgia Homeboy"....it sucked and scared the living bejeebers out of me and I pray to heck the cops figure out who either made it or bought it....before someone around here dies.

                      According to Doc's...there isn't much they can do with the pt's?!? They just have to support them until the drug runs out of the system?? This true??





                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Sat Nov 11, 2006 8:52 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Georgia Homeboy, eh? That's a new name for me. What is it? Hard to guess based on the limited patient info available.

                      Care to share?

                      -be safe.

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Sat Nov 11, 2006 9:16 PM
                      Posted By: jsadin (Veteran Villager)


                      Georgia Homeboy = GHB

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Nov 11, 2006 11:32 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Quote

                      Originally posted by: jsadin
                      Georgia Homeboy = GHB


                      That's almost so glaringly obvious I'm kind of embarassed I didn't pick up on it.

                      Duh!

                      -be safe.

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Sat Nov 11, 2006 11:42 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Two yesterday. Two today. But today's don't really count. While they were transported they didn't amount to much.

                      Yesterday #1: motorcycle vs car. ejected over the car, across four lanes of traffic, landed on the curb. No LOC. Took of his own helmet. Turns out with only minor injuries. I suggested he play the lottery.

                      Yesterday #2: Aluminum baseball bat versus skull. Baseball bat = 1 (unless you want to count each individual fracture). Skull = 0.

                      -be safe.

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau

                       11/11/2006 23:43:17|U



                      Date Posted: Sun Nov 12, 2006 12:24 AM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      At least Georgia Homeboy is what Law Enforcement has related to us that was admitted to....they are thinking that it also could have been something that one of the kids "cooked" up in his little hothouse since he was a known meth addict...the final decision I guess remains to be brought to light as to what it is....but then I've been sleepin *gasp* most of the day trying to catch up....Have any of you worked with ppl who have overdosed on this before? And...what was the final outcome? It's kind of devestated this small town in a way....and I don't know a damn thing about it....


                      Well after doing some research on the net about this stuff...I found a webpage that described almost the same scenario except the pt were older and they were at a "rave" party? Now I have to admit my naivety...what's a rave party??

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       11/12/2006 15:00:37|U



                      Date Posted: Mon Nov 13, 2006 2:30 PM
                      Posted By: bgrondahl (Junior Forum Member)

                      Clutzy,
                      GHB (I don't know much about it) is one of the "date-rape" drugs. It is a CNS depressant, and can be pretty dangerous when mixed with alcohol. I didn't realize that people actually used it as a recreational drug, but apparently it has effects that are not unlike ecstasy (one of its nicknames is liquid ecstasy). Check out this link for more info: GHB http://www.emedicine.com/emerg/topic848.htm. As for a rave, it is generally a dance party that lasts pretty much all night into the early morning. It doesn't have to, but the party usually involves drug use, mostly ecstasy (which is often sucked out of balloons like helium). Sexual promiscuity is also pretty common place. There is a good WikiPedia article on raves at rave party.
                      Anyway, onto the calls for the latest 40 hours:
                      Call 1) Man acting bizarre. Arrived to find a 46 yo male pt. that was very confused, disoriented. Hx/o renal failure with dialysis X3. Wife stated that he had been given a drug the previous day with complication of dialysis (most likely coumadin to keep blood from clotting.) Nurse had told wife to watch for confusion, diziness and to take him into the ER if this occured. Well, it did, and this guy was very confused and not cooperative. In fact, he wasn't even comprehensible and did not reply to any questions or commands. He was "coaxed" onto cot and into ambulance. No hx/o diabetes. Started IV, gave O2 via NC. Anyone know what was going on with this guy?
                      Call 2) Fire Standbye for a housefire. Turned out that we had one patient severely burned, 20% partial thickness burns to face, both arms, back, and left foot. Inhalation burns were possible. This was a load and go, irrigated burns with NS, wrapped in Kerlix, covered in burn sheet, IV in foot. Pt. was later airlifted to burn center after RSI in the ER.
                      Call 3) Another pt. from house fire, smoke inhalation.
                      A 3 yo female died in this housefire, it was quite a shame. Cargivers were having a party, house started on fire. When we got there the house was completely engulfed in flames, and it was thought that 2 children were in the house. When the fire was out, one little girl was found. You never get the images of burns and dead children out of your head. Anyway, keep that family in your thoughts.
                      Call 4) Call to the local jail for an inmate with stomach pains and hx/o ulcers. No transport, told the pt. to take antacid.
                      Call 5.) 7 month old that was coughing...yeah, she has a cold. Already seen by ER today, given some drugs that she probably didn't need, and now an ambulance. Well, she was coughing up some mucous, but there wasn't anything wrong with the kid. Parents convinced that she was dying, because when she was laid down on her back she would cough. Advised parents that this was normal and to keep the 7mo from lying on her back, follow up with family doctor. No transport.
                      That was it, pretty quiet weekend, but one crappy call can do you in.

                       11/13/2006 14:44:31|U



                      Date Posted: Mon Nov 13, 2006 3:18 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Aww crap Brian...sorry to hear about the fire and the little one. Will be keeping the family and "our" crew in my thoughts and prayers...sometimes our crew has just as hard a time with those deaths as the family...take care...and thanks for the info on the "rave"..sounds like all the kids are going to be fine, except maybe the one that bought it..he might be doing some time soon...hope they all learned...

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Tue Nov 14, 2006 1:40 AM
                      Posted By: phunkymedic (Senior Forum Member)

                      Anyone know what was going on with this guy?

                      Bgr,

                      Sounds like something we saw here. The guy had been to dialysis and was fine, then started talking out of his head. The wife called for us. He was digging at his arms when we got there and the concensus was that he had somehow recieved an overdose of Heparin and was given a slow protamine infusion to counter the effects.

                      Check into that.. see if that's what it was, maybe? Just a guess..

                      You never get the images of burns and dead children out of your head. Anyway, keep that family in your thoughts.

                      That seriously sucks. I'll keep them and you in the thoughts and prayers. Take it easy.. and be safe.

                      -------------------------
                      " You have to keep the body going until the brain and heart recover enough to go on their own. "



                      Date Posted: Tue Nov 14, 2006 12:28 PM
                      Posted By: jsadin (Veteran Villager)


                      10pm Sat - Transfer

                      1:55am Sun - MVA w/PI w/entrapment. Arrive on scene to find 50 y/o male, ETOH (could smell him at 20ft) who decided to park his Chevy S-10 in an oak tree. That oh-so-familiar story followed ("I had 2 beers and swerved to avoid a deer"). Significant damage to vehicle, head size hole through windshield. Full c-spine, O2, thorough survey and then some hi-flow diesel to the trauma center. Swung back by the trauma room just as they were inserting the foley. Mildly amused as both the patients legs went straight up in the air when they started shoving that sucka in.

                      9am - MVA no PI. Refusal.

                      10am Sun - 69 y/o female w/swollen eye, not feeling well for 2 days. Missed the line, my partner got it on the other side. I hate him sometimes.




                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Nov 17, 2006 1:32 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      On my volley squad last night we had a two vehicle MVA...evidently a Mario Andretti wannabee was traveling west bound in his F250 at speeds over posted limit on glare ice...commenced to lose control, rolled it twice crossing the meridian and collided head on with a Tahoe going eastbound.
                      I gotta claim that besides the seatbelts both these drivers had Angels sitting on their shoulders!!
                      By the time the ambulance arrived the driver of the pickup was out and walking around--this being a small community, we had plenty of EMT's on scene as hearing the tone that it was a two vehicle accident with extrication, a car full of EMT's followed the rig to the wreck. (I know this would be frowned upon in larger areas, but I'm glad it happened that way last night because we needed everyone who showed up) Three EMT's did a standing take-down with the driver that was walking around while another EMT and I slide thru the glass and engine parts on the Tahoe and began treating the driver....thankfully the point of impact was on the passenger side which was not occupied!!
                      Jaws of Life, KED, LSB and the Tahoe driver is now ready for transport.
                      End report was that both suffered concusions and ended up spending a night in the hospital but both walked out under their own power this morning. From the looks of the two vehicles...you would automatically wonder how many people died...gotta say sumpin for air bags and seatbelts...had this happened on the reservation I work at I think it would have been a totally different story because only about one out of fifty people use seatbelts out there....



                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       11/17/2006 13:33:04|U



                      Date Posted: Fri Nov 17, 2006 2:34 PM
                      Posted By: jsadin (Veteran Villager)


                      Nice of you to show up clutzy, but since you're not a medic you OBVIOUSLY couldn't have done anything beneficial for the patient besides offer them some conversation until a real EMS unit (medics) arrived.





                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Nov 17, 2006 3:44 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      LMAO...but I WAS "lead basic"...so I got to sit and visit with her while all the other "drivers" just stood around nervously munching on their banana's and drinking cappacino....LMAO...

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       11/17/2006 15:46:58|U



                      Date Posted: Fri Nov 17, 2006 9:43 PM
                      Posted By: jsadin (Veteran Villager)

                      Since you were lead "driver" I guess that does give you a smidge of legitimacy on scene. At least you can keep all those other plebeians from hurting the patient and making matters worse. All those first aid cards in one spot is just a recipe for disaster ya know....



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum

                       11/17/2006 21:45:08|U



                      Date Posted: Fri Nov 17, 2006 9:55 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      LMFAO...I'm gonna go get my "driver patch" engraved in gold tomorrow.....

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Fri Nov 17, 2006 10:56 PM
                      Posted By: BushyFromOz (Veteran Villager)

                      Are you two trying to upset other people

                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk



                      Date Posted: Sat Nov 18, 2006 10:42 AM
                      Posted By: jsadin (Veteran Villager)


                      I'm sure I have no idea what you're talking about....



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Nov 18, 2006 3:34 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      **scratches her armpits and looks innocent** Who me? My great Ape George told me the only way to relieve stress is to laugh about it....

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       11/18/2006 15:35:45|U



                      Date Posted: Sat Nov 18, 2006 4:15 PM
                      Posted By: BushyFromOz (Veteran Villager)



                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk

                       11/18/2006 16:16:35|U



                      Date Posted: Sun Nov 19, 2006 8:35 PM
                      Posted By: phunkymedic (Senior Forum Member)

                      Pfffffffffffffffft



                      -------------------------
                      " You have to keep the body going until the brain and heart recover enough to go on their own. "



                      Date Posted: Sun Nov 19, 2006 9:10 PM
                      Posted By: jsadin (Veteran Villager)


                      16hr shift...no calls! I needed the rest (and to harass dispatch)...




                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Nov 20, 2006 2:29 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      My pt today.....

                      50's yo male. Respiratory failure and dilational heart failure.
                      Pneumonia present
                      ?PE
                      ?Pulmonary infarction
                      ?CHF
                      BP MAX 214/114
                      On pressure control ventilation. Pressure control of 18, PEEP 15, PIP 33, VT 600cc+, FiO2 60% Rate 20

                      Versed 20mg/h gtt
                      Pavulon 8mg q2h after a 10mg Versed bolus if needed
                      On antibiotics, steroids, antihypertensives
                      Agitated on 20mg/h of versed... paralyzed twice and given 100mcg of fentanyl twice during shift.



                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Mon Nov 20, 2006 3:10 AM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Wow Gram! No stress there huh??

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Mon Nov 20, 2006 3:32 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Actually... it wasn't that bad. He was one of the easier vents to deal with.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Fri Nov 24, 2006 4:29 AM
                      Posted By: DartmouthDave (Junior Forum Member)

                      Hello,


                      Hey, Grambograham I have a question for you.

                      In PC mode the pressure is the end point for the vent? As opposed to a tidal volume? So, the PC of 14 would be an end point of 14cm H20 (and whatever the tidal volume you could get)????? I haven't used pressure control too much. Either it's AC (CMV, SMIV et al....) and keep them snowed or pressure support ventilation on certain occassions.


                      My second question is about the Versed drip. Have you ran Versed in the 20mg/hr range often?? The few places I have been never really had Versed beyond 0-5mg/hr or 0-7.5mg/hr.


                      Just wondering out of persoanl interest. It is interesting to see different approaches to things.


                      My calls,

                      Call 1: A stressful drive down an icy wind swept winter wasteland to pick up an ABD pain patient. I felt the back of the ambulance drifting around a little. Even with the studded tires. No fun at all.

                      Call 2: A young girl found wandering along a highway (same road as above)in ludicrously cold weather after fleeing from the home of older men (dirt bags) who gave her ETOH, Crack and wanted lots of favors. =(

                      Call 3: Pt. fell and had trouble standing due to ETOH. Off to the cells my friend.

                      David



                      -------------------------
                      David
                      Whitehorse, Yukon



                      Date Posted: Fri Nov 24, 2006 10:56 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      We don't usually see Versed running at 20mg/h. I have seen it on 2 patients only.

                      PC means that the ventilation is always at a given pressure. Volume varies with compliance as a set pressure is given. The less compliant the lung, the less volume will be given. This mode will generally only be used in the case where a pneumo is a real risk.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sat Nov 25, 2006 3:07 AM
                      Posted By: VanHelsing (Veteran Villager)

                      This was wednesday night shift... came in and before I actually got out my car, i got my first call.... then you know its going to be a long shift...

                      #1: Transfer cardiac patient to another government hospital ( medical aid ran out )... stable patient except for the 6 infusions that were up.



                      #2: called for an assault... get ther to find a guy that is sooooo drunk he is border-line comatose, and yes, he was in a fight.... vomiting up lots of lovely stuff, and rather swollen eye. And generally being really obnoxious, swearing at me, kicking the ambulance roof, while lying on the stretcher etc.... So we take him to a private hospital ( because his friend swears he definitly has a medical aid, but the guy has now passed out on our stretcher and will not answer any question with much logic.... )

                      So we off load him, still he wont wake up, but leave him there anyway, its about 20:45.... to be continued.

                      #3: Transfer paranoid schizophrenic with myocarditis from psych hospital to normal government hospital.

                      #4: Driving back to base, when a security guard waves us down.... apparently some guy has been stabbed.... so he takes us to this poor homeless guy that is covered in blood.... with 2 deep stab wounds to the right side of his back. ( interestingly his pulse was 48bpm )....

                      Anyway so after that call its just before midnight, im quite tired, hungry and really thirsty... and the dispatch center tells us, we need to go back to the private hospital where we dropped off the drunk, and transfer him to a government hospital because he still wont wake up, and the hospital will not treat him further....

                      So i am now REALLY irritated... this guy has wasted my time twice in one night... so all the way to the hospital Im imagining how im going to wake him up... throw water on him, scream, slap his face.... you know all the stuff that happens in movies....

                      So i get there, ready for a fight... the nurse says she has been trying to wake him up every 5 mins, with no luck, and points me to his cubical... in I go, and tap the guy on the shoulder, " EH, shaun... its time to wake up. " ANd lo and behold, he opens him eyes, sits up, and asks where he is. After a brief summary of the nights events, he is really appologetic, and greateful to everybody... and he actually turned out to be a really sweet chap. He then signed a hospital RHT and went home.

                      ah, the evils of alcohol.








                      Date Posted: Sun Nov 26, 2006 11:29 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Here is the admission that took 4 nurses, and 2 physicains to complete.

                      A septic lady (presumably abdominal) with a hx of bowel cancer. She arrives from another hospital and gets to our ER completely disoriented and confused. BP was 70/16. Started on 12mcg/min levophed and ICU was called. I go down to help transfer the lady up. She is on an NRB @ 10 and has SATS in the 95% range. She remembers her family's names (large family). She is pleasant and I recieve report and we bring the lady to the ICU. Her BP was 90 systolic.

                      The ER was unable to start and art line but got a CVC in the subclavian. We start a femoral art line on admission to ICU.

                      Her BP starts to decrease into the low 80s. We up the levo to 15mcg/min. We intubate using propofol 20mg, and Versed 2mg. Her BP drops to the 70's. We up the levo to 18mcg/min and start IV pushing phenylephrine to return her BP to the 80s. Her BP will not rise above 80's even when she starts to wake up. She is making urine so we don't push things. Her HR went from 120 prior to intubation to 110 after. Her pulses are palpable at the radius. Cap refill to the feet is <5 seconds.

                      Her initial labs showed a WBC count of 2 and then 6 when drawn in the ICU. She was slightly febrile She was a bit anemic and had thrombocytopenia. She kept us busy for 1.5 hours to stablilize her.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Dec 03, 2006 7:38 PM
                      Posted By: jsadin (Veteran Villager)


                      Sad one this morning. 54yr old male, CVA. He woke up at 9:30am~ not feeling well and went back to sleep. His wife found him sleeping on the couch at 10:30am and woke him to find him aphasic and unable to move his right side. We got the tones at a little before 11am. Quick eval on scene, line and vitals in the truck and then high flow diesel to the nearest stroke center (20min ride). Unfortunately, we were well beyond the thrombolytic point. Daughter rode up front with me and was very upset. The patient was "with it" except for the aphasia and cried when my partner wished him well when we left.

                      Those are the calls I remember.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Dec 03, 2006 7:55 PM
                      Posted By: oldfart (Senior Forum Member)

                      Watched the Cowboys beat the Giants............ Time well invested.



                      Date Posted: Sun Dec 03, 2006 9:11 PM
                      Posted By: ncmedic309 (Veteran Villager)

                      Calls for the day...

                      TO DAMN MANY!

                      I caught about 15 minutes of the Saints and whoever they were playing...



                      Date Posted: Tue Dec 05, 2006 5:39 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      A couple more patients.

                      22yo female post OD on oxycontin and one other. She crushed them and snorted. She is a mother of 2 daughters. BP sits around 200/100. HR 120, RR 24 on Pressure support via ventilator. She has been off of sedation for 48 hours with no improvement in mental status. She makes non-purposeful movements only and climbs all over the bed. Opens eyes to painful stimuli only and does not follow commands.

                      Male in his 50's. Had a pneumonia. Was shipped to us and he was intubated. Pressure in the 70s systolic. Pt required Dobutamine, Levophed, and vasopressin to maintain systolic above 100. Swan Ganz inserted. Chest x-ray shows edema, infiltrate and almost no clear lung. HR 120-140 per minute. RR controlled at low volume high rate as he is paralyzed. Started out on 100% oxygen with SpO2 in 60-70% range. Pt was bronched for large amount of bright red blood. Throughout night, pt SpO2 improved to 90% on 85% oxygen. Didn't think he was going to make the night... now it's a question of how much of him is left neurologically.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Wed Dec 06, 2006 12:20 PM
                      Posted By: RobbyEMT (Junior Forum Member)

                      Hello all, I know it's been a while since I've been in the village but I found a new site that has had most of my attention. I now am seeing a therapist for my poker obsession. Ha Ha, just kidding.

                      Thanksgiving day we has our anual call. Either we get a bad wreck our a code and this Thanksgiving was no different. I was at our substation washing my wifes' vehicle and just finished putting the bucket away, and (insert Squad 51 tones here) we get blown out for a women down, CPR in progress. The location was half mile from our station 2 and I was pulling our backup rig that has ILS equipment and an AED. I arrived on scene within two minutes and we had two persons on scene doing CPR. We got AED on and advised to shock. After one shock, nothing ---> continued CPR, initiated intubation and gained IV access. ---> We had our rig enroute with the meds wbut we had some time before they arrived, so we anaylized AED again ---> shocked advised "ALL CLEAR" ---> No pulse contiued CPR and our rig arrived (time elapsed 6 min) ---> Epi administered, arm raised, and pt hooked to LP 11 ---> Pt shown to be back in V-fib ---> third shock delivered, OH WAIT "ALL CLEAR: ---> Almost converted --> CPR continued --> pt given Lido 100mg --> CPR continued --> Epi #2 on board --> V-fib on monitor --> fourth shock @ 360 and HELLO PULSES. PT returned with BP of 122/60 and good perifferal pulses. She was discharging substantial amounts of emesis but airway was patent and protected. We suctioned esophogas and did some sterile suction of trachea. Lidocaine drip was hung and pt loaded. Transport went well and pt was showing signs of movement upon arrival to ER. (20 minuted transport)
                      Last report pt is leaving hospital and returned home walking on her own. The local fishwrap is doing an article and promoting the fast action of our volley company and the life we saved. The family in new in town and he son has applied to join the fire company. Who says stories don't have happy endings. NO applause just send money...Just kidding....all have safe and happy holidays. I won't ...I'm working both Xmas eve and day...same with New Years.

                      Rob
                      NYSEMT-P

                       12/06/2006 20:04:52|U



                      Date Posted: Wed Dec 06, 2006 12:33 PM
                      Posted By: jsadin (Veteran Villager)


                      Ah, the elusive "save"! Nice work.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Dec 06, 2006 6:56 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      I just hope he meant V-fib! Shocking A-fib at 360J and administering lido would be really bad for A-fib.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Wed Dec 06, 2006 8:01 PM
                      Posted By: RobbyEMT (Junior Forum Member)

                      OOOOOps, yeah sorry...it was V-fib.....daaahhh I edited it so it reads correctly. What wan't I thinking ??

                      Rob
                      NYSEMT-P

                       12/06/2006 20:05:42|U



                      Date Posted: Thu Dec 07, 2006 12:48 AM
                      Posted By: CBEMT (Senior Forum Member)

                      1) Pedi ICU transport with children's hospital team. 6 week old admitted to community hospital #1 with RSV. No improvement after several days in O2 mist tent. Cap refill 4-5 seconds on our arrival. Fluid bolus and 2lpm O2 got it down to 2-3 seconds enroute. Transferred to PICU.

                      2) Pedi ICU transport with children's hospital team. 8 month old new onset "grunting" at community hospital #2 ED. One of his lab values was high, I forget which. And yeah, he was grunting now and then too. Enroute the team was thinking medical floor admit, but onscene decided to play it safe and admit to PICU at least for the night.

                      3) Pedi ICU transport with children's hospital team. 5 week old (born at 30-something weeks and addicted to cocaine) brought to community hospital #1 ED by foster parents after several days with baby's (biological) relatives. Probable end of a run of RSV, transferred to medical floor.

                      4) 61 year old male at community hospital #3's ED being transferred to community hospital #4's cath lab for an inferior wall MI. Woke him out of a sound sleep, luckily for him (we got the call just after 5am). Walked into the ER, apparently. Sinus brady at 50 with First Degree block and elevations in II, III, F, with reciprocal changes. Integrelin bolus, Heparin at 1000/hour, also getting a major saline bolus (they bottomed his pressure to around 80 via NTG prior to calling us). Nurse with us for transport. Started complaining of more tightness walking down the hall towards the cath lab.



                      -------------------------
                      Village Geek



                      Date Posted: Thu Dec 07, 2006 10:44 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      CB,

                      Why did the nurse go with you? This patient does not sound like he needs nurse escort.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Thu Dec 07, 2006 12:37 PM
                      Posted By: jsadin (Veteran Villager)


                      If CB is a basic, he can't transport a running IV w/meds (at least that's the way it is in MA).



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Dec 07, 2006 6:02 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      So, I get a call yesterday to intercept a BLS unit bringing in a two year old female actively seizing. When we meet she is seizing only on her right side for the previous +/-30mins. Pupils were nonreactive to light, heart rate 170, O2 Sats 100% on room air BP 85/40. I started O2, pushed 6mg Diazepam rectally and began transport, (This is our only approved seizure med, midazolam is on its way) Established a 24 ga IV enroute to the hospital, no respone to the needle poke. Blood glucose was normal and I gave a generous GCS of 1-2-1.

                      Diazepam eventually reduced the seizure activity to a spasmodic clenching of her right fingers and GCS increased to 8 after about 15 minutes. Another 10 minutes she had a GCS of 15 but her right side was paralysed. history included a fall from a chair and hitting her head on the floor 24 hours previously, complaints of right side pain before nap time that afternoon, and found in bed actively seizing one hour after being put down for a nap.

                      She was infused with phenytoin before being transfered to a tertiary facility. All in all a decent call, I'll get a followup to the findings from the specialist and post them.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Fri Dec 08, 2006 12:07 AM
                      Posted By: DocHarris (Senior Forum Member)

                      One call today. Pulled me out of a round table discussion on Spinoza and Descartes too. (I was too stupid to book it off and probably fubar'ed my mark on that assignment. Nothing like leaving halfway through your own presentation)

                      Anyways, called to an MVA which is incredibly rare on our campus. Run over and see the car nice and imbedded into the embankment beside the road. Patient had only incredibly minor injuries, (i.e. a little sore and shaken, knuckle scratched, nothing else) but from the looks of the tire marks and the care she paniced and hit the gas during the skid. If it wasn't for the embankment catching her, she would have gone right into the building and taken out a full meeting room. A staff member called her mom to come get her and she just happened to be 2 blocks away. Then it turns out her uncle owns a garage in town and will cover the towing and repair of her car for her. Talk about lucky four times over. Could have been way worse.

                      - Matt

                      -------------------------
                      - Matt Harris
                      Primary Care Paramedic

                      "A sucking chest wound is nature's way of telling you to slow down."



                      Date Posted: Fri Dec 08, 2006 4:41 AM
                      Posted By: DRIVER609 (Senior Forum Member)

                      Quote

                      Originally posted by: DocHarris
                      One call today. Pulled me out of a round table discussion on Spinoza and Descartes too.

                      - Matt


                      Holy Dualism Batman! That is some heavy Ethics for an ambulance driver! I have enough trouble with the mechanism of my car, let alone thinking about heavy stuff like cogito ergo sum...

                      Ah forget it, it just isn't working.



                      Date Posted: Fri Dec 08, 2006 5:07 AM
                      Posted By: pkourkoulis (Senior Forum Member)

                      Rear end MVC. We transport the last patient. Complains of head, neck, back and left upper quadrant pain on palp. Big guy 250lbs (sorry gresh I don't know stones). Spinal the patient and transport restrained in handcuffs to the board (in custody due to ETOH). While in the back we tell the patient he needs an IV.

                      "I don't do needles man" repeatedly. Start crying.

                      Sir we need to start an IV incase your liver has been damaged.

                      "I told you I don't do needles man!" Starts bawling.

                      Patient is CAOx4 despite ETOH and is able to refuse his IV, so no IV attempted. When told that the hospital will start the IV, patient states "no they ain't" still bawling.

                      Oh, did I mention the patient has an elaborate tattoo from his shoulders to below his nipple line and is half sleeved on both arms.

                      Patient also states enroute that he doesn't do seatbelts or airbags either.

                      With all this, the thought runs through my head: "In the animal kingdom this guy would have been eaten a long time ago".

                      PK



                      Date Posted: Fri Dec 08, 2006 5:10 AM
                      Posted By: pkourkoulis (Senior Forum Member)

                      OOOPS! meant spleen.



                      Date Posted: Fri Dec 08, 2006 10:11 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Quote

                      Originally posted by: arctickat
                      So, I get a call yesterday to intercept a BLS unit bringing in a two year old female actively seizing. When we meet she is seizing only on her right side for the previous +/-30mins. Pupils were nonreactive to light, heart rate 170, O2 Sats 100% on room air BP 85/40. I started O2, pushed 6mg Diazepam rectally and began transport, (This is our only approved seizure med, midazolam is on its way) Established a 24 ga IV enroute to the hospital, no respone to the needle poke. Blood glucose was normal and I gave a generous GCS of 1-2-1.

                      Diazepam eventually reduced the seizure activity to a spasmodic clenching of her right fingers and GCS increased to 8 after about 15 minutes. Another 10 minutes she had a GCS of 15 but her right side was paralysed. history included a fall from a chair and hitting her head on the floor 24 hours previously, complaints of right side pain before nap time that afternoon, and found in bed actively seizing one hour after being put down for a nap.

                      She was infused with phenytoin before being transfered to a tertiary facility. All in all a decent call, I'll get a followup to the findings from the specialist and post them.


                      Sounds like a slow bleed to me. I'm thinking that this kid suffered a stroke.. the poor little girl. She probably will not run ever again. Why didn't the parents get her checked earlier... may have saved her brain. That is one of the risks of a concussion. Hopefully I'm wrong about this but somehow it seems right.


                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Fri Dec 08, 2006 10:34 AM
                      Posted By: Medic49 (Junior Forum Member)

                      1. 2300 hrs yesterday. Hunter lost on 25,000 acre ranch hasnt made evening check in. SAR Ops turn up a 350lb WM, with an unstable pelvis, hypothermia, and scratches and lacs from head to toe after crawling all night through mesquite and cactus

                      2. 0400 this morning. High speed rollover 32 miles north of our station. A Ford Escape with 14 mexicans inside in a high speed flight from the Border Patrol resulted in the vehicle yard saleing itself and all of them being ejected. 2 DOS, 4 critical flown by aeromed, 3 critical taken by two of our MICU trucks and the rest ran off to die in the woods.....

                      3. We just got back in from a 48 YOHF CO numbness while taking a shower, AAOSTF PT lying in bed responsive only to deep pain, right sided weakness and flaccidity, left pupil dilated and climbing and right pupil fixed. PT RSI'd and taken to the hosp....

                      B

                      -------------------------
                      B Hudgens NREMT-P
                      Director, KCEMS/Rescue



                      Date Posted: Fri Dec 08, 2006 12:08 PM
                      Posted By: AZCEP (Veteran Villager)

                      Quote

                      Originally posted by: grambograham
                      Quote

                      Originally posted by: arctickat
                      So, I get a call yesterday to intercept a BLS unit bringing in a two year old female actively seizing. When we meet she is seizing only on her right side for the previous +/-30mins. Pupils were nonreactive to light, heart rate 170, O2 Sats 100% on room air BP 85/40. I started O2, pushed 6mg Diazepam rectally and began transport, (This is our only approved seizure med, midazolam is on its way) Established a 24 ga IV enroute to the hospital, no respone to the needle poke. Blood glucose was normal and I gave a generous GCS of 1-2-1.

                      Diazepam eventually reduced the seizure activity to a spasmodic clenching of her right fingers and GCS increased to 8 after about 15 minutes. Another 10 minutes she had a GCS of 15 but her right side was paralysed. history included a fall from a chair and hitting her head on the floor 24 hours previously, complaints of right side pain before nap time that afternoon, and found in bed actively seizing one hour after being put down for a nap.

                      She was infused with phenytoin before being transfered to a tertiary facility. All in all a decent call, I'll get a followup to the findings from the specialist and post them.


                      Sounds like a slow bleed to me. I'm thinking that this kid suffered a stroke.. the poor little girl. She probably will not run ever again. Why didn't the parents get her checked earlier... may have saved her brain. That is one of the risks of a concussion. Hopefully I'm wrong about this but somehow it seems right.


                      Definitely sounds like a epidural bleed. Goes to show that kids don't always bounce like they are supposed to.


                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Fri Dec 08, 2006 12:10 PM
                      Posted By: jsadin (Veteran Villager)


                      Alright, I gotta ask. AAOSTF? Not familiar with that one....

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Dec 08, 2006 1:49 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: AZCEP
                      Quote

                      Originally posted by: grambograham

                      Sounds like a slow bleed to me. I'm thinking that this kid suffered a stroke.. the poor little girl. She probably will not run ever again. Why didn't the parents get her checked earlier... may have saved her brain. That is one of the risks of a concussion. Hopefully I'm wrong about this but somehow it seems right.


                      Definitely sounds like a epidural bleed. Goes to show that kids don't always bounce like they are supposed to.


                      Bzzzzt, both wrong, but I admit that was my thinking too. I talked to the doc today, kid is in PICU with repeated seizures following admission. MRI and CT scans indicate a heretofore unrecognised congenital cerebral anomaly that is resulting in aberations of the electrical motor impulses to her right side. Paralysis and seizures are the result. Neurosurgeons have yet to decide on a surgical or pharmaceutical treatment or why it chose to develop at this time. They think the fall might have exacerbated the situation that it would have eventually revealed itself anyways, or more likely she's just grown enough in size that it is starting to show up and the fall was a coincidence.

                      Poor kid indeed.



                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Fri Dec 08, 2006 2:06 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)


                      Have to admit when I first read the post I thought to myself, slow head bleed...dang, hopefully they will be able to treat succesfully....


                      I did a 24 hour fill in shift and we didn't turn a wheel!! That's a first for me since I transfered to this service! So, I put up the X-mas tree and spent most of the shift re-stocking rigs and bags and cleaning up the bay!! Kind of a nice break for a change!! I imagine it is all going to hit the fan in the morning when I head back in for my usual forty tho, the residents all got their community impact payments....oi....will be lots of partying and drinking going on so can expect the usual OD's, MVA's and domestics....

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Fri Dec 08, 2006 6:03 PM
                      Posted By: CBEMT (Senior Forum Member)

                      Quote

                      Originally posted by: grambograham
                      CB,

                      Why did the nurse go with you? This patient does not sound like he needs nurse escort.



                      Quote

                      If CB is a basic, he can't transport a running IV w/meds (at least that's the way it is in MA).



                      I'm not a Basic, but I'm not a medic either- Heparin is out of my scope, and medics aren't allowed to work the overnights. Not enough medic-required runs after midnight to justify their expense.

                      Either way, a lot of the community hospitals around here will send a nurse for ANYTHING.

                      When I was a basic, we transported a young child from a community ER to the children's hospital for an abdominal CT. Kid had a saline lock in place- that's it. Nurse was "required" to accompany the child by hospital policy. Hospital joke if you ask me.

                      Couple of weeks ago that same ER sent a nurse AND an RT with me for no other reason than the patient was tubed- apparently I'm not qualified to squeeze an ambu bag for 10 minutes.





                      -------------------------
                      Village Geek

                       12/08/2006 18:10:14|U



                      Date Posted: Fri Dec 08, 2006 7:12 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: CBEMT
                      Quote

                      Originally posted by: grambograham


                      When I was a basic, we transported a young child from a community ER to the children's hospital for an abdominal CT. Kid had a saline lock in place- that's it. Nurse was "required" to accompany the child by hospital policy. Hospital joke if you ask me.


                      Was it close to christmas? Maybe she needed the overtime.

                      Quote

                      Couple of weeks ago that same ER sent a nurse AND an RT with me for no other reason than the patient was tubed- apparently I'm not qualified to squeeze an ambu bag for 10 minutes.


                      Are you qualified to replace the tube if it becomes dislodged?

                      What happens if the patient fights the tube? Can you sedate?

                      Can you interpret the EtCO2 and SpO2 waveforms to discover a complication before it becomes a crisis?

                      If you can do these things then I agree, there was no need for them to accompany you.



                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Fri Dec 08, 2006 8:09 PM
                      Posted By: jsadin (Veteran Villager)


                      I think CB's point was that just one of the two folks that went with him would have sufficed.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Dec 08, 2006 9:17 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      My experiences are that nurses can't intubate and RTs can't sedate, so you need them both for the task.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sat Dec 09, 2006 12:14 AM
                      Posted By: CBEMT (Senior Forum Member)

                      Quote

                      Originally posted by: arctickat


                      Was it close to christmas? Maybe she needed the overtime.


                      Nope.

                      Quote

                      Are you qualified to replace the tube if it becomes dislodged?


                      Yes.

                      Quote

                      What happens if the patient fights the tube? Can you sedate?


                      Technically yes, but the company's too cheap to stock the optional meds except for the medic trucks. Neither the RN nor the RT were carrying any. Either way he had enough on board already to keep him from going anywhere for the 10-15 minutes he was going to be with me.


                      Quote

                      Can you interpret the EtCO2 and SpO2 waveforms to discover a complication before it becomes a crisis?


                      No formal training on ETCO2, but I've done a large amount of self-study on the topic. I feel that I could pick up something untoward going on.

                      Quote

                      If you can do these things then I agree, there was no need for them to accompany you.


                      Thank you.



                      -------------------------
                      Village Geek

                       12/09/2006 00:19:44|U



                      Date Posted: Sat Dec 09, 2006 1:27 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Yeah !!! successful resus today !!

                      I only had 3 calls today...

                      Call 1: pediatric with seizures, met ambulance on route to hospital... kid wasn't fitting by that time... just cooled her down.

                      Call 2: Fat lady, gcs 3/15... collapsed on the side of the road. ambulance crew, say her bp is 200/110, her blood glucose is 9mmol, HR 80.
                      Pt cold and clammy...hypoglycaemia looks promising, so recheck the HGT... and low and behold its 3mmol. So I couldnt get up a peripheral line, so sorry for her, she got a external jugular instead. and got 15g of dextrose, which woke her up quite nicely.

                      Call 3: Got dispatched to a small community clinic, newborn baby in cardiac arrest, CPR in progress.
                      Got there, PEA of about 20bpm, and obviously no breathing. kid, normal delivery, but got stuck in the birth canal with cord wrapped awround its neck twice apparently.

                      So I intubated him, shoved some adrenaline down the tube, put up an intra-osseous line, because exteranl jug blew... oopps, but after about an hour and a half, kiddy started attempting to breath on his own, HR 140.

                      So that was a nice, i'l check on him tomorrow and see if he is doing ok.

                      Long day !




                      Date Posted: Sat Dec 09, 2006 2:00 PM
                      Posted By: BushyFromOz (Veteran Villager)

                      hardcore VH

                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk



                      Date Posted: Sat Dec 09, 2006 2:58 PM
                      Posted By: jsadin (Veteran Villager)


                      Damn VH, yer gonna be bored if you come work in the states.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Dec 09, 2006 3:13 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)



                      Way to go VH!! Just what you needed for a lil "picker upper"....

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Sun Dec 10, 2006 12:07 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Nice resus VH, sounds from the skills you provide that you'd fit well into an ACP roll in Canada, but the culture shock would likely kill ya.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun Dec 10, 2006 10:29 AM
                      Posted By: AZCEP (Veteran Villager)

                      If the temperature difference didn't.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Sun Dec 10, 2006 11:16 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Chuckle, they had snow in SA last winter, she'll likely survive that. lol.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun Dec 10, 2006 12:31 PM
                      Posted By: VanHelsing (Veteran Villager)

                      ok...Not such a successful resus after all..

                      I worked again today... went to check up on the baby, and he died. Apparently was fine all night, with spontaneous breathing, and this morning P4'd. I doubt they even resus'd him, most likly they didnt notice that he wasn't breathing until he was in Asystole. ( its a really bad hospital )

                      So, that was crummy, so much for the pick-me-upper !

                      And to top it off, first call for the day, was to declare a 17year old boy dead from TB.

                      And the rest of the calls were " NO SERVICES ".

                      But I still enjoyed the day, was working with a really nice chap !



                      Date Posted: Sun Dec 10, 2006 3:01 PM
                      Posted By: BushyFromOz (Veteran Villager)

                      that sucks man, im sorry

                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk



                      Date Posted: Sun Dec 10, 2006 7:07 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Psssst, Bushy, VH isn't a "Man"

                      Sorry to hear VH, but it still does a body good to know that you at least got a return of a pulse that remained.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun Dec 10, 2006 11:00 PM
                      Posted By: CBEMT (Senior Forum Member)

                      Sorry to hear that VH. Focus on the fact that you gave the little tyke a fighting chance.

                      What happened after that was up to "a higher license."



                      -------------------------
                      Village Geek



                      Date Posted: Mon Dec 11, 2006 12:04 AM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      The most interesting one today was a chainsaw kickback into the left bicep. Tore the arm up nicely, so to speak.

                      -be safe

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Mon Dec 11, 2006 1:44 AM
                      Posted By: BushyFromOz (Veteran Villager)

                      Quote

                      Psssst, Bushy, VH isn't a "Man"


                      No Way!!

                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk



                      Date Posted: Mon Dec 11, 2006 8:36 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: BushyFromOz
                      Quote

                      Psssst, Bushy, VH isn't a "Man"


                      No Way!!


                      Chuckle, I dunno if that's sarcasm or sincere shock.



                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Mon Dec 11, 2006 12:18 PM
                      Posted By: jsadin (Veteran Villager)

                      Hard to tell with Bushy.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Dec 11, 2006 1:11 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)


                      VH~sorry to hear the lil one didn't survive a second code. Like CB said tho, "sometimes it's up to a higher license", and at least you gave the family time to say goodbye...that in itself sometimes is one of the greatest gifts we can give....chin up girl!



                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Mon Dec 11, 2006 2:20 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)



                      Well since I'm tired enough to fall off my compute chair I will make this as short and sweet as possible. I had a funny feeling about my shift before going in...and next time I will call in sick when I have that "funny" feeling!!
                      40 shift= 16 calls/contacts

                      1~0850~Dispatched to area casino. Patron with severe ETOH handicap was dropped by her friends on the way to the bathroom resulting in a little itty bit lac to her noggin. Which I'm sure she won't even notice in the morning when she wakes up with her head pounding like a raging bull in a china shop.

                      2~1000~Woman slipped on the ice and fell leaving Post Office. Appeared to be a fracture along with a dislocation....good thing she hadn't eaten yet....

                      3~1400~Dispatched to casino. Patron must have run out of ETOH and needed a ride to town, unable to keep eyes from focusing on me during a "seizure"....

                      ~4~1800~Standby at casino for yearly X-mas concert by Aaron Neville. Enjoyed a free buffet and a relaxing nap during concert.

                      ~5~2002~Paged out of concert to SOB patient at a bar twenty miles away but still within our boundaries. Walked in the front door in time to see pt placing half smoked ciggy back in the ashtray. Got greeted by very irate and very ETOH husband screaming at us that she was dying...told him she might want to put the ciggy out before she keeled over....

                      ~6~0046~Dispatched to pt down with severe bleeding from head....ever smelled what a slaughter plant smells like?? Had to choke back two gags...walls, floor, furniture covered in blood and blood clots....pt had tried to clean it up by soaking the mop in the sink and swirling the blood all over the floor, walls, self. Pt states she woke up and was all bloody so tried to clean it up when she realized she was still bleeding and called 911.

                      ~7~0310~Dispatched to casino for patron suffering from a severe case of "slotitis"..the inablitly to stand and walk immediately after arising from the chair that she had been sitting in playing the same game for the last twelve hours w/out eating or drinking anything....

                      ~8~0508~Geesh..off to the casino again. Real call this time, Pt had suffered a stroke after feeling "funny" for a few hours and denying something was wrong.

                      ~9~0730~ Severe overload of ETOH and possibly Narc's leading to unwitnessed death.

                      ~10~1005~Elderly pt fell and struck head on table. "Non-conscious" according to dispatch and possibly "Non-breathing". A similar scene to call #6 but with very critical elderly gentleman who looked like he had suffered from bootitis rather than a fall....ALS intercept.

                      ~11~1200~ ETOH impaired patient delivered to our front door suffering from a rather severe bunion....he had to find his own ride to town. I suggested walking, it might rub the bunion off....

                      ~12~1425~ Known diabetic, non-compliant with insulin but very compliant with generous doses of ETOH now non-responsive. BGL 485 and a possible BAL to match.

                      ~13~1600~Standby for afternoon X-mas concert at Casino. Same entertainer. Same program. Same nap. Same buffet.

                      ~14~1810~Known seizure sufferer. Non compliant with meds, generous with ETOH and meth...second seizure in thirty minutes. Non-responsive on arrival. Third seizure experienced enroute to ED.

                      ~15~2000~ Two vehicle MVA. Cancelled enroute. Apparantley it was a wrecker attempting to pull a vehicle out of snow filled ditch which slid backwards into the stuck vehicle and struck it.

                      ~16~2314~(No!! The crazed EMT screams!! I get off in 45 minutes!!) Post surgical BKA, just sent home from hospital yesterday, now complaining of SOB, sweating profusely, anxiety...appeared to be fixing to throw a PE...rapid diesel and high flow 02.

                      0130~~Paperwork, paperwork, paperwork.....fell asleep several times at the computer attempting to enter paperwork into system...decided to take a bit of a nap since on call crew was gone...hee hee...their turn...

                      So all in all it was a weird shift with the usual BS calls intermixed with the serious ones...gotta say it tho, I love my job! Just don't love it quite so much in the days following the "social impact" checks! LOL!! Got a chance to check in with my second pt during one of the runs and she is scheduled for surgery to have a rod placed. The ankle was both fractured and dislocated so she won't be dancing around the kitchen for X-mas.

                      Question on that ankle also. We use air splints which I attempted to place on the ankle for comfort knowing the ride was going to be awful for her. It had tiny little pin hole cracks along the seems where it folds to be carried in the bag, so obviously it deflated quickly after being applied so since her pulses and sensations were intact "as is" I just splinted with a pillow...but it seemed like I wasn't doing a whole lot of good. The only other thing we had were SAM splints and EvacuSplints...what would have been your choice?

                      Now I'm off to dreamland until 1600 when I will return once again to the world of the pretty blue/red lights....

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Mon Dec 11, 2006 2:54 PM
                      Posted By: kohlerrf (Junior Forum Member)

                      You can make this up! We where called for a man beeding from his scrotum. It turns out, he was picking at a pimple on his scrotum and it started to bleed so he called 911. We gave him an ice pack and a 4x4 and promised not to tell anybody!

                      -------------------------
                      Our frustration in life is derived from our unrealistic expectations...



                      Date Posted: Mon Dec 11, 2006 6:10 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      You broke yer promise.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Mon Dec 11, 2006 7:03 PM
                      Posted By: AZCEP (Veteran Villager)

                      clutzy, pillows usually make a very capable splint for the ankle, but if it isn't working I'd have tried the vacuum splint. A SAM can work, but they don't conform real easy to irregular shapes.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Mon Dec 11, 2006 8:36 PM
                      Posted By: jsadin (Veteran Villager)


                      We used to carry the vacuum splints and I found they worked well. I think I would prefer plain padded board splints to SAM splints. Just personal preference.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Dec 12, 2006 2:02 AM
                      Posted By: BushyFromOz (Veteran Villager)

                      Quote

                      Originally posted by: arctickat
                      Quote

                      Originally posted by: BushyFromOz
                      Quote

                      Psssst, Bushy, VH isn't a "Man"


                      No Way!!


                      Chuckle, I dunno if that's sarcasm or sincere shock.


                      Quote

                      Originally posted by: jsadin
                      Hard to tell with Bushy.

                      Well, what do expect from an idiot?

                      I was sarcasm, but its good to see i have you all on the hop!



                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk



                      Date Posted: Tue Dec 12, 2006 3:47 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Ankles I generally wrap in either a pillow splint for very painful or obviously broken ankles. Otherwise I find that a Spika bandage does the trick! I've even had a physician tell a patient to come back to see me to rewrap the ankle. That wasn't in the ICU but while I was volunteering as a lowly SJA brigadeer.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Tue Dec 12, 2006 7:56 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      I've never used a vacuum splint, but from what I've heard about them I would have used one with the dislocation and probable deformity. Like Gresh says though the pillow is great and blankets work well also.

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Tue Dec 12, 2006 9:24 AM
                      Posted By: emt2als (Junior Forum Member)

                      Darwin Award !!!

                      Yest. had a 33y/o M, pull off of Interstate due to check engine light. Pulled over, an found smoke/ steam coming from under the hood of SUV. So, in the process of walking to the closest building, two men approached to see if he needed help. Then proceed to shoot him in the leg, take his wallet, an steal his just about blown up vehicle....These two criminals just earned there first Darwin award... Needles to say the veh. only made it up the road to the next county over...

                      -------------------------
                      Titrate to effect !!!!
                      NREMT-P



                      Date Posted: Tue Dec 12, 2006 9:34 AM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Quote

                      Darwin Award !!!

                      Yest. had a 33y/o M, pull off of Interstate due to check engine light. Pulled over, an found smoke/ steam coming from under the hood of SUV. So, in the process of walking to the closest building, two men approached to see if he needed help. Then proceed to shoot him in the leg, take his wallet, an steal his just about blown up vehicle....These two criminals just earned there first Darwin award... Needles to say the veh. only made it up the road to the next county over...




                      Darwin Awards can only be given posthumously for an act so outrageously stupid that the actors did us a favor by removing themselves from the gene pool.

                      These two boneheads, while outrageously cruel and stupid, don't even come close to a nomination for Darwin Award wannabes.

                      Sorry to burst your bubble.

                      -be safe

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Tue Dec 12, 2006 12:02 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: PARAMEDICMIKE
                      Quote





                      Darwin Awards can only be given posthumously for an act so outrageously stupid that the actors did us a favor by removing themselves from the gene pool.

                      These two boneheads, while outrageously cruel and stupid, don't even come close to a nomination for Darwin Award wannabes.

                      Sorry to burst your bubble.

                      -be safe



                      Actually the award is for those who save humanity from their ability to reproduce. Typically this is a posthumous award, but does not have to be. The publisher does have a catagory for honourable mentions, but that is only for those who should have been killed because of their actions if not for an incredible stroke of luck. Regardless, these guys have done nothing near stupid enough to qualify. Had the car blown up and killed them on the other hand.....


                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Wed Dec 13, 2006 6:08 AM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)


                      Just beginning the first few hours of my next forty....

                      Just found out that my patient #10 from the last shift passed away this afternoon at the hospital. They were unable to stabilize him and get the brain to quit swelling....damnit, he was a sweet old elder too.... Evidently there is an ongoing investigation as someone else didn't think he could suffer that much damage from "falling and hitting his head on the table"....sometimes this job bites....

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Wed Dec 13, 2006 12:43 PM
                      Posted By: Medic49 (Junior Forum Member)

                      Quote

                      Originally posted by: jsadin
                      Alright, I gotta ask. AAOSTF? Not familiar with that one....


                      Sorry bout that AAOSTF in a deep south Texas drawl stands for Ambulance Arrived On Scene To Find....

                      Followed up that day with a couple more calls nothing out of the norm for us here....cocaine cp, dka and a car vs semi truck....

                      Bruce

                      -------------------------
                      B Hudgens NREMT-P
                      Director, KCEMS/Rescue



                      Date Posted: Sun Dec 17, 2006 12:45 AM
                      Posted By: VanHelsing (Veteran Villager)

                      day shift today had its up and downs.

                      Call 1: Ambulance rolled, crew x 3 ok, one lady had a fractured humurous, which she didnt find funny HAHAHA.
                      Other two had roasties and c-spine tenderness.... Ambo written off.

                      Call 2: Taxi accident. ( yip another one of these ) 12 patients. 3xP2 and the rest P3's. Thank goodness for private ambulance companies, they came and helped, which cleared the scene quite fast, or we still would be waiting for our ambulance to arrive now. ( Government )

                      Call 3: MVA, car of drunks trying to outrun the police, which were trying to pull them over.. proceeded to crash into another car. With 7months pregant woman... and he then wondered why somebody on scene punched him. ??? ( it wasnt me... I duely splinted his fracture and sent him to hospital.... sadly without morphine... )

                      Call 4: pedestrain accident, bilaterally fractured femurs. Our ambulance took a while to get there, so we put on the traction splints ... havent had to do that for a while ! good to keep up thopse BLS skills occasionally.... he got morphine... in increments of LOTS !

                      besides that had a lekker ( meaning "REALLY nice" in Afrikaans ) waffle for breakfast... and a few naps through-out the day !

                      VH




                      Date Posted: Sun Dec 17, 2006 3:06 AM
                      Posted By: DRIVER609 (Senior Forum Member)

                      Quote

                      Originally posted by: VanHelsing
                      day shift today had its up and downs.

                      Call 1: Ambulance rolled, crew x 3 ok, one lady had a fractured humurous, which she didnt find funny HAHAHA.
                      Other two had roasties and c-spine tenderness.... Ambo written off.

                      Call 2: Taxi accident. ( yip another one of these ) 12 patients. 3xP2 and the rest P3's. Thank goodness for private ambulance companies, they came and helped, which cleared the scene quite fast, or we still would be waiting for our ambulance to arrive now. ( Government )

                      Call 3: MVA, car of drunks trying to outrun the police, which were trying to pull them over.. proceeded to crash into another car. With 7months pregant woman... and he then wondered why somebody on scene punched him. ??? ( it wasnt me... I duely splinted his fracture and sent him to hospital.... sadly without morphine... )

                      Call 4: pedestrain accident, bilaterally fractured femurs. Our ambulance took a while to get there, so we put on the traction splints ... havent had to do that for a while ! good to keep up thopse BLS skills occasionally.... he got morphine... in increments of LOTS !

                      besides that had a lekker ( meaning "REALLY nice" in Afrikaans ) waffle for breakfast... and a few naps through-out the day !

                      VH


                      Sounds like a reasonable day. Better than the usual spit and dribble jobs. May I ask what a 'roastie' is?

                      Driver609



                      Date Posted: Sun Dec 17, 2006 6:59 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Driver 609.

                      A roastie, ( i thought it was universal )... is slang for abrasions caused by tarmac.

                      Usually used for motor bikers that come off at high speed, and slide along the tar for a while. Very painful, but definitly not serious !



                      Date Posted: Sun Dec 17, 2006 11:06 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Also known as Road Rash north of the equator. VH

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Mon Dec 18, 2006 10:21 AM
                      Posted By: jsadin (Veteran Villager)


                      04:00 - 26y/o male w/PD feeling dizzy (oh yay). Arrived to find said pt standing with officer on sidewalk cc not feeling well after taking 8-10 ecstasy tablets, snorting cocaine and smoking pot. I can't imagine why you don't feel so well....

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Dec 18, 2006 12:12 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Quote

                      Originally posted by: jsadin
                      04:00 - 26y/o male w/PD feeling dizzy (oh yay). Arrived to find said pt standing with officer on sidewalk cc not feeling well after taking 8-10 ecstasy tablets, snorting cocaine and smoking pot. I can't imagine why you don't feel so well....


                      See? That's what I don't get. I thought that stuff was supposed to make you feel *good*! Maybe we ought to enroll that dimwit in Training's "Stupid, not stupid" class.

                      -be safe



                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Mon Dec 18, 2006 2:32 PM
                      Posted By: jsadin (Veteran Villager)


                      Sounds like a plan! Definitely not the brightest bulb in the circuit. I told him I needed to start a line and he comes out with how he hates needles. Amazing....

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Dec 18, 2006 11:50 PM
                      Posted By: DRIVER609 (Senior Forum Member)

                      Ahhh!...... road rash!

                      I actually have seen someone from road rash before. Came of motorbike wearing nothing but shorts on hard packed beach. Slid on beach and did very little damage except taking ALL the skin off his back, most of it off his chest and lots of arms and legs.

                      Eventually metabolic derangement from being unable to maintain any kind of fluid balance and the inevitable nasty infections finished him off. Ouchy

                      Driver609



                      Date Posted: Tue Dec 19, 2006 1:42 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Otherwise known as organ donor, but by then they were likely too messed up too.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Tue Dec 19, 2006 9:33 PM
                      Posted By: DRIVER609 (Senior Forum Member)

                      Yeha, it was a very nice new donorcycle he was riding too. It was a bit messed up as well, which is the most tragic part!



                      Date Posted: Wed Dec 20, 2006 1:59 AM
                      Posted By: VanHelsing (Veteran Villager)

                      night shift... ( private service )

                      call 1: almost resussed.. but then declared. ( 39year old male ... massivly long list of medical problems )

                      call 2: 17year old girl, raped by uncle... again.... ( it was a really sad case, this chick was totally screwed up from a life of abuse, rape, drugs, alcohol and molestation )

                      MAde me VERY angry... too bad the uncle wasnt there.
                      I would have defibbed him, just 4 a laugh




                      Date Posted: Wed Dec 20, 2006 12:42 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Only one so far today. Male in his 20's fell off a roof higher than 25 feet and landed on his feet. Multiple L and T spine fractures. Once he hit the ground his coworkers got him up and walked him to a car and sat him inside.

                      He's lucky he's not paralyzed.

                      It's a beautiful day to fly. I'm sure we'll be headed out again before too long.

                      -be safe

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Thu Dec 21, 2006 12:07 AM
                      Posted By: bgrondahl (Junior Forum Member)

                      Well, about 32 hours into my shift and no calls...thus a spike in EMS Village postings from yours truly. I am sure I have jinxed myself now...maybe later I will have something to really post about.



                      Date Posted: Thu Dec 21, 2006 12:25 AM
                      Posted By: phunkymedic (Senior Forum Member)

                      Calls.. yeah. Which day? Work has been killer..

                      1. Dialysis Transfer.

                      2. Possible sepsis. The guys' BP was roughly 80/40 with a pulse in the 40's. Cool, clammy, O2 SATs were in the 70's.. couldn't get a line on him.. started out as a non emergent call. The poor guy cried all the way to the Hospital, cuz he was scared.

                      3. DOA x 2-3 days in bed at home. Cause of death. Possible electrolyte imbalance due to nausea/vomiting/diarrhea.

                      4. Syncopal episode. 4 month pregnant lady. Had the same vomiting/nauseated sickness that's been going around.

                      5. 4 week old baby with RSV/diff breathing. Took this one to the children's hospital.. fast.

                      6. Transfer from hospital to nursing home.

                      7. Transfer from nursing home to hospital.

                      8. Took patient from dialysis to assisted living.

                      9. Wreck that killed two. Ugly mess on that one. Another unit ran in a trauma arrest..

                      10. 94 y/o L.O.L fall injury. Broken ribs.

                      11. Transfer from residence to Hospital for evaluation for blood in urine..

                      12. Transferred patient from residence to Hospital for back pain [not the same one]

                      13. Last call-- Possible CVA in the middle of no where in the middle of the night..turns out, it was a possible MI instead.

                      -------------------------
                      " You have to keep the body going until the brain and heart recover enough to go on their own. "



                      Date Posted: Thu Dec 21, 2006 2:39 AM
                      Posted By: VanHelsing (Veteran Villager)

                      phunky... rough day at the office !

                      The DOA, must have stunk....

                      just out of mild curiosity, does anybody carry urine dipsticks ?

                      Im the only one I have ever heard of, and everybody thinks im too enthusiastic, but for those long inter-hospital transfers, where the patient has a urine bag, it gives me something to do.

                      VH
                      ____________________________________________________________________

                      As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them



                      Date Posted: Thu Dec 21, 2006 9:15 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      I've got them, but I tend to just play games on my PDA instead.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Thu Dec 21, 2006 10:18 PM
                      Posted By: phunkymedic (Senior Forum Member)

                      Yeah. Rough day. Three more this weekend. I'm personally dreading the Christmas Eve shift.

                      Anyway.. no.. we don't have the urine dipsticks..sounds like an interesting idea though. It might give you a better idea on the UTI factor of the patient, etc.

                      -------------------------
                      " You have to keep the body going until the brain and heart recover enough to go on their own. "



                      Date Posted: Thu Dec 21, 2006 10:42 PM
                      Posted By: Chadwick41311 (Junior Forum Member)

                      My last week,
                      Thursday: full code, did CPR for ALS crew
                      Off 3 day weekend
                      Monday: round trip transfer of nursing home pt for x-rays, ATV accident a mile from a road, flown out.
                      Tuesday, Chest Pain Day
                      Wednesday, bulls*** transfer after bulls*** transfer
                      Thursday, MVC, three patients refused transport , emergency transfer from Drs. Office to ICU.
                      While I was off on the weekend they worked a horrible MVC with multiple pts and a fatality on scene. Four flown to trauma center



                      Date Posted: Fri Dec 22, 2006 9:13 AM
                      Posted By: VanHelsing (Veteran Villager)

                      back at the private service again....

                      call 1: 13year old boy, respiratory distress... turns out he had bronchitis, and was choking on some snot.... NICE.

                      call 2: explosion at the local dynamite factory... one times faulty detonator = one less hand.

                      call 3,4 & 5: got called back to same factory... 3 woman. one that couldnt hear after the explosion ( funny thing that ? ), one that fainted, and one that fell and hurt her knee. ( spot the EMERGENCY ?? )

                      Oh well....





                      Date Posted: Sat Dec 23, 2006 8:01 PM
                      Posted By: paramedicus (New Forum Member)

                      my fun filled day on 12\22

                      1000- Head on mvc driver flown out with open femur fx

                      1230- 22 yo that is 25 weeks pregnant having contractions

                      1500- watched Talladega nights which is a damn funny movie

                      0030- rollover with ejection, on scene pt was combative with snoring respirations of course it was shitty outside so no chopper and soon after begining our 30 min transport to the closest hospital pt goes asystole and was pronounced at the hospital

                      0600- non traumatic back pain for 2 weeks decides to drive up to our station and honk her horn untill we woke up to transport her


                      cant wait to see what x-mas day brings us



                      Date Posted: Sat Dec 23, 2006 9:02 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Posted at the clininc now.

                      11 year old shot in left eye with BB gun. Plastic pellet. Impact lateral to left iris. minor hematoma, no swelling. Fluorescein exam shows no defect. Sent him home with instructions to return if it gets wors.

                      4 day old neonate with blood in diaper. Examination of diaper showed minor pink tinge. Rectal exam showed no blood. Likely cause, constipation causing abrasions to rectum. Mother told to dilute formula another 10%, reduce feeding amout to 60 - 90 mls, and avoid feeding baby iron supplemented food. Return if bloody show intensifies.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun Dec 24, 2006 3:58 AM
                      Posted By: greshmedic (Veteran Villager)

                      Who in their right mind would even think of putting a dynamite factory in J'Burg?





                      -------------------------
                      Before the war on terror, if I saw an unnatended package I used to think "I'll be having that!"



                      Date Posted: Sun Dec 24, 2006 5:53 AM
                      Posted By: VanHelsing (Veteran Villager)

                      good point Gresh !!

                      but these guys did... http://www.ael.co.za/





                      Date Posted: Mon Dec 25, 2006 7:55 AM
                      Posted By: VanHelsing (Veteran Villager)

                      well this is one christmas that will stand out in my memory file... It also includes a step by step guide on " how NOT too work christmas "

                      Step 1... crash your ambulance.

                      ok, well, there is only one step...

                      So the day started out well...

                      call 1 : nausea and vomitting patient, 73 years old, history of pulmonary, cardiac and renal failure...oh, i left out she has cancer...

                      call 2 : vomitting large amounts of blood... B/P 90/60. I am busy treating the patient inside, and my partner is reversing the ambo into the driveway.... then all I hear is SCccrrreeeeeccchhhhing tyres... and that inevitable " CRASHING " sound.

                      Which is bad.

                      a taxi... yes a taxi... T-bones her on her side.( at high speed )
                      She smacks her head against the window, and obviously now has severe C-spine pain.

                      Taxi yields 5 patients.

                      So now i have, my partner ( who is pregnant ), 5 taxi patients, and the original patient, still vomitting up large amounts of blood.

                      ......... Man, this sounds like a bad horror movie.

                      Penguin, if you reading this while on holiday in Australia... Sorry dude, it was Medic 124.

                      I'll leave out the details, but the bottom line is now I am at home... spending christmas with... Hhhmmm... my horse. ( I need a life )

                      just 4 the record... it really sucks treating your own crew mate.










                      Date Posted: Mon Dec 25, 2006 9:42 AM
                      Posted By: jsadin (Veteran Villager)

                      Sucky day VH! Here's my list:

                      Sun:

                      03:30 - 20y/o female, ETOH, keeps passing out (duh). UOA 20y/o fem vomiting into bucket, friend holding her hair back (how nice). No one is sure how much she had to drink, what she had to drink, or if any drugs on board {sigh}. In the truck, IV enroute. Pt felt better after about 500mls NS. ER not so happy to see us (don't kill the messenger).

                      05:10 - MVA rollover. Only fire toned with no mention of ambulance? Start sliding that way as a precaution. Find Jeep on roof about 30ft off the road, no one inside. Dispatch gets on the radio and says driver walked to PD (a good mile away) and is with them. Only injuries are some superficial scrapes on the right forearm. Refusal.

                      09:50 - 85 y/o female fell from standing position and now has altered mental status. UOA 85y/o female supine on kitchen floor cc pain in back of head, not oriented to event or time. Full c-spine, call for ALS in case cardiac event precipitated fall. 12 lead reveals some oddities, but nothing outstanding (hey, I'm only an intermediate...I don't interpret!). Two IV attempts on R arm by me, both blow. One IV attempt by medic on L arm - blown. IV attempts ceased. Any tips and tricks from you master IV inserters on cannulating old ladies, mildly dehydrated with really crappy veins? I didn't attempt it without the tourniquet, but will do that next time to see if that helps.

                      11:00 - 25 y/o male cc lower back pain s/p fall off of 4 wheeler. UOA 25y/o male, supine, helmet still on, cc lower back pain after 4 wheeler landed on him when he crashed (660 raptor...owie). No other complaints of pain. Boarded with helmet on, vitals enroute. CAOX3, - LOC, vitals within normal limits, survey reveals no injuries, no IV attempted (he simply didn't have a need).

                      Christmas:

                      06:50 - 85 y/o female fell from sitting position (yes, this is the same patient from 09:50 the day before). UOA pt supine in almost the same position as we found her previously. Family states the hosp found a small sub-arachnoid bleed yesterday but decided to send her home (nothing they could do for her?). Now she's fallen twice...both out of a chair. One small lac below left temple, no other complaints, mentating slightly better than the previous time. No IV access attempted this time. Brought her back to the same hosp and the resident couldn't understand why they'd released her the previous day (hey, me either, but I ain't the doc).

                      15mins and I'm outta here! Merry Christmas peeps!


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum

                       12/25/2006 09:43:12|U



                      Date Posted: Mon Dec 25, 2006 1:56 PM
                      Posted By: VanHelsing (Veteran Villager)

                      jsadin... your patient should invest in a chair with armrest, or alternatively one closer to the ground !

                      Yeah, my day was pretty bad, but atleast I made the news headlines...

                      http://www.news24.com/News24/South_Africa/News/0,,2-7-1442_2048681,00.html





                      Date Posted: Mon Dec 25, 2006 7:15 PM
                      Posted By: DRIVER609 (Senior Forum Member)

                      Woohoo VH, your fame spreads!

                      Yesterday (Christmas day) 10 hour shift:
                      Male, 48, cerebral palsy, intellectual disability and epilepsy, lives in supported housing (has carers on site). Slightly unwell on christmas eve, now in full blown septic shock. Temp 40 (celsius), resps 40, HR 140, no blood pressure. IV attempt for fluid and antibiotics x 1 - failed. Gave up and transported as we were only 10 minutes to hospital. After 5 or 6 hours of aggressive management in ED with inotropes, large amounts of fluids and so on he is struggling to maintain a BP of 90/40... DIC... MODS... He's off to ICU but it will unfortunately be a one way trip I think.

                      Male 66 Chest pain, weakness. Been investigate countless times for same over past 2 years(!). Today he has the same thing again, but this time has a Mobitz 2 block which he has never had before, so he gets a ride to hospital.

                      Female with 'back pain' who wants to go to hospital... Actually wants to get the hell away from family, but we very kindly play along and give her a ride to the waiting room.

                      18 year old male with facial burns from the old hot oil on stove trick. Another crew is on scene so I let them have it (nearly time to clock off....) The burns looked pretty nasty from where I was standing, lower part of face, partial thickness and marked burns around lips and nose. My partner (new student) jumped in the back to have a look while I was chatting to FD and PD... 30 minutes later I wander back around the front of the house to find that they are still parked in the driveway... I think "oh **** it must have all gone horribly wrong" and run over to give them a hand.... only to find that the reason they are still sitting on scene is that they want to get an IV before starting transport. Why this has taken 30 minutes and had to happen at the scene instead of en-route I have no idea. By this stage the patient is drooling, unable to swallow secretions and is having trouble talking. They apparently don't see this as a problem...
                      Maybe they wanted the practice doing cric's... I will follow up tonight to see what happened. One little gem that one fo teh other crew came out with was "it is only oil burns, there won't be any airway invlolvement...."



                      Quote

                      Originally posted by: jsadin

                      Any tips and tricks from you master IV inserters on cannulating old ladies, mildly dehydrated with really crappy veins? I didn't attempt it without the tourniquet, but will do that next time to see if that helps.


                      Try using small guage needle, and turn the bevel down instead of up. Go in at a steeper angle. This should make it less likely that you will go through the other side (at least in theory) as the bevel wil slide across the bottom part of the vein. No idea if it works, haven't had a chance to try it yet myself.

                      Driver609




                      Date Posted: Mon Dec 25, 2006 8:45 PM
                      Posted By: jsadin (Veteran Villager)

                      Hi Driver,

                      I'd forgotten about the bevel down trick! Another one for the bag of tricks. I did start off using a 22 just because I knew it could get ugly.

                      Slap that crew around for dicking with an IV for 30mins! Jeesh. If that were my relative in the back, I'd have been kicking someone into the drivers seat the hard way....

                      VH, you just used up your 15mins of fame! I'll speak to my patient about getting some arm rests....


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum

                       12/25/2006 20:48:14|U



                      Date Posted: Tue Dec 26, 2006 4:17 PM
                      Posted By: CBEMT (Senior Forum Member)

                      Quote

                      09:50 - 85 y/o female fell from standing position and now has altered mental status. UOA 85y/o female supine on kitchen floor cc pain in back of head, not oriented to event or time. Full c-spine, call for ALS in case cardiac event precipitated fall.


                      Head injury with altered mentation meets Level 1 trauma criteria, at least here. Other than that I have a hard time justifying ALS just because somebody fell and omgmaybeitwasacardiacevent.

                      Quote

                      minutes later I wander back around the front of the house to find that they are still parked in the driveway... I think "oh **** it must have all gone horribly wrong" and run over to give them a hand.... only to find that the reason they are still sitting on scene is that they want to get an IV before starting transport.


                      Absolutely criminal.




                      My only Christmas call of note was for "elevated BP."

                      Yeah, I'd say 240/100 is elevated.

                      Turns out it was an assisted living patient, caught the stomach bug that's been going around the area, so he was throwing up everything he'd eaten in the last 20 years (I had it two weeks ago).

                      As a result, he hadn't taken any of his 4 BP meds in approximately 3 days.

                      Any pain? "Yeah, right around my heart." Greaaaat.

                      12-lead looks ok, but on the way to the truck he's all kinds of irregular. PVCs, PACs, I can't tell where the ectopy ends and his rhythm begins. No history of irregularity. O2 added. Can't describe the pain, rates it a 6, non-radiating, intermitant.

                      Four baby asprin, IV, and we're off. SL Nitro, pressure's about 220, pain is 5. Second nitro, pulling into the ER. Initial BP inside is 197/something. Denies pain "right now," but he doesn't seem like he's going to tell them if it comes back. 20mg of labatelol- pressure of 130/70, pulse 65, perfect NSR. Son of a b!tch.

                      Even though they fixed him within 10 minutes, he still bought himself at least an overnight stay.


                      -------------------------
                      Village Geek

                       12/26/2006 16:18:22|U



                      Date Posted: Tue Dec 26, 2006 9:23 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: VanHelsing
                      124.

                      I'll leave out the details, but the bottom line is now I am at home... spending christmas with... Hhhmmm... my horse. ( I need a life )

                      just 4 the record... it really sucks treating your own crew mate.


                      Yeah, I hear that, my partner 15 years ago and i were in a wreck that required me to take care of him until another unit arrived to transport. fortunately he is well, i hope your partner is also.

                      Lots of places for a horse up here still VH.



                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Wed Dec 27, 2006 12:57 AM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Well boneheaded me was scheduled for a double shift over the holidays...didn't think it would be too pressing since it IS holidays and ppl WILL want to be with family...yyeeeaah....

                      During my duration I got to take care of....

                      MI in progress, no ALS as they were backed up~high flow diesel and 02 and nitro

                      Status epilepticus~ 14 yr old non-compliant with seizure meds for three days

                      One vehicle rollover w/five injured but only two severely enough to transport (suspicion of a tension pneumothorax in progress and fractured collarbone and arm) 5 teenagers driving waay too fast on gravel road after drinking resulting in rolling car....pneumo confirmed hours later when we brought in another pt

                      Non-responsive male at casino~ETOH 479 combined with meth

                      LOL fell displacing her kneecap

                      Gravida 2 Para 1 experiencing contractions for six hours -now calls when they are two minutes apart. She finally decided they WEREN'T going away. Baby delivered exactly 9 minutes after we arrived at ED. Baby needed assistance breathing immediately (apgar 7 at five minutes then 9) and mom needed some assistance to stop severe bleeding...thank you Lord we made it in....both mom and baby stable today when I checked in at hospital on way home no matter how badly I want a stork pin after all these years I'm not going to jeopardize mom and baby....

                      One vehicle rollover~ no injuries/refusal

                      Non-responsive male~ ETOH

                      Unintentional OD Amitriptyline and three other drugs he was given for "chronic back pain" ~~he said he was going on a trip. I asked where to. He said Mars...then he seized......he also had some goofy ECG waves....but I can't interpret...

                      Sick/Not sick~~ just released from hospital and got his first hit of meth and set off a firestorm in his brain....

                      Diabetic hypoglycemic

                      Standby for man running around with and ax
                      Standby for high speed chase

                      Possible MI in progress~ Exhibited all signs, strip proved 3rd degree block according to my boss when I showed it to her this morning who is also a paramedic and trying to help "learn" me on the strips

                      Diabetic experiencing severe foot pain related to diabetic neuropathy. Her family cleaned her out of pain meds.....

                      Assault with several lacerations requiring super glue/duct tape then stitches at the ED when home treatment didn't work..duh

                      There were a couple other ones but I can't remember what they were...jeesh....Merry Christmas to me, Merry Christmas to me....what a quiet shift......


                      I have got to admit that going home at 0300 in the morning after the high flow diesel to the ED with pregnant mommy on board and knowing that she and baby were going to be fine was a BIG high....that's what it's all about folks...guess that was my Christmas present...just knowing that baby could have died being born at home w/out breathing assistance and the possibility that mom could have also because of bleeding..and knowing that they were both going to be fine...well....jeesh....what better gift than that? Even tho I didn't do much of anything but kept talking her thru the contractions and keeping her from pushing until we got in....anyways....that was a highlight of a shift not soon forgotten...







                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       12/27/2006 01:18:09|U



                      Date Posted: Wed Dec 27, 2006 10:24 AM
                      Posted By: jsadin (Veteran Villager)


                      Original quote by CBEMT:

                      "Head injury with altered mentation meets Level 1 trauma criteria, at least here. Other than that I have a hard time justifying ALS just because somebody fell and omgmaybeitwasacardiacevent."

                      I agree. My partner was hot to bring in ALS, so I figured it wouldn't be a terrrible idea, even tho' I wasn't originally going to call. We did transport to a level 1 trauma center and had some lovely 12 lead strips to give to the ER doc.




                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Jan 01, 2007 5:01 AM
                      Posted By: Penguin (Junior Forum Member)

                      So I'm busy writing my CV in Afrikaans (dont ask) and I dont have a dictionary and want to check some spelling. So I google paramedic in the Beeld(a local Afrikaans website) website and read this story about an ambulance vs taxi accident. After realising it is VH (and my beloved M124) I come to EMS village to see if VH posted about it.

                      I'm so sorry VH- hope that it wasnt too bad. Glad to hear that you OK. Busy looking for you number and I'll sms you.

                      That better have that ambo fixed by the time I get back though- couldnt bear working on Medic 40



                      Date Posted: Mon Jan 01, 2007 12:24 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Hey Penguin, welcome back. My condolences for your loss.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Tue Jan 02, 2007 2:56 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Hi Penguin !

                      I am afraid its Medic 40 for you for a while.

                      Now for you guys in a 1st world country... let me explain about " medic 40 "

                      It is a somewhat old ambulance, which in itself, isn't to bad... except NOTHING WORKS.

                      The mainline oxygen regulator leaks, which means you can only use the small portable cylinders, which dont last very long. the doors only partially close, so when you drive it feels like they are actually going to fall off.
                      The headlights work... sometimes. If they are on low beam, on high beam, only the left side works.
                      The strecher legs need assistance, when you loading or off loading a patient, because they dont always spontaneously lock, as they should.

                      But my worst, is the seats at the front. One of the hinges is broken, which means the seat sits at a rather uncomfortable angle, so in order for you not to get out the ambulance with twisted sore back, the suction unit and crisis caps get stuffed behind the seat, and then when you break, they hit you in the back.

                      but on a positive side... it drives so slowly, that even if the door did fall off, you could simply get out while in motion, pick it up, and stick it back on, and continue responding. On the uphills... bicycles overtake us... red lights and all...





                       01/02/2007 14:57:37|U



                      Date Posted: Tue Jan 02, 2007 4:34 PM
                      Posted By: stridor (Veteran Villager)

                      Quote

                      Originally posted by: VanHelsing
                      jsadin... your patient should invest in a chair with armrest, or alternatively one closer to the ground !

                      Yeah, my day was pretty bad, but atleast I made the news headlines...

                      http://www.news24.com/News24/South_Africa/News/0,,2-7-1442_2048681,00.html




                      I love this quote. "The taxi driver was not hurt." Of course not, he caused it, the ones who cause it never get hurt. At any accident scene look for the blithering idiot walking around slurring "Wha happa?" and that's the one who caused it.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Mon Jan 08, 2007 10:21 AM
                      Posted By: jsadin (Veteran Villager)


                      No calls for 15hrs and then the tones for stroke-like symptoms (always at game time). Arrive to find 60 y/o male, CAOX3, positive facial droop, no arm drift, cannot puff out cheek on one side, no weakness noted on either side (hand squeeze), PEARRL. Patient states symptoms X 1 week! Are you friggin' kidding me? Patient is a professor at a local college. Talk about all book smarts and no common sense. I start experiencing signs/symptoms of a stroke, I'll be in the ER before you can say "CVA"....



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Jan 08, 2007 12:15 PM
                      Posted By: jsadin (Veteran Villager)

                      Curt's post got me thinking about this call one of our EMT's had two weeks ago:

                      Call comes in for uncontrolled vaginal bleeding (always fun). Upon arrival they find a female (40ish?) supine on the couch, with some serious vaginal bleeding. Brief questioning reveals that patient miscarried approx 3hrs prior (she was about 12-13weeks along). Ummm...where's the fetus? Patient then states the fetus is "in a tuperware container in the fridge....the clots are in a separate tuperware container next to it". Patient is still having contractions and did not receive any pre-natal care so now the crew is wondering if there are multiple fetus'. Grab the fetus/clots out of the fridge and scoop/screw.

                      I damn near hurled when he told me that story. Still gives me the heebies....

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum

                       01/08/2007 12:17:09|U



                      Date Posted: Mon Jan 08, 2007 12:35 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Jim : I think that both of your above calls fall under the catagory of
                      " you can't cure stupid"
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Mon Jan 08, 2007 3:11 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      The CVA like symptoms don't sound to be a stroke. It sounds more like Bell's Palsy as there is only facial involvement and that is very rare if it is a stroke.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Mon Jan 08, 2007 5:30 PM
                      Posted By: jsadin (Veteran Villager)


                      I was thinking the same thing, Grambo. Either way, I would've called way before a week went by....



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Jan 08, 2007 5:41 PM
                      Posted By: Chadwick41311 (Junior Forum Member)

                      My friend Marsha was in a college class with a profesor and he began having radiatingchest pain, became diaphoretic and pale. One of his students was an LPN student and went and got one of the nursing professors who confirmed that he was most likely having an MI. He refused all treatment until his class was over and was then transported to the ER.
                      Yesterday, was at a class with Lifenet on helicopter safety and landing zone set up while off duty, got called in and ended up at a car fire next to a factory, then called to chest pain ALS intercepted, back to the fire. Then a discharge transport from hospital to nursing home.



                      Date Posted: Tue Jan 09, 2007 11:07 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Wow, not sure what happened around here but hate to admit it.....13 hours into my shift and *gasp, knock on wood* only two calls~~

                      1~Pos Fx ankle up at the high school. Student stated he was playing BB and he made a sharp turn and his ankle didn't..."ouch".

                      2~Lymphoma patient feeling very weak. Upon arrival he is sitting in a kitchen chair leaning on a family member in order not to fall off the chair....loaded and gone since on scene vitals were 85/52 BP, P 100, jaundiced, sweating, tympanic temp 103.2, and well~he just didn't look all that good. Massive lower extremity edema also....to the point where he needed assistance even lifting his legs up off the floor...would hazard a guess that this may be one of the last rides on earth he will be taking...sad deal

                      That has been all **knock on wood** for the day so far

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       01/09/2007 23:57:24|U



                      Date Posted: Tue Jan 09, 2007 11:31 PM
                      Posted By: Chadwick41311 (Junior Forum Member)

                      Well, I went in this morning, checked off my EC unit and walked across the street and grabbed breakfast, and took a nap. I had to work over for one of the 2nd shift EMT's. While I was waiting for her to come in I responded to an elevated blood pressure run, on scene it looked a lot like an anxiety attack, chest pain, SOA, nausea, vomiting, dizziness, bp 180/112, pulse 140, pt was making an effort to not hyperventilate. ALS was available so I had them intercept at the scene. ASL transported the patient.



                      Date Posted: Mon Jan 29, 2007 8:46 PM
                      Posted By: BCPCPer (Junior Forum Member)



                      Not much for today's dayshift(0800-1800)

                      0815-Took a MS pt from nursing home to airport where ALS was flying in to take her to Vancouver for gallbladder surgery. Nothing eventfull.

                      1400-Called for general weakness, senior woman, no other info. Arrived to 96yr old chinese woman with no english whatsoever. Family(who as well had very very broken english) claimed she lost control of bowels 2 days ago(they cleaned her up then) and she hadnt moved off the couch in the last 4 days. Pt apparantly hadnt eatin more than a few nuts in the last 4 days. Ped cuff was almost too big for pt's arm, o2Sat couldnt pick up, pulse was reg and strong but the woman ovbiously had some undiagnosed cancer(bone and skin) despite the familys claims that she was healthy and hadnt gone to the doctor in 50 years.


                      1745 - time for paper work and washing the bus, talk about uneventfull shift!



                      Date Posted: Mon Jan 29, 2007 9:00 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Why was an ALS transport required for a cholecystectomy patient?

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Wed Jan 31, 2007 12:50 AM
                      Posted By: BCPCPer (Junior Forum Member)



                      I dont think it was that the patient was critical, she was quite the opposite, ALS just does all the flying out of our town. Were somewhat rural(20,000 population) with no ALS in our region. BLS is not allowed to fly so whenever a pt needs to go to vancouver or anywhere else a flight team from Vancouver comes up and picks up our pt from the air port.





                      Date Posted: Fri Feb 02, 2007 1:22 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      I have a WTF call rolling around and around in me little mind....any thoughts??

                      Paged out to a rural residence for a twenty yr old female experiencing a seizure. Arrive to find pt in the back seat of a pickup truck in the front yard. Guess they were going to take her in themselves then got scared and called us. At point of arrival pt is A&Ox4, airway patent, shaking violently and holding a jacket over her eyes and crying. Pt states the light is hurting her eyes. States she may have migraines, never diagnosed, happening off and on for last three months.
                      When witnesses were asked if she had a seizure they state that she's just been doing this violent shaking. They considered that a seizure.
                      Pt is assisted into the back of the ambulance, secured to the cot and assessment begun. Heart rate~157, R 30-40 (hyperventalating) BP 146/palp, tympanic temp 97.4, BGL 179, 02 sat 96%.
                      Pt. states she is not on meds, has not taken any illicit drugs, no alcohol, no allergies, no history of any medical treatment for last three years. Pupils about a 5mm and reactive.....
                      Pt. is placed on 02, extra blanket added, lights in rig turned down due to her extreme aversion to any light (I'm thinking migraine at this point) NIBP is hooked up and transport is initiated.
                      I am visiting with patient, she is amicable, polite and respectful, we discuss current s/s and complaint, I coach her to slow down breathing and get her calmed down etc....approximately five minutes into transport she starts hyperventalating again, a glance at the monitor reveals a HR 197, 02 sat 92%, states her eyelids "feel funny" and commences to go into a full blown seizure~entire body is involved, seizure lasts three to five minutes~NPA inserted, suction used, etc...she enters postictal state (I think) then as I begin to suction the copious amounts of phlegm, sputum she becomes extremely violent and combative. She sucker punches me twice in the face once in the ribs, grabs my hand and tries to bite me and is screaming hysterically trying to get off the cot...I am trying to remain calm and talk softly, yeah uh huh....hit the buzzer and get the driver to call for intercept and pull over and get in the back with me because I have this vision of pt and I going out the back door of the moving rig and splatting on the pavement.... I tell the driver to move slow and keep his voice low as she is beginning to calm down, he accidently bumps her and she goes back into the fight mode and it takes both of us to keep her on the cot....after about five minutes we get her calm enough to restrap her to the cot and he jumps out and begins transport again...ALS intercept happens about five minutes later and at this point she is slurring her speech, not oriented to place or time but is oriented to person....long story short there were no more extremely violent episodes for the remainder of the transfer but she did continue to be non-oriented with slow, slurred speech and some episodes of hyperventilation....I do find out that her mother is on anti-seizure meds but pt herself states she has never had a seizure herself....
                      I inquired to the nurse taking over pt care what she thought was happening and all she says is "hyperventilating"....
                      I think there had to be something more....haven't gotten tox screen results or anything back...but any thoughts??

                      **clutzy makes mental note~quicker ducking response next time will avoid unneccesary pain and bruising to face**

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       02/02/2007 13:24:32|U



                      Date Posted: Fri Feb 02, 2007 6:17 PM
                      Posted By: Chadwick41311 (Junior Forum Member)

                      Dispatched to fall with injury. On arrival on scene LOL slipped out of bed and was complaining of R knee and flank pain. Knee imobilized in POC, pt placed on O2 via NC d/t low SpO2 (low 90's). Pt transported to the ER.

                      Post-Op transport to the nursing home.



                      Date Posted: Fri Feb 02, 2007 10:47 PM
                      Posted By: jsadin (Veteran Villager)


                      Clutzy, I'd make a guess that something is playing havoc with the poor girls brain...encephalitis, brain tumor, who knows. Weird call for sure. Will you be able to follow up?

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Feb 02, 2007 11:08 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Clutzy, two words. Crystal meth.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Fri Feb 02, 2007 11:13 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      I don't think so ArcticKat. The lack of fever is not indicative of meth. What were her pupils like? This sounds more like encephalitis. One of the most common causes.... herpes virus.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Fri Feb 02, 2007 11:25 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Crystal Meth is always my fall back. It's a good blame all. Seriously...Temp doesn't always indicate a meth addiction. I was thinking more like a flashback but wanted to see some discussion. I've honestly not got alot of exposure to the stuff though, so I could and likely be wrong. One of the curses of being a rural medic.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Fri Feb 02, 2007 11:32 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      The other issue is that those symptoms occur on withdrawal... probably a couple days without meth after frequent use. You would probably notice pok-marked skin and a shinyness to the skin.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Fri Feb 02, 2007 11:40 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)


                      Pupils were dilated to 6/7mm and reactive.
                      I didn't notice the scabby skin that you see on a lot of meth users, nor the rotten teeth, but she could just be starting out...
                      I won't have follow up until my next shift next week, I guess I was thinking meth also. A lot of the users that we have been picking up that show positive for meth in the tox screen have had low body temps also...
                      encephalitis? hmm...never thought of that...would explain the headaches tho...

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Sat Feb 03, 2007 1:23 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      I can't pull our old records, but this sounds a lot like a pt we had who had taken an entire OTC box of benadryl for kicks. In talking to poison control at that time they were having quite a rash of these as well as Pseudoephedrine and others giving really weird reactions. I should have looked up these Rx's first to see if they fit, but no time now.

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Sat Feb 10, 2007 6:58 PM
                      Posted By: DocHarris (Senior Forum Member)

                      I originally went to post this looking for input, but then my comp crapped out and I lost the whole thing. Now I've got my answer but still feel like posting.

                      So last week I was on with another senior responder and a rookie shadow (my girlfriend actually who just decided to join the team) We had nothing all night but get woken up at 0545 and paged to the admin building on campus (just about the furthest run from our office possible) I for some reason can't find my coat, sweat, hat or mitts in the hustle and decide to run as is (long sleeve t-shirt). Big mistake as the temp was about minus 30 C that night.

                      Arrive on scene to find a male approx 55y/o leaning against a desk in an office. He's pale, diminished LOC/LOA and he's holding a towel to his rear that is visibly soaked in blood. We're informed by bystanders and Campus Security already on scene that the patient had come up to the building from his usual workarea to use the washroom, came out and asked for an ambulance to be called. Security was advised and they contacted us.

                      My partner and I help the patient to the ground and the rookie starts the paperwork. We do a quick assessment and find no injuries anywhere else, no relevant history. We started vitals and found RR 12, Pulse 66, Sat 92%, skin pale and cool. No BP was taken as EMS arrived only a few minutes after we did and took over. We got a blanket on him and started O2 via NRB at 15lpm.

                      After we laid the patient onto the ground I noticed the full extent of the bleeding. The patient was hemmoraghing rectally. Blood had soaked through his underwear, jeans and the towel he was using and was pooling on the floor rapidly. EMS started an IV, hooked up the LP12 and we helped load him up so the could go. Vitals taken by EMS at scene were similar to our findings. (can't remember exact rates)

                      So originally I could not for the life of me figure out what was wrong with him for sure. But I found out through a colleague at Security that he'd been diagnosed with colon cancer. They expect him to be at work again in 2-3 months.

                      That was two weeks ago. No calls in 4 shifts since then. Campus is busy as hell but I'm missing them. (4 thursdays in a row EMS and PD called in to take our patient under mental health act. Not to mention the couple dozen other calls.) We're looking at a new team record this year for calls.

                      Anyways, would anyone here consider any ways to control that sort of bleeding? It was the most blood I've ever seen at a call in my limited experience, but it's not like there's a place to put pressure.

                      - Matt

                      -------------------------
                      - Matt Harris
                      Primary Care Paramedic

                      "A sucking chest wound is nature's way of telling you to slow down."



                      Date Posted: Sat Feb 10, 2007 11:45 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Rectal bleeding of that severity can only be stopped in the OR. He will probably need a couple units of blood and some FFP.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Feb 11, 2007 12:36 AM
                      Posted By: DocHarris (Senior Forum Member)

                      Thanks Graham. I couldn't think of anything, but it's good to know from someone else that there was nothing else I could do. This was really the first time I'd sent someone off not sure if they'd make it.

                      -------------------------
                      - Matt Harris
                      Primary Care Paramedic

                      "A sucking chest wound is nature's way of telling you to slow down."



                      Date Posted: Tue Feb 13, 2007 7:22 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      So, my soon to be wed fiance and I hop onto our catamaran with 38 others for a snorkelling tour North od Playa Del Carmen and before we can even leave the marina some guy has his head buried into a pail. Not puking yet, but close. Next thing we know his wife is shouting at him. I take a look and the guy is falling back in his seat eyes rolled back, so pale as to cause my first thought to be, "I wonder if this boat has an AED." I pounce over to him and tell the sailor that, "I'm a paramedico" and begin assessing the guy. Diaphoretic, non responsive, stridorous resps. With the sailor's help I lay him on the floor and open his airway, Carotid pulse is present at about 40 bpm. By then a nurse and a retired urologist have made their way over, both wisely defer to me...chuckle. Our patient starts a grand mal siezure but only lasts about 10 seconds. I'm thinking, oh crap, I'm on a boat...BLS, BLS, BLS, where's my valium!!???

                      Anyhow, siezure ends and patient heart rate begins to rise, radial becomes more palpable, pupils are equal, eventually he wakes up. Pukes and sits up. Heart rate into the 80s. Grip strength is weak, but equal. Past Hx of diet controlled HTN, Stomach pain since previous evening. No heavy drinking the night before, toast for breakfast, No allergies, no Meds. By this time the catamaran had docked and we offloaded him to the locals.

                      Passengers raise a toast and cheer as I reboard and the captian gives me a free beer. (The ride was all inclusive BTW) Snorkelling trip resumed with only three seasick victims, of which I was not one...I took my dimenhydrinate before we left this morning.


                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Tue Feb 13, 2007 7:51 PM
                      Posted By: greshmedic (Veteran Villager)

                      You must have gone to the same catamaran / snorkelling trip as us.

                      By the way, I peed in one of the snorkels before i handed it back

                      -------------------------
                      Before the war on terror, if I saw an unnatended package I used to think "I'll be having that!"



                      Date Posted: Tue Feb 13, 2007 9:07 PM
                      Posted By: jsadin (Veteran Villager)


                      Hmmm, that's why that snorkel tasted funny.

                      Kat, you just can't get away from work. Hard to work the trade when you don't have any tools available. Glad the gent was ok...



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Feb 14, 2007 1:55 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Jsadin.... She put it in a tuperware in the fridge ?

                      What was she thinking ? <insert really shocked look>

                      ?



                      Date Posted: Wed Feb 14, 2007 4:10 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Ah yes Tupperware locks in freshness !!!! :-]
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Wed Feb 14, 2007 7:10 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: greshmedic
                      You must have gone to the same catamaran / snorkelling trip as us.

                      By the way, I peed in one of the snorkels before i handed it back


                      Good thing I brought all my own scuba gear...probably why my guy got sick tho...thanks for that. We went on the Fat Cat.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk

                       02/15/2007 22:12:30|U



                      Date Posted: Thu Feb 15, 2007 12:19 PM
                      Posted By: jsadin (Veteran Villager)


                      VH, I know what I was thinking....."Ewwwwwww!"

                      I'm fairly certain she was going to bury it in the yard later (once she felt strong enough). Since the fetus at that point isn't considered a person, no crime would be committed. WAY icky, but not a crime.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Feb 15, 2007 10:14 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Patient update.

                      Saw him yesterday, doing great. He has no recollection of me or what happened, only that he was feeling ill. He went to the resort Doctor who treated his illness. Likely cause was from brushing his teeth with tap water.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Fri Feb 16, 2007 12:37 PM
                      Posted By: VanHelsing (Veteran Villager)

                      I cant get over this tuperware story..

                      I had a mental image of hubby coming home, and looking in the fridge for a late night snack.





                      Date Posted: Fri Feb 16, 2007 2:29 PM
                      Posted By: jsadin (Veteran Villager)


                      The there would be a fetus AND puke in the tuperware.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Feb 18, 2007 10:46 AM
                      Posted By: BCPCPer (Junior Forum Member)



                      Nightshift Feb 17/2007

                      My father has been increasingly interested in what it is I actually do. I arranged a ridealong for him for my Alpha Night Shift last night.

                      Things were going slow till we went out at around 2300 for a chest pain. Arrived to a diaphoretic and panicing 75 year old woman(who was my teacher all through elementary school) who was complaining of SOB that has been worsening all day with zero chest pain. Presented very much like a silent MI in my mind. Very weak and thready pulses, much to thready for any sort of rate or palpable BP. As we were loading her into the back of the ambulance she arrested. Did our mandatory 12 minutes CPR on scene then recieved orders to transport. Pronounced at hospital.

                      Call number two was a general weakness w/t vomitting. Looked like a case of a bad flu thats been going around. Pt dry heaving excessivley but no actuall emesis. Held emesis bag to pt's face entire trip to Emerg.


                      Call three was for a diabetic collapse. Arrived to morbidly obese diabetic in wheel chair, states fell off chair 30 mintues ago, climbed back on, no pain, ANU call, pt refusal.

                      Got done all my paperwork from the arrest as long as the other calls buy around 0400. Hit the sack for 3 hours then starting to back up and debrief pops, he was fine and had a awesome time and a reinforced respect for "ambulance guys" everywhere.

                      0800 another brick in the wall






                      Date Posted: Sun Feb 18, 2007 11:40 AM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Quote

                      Originally posted by: BCPCPer
                      Did our mandatory 12 minutes CPR on scene then recieved orders to transport.


                      Mandatory 12 minutes of CPR prior to transport? Can you explain this a little more, please?

                      Do you mean 12 minutes of CPR with full ACLS showing a change in rhythm indicating a need for transport? Do you mean you couldn't get a hold of the doc for 12 minutes? Or, as it's written, do you need to do 12 minutes of CPR on scene before you're allowed to transport a patient?

                      I'm just confused by your wording. Can you clarify?

                      -be safe



                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Sun Feb 18, 2007 2:51 PM
                      Posted By: BCPCPer (Junior Forum Member)



                      Hello Mike, sorry for the confusion,


                      Ill get into it but please dont be too judgemental about my protocol, I am relativley new(6months) and work for a provincal service that is very strictly protocol drivin.


                      Our Cardia Arrest Protocol states that weather the arrest is witnessed by EMS or arrest before EMS arrival, we stay on scene or stop wherever we are and do 6 2minute long rounds of CPR as well as Analyzing the pt with our defibrilator. After our 6 rounds of CPR which is approximatley 12 minutes(maybe add 2 minutes for pulse checks etc) we are required to call the on call doc and explain our situation. He then decides if we transport the pt with CPR enroute, or call it on scene. We were advised to transport, so we did CPR enroute and the pt was pronounced dead on arrival to EMERG.

                      One thing I should state is that we are a BLS community with NO ALS. We have one full time car and our back up car in a pager crew that is a minumum 20 mintues away. When we are working in a larger town with ALS, the arrest calls for very very different as you could imagine. We do our protocol and the ALS guys work around us pushing epi/atropine printing rythms and sending them to hospital.


                      Even if we DO get ahold of the doc before our 6 cycles are up, we would be breaking protocl if we transported before our 12minutes CPR.


                      Hope that clears it up, i know the protocol isnt perfect.

                      bcpcper








                      Date Posted: Sun Feb 18, 2007 4:10 PM
                      Posted By: jsadin (Veteran Villager)



                      That sux that you're tied into that protocol. If I had a patient loaded, I'd be a little upset if I had to sit on scene with NO ALS and do CPR, especially with a witnessed arrest. Crappy, crappy protocol.

                      My only call last night was for a 53y/o female dizzy/nausea/sensitive to light. UOA she was lying supine on bed, CAOX3, w/very warm skin. BP 88/50, pulse 70, SaO2 98% RA. Fore/aft lifted to stairchair. COT to EA. She requested the lights off in the truck, so I had to work by one light in the back. She had one good vein and I cannulated that one using the force in near darkness. Obi Wan would be proud.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Feb 18, 2007 11:02 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Thats the reason I was taught to close your eyes and palp it before you decide to look.
                      Good onya OBI Jim ! May the force be with you.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Sun Feb 18, 2007 11:27 PM
                      Posted By: CBEMT (Senior Forum Member)

                      Quote

                      Hope that clears it up, i know the protocol isnt perfect.


                      Understatement of the year.



                      -------------------------
                      Village Geek



                      Date Posted: Mon Feb 19, 2007 1:16 PM
                      Posted By: BCPCPer (Junior Forum Member)

                      Quote

                      Originally posted by: CBEMT
                      Quote

                      Hope that clears it up, i know the protocol isnt perfect.


                      Understatement of the year.




                      Nice productive responce.

                      I work in a 2000 call-a-year station, we have NO ALS and ONE full time car. We are BLS and we do the best we can. Personally I am proud that all the calls i do, I do myself with no ALS doing all the work and me standing back watching.

                      Our protocol is designed because most stations in my service are BLS with one full time car on shift. This is not a small town hillbilly protocol that is used by backwood volunteer systems. It was carefully contemplated and implemented by our medical directors and is used in a service that has over 4000 paramedics and serves the ENTIRE province of British Columbia.



                      Date Posted: Mon Feb 19, 2007 1:47 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Well, on a certain level I can understand this. How hard is it to do CPR in the back of a moving ambulance? Pretty hard. So, in a sense, stopping can make CPR easier to complete. Plus, if you have an AED, as it looks like is the case here, then you can actually stand a chance of doing something good with the patient with regards to the CPR and shocking (if indicated).

                      However, there is so much that's wrong with it that I don't know where to start. So I won't.

                      Thanks for the clarification. You work with what you have and with the limitations imposed by the medical director. The best you can do is recognize that it's stupid, lobby for change while abiding by the current rules, and go from there.

                      Good luck!

                      -be safe

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau

                       02/19/2007 13:49:21|U



                      Date Posted: Mon Feb 19, 2007 4:10 PM
                      Posted By: ESPARKS (Veteran Villager)

                      BCPCPer

                      you really gotta cut back on the caffeine, your way to quick to be on the defensive whenever some body makes a comment.

                      Quote by BCP "This is not a small town hillbilly protocol that is used by backwood volunteer systems."

                      Well I gotta tell you I, am now in a backwoods rural service in a very large state with a small population and our statewide protocols are much more aggressive when dealing with cardiac arrest.We run all codes to the current AHA guidelines including full ACLS recommendations. Just because your in a rural area doesn't mean you need to be the bubba & me transport service. Strive to better yourselves and it CAN happen If your provincial government body does not feel it is necessary, vote their arses out of office and get somebody who cares into office. Don't just ASSume that because a service is staffed by volunteers that they are uneducated and unqualified to provide excellent prehospital care at the ALS level.

                      Expand your horizons and your knowledge , you might find that every service does not consist of fat lazy donut eating basics with a poor attitude!
                      Rant done
                      Ed


                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Mon Feb 19, 2007 5:25 PM
                      Posted By: BCPCPer (Junior Forum Member)



                      I hear ya Ed,

                      I apologize if i made it seem like am against rural services or volunteer services. I did not intend to do that. I just felt like i had to justify my protocol. I realize now how different my protocol must seem to others. I do agree that my protocol definatly needs some work. As I am a new attendant this is really the only arrest protocol i have ever know. I am curious though, could you tell me what your protocol for an arrest is? I can imagine it is quite different from up in British Columbia. From talking to other people ive kind of found out that not many other services make their medics stay on scene for a exact period of time.

                      Once again, i did not mean to offend anyone, I just wanted to kind of defend the protocol(although i realize now that i wasnt really attacked in the first place)





                      Date Posted: Tue Feb 20, 2007 4:36 PM
                      Posted By: ESPARKS (Veteran Villager)

                      BCP: here are our entire statewide protocols for all license levels. the link will give you a PDF file that you can peruse at your leisure. They are laid out in a simple to follow color coding format. every provider in the state is covered by one set of protocols instead of being service or receiving hospital specific.
                      http://www.maine.gov/dps/ems/docs/index.html#Protocol

                      Ed



                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Fri Mar 02, 2007 1:52 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Okay I'll give you a call that will be hard to beat!!!!!!

                      05:40 this morning we were toned out for a vehicle crash through the guardrail at the bridge. While en-route received a call from the deputy off at the scene informing us that it was in fact a large dump truck sized plow & sander truck that had crashed completely through the barrier and several large trees and was completely submerged in the ocean channel beyond the bridge. All he could see was a slight glow of the yellow roof of the truck under about 4 feet of water.
                      We get the heavy rescue truck started with all the water rescue gear and survival suits along with additional manpower. As we pulled up on scene we observed several people leaning over the side of the bridge looking down the 20 ft. drop into the water. Thinking to ourselves this is a hell of a way to start the day. we gather up our gear & head down the hill.
                      The weather is just about a white out snow storm and blowing 30 easterly at around 25 degrees f air temp , 36 degrees water temp.

                      As we were getting set up to go exploring a way down the bank the deputy calls to say the driver is out and had climbed up the rocky cliff to a house. He was a verrrrry lucky fellow and only had minor scrapes and abrasions plus a bunch of contusions and a little bit of hypothermia going on. packaged and off to the hospital we go.

                      Right now we are waiting on the Coast Guard , the DEP, the EPA and a host of other agencies to decide how they're going to get this truck back from the bottom of the ocean as it is leaking fuel and oil into sensitive fishing grounds and clam flats.

                      A call you'll never see in the big city !
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Fri Mar 02, 2007 2:26 PM
                      Posted By: jsadin (Veteran Villager)

                      It's gonna suck for the truck driver when he gets the bill....



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Mar 02, 2007 2:28 PM
                      Posted By: elvismedic (Veteran Villager)

                      I've heard of giving your truck a bath before but that is a little extreme.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Fri Mar 02, 2007 4:39 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Just found out that they are going to wait until 5:30 tomorrow morning due to the storm surge and timing of low slack tide. They are bringing an 80 ton crane down to set up & pick the truck from the drink That will completely block our only way in or out of the islands for however long it takes. They also need a 4 man dive team to go in to hook up sling cables under the truck. This ought to be quite the show. good for a few laughs. The truck belongs to one of the largest site work / paving contractors in New England and they will probably eat the bill in house rather than file an insurance claim.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Sat Mar 03, 2007 5:36 PM
                      Posted By: elvismedic (Veteran Villager)

                      Great weather for a swim in Maine. Better them than me.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Mon Mar 05, 2007 12:19 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Well as I thought it turned out to be a 6 hour cluster duck. We arrived on scene & set up traffic control and waited for the ensuing masses to arrive. By the time all was said and done we had our fire /rescue dept. a dive team with 40 foot boat , the coast guard , clean harbors, the state marine patrol , county sheriffs deputy, and about 30 employees from the company that owned the submerged vehicle, along with various trucks , front end loaders an 80 ton hydraulic crane with 150' stick, two lowboy tractor trailers and a bunch of safety dept. folks. Also camera crews from two of the network tv stations to record this for posterity and the evening news.

                      After seeing the damage to the vehicle it was very apparent that the driver was the luckiest man alive to have survived this crash and been able to escape from the submerged truck. We told him to go out and buy a bunch of lottery tickets that night.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Thu Mar 08, 2007 9:50 PM
                      Posted By: Chadwick41311 (Junior Forum Member)

                      I am just going to hit the high points of the last two weeks.

                      Monday, 12 yo fall with injury. 1 inch lac L forehead, CA&OX2 out of 4, PERRL@3mm.

                      Tuesday, multi-car MVA, 2 Patient Refused Treatment and Transports, One Concusion in my unit c/o everything pain bilaterally. Boarded and collared. Good PMS, PERRL @ 4mm, CA&OX2 of 4.

                      Wednesday, What started out as a routine transport to the cardiologist started having severe chest pain and severe SOB. Pt had extensive cardiac history. PVC's everywhere on the monitor. Lights and Sirens to the ER.

                      Thursday, OFF.

                      Friday, I cleaned up before work, shined boots, the whole 9 yards and got paid back by the trauma gods with a single vehicle SUV vs. tree, two patients, 21 yo WM semi conscious, oriented X1, L pupil sluggish, L chest pain, diminished breath sounds on L, SOB, two lacerations on his face and scalp (windshield spidered), bilateral leg pain midshaft tib-fib (no other s/s of fx) and bp 190/100. The other little guy was a 17 yo c/o head pain and L mid shaft tib-fib pain. CA&OX4, PERRL@4mm, V/S's WNL. No other transport units within 30 miles at that time. I put one on a board on the bench and one on the stretcher and went very fast with lights and sirens. Unit and I were both trashed at the ER.

                      Tuesday, stress related chest pain, middle aged WF, PRT, ALS called back, obvious signs of a bloody fight and pt is now stoned.

                      there have been several not so eventful transports in between, even a nasty forest fire today.

                      My partner Sandy tells me that here lately I have been a magnet for the sick and weird.



                      Date Posted: Sat Mar 10, 2007 2:44 PM
                      Posted By: Chadwick41311 (Junior Forum Member)

                      Ok so theres more,
                      Friday: 6am, transport to outpatient surgery

                      11am, call came in "pt not breathing" ALS had me ride with them, enroute dispatch got on the radio, "pt is 14 yo with long medical hx. CPR in progress." I was in the back so I was throwing things on the stretcher for a code. We get on scene, pts in the basement. We grab the medic bag and the monitor and head down stairs. Pt is in the back bedroom. Family member attempting CPR on a young girl with hx of multiple genetic birth defects. Upon exam pt found to have lividity, asystole in all three leads, coroner contacted.

                      3pm,Transport from home to Physical Therapy Dept for wound care and then back home.

                      6pm, Hospice transport from res. to hospital for respite care, hospice stated pt was actively dying. Pt had that look about him, made it to the hospital alive.

                      9:30pm, dispatched to single car injury accident multiple occupants. On scene 5 PRT's. They had been out riding around and swerved to miss a deer and went for a ride in the ditch.




                      Date Posted: Fri Mar 16, 2007 4:51 PM
                      Posted By: snapcount (Junior Forum Member)

                      I did ambulance ride 2 of 3 recently for my EMT-B clinicals:

                      - 85 yom chest pain, woke him up in the middle of the night, 10/10 non-radiating, sharp and aggrevated by respirations. Has a pacemaker/defib implant, tells us this is "the same pain he had during his first heart attack". Obvious dependent edima, very pale and diaphoretic, SOB. Medics put him on the lifepack and gave him a spray of nitro, couldn't get an IV started, 15L NRB. Hospital was only 3 minutes away transported emergency.

                      - 71 yom unresponsive at a nursing home. Found him supine in bed, snoring resperations, jaw dropped open. Staff had him on a simple face mask. Asked what his sugar was and we get "...pause... stutter... 71 an hour ago". History of renal failure, had dialysis yesterday. Guy was swollen all over. Medic took BGL en-route, it read "low" which means < 30. Hospital is literally right across the street. We arrive they get a line in the guy, check his BGL again and it's 13! Paramedic walks back across the street and talks with the supervisor about the "71". Nurse pushed some dextrose and two minutes later the guy was awake and talking. First time I saw that so it was cool to see such a drastic change.

                      - 75 yof syncopal episode.

                      - MVA motorcycle -vs- ground. Guy dumped his bike low speed coming off the interstate on an off ramp. Woo hoo trauma! He was very stable, minor abbrasions, complaining of L side pain. + helmet, leather everything, boots (smart guy). Got to pack him up, do rapid and detailed assessment on him. He was worried more about somebody telling his wife than anything. "She'll kill me, don't call her" x 100.

                      - MVA car -vs- car. Cancelled by FD.

                      - MVA car -vs- motorcycle. Cancelled by FD.

                      - 15 yof SOB at the high school. Boyfriend breakup leads to panic attack.

                      - SOB cancelled by Fire. Pt. Refusal.

                      - 52 yom ETOH found passed out on the side of the road by LEO. BGL was good, no injuries... he left in the "other van" to sleep for a few hours.

                      - 60 yom allergic reaction. Guy took his loritabs with Cap'n morgan. Refused transport.

                      -------------------------
                      snapcount



                      Date Posted: Fri Mar 16, 2007 9:32 PM
                      Posted By: jsadin (Veteran Villager)


                      Mmmm...Cap'n Morgan and meds. A winning combination to be sure.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Mar 16, 2007 11:05 PM
                      Posted By: AZCEP (Veteran Villager)

                      Geez, I thought everyone knew that you don't mix lortab and the Captain. It's percocet and Captain Morgan. Lortab and Smirnoff's.

                      Get it right people.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Fri Mar 16, 2007 11:19 PM
                      Posted By: snapcount (Junior Forum Member)

                      You know... that call really drove home the importance of "forming a general impression" and "scene size up". My thought process as we walk in the hotel room.

                      "Scene safety, check. Doors to my back and the cop has a gun and a taser".... "hmm... half empty bottle of Cap'n Morgan..... and a pill bottle"...."half empty pill bottle".... "half empty bottle of loritab".... "this isn't an alergic reaction this is natural selection..."

                      Turns out he consumed the loritabs at a far slower rate than the Cap'n. His wife freaked out and called... he was very relaxed and calm. I was hoping I'd get to mix up some activated charcoal but he took the crap 2 hours prior to arrival and his vitals were fine. He was just a little sleepy =)

                      -------------------------
                      snapcount



                      Date Posted: Sun Mar 18, 2007 11:05 AM
                      Posted By: VanHelsing (Veteran Villager)

                      I need a winge... sorry oakes.

                      I was working on friday day, at the goverment/provincial service, and we got dispatched to go and meet the ambulance crew for back up. "Patient assualted with a brick, not responding."

                      So we finally meet up with them... lets start with the ambulance, its an old box shape ambo, not even big enough to swing a lemming in without hitting every side panel... but ok, so I crawl inside, and sure enough there's our patient, with a massive bandage around his entire head, except for his mouth, which was put on after he managed to spurt blood all over ever surface in the ambo.

                      pateint is lateral ( WOW, well done ambo crew... usually I find them lying supine, gurgeling on their own blood ), but as luck would have it... trismus.

                      Attempt IV sites in his arm, with no luck, so he gets a external jugular vein, and lots of morphine and midazolam.

                      Now it is impossible to pre-oxygenate with a BVM because (a) Its broken , and (b) bandage makes a seal impossible.

                      Now back to the Ambo... there is about 10cm of space above the patients head, before the front panel. The strecther gets pushed in right to the front, i.e. no convenient gap to sit in while intubating. So i am trying to shrink into that space ( unsuccesfully ), and end up having to lie on my side ( in all the blood ) and do a semi- lateral, upside down intubation... which worked eventually.

                      But thats after I ask the driver to pull over and stop the vehicle ( She went inbetween stalling, and 120mile per hour around corners and traffic, the 4th time I got thrown against the wall, I though that was enough )... so she stops as requested, and comes around to the back of the ambulance and opens the door... This is where I go into heart failure. The driver has just stopped smack in the middle of the highway, and all I see when looking out the back doors is lots and lots of fast oncoming traffic...

                      No, sweetie, please stop somewhere SAFE !

                      Now being the provincial service, everything is broken, so we have no sp02, no nothing, except the ET tube and the BVM. the patients eyes have been bandage shut, and the rest of him is covered in blood. And to make things fun, the main line of the oxygen is leaking, and the wall flow meter is faulty... And no Sp02.

                      So I used my portable cylinder, so atleast one thing was correct.

                      We finally get to Johannesburg general hospital, and they are closed for P1 patients... NO ! I had just finished thanking the man upstairs for letting me get to THIS hospital alive.

                      Please let me never relive that call. Just for the record, I had never seen these 2 ambulance crew before, and I'd like to keep it that way.







                      Date Posted: Sun Mar 18, 2007 2:23 PM
                      Posted By: jsadin (Veteran Villager)


                      Jeesus VH. I can't post about my little old lady with SOB at 4am after that.

                      Get some rest and go wash your blood-soaked uniform. When you moving to Australia?



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Mar 18, 2007 9:42 PM
                      Posted By: ncmedic309 (Veteran Villager)

                      I hate those kind of calls - you can't win regardless...



                      Date Posted: Tue Mar 20, 2007 12:59 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      Wow! Almost makes me want to quit bitchin' and say thanks. ...almost

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Thu Mar 22, 2007 9:23 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      I'm beginning to think working my forties and then having the entire week off is not going to cut it much longer.....either that, or I'm going to have to learn how to sleep during the day...

                      Just a quick synopsis...
                      14 yr old assault victim w/Fx nose and facial trauma~transported
                      30ish diabetic with a sugar underload~transported
                      30ish with too much ETOH~vomited, felt fine~non-transport
                      38 yr old male assault victim~related to person that assaulted first patient~transported
                      14 month old with sustained seizure~airway, suction, high flow diesel
                      50ish Tummy ache w/fever~non transport
                      64 yr male with MI history in January now having 9/10 CP and SOB~BP 200's/120's~nitro, ASA (yes it was ordered my medical control...)and intercept
                      2 teens in rollover~cancelled by PD
                      34 yr old alcoholic w/kidney damage having extreme pain~hypertensive, has pitting edema in lower extremities, very hard abdomen~transported
                      13 mo old w/hives~evaluate and send by the ride service the reservation provides to residents w/out cars, or cars w/out keys, or cars w/no gas...hence the nokeyitis, nocarditis....
                      43 yr old male~hypertensive, tachycardic after digging drainage ditches in his yard~but he thinks it's just a panic attack and after thinking about it refuses transport (might have, just might have been some meth involvement there~me does pages of paperwork to CYA myself)
                      Welfare check on elder that won't answer phone....funeral is next week....

                      I think there was a couple of other ones in there, but can't remember the details...must not have been transported.

                      Now I'm going to go take a nap.....wake me next week in time for the next shift please......

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       03/22/2007 21:26:57|U



                      Date Posted: Sun Mar 25, 2007 4:52 PM
                      Posted By: jsadin (Veteran Villager)


                      Yikes Clutzy! Busy 40.

                      Only two calls during my 16hrs. Croupy 2yr old male at 1am....transported at docs request (young lad was fine). 2nd call was THE messiest code I've ever worked. 64 y/o male coded on the toilet. When I saw him, a first responder had removed him from the toilet and placed him supine on the bathroom floor...in about 1/2" deep of dark brown GI contents (which filled his mouth to the top, btw). I directed the first responder to get compressions going while my partner hooked up the defib and I suctioned the airway. There was no where to stand/kneel that wasn't covered in yuck, and we all ended up with it on ourselves somewhere. He was asystole during the whole time with a bit of PEA in the ER. It took us about 1hr to decon the truck and all associated equipment. My uniform is in the wash right now.

                      On the up side, everyone did a great job and there was good teamwork.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Mar 25, 2007 6:26 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Jim: nothing like a code brown to make you ask Why am I doing this????

                      Clutzy: you need to take it a little easier girl, Thats way too many calls for one crew!
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Sun Mar 25, 2007 9:08 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      I have to agree Ed.
                      I am going to try two more shifts, and as soon as my reports are done I am going to lay down and try to catch some sleep. I think some of my problem is not knowing when to rest....like in the middle of the day, lol. If it still feels like I am not on the top of the game towards the end of shift I am going to start pushing for shorter shifts.
                      I just got done reading the article in the current Jems magazine about sleep deprivation, and boy does that make sense. I am willing to try a couple more shifts, try to sleep some, and then see how I feel about continuing with the forty's....if I feel I am vulnerable to making mistakes towards the end of the shift then I will have to try and see if the schedule can be modified.
                      I know they have always ran forty hour shifts for the EMT's since they began, but the call volume wasn't there in the past either, and that makes a huge difference.....

                      Jim~thought something smelled kind of funny....**hands Jim a case of wet wipes and a beer** been there, done that...lol. Takes awhile to get the smell out of your nose tho...

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       03/25/2007 21:11:16|U



                      Date Posted: Mon Mar 26, 2007 8:09 AM
                      Posted By: ESPARKS (Veteran Villager)

                      Not only are the shifts doing a lot more calls than in the past , resulting in less sleep , lets face it girl We are all getting older. When I was in my twenties I thought nothing of working 2 or 3 back to back 24's. Then as the 300's & 40's came along my body started demanding at least 4-5 hours per night. Now that i'm into my 50's i really play hell trying to catch up on all the lost sleep from my youth. the other night after being up for 32 hrs straight , i went to bed at 6 pm. and slept straight through until 9 the next morning.

                      Take care & get some ZZZZZZZ's
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Mon Mar 26, 2007 8:28 AM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Quote

                      Originally posted by: ESPARKS
                      Then as the 300's ...


                      You're older than 300???

                      Gadzooks, man! Just how much EMS experience do you have????

                      -be safe

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Mon Mar 26, 2007 9:31 AM
                      Posted By: jsadin (Veteran Villager)


                      (takes wetnap from clutzy and wipes ick off ruben, boots, pants, etc...downs beer in one long swallow)

                      40hrs straight is a b*tch, especially when you don't get sleep. I've done up to a 36 straight with no sleep, but I was a giant mess by the end.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Mar 26, 2007 10:10 AM
                      Posted By: elvismedic (Veteran Villager)

                      Dirt is younger than Ed. That's about the only thing I know of. Ed's license is engraved on a stone tablet.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Tue Mar 27, 2007 9:17 PM
                      Posted By: ESPARKS (Veteran Villager)

                      I had a couple of very busy days & nights at the end of last week. Started @ 3 AM thursday and didn't manage to get a whole lot of sleep until sunday night. Just a little slap happy !!!! Elvis is right my original EMS license only had 3 digits. I had to turn that one in cause that damn piece of granite was way toooooo heavy to carry around. The new paper ones are much easier to put in your pocket. :-]
                      ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Tue Mar 27, 2007 9:22 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Mike: If you check into the history books You will find a picture of me with my first ambo crew standing beside our 1967 pontiac raised top wagon. Wasn't a lot of room but it sure did go like a rocket ship pass anything but the gas pumps.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Sun Apr 01, 2007 7:03 PM
                      Posted By: jsadin (Veteran Villager)


                      04:30am - code (wakey wakey! Shouldn't have watched Borat until 1am). Thankfully not the "code brown" that I had last Sunday. Got my first field tube (woot woot). Hey, those cords look just like they do in the OR.

                      10:30am - transfer home.

                      12:30pm - 14yr old on side of road bleeding from head. Friend states she fell, patient doesn't have a clear recollection of the incident, positive LOC. Decent 1" lac to midline occipital portion of head, PLUS two lacs on left side of face (one above left eye and one under left nostril). Huh? How do you fall while walking down the road and injure both sides of your squash? PD isn't buying it either and after some interrogating of the friend it is revealed that the friends boyfriend beaned her off the head with a large piece of ledge. Not sure if it was horseplay that got carried away or if he was really trying to hurt her, but the location of the injury on the back of her head had some potential for serious harm....even death. Friend's boyfriend arrested for assault/battery and patient transported to hospital without incident.


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Apr 01, 2007 9:12 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Congrats on the tube Jim !! It's always nice when things go as you plan.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Sun Apr 01, 2007 10:31 PM
                      Posted By: BCPCPer (Junior Forum Member)

                      March 31st night shift was semi slow but 2/3 calls were quite interesting,

                      Call 1 1300 for a "SOB Infant" arrived to find baby in moms arms blue, limp and definatly not breathing, baby apparantly got her head stuck in an open shelve just slightly taller than herself, grab and go while bagging the baby the whole way, by the time we got her to the hospital she was breathing on her own around 30 a minute and was starting to pink up,

                      Call 2 1534 for abdo pain, frequent flyer off his meds, pain all over, hasent eaten in few days, drinking for weeks, etc etc,

                      Call 3 1755(just before shift change) for a suicide attempt, arrived to 50 year old male on the floor of apartment, fire department holding his head and bagging the pt. Rope still between doorway, ovbious abrasions around neck, pt unresponsive and bleeding excessivley through his mouth. Empty morphine and lorazepam bottles by pt's feet, naloxone enough so he could maintain his own airway, 2 iv's, unresponsive but breathing on own entire way to hospital, last time I checked at around 2200 that night he was still unresponsive after repeated narcan's and was to be xrayed,ct'd.

                      That was our 3rd hanging in just under 24 hours, wonder whats up with that,



                      Date Posted: Mon Apr 02, 2007 12:33 PM
                      Posted By: jsadin (Veteran Villager)

                      Thanks Ed! Didn't even need a bougie.

                      3 hangings in 24hrs? Good crap...that's a bad run.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum

                       04/02/2007 12:34:34|U



                      Date Posted: Fri Apr 13, 2007 9:25 PM
                      Posted By: elvismedic (Veteran Villager)

                      First call is a "diabetic emergency." We arrive on scene to find a 75 YO F arms shaking violently and hyperventilating. Pt is responsive to verbal stimuli. I tell her to take slow deep breaths as I check her blood glucose. Off the finger stick it's 250. Shaking is almost stopped now. Extremity carry pt to stretcher move her to the truck. Inside, Pt is still responsive to verbal. Appears worn out. Pt admits to feeling tired. Pt vitals taken WNL. IV est. Labs and glucose off IV is 145. Pt on monitor SR in the 80's. Pt at gathering following a funeral for her 48 YO son.

                      Next call 36 YO M C/O migraine. Pt found in bathroom of town pool. Pt Known to EMS for same. Refused Tp. Was driving by when migraine became unbearable and he had to go to a dark place.

                      3rd call 7 YO F C/O R arm Fx. EMS on scene after Engine Co. and off-duty FF/FMT-P (neighbor) Pt in no apparent distress. Arm Fractured approx 3" proximally to wrist. Splinted w/ magazine? (prior to EMS) and swathed. Medic on scene reports Collies Fx. + CSM's. Pt Tp to Pedi ED.

                      While clearing Pedi ED dispatched as primary ALS to Code a the assisted living center. BLS on scene AED no shock. Staff states +20 min down time. CPR ALS 15 min away. Mutual aid ALS started. Recall off duty ALS. Arrive on scene. Off-duty ALS reports Pt initially asystolic. intubated, EJ, IVP epi X 3, Atropine X2. Rhythm changes to accelerated IVR @ about 80 w pulses and spontaneous intermittant resp. Rhythm changes again to AF. Resp's continued assisted with increasing incidence of spontaneous resp. HR increases to 100. Corresponding pulses. Rhythm to SR in the 100's no change in resp's. Figure poor long-term outcome. But excellent BLS CPR.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sat Apr 14, 2007 9:41 AM
                      Posted By: jsadin (Veteran Villager)

                      Elvis, what's accelerated idioventricular rythm look like on the monitor? I'm assuming it's just QRS complexes (no p-wave) at a rate higher than what one would normally expect for a ventricular moderated rythm. Have you seen much of that in the field?



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum

                       04/14/2007 16:55:07|U



                      Date Posted: Sat Apr 14, 2007 10:58 AM
                      Posted By: elvismedic (Veteran Villager)

                      Jim this is what ECG's Made Easy 2nd Ed. says about Accelerated IVR.

                      Rate 41 to 100 (I was told by another medic that a good rule is any ventricular rate above 60 is accelerated)

                      Rhythm Essentially regular

                      P waves Usually absent or, with retrograde conduction to the atria, may appear after the QRS (usually upright in the ST segment or T wave)

                      PR interval none

                      QRS duration greater than .12 seconds, T wave frequently in opposite diection of the QRS

                      I'd describe it no P wave Q wave is deflected negitivly and pointed with a width of about .12. The R wave is positively deflected about equal in amplitude to the Q with a width of about .2 and rounded peak. There is no S wave

                      http://library.med.utah.edu/kw/ecg/mml/ecg_accel_idio.html

                      It's not exactly what I was looking at but it's as close as I could come

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sat Apr 14, 2007 4:57 PM
                      Posted By: jsadin (Veteran Villager)

                      Thanks elvis. That's kindof what I was picturing in my mind, with a few additions.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Apr 14, 2007 5:31 PM
                      Posted By: AZCEP (Veteran Villager)

                      AIVR is faster than 40 beats per minute and less than 100. Typically it will be about 65-70 beats/minute, but the definition stands.

                      IVR is going to be slower than the 40 beats per minute that is the inherent rate of the ventricular pacemakers.

                      It's actually become quite a bit more common as the technology develops to identify it sooner. AED's/AICD's/faster manual defibrillators all make it more likely that a idioventricular rhythm will present at some point. It also shows up following reperfusion of an MI.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Sun Apr 15, 2007 1:24 PM
                      Posted By: jsadin (Veteran Villager)


                      AZCEP, I knew you'd be here eventually!

                      Thanks for the info.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Apr 18, 2007 2:48 AM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Only one call in the last four days!! Wooohooo.....oh yeah, chuckle, I'm just on the volley squad, the "real" job starts tomorrow.
                      Kind of weird because I've had this "icky" feeling the last few days that I've been on the volley pager that something "not good" was going to happen, and I don't get them very often...

                      Paged out this morning at 0744 for a "child bitten in the face by a dog".
                      *feel the stomach sinking*
                      Arrive to find several school children and parents gathered around a seven year old boy that had been mauled by a (sorry Kat) half breed husky. He wasn't just "bitten" in the face, the damn thing sunk it's teeth in directly under the eye socket and pulled the left side of his face away, back of his scalp, and he also had a pretty significant bite wound to his neck as well as several on his arms and hands where he was trying to keep his face covered. Obviously fractured septum as well as possible fractures to his zygoma and maxilla....
                      Not 100% sure what ensued before the attack, but apparently the dog was nursing six puppies and the little boy picked on up and one of the other kids that was there said the puppy started squealing and that was all it took for the attack.....
                      Gotta say I'm an animal lover from the bottom of my manure encrusted cowgirl boots to the top of my hard head, but when it comes to having a dog that even has the slightest bit of "attitude", it is definetely NOT going to be allowed to be loose. Not even if it's in my own yard unless I have a fence tall enough that no-one can get in and the dog can't get out. Apparently this isn't the first time the dog has bitten someone.....

                      End of Rant......

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       04/18/2007 02:50:13|U



                      Date Posted: Wed Apr 18, 2007 1:32 PM
                      Posted By: jsadin (Veteran Villager)


                      Nasty call Clutzy! I hope the little guy gets put back together ok. I gotta wonder why he was near the dog and its puppies unsupervised? Everyone knows you don't get between mama and her babies (not if you value your appendages).



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Apr 18, 2007 3:28 PM
                      Posted By: AZCEP (Veteran Villager)

                      Tough to blame the dog for that one. Past history aside, some will only learn through a painful event.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Wed Apr 18, 2007 8:42 PM
                      Posted By: stridor (Veteran Villager)

                      Started the day with a nasty dog bite to an eight year old, followed by an MVA, then had a nice fall victim, she really was a sweet old lady, then a diabetic emergency, directly to a vaginal bleed, then had a resp call turn into an inferior MI right in front of me, two more mva's, a seizure, another resp, and a refusal. then I came home.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Wed Apr 18, 2007 9:12 PM
                      Posted By: jsadin (Veteran Villager)


                      Busy day stridor! Here...have a beer.


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Apr 19, 2007 10:53 PM
                      Posted By: CBEMT (Senior Forum Member)

                      Quote

                      Originally posted by: stridor
                      Started the day with a nasty dog bite to an eight year old, followed by an MVA, then had a nice fall victim, she really was a sweet old lady, then a diabetic emergency, directly to a vaginal bleed, then had a resp call turn into an inferior MI right in front of me, two more mva's, a seizure, another resp, and a refusal. then I came home.


                      There. Now isn't that better than 12 dialysis runs?



                      -------------------------
                      Village Geek



                      Date Posted: Fri Apr 20, 2007 11:14 AM
                      Posted By: stridor (Veteran Villager)

                      absolutely, I wouldn't have it any other way. I'm jumping other peoples calls, squirreling runs, and self dispatching left and right.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sun Apr 22, 2007 11:56 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Last night was quite rough...

                      We had a total of 7 MVA's. I can only remember that because i looked at my trip sheet this morning, they all kinda blurred into each other.

                      Then we had 2 PVA's, both dead.

                      Then we had to go and declare 4 dead people, 1 medical, and 3 assualts.

                      THEN... the call I do remember...

                      Dispatched to a burns patient, arrive on scene to find an 8 year old girl, burns approx 50% BSA, from beng caught in a shack fire. But here is the sad part, the mother stabbed a man ( unknown ), so as pay back, he poured petrol all over the shack and set it alight while the 2 children were inside. Unfortunately the 3year old sister was burnt to death.

                      The 8 year old suffered inhalation burns, burns to the face, 50% of left arm, 30% of right arm, 60% to back, and 100% circumferential burns to both legs.

                      Treatment included intially a B2 neb, then I sedated her with Morphine and midazolam, and intubated her, putting in an inline nebuliser with adrenaline and more B2. her chest cleared up considerably, but I still fear her prognosis is poor.

                      bunch of savages in this country.




                      Date Posted: Sun Apr 22, 2007 11:58 AM
                      Posted By: AZCEP (Veteran Villager)

                      Aside from the burning of two children, we have similar problems here VH.

                      The world is a scary place some times.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Sun Apr 22, 2007 7:46 PM
                      Posted By: jsadin (Veteran Villager)


                      VH's calls always make me fell so....inadequate.

                      Call1: 67 y/o male calls the station direct requesting an ambulance for a cramp in his right leg X 3 days {sigh}. UOA pt is sitting on bed attempting to put on pants. No swelling or redness noted in effected limb...pt states cramp started in right calf after a fall on Friday. PmHX: IDDM, MI X 3, HTN. Good pedal pulses, no pain on palpation, able to ambulate ok but pt insists on transport (no, I didn't try to talk him out of it. ). Mental status seems a little "off" (sorry maj). BGL in truck is 398. IV established (NS), 12 lead (NS w/occasional PVCs), O2. Recheck pedal pulses and find right foot getting cold. Hello Mr. DVT! Pt was headed for an ultrasound before we left the hospital.

                      Call2: 49 y/o male, altered mental status. Patient is able to give all the correct answers to questions, but is slow to respond and very lethargic. Schizophrenia history. Sister states pt not compliant with meds last few days and not eating well. NS lock, vitals, transport w/o issues.


                      I wasn't on the call, but five teenagers were involved in a high speed crash on a back road in a neighboring town...four dead, one in a coma. The families are a mess.


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Apr 23, 2007 1:39 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Had a few good patients today.

                      1. Two men cleaning out a tank which formerly contained white liquor and was cleaned with solvents. Started coughing while in tank. Became SOB, throat, nose, and lungs all burning. Thankfully no pulmonary edema. Had them drink some milk to stop the irritation of the throat as no swelling was apparent after 1 hour. Then they went back to work fourty five minutes later.

                      2. Male suffering from lime burns to eyes bilaterally with a line in his peripheral vision of L eye. Sent to hospital via ambulance after flushing eyes.

                      3. Male with ash in L eye. Visualised and removed with eyewash and a sterile cotton applicator. Relief felt. Polysporin eye gtts then back to work.

                      Also had multiple blisters and lacerations throughout day.

                      I worked industrial nursing today,

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Mon Apr 23, 2007 10:57 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Sorry jsadin, I also have quite days sometimes !

                      Grambo, how did he get lime in both eyes ? and what was the source ? Gardening ? just was wandering...

                      VH



                      Date Posted: Mon Apr 23, 2007 2:24 PM
                      Posted By: jsadin (Veteran Villager)


                      Your quiet days are my busy days VH.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Apr 23, 2007 10:51 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      He was working on taking some tubes out of a large piece of equipment. As they did this, the lime in the ash surrounding these tubes loosened and he got a cloud of it in his face. It penetrated under his safety glasses and got his eyes.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Mon Apr 23, 2007 11:29 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      VH does more in a day than I do in a month out here.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Tue Apr 24, 2007 4:06 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      Jsadin, VH - Please! never say the "Q" word when I can read it here in the ER - it will ruin my 8 hr coffee break.

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Tue Apr 24, 2007 9:23 PM
                      Posted By: jsadin (Veteran Villager)


                      The Q word? Oh, you mean QUIET!!!



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Apr 24, 2007 11:10 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Jim : i hope your next shift is filled with drunken high schoolers and lots of chum.!!! never use the Q word. :-]
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Wed Apr 25, 2007 9:47 PM
                      Posted By: jsadin (Veteran Villager)


                      Thanks for the well wishes Ed!


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Apr 25, 2007 11:02 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Don't mention it! no worries mate you shall be rewarded for using the word.
                      ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Thu Apr 26, 2007 3:38 AM
                      Posted By: CBEMT (Senior Forum Member)

                      Middle-aged male, history of HTN, sudden onset of 10/10 chest pain with SOB at work (contracted local college). Took two asprin prior to our arrival, pain 6/10 on arrival but he was still grey with the Look of Impending Doom. No 12-lead monitor for me today, NSR in 3 leads. Vitals ok except for resp rate. NRB, IV, 2 more asprin, 1 nitro. Offscene in 11 minutes including removal. Closest PCI facility diverting, skipped 2 community hospitals in favor of the next closest PCI (an extra 3 minutes). Pain "almost all gone" in triage, color back, no longer in distress.

                      SOB since the weekend at the nursing home. In-house CXR says "maybe LL infiltrates, maybe CHF." Mid 80's% on 2 liters with a long and distinguished COPD history. Wheezing along quite well. Vitals ok. Monitor, IV, 4 liters, one neb enroute. Decided not to go the CHF route, not enough to go on. Family says we gave her more care in the first 10 minutes than the nursing home has since she's been there (2 weeks).

                      "Weak and dizzy with low BP." Yeah, I'd say 70/nothing is low enough. NRB, monitor, saline WO with the biggest IV anybody's going to get in her (20), and run. Sugar's fine. HR is irregular with no history but couldn't confirm AF. Found out yesterday that she went back to the nursing home later that night but don't know the dx.

                      -------------------------
                      Village Geek



                      Date Posted: Thu Apr 26, 2007 6:45 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Hi CB.

                      Sounds like good calls, I was interested to read that you gave more aspirin to your first patient. What was his total dose, and can you explain why you gave the second dose ?

                      Just out of curiousity, had the pain not subsided, would you have considered Morphine ?

                      VH



                      Date Posted: Thu Apr 26, 2007 10:15 AM
                      Posted By: jsadin (Veteran Villager)


                      If CB's protocols are similar to ours, we can give up to 320mg of ASA. If the patient had taken two 80mg baby aspirin, you still have two more you can give.

                      Not sure if they've blessed CB with the magical morphine yet.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Apr 26, 2007 12:47 PM
                      Posted By: AZCEP (Veteran Villager)

                      There is yet to be a determination of what the "optimal" dose of ASA actually is. Some like to start low, watch for adverse reactions, then re-dose. Others will give the full amount, problems be darned.

                      My personal rule is if I don't see you actually take your ASA, you get two more, because as we all know, patients lie.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Thu Apr 26, 2007 2:33 PM
                      Posted By: jsadin (Veteran Villager)


                      Oh so true! I love when you get to the hospital and you're giving your report and they suddenly change their story (and then the nurse looks at you like you have three heads).



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Apr 27, 2007 12:43 AM
                      Posted By: CBEMT (Senior Forum Member)

                      Quote

                      Originally posted by: VanHelsing
                      Hi CB.

                      Sounds like good calls, I was interested to read that you gave more aspirin to your first patient. What was his total dose, and can you explain why you gave the second dose ?

                      Just out of curiousity, had the pain not subsided, would you have considered Morphine ?

                      VH


                      Hi yourself VH.

                      Assuming he took the 2 at the onset of pain like he said he did, his total for the incident was 324mg. My protocols were recently changed from 162-500mg down to 162-325mg, in accordance with AHA recommendations. The rational for the 500mg limit, as I've been told, was to account for larger patients for whom 324mg might not be enough given their size.

                      Basically I gave him the additional dose because ASA has been shown to be the safest intervention with the best cost/benefit ratio of any AMI treatment short of PCI. There was no contraindication to this patient getting more Asprin and the benefits as I said are obvious. I'm not sure why I wouldn't have!

                      If the pain didn't subside, he was getting another nitro. I can consider Morphine all I want, but it's an optional drug here and we don't carry it. It's also a Medical Control option and without a 12-lead I doubt I would've gotten clearance for it. Finally, given my transport time, by the time I got off the phone with the doctor my partner would have been standing at the back door tapping his foot waiting for me to let him pull the stretcher out.

                      That's also assuming the ER Communcations Center nurse doesn't hang up on me when I ask for a doctor like they did last time- when I DID have a hot MI.

                      -------------------------
                      Village Geek



                      Date Posted: Fri Apr 27, 2007 7:55 AM
                      Posted By: stridor (Veteran Villager)

                      Yesterday was an interesting day. Started with a drug overdose in the detention center. A two year old who fell out of a stroller and down a flight of stairs +LOC <1 minute. Pedi board and trauma transport. An eight month old with N/V and dehydration. Then two fall victims, immediately followed by seizures, a diabetic, another diabetic that was really an MI, an RMA, and a recall. Then we had an impending delivery, high flow diesel to the hospital. Finished the day up with a resp and then on the way home attended to an accident since it was blocking the road and I couldn't really go anywhere anyway.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Mon Apr 30, 2007 11:07 AM
                      Posted By: VanHelsing (Veteran Villager)

                      ok, just to prove we also have quiet days...

                      last night:

                      Call 1: Gun shot wound, to bilateral tib/fibs. ( personally I think this security guard actually dropped his gun, by the angles of the wounds, but he swears somebody else shot him )

                      Call 2: 3am in the morning, pt calls us because he is shivering..... , well, it IS winter.

                      And that was that.



                       04/30/2007 11:08:27|U



                      Date Posted: Mon Apr 30, 2007 12:39 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      And the temerature was what? 24 degrees C?

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Wed May 02, 2007 2:05 AM
                      Posted By: VanHelsing (Veteran Villager)

                      No, to give him credit, it was REALLY cold. I rate ATLEAST 10degrees C.





                      Date Posted: Sun May 06, 2007 12:31 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Chuckle, if that is REALLY cold, you'd better dress warm when you come visit. That's a typical overnight low in mid summer here and it'll be winter when you arrive.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun May 06, 2007 4:18 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      If you put a minus infront of that 10 C (-10 C) then you aproach the average high during winter in most of Canada.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun May 06, 2007 4:43 PM
                      Posted By: CanuckEMT (Junior Forum Member)

                      Unless you live in the Southern Alberta bananna belt!!!!

                      Gotta love those chinooks!!!

                      -------------------------
                      Challenge is what makes life interesting, overcoming them is what gives it it's meaning.



                      Date Posted: Sun May 06, 2007 6:37 PM
                      Posted By: jsadin (Veteran Villager)


                      24hrs and 1 patient...whooo...I'm pooped.

                      56 yr old female cc chest pain. O2 and ASA before the long carry down the stairs from her house (she was not a skinny little thing, either). Medic sets up a 12 lead while I attempt IV access. Pt is also diabetic, takes lasix, has 1 kidney and tells me right away they have a hard time getting a line on her (oh great). Needless to say, I can't find anything worthy of cannulating, but I make two attempts (flash..blown) and then hand the reins of IV power over to my partner. My partner manages to get a "positional" 20 in the hand (take what you can get, right?). I felt a little better when the ER couldn't draw labs after multiple attempts (I did feel bad for the patient who looked like a pin cushion by then).

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue May 08, 2007 1:41 AM
                      Posted By: stridor (Veteran Villager)

                      Was supposed to work 1900-0700 instead worked 1400-1900 1900-0700 and got five more hours. First part did five calls. Two seizures, a pedestrian struck, an MI, and a pediatric fall. Since 1900 I've had , a cardiac, diff breather, back pain, an allergic reaction, two recalls and an assault. Don't know what the next five hours got in store for me.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Tue May 08, 2007 8:43 AM
                      Posted By: stridor (Veteran Villager)

                      Got a diff breather at 0345 that turned into a medic call with capap and eventually intubated, a couple of maternity cases and an mva at 0550. Then I cleaned up the truck and took off for home.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Tue May 08, 2007 10:11 AM
                      Posted By: jsadin (Veteran Villager)


                      Stridor, your call review postings are starting to look like VH's!

                      Better than 12 dialysis runs in a row, eh?

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue May 08, 2007 4:35 PM
                      Posted By: stridor (Veteran Villager)

                      Quote

                      Originally posted by: jsadin
                      Stridor, your call review postings are starting to look like VH's!

                      Better than 12 dialysis runs in a row, eh?

                      Yeah, I was thinking that when I wrote it. Camden feels like another world sometimes, but I wouldn't have it any other way. I like to actually make a difference. Not any cheesy crap like "Saving" anyone, its just actually attending a situation that you can help with rather than feeling like I am contributing to the decline of the medicare program, and contributing to a poor quality of life.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Tue May 08, 2007 9:00 PM
                      Posted By: jsadin (Veteran Villager)


                      It's just nice to come home at the end of the day and feel like you accomplished something. Glad to see you're experiencing that. For a while there I was worried that you were going to throw in the EMS towel and go work in the plumbing dept at Home Depot.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue May 08, 2007 9:11 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: phunkymedic

                      After a year or two of metro I may get burnt out and wish I was back on the quiet rural system.. we'll see.. but for now, I'm enjoying the change of pace. I think we all need it now and then.


                      Let me know when you want to return to the quiet days of a rural service.



                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Tue May 08, 2007 9:13 PM
                      Posted By: stridor (Veteran Villager)

                      Kat, when I get my medic cert, I'm gonna hold you to the whole Canada thing.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Tue May 08, 2007 9:18 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      I don't want you. You and all your big guns scare me.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Tue May 08, 2007 10:25 PM
                      Posted By: Police_EMT (Junior Forum Member)

                      Looks like i'll have to check someone's permits and see if their current. Do you think a psych is called for?

                      Thanks for the concern, i'm having the first signs of 911 symptoms, I'll be well taken care of , my little lady is a nurse. Thank Clutzy also.

                      -------------------------
                      Welcome to Le'Village.


                      Village Cop, tazer ready



                      Date Posted: Wed May 09, 2007 7:38 AM
                      Posted By: stridor (Veteran Villager)

                      Quote

                      Originally posted by: arctickat
                      I don't want you. You and all your big guns scare me.

                      You slay me Kat. That's funny dude.
                      Just what do you think I would be getting rid of to satisfy Canada's self sufficiency requirements?

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Wed May 09, 2007 10:09 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Gun collectors are allowed to keep their weapons, you'd just have to pay through the nose for licensing.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Wed May 09, 2007 1:36 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Yeah, stridor is starting to sound like me...

                      Who do I sound like:

                      1 call in a 12 hour Saturday night shift : 5 hour return trip for a blocked catheter....







                      Date Posted: Wed May 09, 2007 6:33 PM
                      Posted By: jsadin (Veteran Villager)


                      That sounds vaguely familiar...



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed May 09, 2007 11:20 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Ahh, nice and relaxing.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Thu May 10, 2007 7:24 AM
                      Posted By: stridor (Veteran Villager)

                      Yesterday I did a half shift 1500-2100. It was apparently pediatric day, had a 10 year old
                      w/resp, a fall with fracture also 10 yo, a 6mo old baby boy with an allergic reaction, a 6 yo boy hit by a car on his bike, and another resp. Then went home. After a 17 hour shift a 6 hour shift just whizzes by.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sat May 12, 2007 9:34 AM
                      Posted By: stridor (Veteran Villager)

                      Did a 0700-1500 yesterday wasn't too bad. Came in to a respiratory, then a seizure, a diabetic, and a psych. Had a little break then went to a sepsis case, and then a syncope in a dialysis center where they took too much fluid off of a guy and put his BP in the crapper. Had two no pt. found cases, and a possible stroke.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sat May 12, 2007 11:14 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      I'm glad you didn;t pace her.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sat May 12, 2007 11:32 AM
                      Posted By: VanHelsing (Veteran Villager)

                      yeah, you have to cardiovert, right ?



                      Date Posted: Sun May 13, 2007 7:18 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      I might as well share our night.

                      Cleaned up after the last shift. In their last little bit they got their second motorcycle, this vs deer, we got the splinting job (first was a wheelie that destroyed the Tib).

                      MVA with anterior disloc, and her partner with mult facial lac, Fx nose, trashed sinuses - these two put their car over an edge and hung it vertically in a tree 6' off the ground. Reduction, Sutures to face

                      Chest Pain

                      Tot with a persistant UTI

                      Two teenagers living in a meth lab- mom now in the crowbar hotel. Drug screening

                      Bronchitis

                      Kidney stone Sx, prob. constipation

                      And whatever comes in next. At night we're Admitting, Records, the switchboard, there is no ward clerk, Cardio/pulm and pharmacy. on weekends we also have to wait for lab and radiology to come from home - the delays can lead to a jumbled confusion at times - can be as hectic as working on the rig, but the weather's better.

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Sun May 13, 2007 3:38 PM
                      Posted By: jsadin (Veteran Villager)


                      One call last night at 11:30pm.

                      Dispatched for 62y/o male sudden onset SOB. Arrived to find said male standing in doorway of trailer with mild difficulty breathing (still speaking in full sentences). No CP, no asthma, no emphysema, no COPD. SpO2 89% RA. Place on non-rebreather at 15ltrs and SpO2 up to 95%. Assist to stretcher and move to ambulance. Pt suddenly becomes severely agitated, begins complaining of 9/10 CP and stating "I'm not going to make it". Oh joy. Call for ALS intercept, send wife to front with partner, get rolling. 4 ASA, establish a line enroute, set up 12 lead for medic intercept. Meet up with medic and open the door to see a young female medic with severe deer-in-the-headlights syndrome. Yup...brandy new. Give her a quick rundown of what we have and almost before I'm done she's on the radio calling for another medic. Patient is so diaphoretic the pads are falling off while we're trying to get a decent 12 lead. 3 s/l nitros w/no relief. 2nd medic hops on board (about 1 min from the hospital), takes a quick look and says "just go...by the time we draw up the meds we'll be there".

                      Needless to say, pt was RSI'd and tubed before I finished my run report.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed May 16, 2007 3:40 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      That medic should be thanked and congratulated. She knew her limits and was not afraid to call for help when she needed it. She did not fake it and that can be hard to do when you are "supposed" to know it. Be sure to give her a pat on the back for that one.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Wed May 16, 2007 9:21 AM
                      Posted By: EMB08 (Junior Forum Member)

                      Im new on here, just trying to get involved when I can, so Ill post...I had an awesome day, 12 hours, 3 calls...love it!

                      #1--57 yo F, allergic reaction to shell fish, also noted white stuff on her lips, apparently she thought it was a good idea to CHEW 2 Vicodin prior to our arrival, I informed her Vicodin was the wrong drug, and def. the wrong admin route!

                      #2- 36yo M, back pain, nothing special, picked up his kid and felt a pop

                      #3- Structure Fire @7-11! Very exciting, not really, but would have been if the place was well off!



                      Date Posted: Wed May 16, 2007 10:18 AM
                      Posted By: jsadin (Veteran Villager)


                      Grambo,

                      You are absolutely right...she knew she was out of her league and called in the big guns. I always thank any medic that intercepts with me.

                      On another note, what do the resident medics here think about this situation? Should a new medic be able to run this type of call solo or is that simply expecting too much?



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed May 16, 2007 10:46 AM
                      Posted By: elvismedic (Veteran Villager)

                      As a new medic I was told by my Chief that if I had a priority 1 call or a call that I thought it might progress to a priority 1 I have to call for another medic. Two years later I still don't feel comfortable with every call and question myself all the time. I was told by a very experience medic when I got my I that the further you progress in skills the easier and quicker you can kill patients.

                      I can only guess what she was feeling and thinking, but I'd say she made the right decision. If you call and nothing happens then so be it. All you did is inconvenience another medic. If she hadn't called and the call went down the crapper then she'd be hung out to dry. It's a catch 22 situation.

                      I will say that if I'm less than 5 out from the ED I'm not stopping. That's the only issue I see with your situation.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Wed May 16, 2007 6:34 PM
                      Posted By: jsadin (Veteran Villager)


                      We didn't waste any time waiting for the 2nd medic, so I don't have a problem with how things went. It's good that she another medic to reach out to...that's not always the case in the rural areas I frequent.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed May 16, 2007 9:37 PM
                      Posted By: elvismedic (Veteran Villager)

                      Jim I certainly am in no place to criticize the decisions that were made. I was just stating my opinion. I am nowhere near experienced enough to pass judgment on another medics actions. I've just seen to many practitioners at all levels sit and wait for more help when they could have already arrived at the ED instead of sitting on the side of the road.

                      In my own service this happens all the time. Especially with the less experienced BLS providers. I've seen many occasions where the BLS crew waited 10 to 15 minutes for the ALS crew to respond back from the ED instead of loading the patient and heading to the ED and meeting the ALS crew enroute.



                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Wed May 16, 2007 9:53 PM
                      Posted By: jsadin (Veteran Villager)


                      Didn't even think you were criticizing elvis! I'm always glad to have input from everyone.

                      Yeah, waiting on the side of the road bugs me. I'm a big fan of get-the-hell-in-the-truck, especially considering our extended transport times. We burn enough of the golden hour just driving.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu May 17, 2007 12:16 AM
                      Posted By: CBEMT (Senior Forum Member)

                      I think the senior medic needs a pat too, for knowing that things had progressed to the point where he wasn't going to make the situation any better.



                      -------------------------
                      Village Geek



                      Date Posted: Thu May 17, 2007 10:25 AM
                      Posted By: jsadin (Veteran Villager)


                      Too true CB.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu May 17, 2007 3:27 PM
                      Posted By: EMB08 (Junior Forum Member)

                      Maybe Im wrong here, but as a new medic, I sometimes feel more comfortable with a code, or an MI than somthing that is a little more confusing, because those are the scenarios that you run over and over and over in class, and in your head. I ran a code about 2 weeks ago that I felt good after, but ran an allergic reaction on Monday that I felt like a bumbling idiot afterwards!



                      Date Posted: Thu May 17, 2007 4:42 PM
                      Posted By: stridor (Veteran Villager)

                      Quote

                      Originally posted by: elvismedic
                      Jim I certainly am in no place to criticize the decisions that were made. I was just stating my opinion. I am nowhere near experienced enough to pass judgment on another medics actions. I've just seen to many practitioners at all levels sit and wait for more help when they could have already arrived at the ED instead of sitting on the side of the road.

                      In my own service this happens all the time. Especially with the less experienced BLS providers. I've seen many occasions where the BLS crew waited 10 to 15 minutes for the ALS crew to respond back from the ED instead of loading the patient and heading to the ED and meeting the ALS crew enroute.

                      You guys don't have the golden tent peg award? If one of our crews waits too long on scene when they get back they have to carry the golden tent peg until the next crew waits too long on scene, then they can hand it off. On a serious note I really don't like to tie up medic units to "Come check this guy out" and it usually doesn't make good sense to wait on scene. I call and ask for an ETA on medics and then cancel them if I am closer to the hospital than the ETA is cause they won't catch me.
                      Guess I will go ahead and post my slow day here. 0900-1500 had a psych, a resp, two cardiacs, one with medic treat, a hypoglycemic pediatric patient, a chf with medic treat, and a recall.



                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Thu May 17, 2007 9:28 PM
                      Posted By: elvismedic (Veteran Villager)

                      I love it.

                      Never heard of the Golden Tent Peg before. I'll have to stop at Wally World for tent pegs and gold paint.

                      It really irks me to see crews sitting on the side of the road when they could be at the hospital in the time they spent waiting.

                      I believe this occurs because crews are afraid to be chewed out by the ED nursing staff for not being ALS. Personally, I try to educate them on my protocols. When that fails I just turn and walk away.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Fri May 18, 2007 8:27 AM
                      Posted By: stridor (Veteran Villager)

                      That's really all you can do Elvis. While it irks me to see crews sitting on the side of the road, and the golden tent peg is funny if done correctly, I can't say that breaking balls helps make them better BLS providers. I wish I could condense the philosophy of one of the best medics I have ever worked with into a few sentences, but basically he chose to educate rather than humiliate. The medics here are pretty awesome, they are competent and conscientious. The thing I think I like the best about them is that none of them act like they never were emt's, and they understand what it is like to be terrified and have no idea when the cavalry is coming.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Fri May 18, 2007 12:34 PM
                      Posted By: elvismedic (Veteran Villager)

                      I know it's kinda childish now, but, when I first started working full-time I made a pact with my first regular partner. In the agreement we both said that if either of us advance our training and forgot where we came from the other had the right to punch the other in the face and say remember where you came from. I realize neither of us would have taken it literally, but it's always been there in the back of my head. Remember where you came from.

                      I haven't been a medic for very long. I've spent most of my career as an I. In that capacity I've worked with some really good and some really bad medics. Most of the bad one's were very arrogant and belittling. One medic stated to me flat out "All you are allowed to do is vitals. I'll do the rest." So that is all I did. The medics attitude change soon after. Some of the I's I've worked with had more knowledge than their medic partner.

                      I do have to admit thought. I love going to the ED and using medical terminology that is pretty basic with the arrogant nurses. Dysphagia, dysphasia, and tachypneic are the most commonly used. I love to see the blank their blank stare of incomprehension. Again I know this is childish but it's still fun.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Fri May 18, 2007 11:35 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Elvis : I'm proud of you my boy. You seem to have learned the lessons we tried to pass along as we handed out aspirin patches. Good on ya! Bobby would be proud. may he R.I.P.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Sat May 19, 2007 3:10 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Quote

                      Originally posted by: EMB08
                      Maybe Im wrong here, but as a new medic, I sometimes feel more comfortable with a code, or an MI than somthing that is a little more confusing, because those are the scenarios that you run over and over and over in class, and in your head. I ran a code about 2 weeks ago that I felt good after, but ran an allergic reaction on Monday that I felt like a bumbling idiot afterwards!


                      You should never feel comfortable in complex situations and especially codes. When I approach a code I usually feel like wetting myself before we started.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sat May 19, 2007 9:29 AM
                      Posted By: VanHelsing (Veteran Villager)

                      grambo, I dont think thats exatly what EMB08 meant.

                      I think I see where he is coming from, more along the lines of feeling more confident, because he knows exactly what he has to do, and whats going to happen next.

                      I can understand that mentality.

                      Where as you get to a patient, who has a disorder you are not familiar with ( Acanthocheilonemiasis ), you dont know what to do, what to give, and keep wandering, is this patient about to drop dead.

                      yeah.. thats a bit nerve racking !



                      Date Posted: Sat May 19, 2007 9:31 AM
                      Posted By: VanHelsing (Veteran Villager)

                      And just for the record...

                      Acanthocheilonemiasis is a rare tropical infectious disease caused by a parasite, Acanthocheilonema perstans. It can cause skin rashes,abdominal and chest pains, muscle and joint pains, neurologic disorders and skin lumps. The parasite is transmitted through the bite of small flies.

                      VH




                      Date Posted: Sat May 19, 2007 9:57 AM
                      Posted By: jsadin (Veteran Villager)


                      Another reason I don't live in the tropics...weird f'n diseases.


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat May 19, 2007 11:45 AM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Quote

                      Originally posted by: VanHelsing
                      grambo, I dont think thats exatly what EMB08 meant.

                      I think I see where he is coming from, more along the lines of feeling more confident, because he knows exactly what he has to do, and whats going to happen next.

                      I can understand that mentality.



                      I can see both sides of this. I can see how running through codes in school over and over again can instill a sense of confidence in actually running one in the field. Unfortunately, I think this "confidence" breeds complacency.

                      Running a code in school is always the same. It's the same movements over and over again. There's little room for assessment. You don't look for other causes save a passing mention of "5 H's and 5 T's". You don't look for reversible causes much less do anything about them.

                      So what happens? In real life you wind up in the field with a cardiac arrest that *is* treatable and potentially salvageable and you do nothing about it. Why? Because you've run these mock codes in school, never had the chance to actually address the issues surrounding the code and never had to think for yourself. This is where I think some of Grambo's concerns come into play.

                      And ultimately, I think I'd side with him on this particular issue.

                      Having a sense of confidence is a good thing. Unfortunately, and I think this can happen to anyone especially those new to their level of practice, confidence breeds cockiness breeds complacency breeds bad medics.

                      And we don't need bad medics.

                      But that's just me.

                      -be safe



                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Sat May 19, 2007 12:18 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: grambograham


                      You should never feel comfortable in complex situations and especially codes. When I approach a code I usually feel like wetting myself before we started.


                      Remember people, this quote is from a Nurse. Can we really expect any more?

                      Edit:

                      Me too Mike. Megacode scenarios simply provide us with an ability to practice going through the motions, but provides nothing that can help us to identify many of the more complex and reversible causes for the code. We are led down the yellow brick road of thinking we did everything right, but he stayed dead, rather than realizing there was something we could have done to alter the outcome and potentially save this life. It's goten to the point of paramedics acting like robots, start CPR, IV, push med A, intubate, push med B, but not recognise that the rhythm showed huge peaked T waves just before the arrest. I, for one, am a big fan of also using point of care blood chemistry. Medics can be intelligent enough to be able to have a very strong index of suspicion in most cases if they want to be, but having the blood chemistry to confirm an electrolyte imbalance would go a long way to solving a big problem.


                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk

                       05/19/2007 12:46:23|U



                      Date Posted: Sun May 20, 2007 2:46 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Nice ArcticKat, bash the nurse's statement and then agree with it.... typical medic.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun May 20, 2007 9:14 AM
                      Posted By: stridor (Veteran Villager)

                      Yesterday was the single most boring day I have had yet at work. had six runs. Two were cancelled, one refused, one resp, one psych, one pediatric trauma.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sun May 20, 2007 9:23 AM
                      Posted By: stridor (Veteran Villager)

                      Quote

                      Originally posted by: PARAMEDICMIKE
                      Quote

                      Originally posted by: VanHelsing
                      grambo, I dont think thats exatly what EMB08 meant.

                      I think I see where he is coming from, more along the lines of feeling more confident, because he knows exactly what he has to do, and whats going to happen next.

                      I can understand that mentality.


                      Having a sense of confidence is a good thing. Unfortunately, and I think this can happen to anyone especially those new to their level of practice, confidence breeds cockiness breeds complacency breeds bad medics.

                      And we don't need bad medics.

                      But that's just me.

                      -be safe

                      Mike I think the fact that you put the word confidence in quotes in the first sentence of your reply is what tells off on the whole concept. True confidence knows it limits. Fals confidence is like false pride it can not allow anyone to know that it has limits. Fear will paralyze a person, fear is a killer. I don't think that you or Graham actually "Fear" codes, I think that both of you wisely respect the potential that is present in that situation and conduct yourselves accordingly.


                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sun May 20, 2007 2:03 PM
                      Posted By: MJMC4404 (Senior Forum Member)

                      Quote

                      I don't think that you or Graham actually "Fear" codes, I think that both of you wisely respect the potential that is present in that situation and conduct yourselves accordingly.


                      Exactly what Stridor said.

                      -------------------------
                      I'm NOT short, I'm INSEAM CHALLENGED

                      Village Sanitation Engineer



                      Date Posted: Sun May 20, 2007 2:51 PM
                      Posted By: jsadin (Veteran Villager)


                      Call 1: OD on Klonopin (well, not really. 6 0.5mg pills 10mins prior to our arrival).

                      Call 2: Uncontrolled epistaxis. Thought it would be a crap call 'till we rolled in and saw granny with about 3-400cc's of blood loss and still bleed profusely (on coumadin). Pinching the nose slowed the blood loss considerably. Cleaned her up as best we could and put on a new bathrobe. Line, vitals, direct pressure. She did fine.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun May 20, 2007 6:02 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Woo Hoo!! I got to butt heads with a Doc today....Yippee!!! I just hope I won.

                      Here's what happened.

                      24 year old female, primagravida. She had no idea that she was pregnant. Last menses was May 4th. I get called to transport her to a hospital with an obsterician. I arrive for report, she's been in labour for 12 hours, 4 cms dilated, 90% effaced, membranes intact, and possibly carrying twins. Where do they send her? To a freaking hospital that does not have a NICU.

                      Don't get me wrong here, where they wanted us to go is fully capable of delivering these babies and the Doc there is an exceptionally competent obstetrician, but I don't think anyone really thought about what to do after the babies are born. You see, since this hospital does not have a NICU they would have to transport these babies another 90 miles to the NICU. They probably would have flown them with the neonatal transport team, but out here medical air service usually takes about 2 hours to show up. So...lets go through the high risk factors here....

                      1. Primagravida
                      2. No prenatal care
                      3. Twins
                      4. Small fetus (At least the head we could feel was small)
                      5. No clue when conception took place or if these are preemies
                      6. University student, no drug use, but she was drinking at parties throughout the pregnancy.

                      I managed to convince the doc the hard way that a hospital with a NICU would be a much better choice even if it was an additional 30 minute drive for her and, that if I had to, I could call for assistance from highly experienced neonatal transport medics. The only reason they chose the place they did was because it was closer and they thought she might not even make it there before giving birth. I pointed out that it took her 12 hours to get 4cm, and although it can't be predicted, it'll likely be more than three before she's even close to delivering.. By the time we arrived she'd dilated only one more cm. I suspect she'll deliver in about 4 more hours. The doc wasn't happy, but I made it clear that I was taking her to the best hospital and that he'd better call and make arrangements.

                      See? It's not only newbies here that I'm a jerk too, I even chew up docs in real life. I just hope I was wrong, I figured the odds were about 1:10 for those kids to stay out of the NICU though, it was the best choice though in my mind.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun May 20, 2007 8:21 PM
                      Posted By: jsadin (Veteran Villager)


                      Good work Kat. Sounds like with the info presented that you made the right choice. Tough call to butt heads with a doc tho'. Anyone that can make life hard for you?



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun May 20, 2007 9:33 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Naw, he was a locum. My docs would have listened and respected my opinion, then told me hmm, VH, what's the SA version of F-off?

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk

                       05/20/2007 21:33:52|U



                      Date Posted: Sun May 20, 2007 9:42 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Quote

                      Originally posted by: arctickat


                      24 year old female, primagravida. She had no idea that she was pregnant. Last menses was May 4th. I get called to transport her to a hospital with an obsterician. I arrive for report, she's been in labour for 12 hours, 4 cms dilated, 90% effaced, membranes intact, and possibly carrying twins. Where do they send her? To a freaking hospital that does not have a NICU.




                      Kat, clarify for me, please. Getting ready to deliver twins yet her last menses was almost three weeks ago?

                      Otherwise, I'd say beat heads with the doc. I think you argued a valid point. Let us know what happens!

                      -be safe

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Sun May 20, 2007 9:55 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Yes, her last menses was 3 weeks ago. That's why there was no prenatal care...she didn't think she was pregnant. It really concerns me too if she was trying to diet thinking she was simply getting fat. You hear stories like this, but you never think you'll actually see it. This woman was by no means overweight and had significant stretch marks. Either she was in severe denial or just not in tune with her body at all.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun May 20, 2007 9:59 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)



                      Yipe!

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Mon May 21, 2007 2:34 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      I called the hospital today for a followup. Mom and babies are doing well. babies were both under 5 pounds but are expected to thrive well.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Mon May 21, 2007 8:27 PM
                      Posted By: stridor (Veteran Villager)

                      That's great news about the babies Kat. Mothers to be with complications scare the crap out of me. Had a diabetic today straight out of the gate, a resp, an mva, an assault, two more resps, a cardiac, back pain, two cancelled by PD, and finished up with a resp. Average day in Camden. I can smell the gunpowder on the wind, it's getting warmer and we're getting more assaults its only a matter of time till they start shooting.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer

                       05/21/2007 20:28:20|U



                      Date Posted: Mon May 21, 2007 8:52 PM
                      Posted By: jsadin (Veteran Villager)


                      Is it still better than dialysis runs stridor?




                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon May 21, 2007 10:42 PM
                      Posted By: elvismedic (Veteran Villager)

                      So far today:

                      1. Motor vehicle Vs. Pedestrian No transport

                      2. Chest pain and "the shakes." The shakes were supposedly hereditary but not parkinsons. No changes and no CP

                      3. Another chest pain. No changes. Relieved pain with 1 ntg and 325mg asa

                      4. MVC in front of station. No transport.

                      5. Called away from MVC for car fire. I am second medic in town on ALS engine company.

                      That's it for now but there's still 9 hours left in the shift.

                      Hung the "closed" sign on the door and turned off the lights.


                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Mon May 21, 2007 11:54 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      No calls today, I just wanted to post the 500th message to the thread. Great topic VH

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Tue May 22, 2007 7:09 AM
                      Posted By: stridor (Veteran Villager)

                      Quote

                      Originally posted by: jsadin
                      Is it still better than dialysis runs stridor?



                      Always


                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Fri May 25, 2007 4:47 PM
                      Posted By: MJMC4404 (Senior Forum Member)


                      Quote

                      Originally posted by: stridor
                      Quote

                      Originally posted by: jsadin
                      Is it still better than dialysis runs stridor?



                      Always



                      EVERYTHING, and I mean EVERYTHING is better than dialysis runs.

                      Wednesday:

                      1. 91yo Female with "shooting pinky toe pain" and actually was in apparent pain... but allergic to morphine and other opioids. And, oh yeah says the nursing home nurse: she's confused today and it was hard to wake her up. (She lives with Alzheimer's already, so....) Turns out she was actually as sharp as a tack and knew more than the nursing home staff did.

                      2. Difficulty breathing, home health aide came to patient's house to find him sitting on floor with nasal cannula 8 feet away. Nailbeds and lips blue, goes ~350lbs EASY w/ some pretty bad looking feet if ya know what I mean.

                      3. Nice little "age challenged" woman tripped at the curb when exiting the local beauty shop, friend helping her couldn't help but laugh when describing how patient bounced off their parked car and landed on her butt. Ya know the patient might be a retired nurse when she tells you that it's her "coccyx hurts".

                      4. "Overdose" on medication... took 4 extra-strength Tylenol over the period of 5 hours. Bottle said every 4 hours, daughter concerned for her "age challenged" arthritic father.

                      5. 13yo female softball player heat exhaustion during a game.

                      6. Dispatched for a "91yo female with an altered mental status". I said to my partner..ya gotta be kidding, it can't be. Yep! Same woman from the morning. Still sharp as a tack. Staff told us walking in that "she's in bed and we can't wake her up". When we walk into Patient's room she is in the bathroom tending to business. Says that nothing is wrong, why am I back again? Aaaarrrrrrggggghhh!

                      Thursday: Nothing (?!?)

                      Friday: Nothing with 80 minutes left in the shift. WTF?!?

                      I guess anyone who needed my services this week took care of everything Wednesday.





                      -------------------------
                      I'm NOT short, I'm INSEAM CHALLENGED

                      Village Sanitation Engineer



                      Date Posted: Sat May 26, 2007 9:15 AM
                      Posted By: stridor (Veteran Villager)

                      Quote

                      Originally posted by: MJMC4404
                      Quote

                      Originally posted by: stridor
                      Quote

                      Originally posted by: jsadin
                      Is it still better than dialysis runs stridor?



                      Always



                      EVERYTHING, and I mean EVERYTHING is better than dialysis runs.



                      You know it. Anyway, on thursday I had 4 falls, two medicals, a resp, two refusals, one lift assist, and a no patient found. Yesterday I worked 1-7 to fill in for a guy and had two resps, a cardiac, a little girl who fell and bloodied her nose, a refusal, a a cancelled, and a no patient found. Still loving it. One of the no patient found cases was called in as a gunshot, I guess the guy had better bullet dodging skills than the caller thought. We never did find any blood or anything even though it happened close enough to base for us to hear the gunshots.


                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sun May 27, 2007 5:50 PM
                      Posted By: jsadin (Veteran Villager)


                      11:30pm - Chest pain, SOB. Dude had to weigh almost 400lbs. Thank gawd he had one of those electric lift chairs to get him off the 2nd floor. ASA, O2, line, nitro, ALS intercept. Pain went from 8/10 on scene to 0/10 at the ER. Nice.

                      9:00am - Roll over MVA, car on fire, kids and driver entrapped (gulp). Kids already out by the time I arrived; I took the driver. 38y/o male, perseverating, already extracted by first responders/PD (good by me since the car was burning). Acting the part of a head injury, but the physical injuries didn't seem right. He came around a bit with high flow O2 and then told me he was diabetic. Checked a BGL after I got a line and he was 21. Hey bud, I know why you crashed! The helo had already been called and was less than a minute out by then, so I let them take him in. Called the hospital for some patient info later that afternoon and he'd already been released (kids ok too). Good deal.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon May 28, 2007 11:09 AM
                      Posted By: stridor (Veteran Villager)

                      Man that sounds like a high pucker factor on that call Jim! I had a pretty average night last night. A resp, a couple of kids with high enough fevers to seize, an assault that got collared and boarded , a domestic, and a no patient found. Oh the things you can do in a seven hour run.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Mon May 28, 2007 12:32 PM
                      Posted By: Mother (Veteran Villager)

                      Quote

                      Originally posted by: jsadin
                      38y/o male, perseverating...
                      Verbally, or otherwise?



                      -------------------------
                      I see dead people.



                      Date Posted: Mon May 28, 2007 4:54 PM
                      Posted By: jsadin (Veteran Villager)


                      Strictly verbally Mother.

                      Question for the villagers: by the time I had the BGL and realised this was a diabetic issue, the helo was almost landed. I opted not to give any oral glucose and simply asked the doc to push D-50 when he jumped in (it's not within my scope, but I had a good 18 in his left AC). Did I make the right call or should I have gone with some oral glucose?

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon May 28, 2007 7:11 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      If he was at all altered mentally, you made the right call. Why risk aspiration if D50W is an option quickly. Glucose only does well if it is swallowed. The glucose molecule is too large to penetrate the buccal membrane so having the glucose in the mouth will do next to nothing.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Mon May 28, 2007 7:54 PM
                      Posted By: AZCEP (Veteran Villager)

                      Finally have something worth adding to this thread.

                      41 year old male assaulted with a pipe to the face. Point tenderness to cervical spine. Shooting pain to lower back. Positive loss of consciousness. Laceration under left eye. NO spinal precautions taken by BLS first responding EMT. A little educating of the EMT done with a hopeful understanding of what this mechanism may cause.

                      31 year old female assaulted with closed fist to nose. No loss of consciousness. No neck/back pain. Bleeding from nose controlled with a little pressure. Full spinal precautions taken by BLS first responding EMT. A little more educating of the EMT with more hope that discretion will be used in the future.

                      61 year old male with "palpitations". Turns out he had a run of Afib RVR and on our arrival heart rate bouncing from 110-140/minute. Discussed what was going on, and convinced him to allow us to transport. Enroute heart rate increased to 180-225/minute with symptoms associated. 2.5 mg of Verapamil later, heart rate maintained at 110-118/minute.

                      ER doc and nurse wanted to know why I didn't use Cardizem to control the rate (we don't carry it), and why we didn't use Adenosine first (won't work for identifiable AFib/flutter). First time in probably 6 years that Verapamil has been used in the area.




                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Mon May 28, 2007 8:19 PM
                      Posted By: jsadin (Veteran Villager)

                      Hi Grambo,

                      Thanks for the response. That was along the lines of what I was thinking. He was slow to respond and lethargic, so I didn't feel comfortable having him try to swallow oral glucose in a supine position. The doc didn't seem to grasp the point that I wasn't able to push D-50 at the intermediate level, although most people I meet in the hospitals have no clue what an intermediate is; they are only familiar with paramedic and basic EMT levels.

                      AZCEP, good for you for passing along a little education! Full spinal for a punch in the nose and not for the assault with the pipe? I hope this wasn't the same crew!

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue May 29, 2007 12:39 AM
                      Posted By: AZCEP (Veteran Villager)

                      Yep, same exact person doing the patient care for both.

                      I was being a bit generous considering these two calls made for numbers 5 and 6 for her.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Tue May 29, 2007 10:14 AM
                      Posted By: jsadin (Veteran Villager)


                      Poor kid sounds like she was having a rough day. Kind of you to educate and not squash like a bug...


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue May 29, 2007 10:24 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Well nobody actually needed medical care, but I did the medical stand-by for the Zulu Rally in Durban. The racing was great ! In my next life I want to be an off road rally driver... well, I guess there is still time in this life... anybody want to sponsor a Subaru ?





                      Date Posted: Tue May 29, 2007 10:27 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Subaru already has a team. Might wanna try a Merceges Sprinter.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Wed May 30, 2007 1:45 AM
                      Posted By: VanHelsing (Veteran Villager)

                      This is true, however the toyota quantum i did take around the stages didn't handle the corners very well at high speeds, the center of gravity is all wrong.

                      Subaru already sponsors a chicks teams, sp prehaps the mitsubishi lancer / evo , is the way forward.

                      VH



                      Date Posted: Fri Jun 01, 2007 9:27 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Thursday Night shift.

                      Call # 1: Gun shot wound , left auxillary and right auxillary... patient was intubated and chest was decompressed, but all a futile effort, he died on scene.

                      Call # 2: MVA - no service required

                      Call # 3: People stuck in lift for 2 hours, halligan tool, jack and elbow grease required.. no medical intervention needed

                      Call # 4: Head on collision at high speed. 4 occupants in one car, driver entrapped, femur fracture among other problems, not intubated, just given Morphine. All occupants unrestrained. Driver of other car P2... toyota tazz versus volvo... guess who won ! tazz now convertible.



                       06/01/2007 09:28:27|U



                      Date Posted: Fri Jun 01, 2007 1:52 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      *drags body over to computer**

                      Home finally from another shift in Hell....forgot to keep track of them but there was at least seven calls with ppl under 25 suffering chest pain and arm numbness. All of them were tachy with high BP's. Rumor has it that a new shipment of Meth has arrived and there is something wrong with it....evidently EMS and hospital personel are the only ones that know there is something wrong with it cuz they keep using it.....

                      One interesting call that is concerning me and I would like feedback on what others would think they are dealing with~~ 2030 or so we get called by the PD and asked to respond to a residence about 15 miles away for a parent that has called in and reported that her less than one month old infant is having difficulty breathing and is turning colors~~when I arrive the baby is lying flat on his back on the sofa bed and the PD officer has his hand on his chest and is watching him breath. I get over to the baby and ask what has been going on this evening~ the mother states that the baby has been sounding congested for the past couple of days. She has had him in to two doc's and they have sent him home after taking chest x-rays telling mom he's fine. Tonight she happened to be sitting beside him on the sofa and was watching him breath when she noticed that he took a big breath, screwed up his face as if he was trying to poop and quit breathing. She picked him up when he started turning blue and he immediately took a deep breath of air and began to breath again but irregularily...
                      VS on my arrival are R 35, HR 141, BP 68/p, PERLA, lungs sound slightly congested, abdomen slightly hard and tender. The infants head, face and neck are all "pink" and warm but his torso and extremities are mottled and cool to touch. The household temperature is warm, not hot in there and not cold, just a comfortable warm. The baby is dressed in a "onsie" and is fully alert. This is mom's fourth baby. He was born at 37 weeks and rushed off right away to a hospital with a neonate unit but released five days later with a full bill of health. She is compliant with all check-up apts.
                      As I am assessing he has another episode where he holds his breath and turns blue on me. This lasts approximately 30 seconds then he begins an irregular resp rate around 35-40, HR 135, BP 50/p, 02 reading is in the mid to upper 90's but I'm not trusting it.
                      Load baby into his carseat and carry him out to the ambulance~once inside the ambulance (remember he's sitting up in his carseat now at a 45 degree angle) strap his car seat into the captain's chair, place baby on 02, get mom strapped into the seat on the side bench and initiate transport. VS on baby are now P 155, R 58 and regular, BP 58/p and he is "pink and warm" on all extremities and torso, no longer has the "sick" look about him.
                      Baby transfers well to hospital w/out any "episodes", his VS remain midline for neonates and he is comfortable.
                      Upon arrival at the ED he is transferred over to the RN on duty, she takes him out of his carseat and lays him flat on the examination table where in less than two minutes he has turned cyanotic in his extremities again and is breathing sporadically with low 02 sats (89%)according to their ped monitor.....

                      My impression is a possible hole in a heart vessel or heart abnormality?? Any thoughts?

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       06/01/2007 13:55:44|U



                      Date Posted: Fri Jun 01, 2007 2:32 PM
                      Posted By: jsadin (Veteran Villager)


                      Possibly seizing due to orthostatic hypotension. What's causing the hypotension is another story.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Jun 01, 2007 3:09 PM
                      Posted By: MJMC4404 (Senior Forum Member)

                      Well, if it is a congenital heart defect, then tricuspid atresia would fit. Just seems it would have manifested earlier. Will spend some time thinking what else, and check back. Keep us posted.

                      I wondered where you had been!

                      -------------------------
                      I'm NOT short, I'm INSEAM CHALLENGED

                      Village Sanitation Engineer



                      Date Posted: Fri Jun 01, 2007 3:44 PM
                      Posted By: p3medic (Senior Forum Member)

                      tetralogy of fallot might fit the bill, love to hear some follow up if you get it



                      Date Posted: Fri Jun 01, 2007 4:04 PM
                      Posted By: AZCEP (Veteran Villager)

                      Being only a month old, I'd suspect any of a number of issues with the great vessels.

                      Patent foramen ovale, tricuspid atresia, tetralogy of Fallot, and patent ductus arteriosis can all present like this. Luckily I've only had to deal with a PFO and a tet child.

                      Follow up would be great, if you can get it.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Sat Jun 02, 2007 10:55 AM
                      Posted By: stridor (Veteran Villager)

                      Did a 2p to 2a 5/30 and had nine calls, two resps, a fever, a fall, an mva, a respiratory arrest, two assaults and a throwing up all night. Last night I did a 7p to 7a and had a dozen calls two refusals, two mva's, two resps, a cardiac, a CHF, an assault, a stabbing, an intoxicated person, and a kidney stone case.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sat Jun 02, 2007 11:13 AM
                      Posted By: jsadin (Veteran Villager)


                      Stridor, that is one hell of a busy service!

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Jun 03, 2007 6:24 AM
                      Posted By: rotorhead303 (New Forum Member)

                      I'm headed in ronight for a 36. I worked 24 on friday and did 4.

                      1) Cardiac transfer to ICU. 54 y/o male with AICD firing multiple times due to runs of v-tach. The referring hospital already had him maxed on the lido drip and he was fairly stable until we got in the air. He began in v-tach with a pulse rate of around 210. We ended up bolusing him with Amiodarone and then running a drip to convert him.

                      2) Scene response for 60+ year old male who got his wedding ring caught on something and partially amputated his ring finger. We bolused him with some Fentanyl and transported him to the hand center.

                      3) My depressing call for the shift. 74 yr old male with terminal lung cancer c/o severe respiratory distress. The referring ER started him on CPAP which made him feel a lot better. He's a DNR and doesn't want to be intubated. Our transport vent can't do CPAP so we rigged one with an anesthesia bag, manometer and an in-line nebulizer kit. His best friend was out in the hallway. They were together in the Army and had served as best man in each other's wedding. It just blew me away that they had been friends for that long.

                      4) Scene response for mvc, 18 wheeler vs car. Guess who won? We've had a new nurse riding with us all shift doing orientation so my regular partner has been kind of sitting back letting her do all the stuff. We get in the back of the ambulance and the patient's doing ok. 50 yr old male, slightly altered with GCS 13. Minor lacs to his head, vitals stable. We step out of the ambulance getting ready to load and my partner is standing there with 2 dozen Krispy Kreme donuts in hand. The delivery truck was sitting there in the parking lot we landed in so he had walked over to try and buy a dozen. The guy wouldn't take his money and gave him 2 dozen instead. Now, I don't know about everyone else but at 0630 in the morning, I didn't ask questions. I will say though that drinking ER coffee and eating Krispy Kreme donuts while watching the sun rise over Atlanta and talking with your best friend isn't a bad way to start your day.

                      Y'all be safe!

                      Patrick



                      Date Posted: Sun Jun 03, 2007 8:45 AM
                      Posted By: stridor (Veteran Villager)

                      Quote

                      Originally posted by: jsadin
                      Stridor, that is one hell of a busy service!


                      It's always like that, it's not always bona fide emergencies, but it's always busy. That night the two resps, the fall, and the fever could have went by pov, but they didn't have cars. I do kinda approach things differently there. Most of the time when we get called for something that doesn't really need an ambulance there are mitigating factors like the time that it happens there isn't any bus service or something like that. But boy do we get our share of BS along with all of it too. But all in all I would still rather take a hundred walking fever cases to the hospital on the night shift than do ten total bs lift jobs at my old gig.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer

                       06/03/2007 14:30:22|U



                      Date Posted: Sun Jun 03, 2007 4:25 PM
                      Posted By: jsadin (Veteran Villager)


                      I hear that stridor. Was at the hospital today after taking in my one patient in 24hrs (phew, I'm beat) and ran into a couple of friends that work for A*R. This paramedic/intermediate crew was doing a psych transfer. Great, lets pull an ALS crew out of the 2nd largest city in New England to do a psych transfer. Good ol' A*R.

                      My one patient (not including the ALS transfer for esophageal varices) was a 70 y/o male cc SOB. I'd taken him last week for chest pain/SOB and they placed three stents on Tuesday. Put him on the monitor and he's showing new onset A-fib (he was normal sinus before the stents). His arms were a wreck from all the poking at the ER during the week, but I managed to summon up a vein in his AC (couldn't see it, barely felt it) and I felt ok with that. A little O2 and some kind words and he was feeling much better when we hit the ER doors.





                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Jun 03, 2007 8:08 PM
                      Posted By: AZCEP (Veteran Villager)

                      So far, two patients in 24 hours, but there is an interesting development for one of them.

                      Patient #1: Mid-60s male complaining of chest pain X 18 hours. Oxygen/IV/ECG with no changes. One NTG and the pain disappears. Transported without incident.

                      Patient #2: 56 year old male assault victim. He was struck numerous times to the back of the head with a baseball bat, and a closed fist. Positive loss of consciousness prior to our arrival. Vitally stable. Repetitive questions/statements. Full spinal precautions, oxygen and an IV. Now, here's where it gets interesting.

                      During transport, I have the lights on in the back of the ambulance and the patient says that he sees a yellow spot out of his left eye. Okay, I think, maybe the lights are too bright. I dim the lights, and he tells me that now he sees a red spot out of his right eye, and the yellow one is still there. I check oculomotor function and there are no deficits. Good tracking and range in the four compass directions. I hold up a sheet of paper with some Sharpie created letters, and he tells me that the "spots" don't allow him to see the letters. From what he tells me, the spots are at about 45 degrees from straight up, and extend to about 75-80 degrees. No bleeding or other trauma noted to either eye or orbit. Posterior skull intact, without any soft tissue injury noted.

                      Rather bizarre, but nothing I'm going to do with the information besides tell someone else. Ideas?

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Mon Jun 04, 2007 12:38 AM
                      Posted By: CBEMT (Senior Forum Member)

                      Quote

                      This paramedic/intermediate crew was doing a psych transfer. Great, lets pull an ALS crew out of the 2nd largest city in New England to do a psych transfer. Good ol' A*R.


                      You sure? A*R hasn't run trucks in Providence for about 3 years now.

                      -------------------------
                      Village Geek



                      Date Posted: Mon Jun 04, 2007 3:25 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Friday night wasnt too busy, but we just had strange stuff happen...

                      Call 1: chest pain, difficulty breathing... So we arrive at the complex, and park the ambulance ( locked but window down ).. and start walking to house 247. We get inside and start treating, when our ambulance siren and lights go off...

                      My partner runs out to find out whats going on, and finds a chap with his hand still on the hooter, with eyes the size of saucers.. just frozen still. When all hell is controlled and the sirens and lights turned off, and now everybody in the complex has come out to see whats going on, this chap said, he was just trying to get out attention by pressing the hooter, so he could show us where to go. < our hooter activated all lights and sirens - he wont do that again >

                      Call 2: MVA - drunk driver... passenger in the car ( also drunk ) wants to go to hospital, so we load him up, and the friend says that he want to go with him, to the hospital.. so off we go, hand over the patient, and now the friend says we must take him back to the accident scene, so he can see whats going on with his car. At this stage we have another call waiting, so we tell him, that is not possible. He then climbs back into the ambulance and refuses to get out.

                      Instead of doing what I wanted to, and that was remove him with necessary force, my partner, who is more level headed and calm suggested we take him to the police station. and so we did, where the police were more convincing that he should get out our vehicle...

                      Call 3: long transfer from airport, chest pain, heart rate of between 25 and 70.

                      Call 4: dispatched to an old age home, for a 74year old lady that was not responding, on arrival find a patient that is breathing well, but has a low BP ( 80/40 ), and responding only to pain. The ecg reveals multiple PVCs >12pm, oxygen therapy resloves them, and we load her into the ambulance. About 3 minutes into the trip, she becomes bradycardic, and stops breathing...

                      I could not get a peripheral line up on scene, so an external jug. was sited on route, the patient was also intubated, and CPR ensued, when the ECG rhythm that went from 100 - 50 -30 - Major ST elevation - Ventricular tachycardia - agonal rhythm - asystole in the space of about 5 minutes.

                      The patient was administered Adrenaline 1mg, and Atropine 1mg, then another dose of each after 4 minutes.

                      The resus effort was terminated.



                      Date Posted: Mon Jun 04, 2007 9:56 PM
                      Posted By: jsadin (Veteran Villager)


                      Alright CB, by what...less than 1000 peeps?

                      You are correct sir that Providence is slightly more populated than Worcester. My bad.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Jun 05, 2007 5:51 PM
                      Posted By: CBEMT (Senior Forum Member)

                      Quote

                      I could not get a peripheral line up on scene, so an external jug. was sited on route, the patient was also intubated, and CPR ensued, when the ECG rhythm that went from 100 - 50 -30 - Major ST elevation - Ventricular tachycardia - agonal rhythm - asystole in the space of about 5 minutes.


                      Did she go too quickly for a defibrillation?



                      -------------------------
                      Village Geek



                      Date Posted: Wed Jun 06, 2007 9:18 PM
                      Posted By: jsadin (Veteran Villager)


                      Just got back from a neighbor's house up the street. He managed to cut off two fingers with his lawnmower. That's gonna leave a mark.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Jun 07, 2007 9:46 AM
                      Posted By: stridor (Veteran Villager)

                      Yesterday and the day before weren't too busy, but I sure paid for it in difficulty. 6/5 2000-0200 6/6 we ran three calls, all walked, all were BS. 6/6/07 0700-1300 The first call was a diabetic with low blood sugar. WRONG! When we got there she was purple in the face rolling around on the floor, put high flow on her and started taking vitals. HR 20 BPM resps 6 and bp unobtainable. Began bagging her, medics walked in. Monitor and glucometer monitor shows asystole. Began compressions medics made two attempts at a tube, placed OPA, IV initiated, Epi, atropine on board, stopped compressions, two shocks, HR exploded 230 BPM, Lido administered HR slowed to 113. pt became concious enough to fight like hell, barfed everywhere, pulled the OPA out and snatched the line. Bleeding everywhere because just the INT came off and left the catheter in the vein. Carried pt who was 420 easy to the truck, while attempting another line, patient fighting like hell, covered in blood and puke. I got scratched and cut by her nails which are covered in blood. They got a line finally, and I got back out of the truck covered in the unholy trinity, (blood,sweat, and vomit) then drove the medic responder truck while both medics took care of her all the way to the hospital. I called the Supervisor and we went OOS and I filled out the exposure forms, and submitted blood samples. It was a real EMS call. Every Minute Sucked

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer

                       06/07/2007 09:48:18|U



                      Date Posted: Thu Jun 07, 2007 12:11 PM
                      Posted By: jsadin (Veteran Villager)


                      Stridor, there's only one way to describe that call; eewwwwwwwww.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Jun 08, 2007 1:05 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      That'll teach you to save a life! Strong work, Stridor and crew.

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Fri Jun 08, 2007 10:08 AM
                      Posted By: VanHelsing (Veteran Villager)

                      CBEMT... yes.

                      The ventricular tachycardia lasted for approx 15 seconds ( had the environment been better, I might have just managed to get one shock in, but we were in the back of the ambulance already, I was at the head with the tube, and another chap was inbetween me and the monitor )... I don't think it would have done much good either way, she had already left the building.





                      Date Posted: Fri Jun 08, 2007 1:35 PM
                      Posted By: MJMC4404 (Senior Forum Member)

                      I am SO GLAD that I read your post AFTER lunch Stridor. Tell me again how it is better in Jersey??!!
                      Sounds like you guys did a bang up job. Kudos. Now go take shower, again. My skin is still crawling.

                      VH- Been there before. Are you using the paddles or the newer pads? I miss having paddles SO much sometimes its not funny. I cannot read the monitor, get out the package, open the package, pull backing off, adhere to chest (that's if the shirt is already open/off), charge and defib in under 15 seconds. With the paddles our patients at least had a fighting chance of you getting in there.

                      So far today...and I'm not kidding....

                      #1 Blood in nephrostomy tube, changed bag twice this morning, still bloody. VS? Stable, not even problematic. 2/10 non-raditating retroperitneal pain with onset yesterday. Woke up with the bleeding this morning.

                      #2 I can only imagine it will get better.

                      -------------------------
                      I'm NOT short, I'm INSEAM CHALLENGED

                      Village Sanitation Engineer



                      Date Posted: Fri Jun 08, 2007 5:54 PM
                      Posted By: stridor (Veteran Villager)

                      Today was busy as balls, we did twelve calls in 8 hours. The other crews did 13 and 15 calls during the same time. God I am tired.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Fri Jun 08, 2007 6:40 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      But it's a good tired, right? Better than the worn our and frustrated, burnt out tired from some of your past jobs, right?

                      -be safe

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Fri Jun 08, 2007 7:43 PM
                      Posted By: jsadin (Veteran Villager)


                      Most I ever did was 11 calls in 8hrs. They need to put some more trucks on the road out there. They certainly have the call volume to support it.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Jun 08, 2007 7:51 PM
                      Posted By: stridor (Veteran Villager)

                      Quote

                      Originally posted by: PARAMEDICMIKE
                      But it's a good tired, right? Better than the worn our and frustrated, burnt out tired from some of your past jobs, right?

                      -be safe

                      absolutely! this is the kind of job where I can go to work, do my job, and leave it there when I go home.


                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sat Jun 09, 2007 2:02 AM
                      Posted By: oldfart (Senior Forum Member)

                      Had to watch the Blue Angels fly today. Front row center. also several other performers practicing. Not bad getting paid for this.



                      Date Posted: Sat Jun 09, 2007 9:49 AM
                      Posted By: jsadin (Veteran Villager)


                      Not bad at all! Event work is probably the only thing I miss about working for A*R.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Jun 09, 2007 11:19 AM
                      Posted By: MJMC4404 (Senior Forum Member)


                      I am guessing you never had to cover a dirt track or motorcross event? dirty dirty dirty

                      My all-time favorite event is the pro-snowcross.

                      -------------------------
                      I'm NOT short, I'm INSEAM CHALLENGED

                      Village Sanitation Engineer



                      Date Posted: Sat Jun 09, 2007 1:48 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Newer Pads ? hahahahaha

                      nope, we still use paddles.

                      We can use the pads for pacing, but otherwise they are way too expensive to justify using them when paddles work just fine ( besides its looks much more dramatic leaning over the patient... STAND CLEAR !.. rather than just pushing a button on the monitor... i watch alot of TV hehehehe !

                      but thanks for the laugh !!

                      VH





                      Date Posted: Sat Jun 09, 2007 7:10 PM
                      Posted By: oldfart (Senior Forum Member)

                      That was not a special event for me. It was my regular shift and we provide coverage for the AFB in our area. We just happened to be the ones there yesterday. Today is the airshow. But I am off drinking a cold one



                      Date Posted: Sun Jun 10, 2007 2:06 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Quote

                      Originally posted by: clutzycowgirlEMT
                      *drags body over to computer**

                      Home finally from another shift in Hell....forgot to keep track of them but there was at least seven calls with ppl under 25 suffering chest pain and arm numbness. All of them were tachy with high BP's. Rumor has it that a new shipment of Meth has arrived and there is something wrong with it....evidently EMS and hospital personel are the only ones that know there is something wrong with it cuz they keep using it.....

                      One interesting call that is concerning me and I would like feedback on what others would think they are dealing with~~ 2030 or so we get called by the PD and asked to respond to a residence about 15 miles away for a parent that has called in and reported that her less than one month old infant is having difficulty breathing and is turning colors~~when I arrive the baby is lying flat on his back on the sofa bed and the PD officer has his hand on his chest and is watching him breath. I get over to the baby and ask what has been going on this evening~ the mother states that the baby has been sounding congested for the past couple of days. She has had him in to two doc's and they have sent him home after taking chest x-rays telling mom he's fine. Tonight she happened to be sitting beside him on the sofa and was watching him breath when she noticed that he took a big breath, screwed up his face as if he was trying to poop and quit breathing. She picked him up when he started turning blue and he immediately took a deep breath of air and began to breath again but irregularily...
                      VS on my arrival are R 35, HR 141, BP 68/p, PERLA, lungs sound slightly congested, abdomen slightly hard and tender. The infants head, face and neck are all "pink" and warm but his torso and extremities are mottled and cool to touch. The household temperature is warm, not hot in there and not cold, just a comfortable warm. The baby is dressed in a "onsie" and is fully alert. This is mom's fourth baby. He was born at 37 weeks and rushed off right away to a hospital with a neonate unit but released five days later with a full bill of health. She is compliant with all check-up apts.
                      As I am assessing he has another episode where he holds his breath and turns blue on me. This lasts approximately 30 seconds then he begins an irregular resp rate around 35-40, HR 135, BP 50/p, 02 reading is in the mid to upper 90's but I'm not trusting it.
                      Load baby into his carseat and carry him out to the ambulance~once inside the ambulance (remember he's sitting up in his carseat now at a 45 degree angle) strap his car seat into the captain's chair, place baby on 02, get mom strapped into the seat on the side bench and initiate transport. VS on baby are now P 155, R 58 and regular, BP 58/p and he is "pink and warm" on all extremities and torso, no longer has the "sick" look about him.
                      Baby transfers well to hospital w/out any "episodes", his VS remain midline for neonates and he is comfortable.
                      Upon arrival at the ED he is transferred over to the RN on duty, she takes him out of his carseat and lays him flat on the examination table where in less than two minutes he has turned cyanotic in his extremities again and is breathing sporadically with low 02 sats (89%)according to their ped monitor.....

                      My impression is a possible hole in a heart vessel or heart abnormality?? Any thoughts?


                      Did the baby pink up with crying? It's an important question to ask. I doubt this is a cardiac issue. Tetrallogy of Fallot causes an abnormal heart shape on an x-ray. Tricuspid atresia would kill this baby long before now. Keep in mind that atresia means that there is a lack of a tricuspid valve. This means that little to no blood would be oxygenated. This sounds more like laryngeal malacia to me or a tumor laying on the trachea.

                      If this infant is fairly new, irregular breathing can be normal. Is the kid constipated? Could this be a vagal response caused by bearing down as he is straining to poop?


                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!

                       06/10/2007 02:10:27|U



                      Date Posted: Sat Jun 16, 2007 11:52 AM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)



                      Thanks for all the replies in regards to the infant that caused me to scratch my head and research, research, research~~Not sure anyone is going to believe this but the diagnosis on this little guy after five days in the hospital is~~~

                      Acid Reflux or GERD

                      Apparently the little guy went thru every test known to cardiologists and pediatricians and eventually one of them ordered an esophagus endoscopy where they found that the entire lining of the oesophagus was so irritated that it was actually bleeding slightly (according to the mother).

                      Thinking back to when my grandmother was diagnosed with GERD I remember her telling me that sometimes it hurt so badly she thought she was having a heart attack so I can only imagine the little guy was holding his breath due to the pain?? I'm just glad he's okay and back home again......sounds like he will be spending much of his time at a 45 degree angle now~~~

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Sat Jun 16, 2007 5:39 PM
                      Posted By: jsadin (Veteran Villager)


                      Never would have thought GERD would present like that! Very interesting. Thanks for the follow up.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Jun 16, 2007 7:23 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      That's interesting to say the least.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sat Jun 16, 2007 8:00 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Okay, grad weekend at the clinic. 12 hour night shift:

                      1. Non-compliant to meds, ETOH. Chest pain and peripheral edema
                      2. 51 year old physically fit with chest pain X 3 days. Q wave change and +1 S-T elevation in V1 and V2.
                      3. Hemorrhoids
                      4. URTI
                      5. Fractured Hand from fight, ETOH, sent for X-rays
                      6. Assault with a knife, minor face lacs. Payback for the hand. Sutures.
                      7. Tonsilitis
                      8. Laceratin from Beer bottle. Sutures
                      9. Fractured nose.
                      10. partial thickness and 2nd degree burns to lower back. (1% in size)

                      Hopefully tonite will be quiet, the trouble makers are all in jail or in too much pain.


                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sat Jun 16, 2007 8:05 PM
                      Posted By: jsadin (Veteran Villager)


                      I have my daughter's dance recital tomorrow, so I'm really hoping for a good nights sleep at the station (I'm only working 8hrs instead of my usual 24). That being said, I'll probably be out all night.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Jun 17, 2007 9:14 AM
                      Posted By: stridor (Veteran Villager)

                      Last night was kind of quiet. A stabbing, a resp, two cardiacs, two MVA's, two assaults, a sepsis case, and a stroke. 2p to 2a is definately the most interesting shift.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sun Jun 17, 2007 9:00 PM
                      Posted By: jsadin (Veteran Villager)

                      10 calls in a 12hr shift is quiet? You sir are disturbed...




                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Jun 17, 2007 10:09 PM
                      Posted By: CBEMT (Senior Forum Member)

                      Stridor I've been wondering. What would you say your ratio of BLSing it in yourself versus getting ALS is in.... Newark is it?

                      -------------------------
                      Village Geek



                      Date Posted: Mon Jun 18, 2007 7:34 AM
                      Posted By: stridor (Veteran Villager)

                      I work in Camden, there is a branch of UMDNJ in Newark but they have their own ALS so it would probably be different there. Our dispatchers are really good about sending us medics when the call warrants it. So good in fact that I cancel the medics more than I use them. I would say that on bona fide ALS calls we usually have a medic available we have medics out of Virtua hospital. There are however calls like "unknown diabetic" Where the caller just thought that was the most pertinent part of the persons history to yell at the top of his/ her lungs at the 911 dispatcher and arriving crews, when in actuality they are having a massive MI right there in front of us, by the time we arrive they are unconcious lying in a puddle of fruit juice, and purple in the face. On those calls it doesn't make sense to ask for a medic because in Camden we can be at a hospital in under five minutes from most anywhere. We ask, they give us an ETA and we beat feet. If the medic says, "Hey guys, I'm right around the corner and we have packaging issues anyway we will wait. So I would say that it is about 50/50. Oh, and Jim, I did nine calls before 10 am on a 7am shift last week.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer

                       06/18/2007 07:36:35|U



                      Date Posted: Mon Jun 18, 2007 10:16 AM
                      Posted By: jsadin (Veteran Villager)


                      Stridor, is everything ePCR with you guys? I can't even imagine writing out that many run reports in a shift.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Jun 18, 2007 2:18 PM
                      Posted By: stridor (Veteran Villager)

                      Nope good ole paper and pen, that's not all either. I have to keep a demographics sheet, and a tally of medic treats and police/fire assists.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Mon Jun 18, 2007 9:15 PM
                      Posted By: jsadin (Veteran Villager)


                      eeesh.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Jun 24, 2007 9:12 PM
                      Posted By: jsadin (Veteran Villager)

                      One whole call in 16hrs (I'll take the sleep tho'):

                      51 y/o male cc belly pain. I've been taking this particular gent to the hospital on and off for the past 6 yrs and it's sad to see how much he's gone downhill. Former IV drug user, multiple stomach surgeries and just a freakin' mess. It's not going to be much longer before he no longer graces our lovely town.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Jun 26, 2007 8:17 PM
                      Posted By: stridor (Veteran Villager)

                      Man, I only ran nine calls today and not one medic treat. I'm just not feeling the love. Had a resp straight out today, followed by a belly pain, and then throught the day had 3 mva's, a penetrating trauma to the foot(stepped on a nail), two dehydration related issues, and a couple of refusals.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Wed Jun 27, 2007 9:56 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Just returned home from a lovely shift~~
                      Started out with a sexual abuse/assault of a minor female (child actually since she wasn't even thirteen)
                      Anxiety attack
                      Seizure which progressed to GCSE and a dislocated shoulder
                      Severe asthma attack which prompted pt to call for ambulance after using personal nebulizer six times and rescue inhaler too many times to count
                      Stabbing in the back with knife still impaled approx 1/4 from the spinal column angling toward it (directly related to first glorious call of the shift)
                      Meth overdose
                      Hypotensive/hypoxic elder
                      16 yr old w/chest pain related to meth useage
                      Psych pt who had to be restrained enroute then had to stop and have LE accompany us
                      Assault with brutal facial Fx and several deep lacerations located in various parts of the body
                      Diabetic with BGL 32 who went unresponsive before intercept
                      Teenager who "only had two beers" and was unresponsive (later learned he had a BAL of 300 something)
                      Return to prior Anxiety pt who wanted more of the "good" med she got in ER
                      Stand by to witness/pronounce a hospice pt's final breath

                      Of course, since I'm only a small gnat on the scrotum of EMS~~they all died tho~~

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       06/27/2007 21:59:29|U



                      Date Posted: Wed Jun 27, 2007 10:24 PM
                      Posted By: jsadin (Veteran Villager)


                      Gnats on scrotums...ewwww...

                      Sounds like one of Stridor's shifts Clutzy! How you holding up? This fellow gnat is concerned for your well being.




                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Jun 29, 2007 8:00 AM
                      Posted By: elvismedic (Veteran Villager)

                      This one stumped me.

                      Get called for the ambiguous "Medical" "transport to XYZ Hospital." Arrive on scene after the ALS Engine. Engine medic reports 42 YO F C/O generally not feeling well for previous 3 weeks. Engine medic reports pt states nausea, lightheadedness, and head ache off and on frequently during this time period. Pt found on couch laying flat. Pt BP 126/82, P 90's, R 20, Sat 98% RA, and pt in sinus rhythm. Pt sat up with feet hanging over edge of couch, reassessed vitals: BP 120/80, P low 80's, no other changes. Pt moved to ambulance.]

                      Pt now informs me that Sunday night (it's Tuesday) she experiences what she describes as "electrical current" coursing through her body. She also states that she is experiencing circumoral paresthesia and paresthesia bilaterally from elbows down into each hand. She has no facial droop, arm drift, or hemiparesis. She has normal non-slurred speech, equal grip strength, and seems to be intact neurologically.

                      She describes her head ache as constant and noticeable but not debililtating. She says that it is located around base of skull near top of spine. She has no nuchal rigidity.

                      She saw her PCP yesterday and was ruled out for: Lyme disease and "the relative of Lyme disease," mononucleosis, pituitary gland abnormalities and abnormalities of the adrenal gland. However she did state that her PCP told her that she may have a problem with her "meta norepinepherine." I googled it and couldn't find anything related.

                      I am just wondering what everyone thinks.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Fri Jun 29, 2007 10:48 AM
                      Posted By: p3medic (Senior Forum Member)

                      Did she mention if the paresthesia was constant or intermittant? Pain at the base of the skull with c/o paresthesia leads me to believe someone should order an MRI. I'd be concerned about a neoplasm perhaps, assuming there is no trauma story. Look up L'hermitte's sign, (sp?) sound like what she had?



                      Date Posted: Sat Jun 30, 2007 1:17 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Sounds like a spinal tumor to me. The chance that it is an issue involving norepi is slight as the vitals don't fit. Oxygen toxicity would fit better but I don't see how it could happen without high flow oxygen.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Jul 01, 2007 9:05 AM
                      Posted By: elvismedic (Veteran Villager)

                      p3: L' hermitte's sign did fit although I didn't think to ask what, if anything, brought on the paresthesia. I did think that MS might be the root but wasn't sure what the initial signs and symptoms were.

                      Gram: That's what I thought (about the norepi) but who am I to say that her PCP was wrong. He/she has way more education than I do.

                      At first I thought head ache at base of spine = meningitis. So I asked her to touch her chin to her chest. She did this without pain or difficulty. She didn't display any photophobia or sensitivity to light.

                      Because I was stumped I told her she might want to consult a neurologist because this seemed neurological in nature.

                      thank you for your suggestions.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Mon Jul 02, 2007 2:00 AM
                      Posted By: elvismedic (Veteran Villager)

                      To start off I am in the middle of a 39 hr shift.

                      First call 1945h 21 F intoxicated after drink 1/2 pint So Co. BLS to the ED.

                      Second call 1000h 42 F w fever 102.2

                      Third call 2215H 73 F HTN BP 230/110 no complaints (H/A , blurred vision, ringing or pulsing in ears, CP, SOB) BLS to ED.

                      Forth call 2316H Now this one is interesting.

                      Get called for SOB. So We respond normally; shift Commander C-3 with 1, Ambulance 2 with 2, and Engine 2 also with 2, tonight however the engine has 2 medics. We all arrive from 2 diffrent stations at approximately the same time.

                      As I approach the residence I find a male acting matter-of-factly. He states to me the patient is "upstairs to the right." I assend the stairs, turn right into a bedroom to find a middle age woman cradling an elderly lady in her arms. The woman states "I was putting my mother to bed when she gasped loudly, her eyes rolled back, and she became unresponsive.

                      Ok so now we have a code. We move her to the floor start treating her. CPR, IV, ET, ETCO2, Monitor. She's asystolic in 3 leads. So we begin the ACLS algorithm: epi and atropine q 3 min. As I bag her I notice that respirations are getting harder and harder and the expiratory phase is lengthening, to about 4 sec. So we begin an in-line combivent. This helps some but we then started to notice subceutaneous emphysema bilaterally across her anterior chest. So now we call for orders to bilaterally decompress this lady. Surprisingly enough we get the order. Now I am by no means what I would consider an experienced medic. The 2 other medics are way more experienced then I'll ever be so they had me decompress her chest. I have to say that it wasn't as bad as I thought it was going to be. So her chest is decompressed with bilateral 14's, actually heard a rush of air.

                      The rest of the run was anti-climatic. She was called on our arrival. Where I work we tend to work everyone more for practice than anything else.

                      I appologise in advance if any of this is confusing it's 0200 and I'm up writing this instead of hitting the rack.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Mon Jul 02, 2007 10:41 AM
                      Posted By: AZCEP (Veteran Villager)

                      Quote

                      Originally posted by: elvismedic I ASSend the stairs...

                      And you aren't hurt from this maneuver? When I do this, I spend a few minutes making sure all the parts still work.
                      Quote

                      Originally posted by:elvismedic...turn right into a bedroom to find a middle age woman cradling an elderly lady in her arms. The woman states "I was putting my mother to bed when she gasped loudly, her eyes rolled back, and she became unresponsive.

                      KEEP BREATHING MOMMA! Sorry, this is what I walk into.
                      Quote

                      Originally posted by:elvismedic This helps some but we then started to notice subceutaneous emphysema bilaterally across her anterior chest. So now we call for orders to bilaterally decompress this lady. Surprisingly enough we get the order. Now I am by no means what I would consider an experienced medic. The 2 other medics are way more experienced then I'll ever be so they had me decompress her chest. I have to say that it wasn't as bad as I thought it was going to be. So her chest is decompressed with bilateral 14's, actually heard a rush of air.

                      Do you have to call for needle decompression if you just need one side? This requirement seems a bit odd to me. We usually manage the A-B-C's as we see fit. Different strokes I suppose.
                      Quote

                      Originally posted by:elvismedic The rest of the run was anti-climatic. She was called on our arrival. Where I work we tend to work everyone more for practice than anything else.

                      Despite our medical directors frequent warnings, we follow a similar practice. We give them 20 minutes to respond to what we do, then decide from there. Since you got to do something you hadn't done before, that another patient may benefit from, this was a good thing to do.



                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Mon Jul 02, 2007 11:14 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)


                      Well I'm officially not working so this isn't actually a "call for the day" but after I had a re-check on my wrist I stopped to chat with my favorite ER Doc since he was working and learned some bad news~~

                      Sad to report~the infant that I posted on a few shifts back was brought in early this morning~the parents left him in town with a "cousin" and evidently when she got up to get ready for work this morning she found him not breathing in his crib~ Doc says there is going to be an autopsy so I hope to learn more in a couple of weeks~~~
                      Sounds weird, but I never could get this little guy out of my head, always thought there was something more than the "GERD" going on with him since my now five year old had GERD so badly he was hospitalized with it as a four month old and he never presented like that little guy~~or it just may be the fact that he stuck with me because he presented so differently and I never found anything while "researching" his s/s that really matched up~~~anywho, just thought it was worth passing along~~


                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Tue Jul 03, 2007 8:03 AM
                      Posted By: ESPARKS (Veteran Villager)

                      Sorry to hear that clutzy. Keep us posted on any further info you can get.
                      Lose the avatar though it's as annoying as bushy's
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Tue Jul 03, 2007 8:28 AM
                      Posted By: stridor (Veteran Villager)

                      I'm sorry to hear about your patient clutzy that's never easy.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Tue Jul 03, 2007 10:18 AM
                      Posted By: jsadin (Veteran Villager)


                      That sux clutzy.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Jul 03, 2007 1:59 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Sorry Clutzy, something like that is never easy....hugz. BTW, your new avatar is giving me siezures.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Tue Jul 03, 2007 3:26 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Our coroner also works as an ER doc so I imagine I will be hearing something in a couple of weeks when I go back to work~~just seems like the little tyke had so many 'tests' that you'd think they would have found something~~I don't know~~

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       07/03/2007 15:28:36|U



                      Date Posted: Tue Jul 03, 2007 4:03 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Thank you Clutzy: now you look only half as bad as Kat. :- ]
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Tue Jul 03, 2007 8:10 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      At least Clutzy has clothes covering her nether-regions. The bear is displaying her's.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Tue Jul 03, 2007 10:47 PM
                      Posted By: jsadin (Veteran Villager)

                      Looks like an ex-girlfriend of mine, only slightly sexier.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Jul 03, 2007 11:08 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: grambograham
                      At least Clutzy has clothes covering her nether-regions. The bear is displaying her's.


                      How's my new pic Graham?



                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Wed Jul 04, 2007 2:32 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      Seems like Artickat has a flashing fetish going on - can't get him in any other position. At my age I'll tell you next week if it excites me.

                      Clutzy - thanks for the change. You're pretty good looking there!

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.

                       07/04/2007 02:33:33|U



                      Date Posted: Wed Jul 04, 2007 3:24 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Very funny. What... do you troll around looking for that pose? Is that some kind of a sick joke? At least the cat is a little more covered!

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Wed Jul 04, 2007 10:27 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      That is actually a picture of my cat. One of his favorite positions. Caught him in it the other day and thought of you.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Wed Jul 04, 2007 11:00 AM
                      Posted By: greshmedic (Veteran Villager)

                      Firstly, sorry to hear about the little chap.

                      Secondly, does leaving an infant that has been in poor health with a "cousin" not sound slightly odd considering that on this occasion the infant died?

                      Thirdly and most disturbingly, I have the horrible feeling that i may have woken up to something that looks like Clutzy's avatar at some point in my Army career. If it gives most of you seizures just think of the mental torture i'm experiencing!

                      -------------------------
                      Before the war on terror, if I saw an unnatended package I used to think "I'll be having that!"



                      Date Posted: Wed Jul 04, 2007 4:12 PM
                      Posted By: stridor (Veteran Villager)

                      Last night was pretty average. Eleven runs in a twelve hour shift. Had three resps, a couple of abdominals, a kidney infection, MVA, two lifts, and a some assorted medicals.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Thu Jul 05, 2007 12:14 AM
                      Posted By: CBEMT (Senior Forum Member)

                      Quote

                      To start off I am in the middle of a 39 hr shift.


                      You're the guy who talks about how seriously your department takes EMS, right?

                      -------------------------
                      Village Geek



                      Date Posted: Thu Jul 05, 2007 1:01 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Started the day off with a 20 yo suicide by hanging + dealing with completely off the wall Mom and siblings. What a way to start the shift. I'll be ready for a large cocktail when this day is over! Might even break out the bottle of Jonnie walker black I've been saving.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Thu Jul 05, 2007 2:39 PM
                      Posted By: jsadin (Veteran Villager)


                      Ed, hold off on the JW Black and I'll swing by Saturday on my way up north. It'd be worth the detour.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Jul 05, 2007 5:28 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Jim : We're headed out tomorrow going north to Dover Foxcroft for the weekend . I'll save it for when I get the camper parked .

                      This afternoon we had to meet up with the coast-guard for a sailor who ran his very expensive sailboat up on a ledge out in the bay. Back and rib trauma plus a good dose of hypothermia from being over board in the 50 degree water several times.
                      Always fun here in the summer!
                      Be glad for the long weekend off!
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Thu Jul 05, 2007 7:30 PM
                      Posted By: jsadin (Veteran Villager)


                      Enjoy your time off Ed. I'll sample whiskey with you another time.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Jul 05, 2007 9:47 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Don't waste your time with whiskey. Scotch is smoother, better tasting, and more civilized. Mmmmm... Scotch.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Thu Jul 05, 2007 9:49 PM
                      Posted By: jsadin (Veteran Villager)


                      I'm sure it is, but I ain't civilized.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Jul 05, 2007 11:26 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      cognac

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Fri Jul 06, 2007 1:13 AM
                      Posted By: CanuckEMT (Junior Forum Member)

                      PILSNER!!!!!!!!!!

                      -------------------------
                      Challenge is what makes life interesting, overcoming them is what gives it it's meaning.



                      Date Posted: Fri Jul 06, 2007 3:14 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      Bourbon!

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Fri Jul 06, 2007 1:01 PM
                      Posted By: MJMC4404 (Senior Forum Member)

                      Alright, taking two classes at once this summer was a big mistake. Not enough free time.

                      Clutzy - sorry to hear about your little guy. My wife is an RN in our NICU and we know how it feels.

                      I do have to as though as to your post back on June 27th... you said you stabbing patient call was directly related to the first call of the night. Uh, well, eh... did you uh, mean "related" or uhh..."related"? Eww.

                      And... has anyone not yet made the joke that Kat has gone from a big white hairy flashing polar bear to a big white hairy flashing... Yeah, I'm not gonna say it either.



                      -------------------------
                      I'm NOT short, I'm INSEAM CHALLENGED

                      Village Sanitation Engineer

                       07/06/2007 13:02:56|U



                      Date Posted: Fri Jul 06, 2007 2:31 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)



                      Sad to say MJM~both versions of the word "related" would be appropriate in this case.
                      It was a direct relative that did the fist incident and another relative that did the stabbing~
                      As the rez turns...............

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Fri Jul 06, 2007 9:46 PM
                      Posted By: stridor (Veteran Villager)

                      worked 0100 to 0700 this am. Only two calls, both were GSW to the head, both still had pulses and respirations.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Fri Jul 06, 2007 10:00 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Let me guess, treatment was 600 kilos of dirt, PRN?

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sat Jul 07, 2007 5:30 AM
                      Posted By: stridor (Veteran Villager)

                      pretty much

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sat Jul 21, 2007 1:18 PM
                      Posted By: AZCEP (Veteran Villager)

                      68 y/o male difficulty breathing

                      Patient with periods of apnea prior to our arrival. When we got on scene the patient was sitting on the floor, mottled neck/chest/arms/legs, and a bit purple from the neck up. Wife told us that he had been sick for the last few days, and was in the hospital the previous week.

                      Inspiratory/expiratory wheezes in all fields with diminished tidal volume throughout. Patient's respiratory rate >40 per minute, speaking full sentences. Oxygen administered at 6 lpm, and moved to the ambulance. Back-to-back SVNs with Combivent with no change in tidal volume or breath sounds. Capnography showing a good waveform, with a rate >40 per minute.

                      Patient now tells us he is tired, and can't hold the SVN any longer. ECG Sinus tachycardia at 120 per minute without ectopy. Patient intubated with tube placement confirmed and capnography in place. Patient sedated with Valium/Morphine and transported to the hospital without any other changes.

                      Patient dies two days later from M.O.D.S secondary to sepsis and staph pneumonia. We are currently waiting to find out if the staph was MRSA or not.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Sat Jul 21, 2007 2:39 PM
                      Posted By: jsadin (Veteran Villager)


                      Guess the hospital missed something the week before! Multiple organ failure within a week of leaving the hospital? Eesh. Was he on any meds? Also, you say you tubed him and then sedated him, is that correct?



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Jul 21, 2007 5:27 PM
                      Posted By: AZCEP (Veteran Villager)

                      Yep. His respiratory effort was just enough to successfully nasally intubate. He needed ventilatory support, but still had a gag. I didn't want to snow him then not be able to get the airway secured.

                      As for meds, only combivent and fluticasone inhalers. No antibiotics in the house, which probably wouldn't have done much for him anyway. This makes the 6-7th MRSA code at our hospital this year that is transported by EMS, if it turns out to be MRSA anyway.

                      Reinforcing the need for effective BSI during airway management.


                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org

                       07/21/2007 17:28:57|U



                      Date Posted: Sat Jul 21, 2007 7:57 PM
                      Posted By: jsadin (Veteran Villager)


                      Nasal intubation is outside my scope, but would you be so kind as to walk me though it? I've never seen it done before, even at the airway seminars I've attended.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Jul 22, 2007 12:18 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Works pretty much the same way as oral intubation but with a smaller tube. Once the tube is advanced into the posterior oropharynx, then usually a person grabs the tube with a set of Magills or another form of clamp and directs it into the trachea.

                      Another popular method for concious people is to insert an NPA and then sedate. Then the intubation can be attempted. If there is a failed attempt, the NPA is still intact. Neither is pleasant for the patient even if Hurricane-spray (lidocaine spray) is used. The pressure felt can be painful as either tube is advanced. It is common for severely obese patients to undergo intubation while concious (at least NPA).

                      Hopefully that answers that question well enough.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Jul 22, 2007 11:07 AM
                      Posted By: AZCEP (Veteran Villager)

                      You've described the visualized nasal intubation grambo, and to be honest I've never seen the utility of it. In that situation, an oral intubation would be a better route to go.

                      My procedure for nasal intubation is quite simple. Sedation with Valium, (that's what I've got) topical anesthetic, (Hurricane works well for this in the nose and posterior oropharynx) 7.0 Endotrol tube, (this allows better control of the distal tip, and reduces the pressure on the posterior nasopharynx) and a BAAM whistle.

                      The patients that get this are those that still have a respiratory drive, but I can't wait for IV access or medications to take effect. If I don't have a line, and the jaw is clenched the tube goes in the nose. When I have a good line, and can get some sedation in, and the jaw clenches, the nose it is again.

                      I would much rather orally intubate, since the ER will promptly remove the tube on arrival, but when it is an airway or bust situation, the nasal intubation is very useful.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Sun Jul 22, 2007 3:40 PM
                      Posted By: jsadin (Veteran Villager)


                      Thanks for the description of the procedure AZCEP. I could have used this (or a bougie) last night:

                      Dispatched for ALS intercept for 24y/o unresponsive male, bystander CPR in progress. UOA, 24y/o male being wheeled out on stretcher, no CPR in progress (could be good, could be bad). Patient apparently was not a code and had pulses and respirations. The young lad had been drinking all day/night with friends and passed out in a chair. The friends heard a gurgle and found him choking on his vomit. Respirations 8 and agonal, pulse 140 (sinus on monitor), BP 160/p, slightly cyanotic around the lips. My medic partner started a line while I attempted the tube. Lots of vomitus (more than the suction could handle) and shooting for the bubbles proved fruitless. I was able to bag him up to around 87% with a BVM/OPA while another EMT suctioned vigorously. Transferred care to ER staff (total transport time around 10mins) who spent the next 15-20mins attempting to tube this guy (the doc missed twice, but the RT finally got it after a lot of work. Not sure why they didn't do a surgical airway). 5mins after finally getting a good tube, he coded. They called it shortly after.

                      Very frustrating to have a young patient with pulses and respirations go so quickly. No telling how long he'd been aspirating before someone noticed, however.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Jul 22, 2007 4:52 PM
                      Posted By: AZCEP (Veteran Villager)

                      On to new and exciting

                      MVA rollover. On scene we find 10-15 Hispanic-Americans that were in a Nissan compact truck in various manner of ambulation. Some are sitting on the roadway, others are lying in the runoff ditch, others still are walking around calling who knows what on their cell phones. Total of four transported. 25 y/o female driver of the truck, 18 y/o female interior passenger, 7 y/o female unrestrained in the bed of the truck, and a 5 y/o male also in the bed of the truck. The sheriff's office is working on a nice ticket for the driver.

                      Roughly two hours after we were dispatched for this mess, and about ten minutes from being complete, we respond for a second rollover. This one is about 25 miles from our station. On scene we find 5 Korean-Americans in similar condition to the previous accident. One patient is still in the minivan, and a flight service is working on extrication. Minimal English speaking, so most of the patient care is done with an interpreter that was involved in the accident. Two teenage daughters of the driver, uninjured volunteered to translate for us. (Thank goodness).

                      Patient that was still in the vehicle removed to the waiting helicopter. Patients two and three moved to our ambulance, awaiting incoming aircraft. Patient two loaded on the DPS helicopter. Patient three transported to the landing zone at the station. This worked out well since we could now allow DPS to reopen the highway, and we could use the 15-20 minutes waiting for a helicopter to gather patient information and provide some treatment.

                      Almost felt like the U.N. decided to have a meeting in west AZ yesterday.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Mon Jul 23, 2007 12:07 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Wow, I had a relaxing shift for a change!!

                      Started it off with a lacerated finger, then a seizure, then an OD, caught a few hours of zzz's and finished it off with a roll-over, a non-responsive adult male, and an assault!! I can't remember the last time I did less than ten calls per shift~~~

                      But something inside of me is telling me that I better get lots of rest because my next shift will be during the Pow-Wow and we will have Native Americans from pratically every state in the nation competing in all the dances as well as an amateur rodeo and amateur fight night......... (I don't expect the amateur fight night to be any different than any other friday night around the rez tho)

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       07/23/2007 12:15:22|U



                      Date Posted: Mon Jul 23, 2007 12:14 PM
                      Posted By: jsadin (Veteran Villager)


                      Sounds like yer gonna have some fun Clutzy! Get some rest now before the onslaught.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Jul 23, 2007 5:22 PM
                      Posted By: AZCEP (Veteran Villager)

                      0320 this A.M.

                      Dispatched to a reported shooting. Sheriff's office on scene with a single patient, three GSWs, vehicle fire on approach.

                      Access to the patient could only be made by walking approximately 4 feet from the front of the vehicle that is actively burning. Several aerosol cans in the vehicle are sounding off from the heat.

                      Patient scooped and moved to our ambulance quickly. GSW #1 left anterior chest, #2 distal left radius/ulna (probably defensive injury), and #3 left lateral abdomen. Sealed the chest, dressed/bandaged the abdomen, splinted the forearm. Pair of IVs, oxygen, consideration of intubation was made and decided that it wasn't needed just yet. Moved to helicopter for transport to trauma center.

                      Is this weekend going to end?! Feels like I should move to Johannesburg.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Mon Jul 23, 2007 6:06 PM
                      Posted By: jsadin (Veteran Villager)


                      Haven't seen this much activity from you in ages AZCEP! BTW, if you move to Johannesburg you'll get carpal tunnel from your "call review" entries.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Jul 23, 2007 6:12 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Chuckle, so that's why we haven't heard from VH in a month?

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Wed Jul 25, 2007 2:48 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)


                      I thought I would let everyone know that the final coroner's decision on the infant that I had posted on and it subsequently died was Wolff-Parkinson-White disease.

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Wed Jul 25, 2007 8:46 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Huh... who'd a thunk it.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Wed Jul 25, 2007 9:39 PM
                      Posted By: jsadin (Veteran Villager)


                      WPW eh? Interesting. Thanks for the update.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Aug 04, 2007 8:57 AM
                      Posted By: VanHelsing (Veteran Villager)

                      well after a month of holiday abroad, I was reeled back to the harshness of reality with my first shift.

                      Call 1: Gun shot abdo and femur
                      Call 2: Pedestrian Vehicle accident with mutliple fractures
                      Call 3: Stabbed chest
                      Call 4: MVA no injuries
                      Call 5: MVA, 3 patients, 2 needing to be extricated with jaws
                      Call 6: Stabbed neck, patient intubated but died on scene

                      at about 4am the city became quiet, but because it was so cold, i couldnt sleep. ( Mental note to self... bring warmer jacket to work in winter !! )

                      VH



                      Date Posted: Sat Aug 04, 2007 10:05 AM
                      Posted By: jsadin (Veteran Villager)


                      Sounds like you're back to your normal routine VH! You're going to be bored to tears doing EMS elsewhere. That may be a good thing in your case, however.

                      I just checked Johannesburg weather and I'm surprised to see it down in the 40's (F) at night! Chillier than I expected it to be. Flipping hot here lately. 90's during the day and 70's at night.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Aug 04, 2007 10:56 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: VanHelsing

                      at about 4am the city became quiet, but because it was so cold, i couldnt sleep. ( Mental note to self... bring warmer jacket to work in winter !! )

                      VH


                      Wow, so low I'll bet you could even see your breath if you puffed real hard. No worried VH, my company supplies uniform coats, but in your case I may have to stuff more insulation into them. -20 is T-shirt weather here.


                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun Aug 05, 2007 1:15 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      So she is working for you Kat. Good. Someday, I'll have to come visit both of ya.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Aug 05, 2007 1:51 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      Kat - you'll probably need to get a bigger rig - she'll have so many layers on even in the Summer that it'll be like the Michelinman coming to work.

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Sun Aug 05, 2007 2:10 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: grambograham
                      So she is working for you Kat. Good. Someday, I'll have to come visit both of ya.


                      I will neither confirm nor deny......

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun Aug 05, 2007 2:52 AM
                      Posted By: xtendacom (New Forum Member)

                      Sorry i have not been online the last week or two,

                      Been a busy weekend for me at least

                      case 1-MVA Cyclist, no real injuries except maybe pride
                      case 2 MVA Again a call that should have been stood down.
                      case 3 Stab to neck Blah blah Nothing out of the ordinary?
                      case 4 Assault Pt severe Hypothermia he had been left outside in the cold about 3 degrees in the rain
                      Case 5 MVA Silly woman tries an unconventional U-Turn on the main highway and wonders why she has a side impact.
                      Case 6 MVA Cyclist unfortunately not much for me to do, other than declare him that was massive impact the engine of the car was cracked.
                      case 7 RAPE I felt for this girl she had been raped by three men who had the nerve to still be there one was the boyfriend they thought she was dead because once they were finished with her they threw her into an oncoming car, who left the scene in a hurry. After i turned this girl and got a line up on her, she started talking for the first time, she partially explained what happened we were lucky that there were many police vehicles and officers on scene i called one of the inspectors over explained that the three individuals were to blame when she was asked if this was true she mumbled yes.
                      The three men lost their grin.

                      I have to say i was pleased that another vehicle rocked up this girl had allot going on and i needed to stabalise her Open fractures in multiple placed she was two months pregnant and definitely showed signs of internal bleeding, getting a line on her was a mission!

                      But she is fine now she lost her baby and that ended my night.

                      It was a funny Alert though i first got called by the police who were on scene, before their call was up i got a call from one of the volunteer fire guys, then a call from a local security company, im still trying to get out of bed having the delays of these calls, then i have a call from our control man what a hectic alert system, finally im now dressed and ready to go and im hearing hooters outside this is all in like 2minutes max. Outside there is a security vehicle he has come to collect me, guide me to the scene.

                      Man in the 15 minutes when i was alone with the patient i was really hoping the Ambo would get there fast.

                      -------------------------
                      www.parastarbags.com



                      Date Posted: Sun Aug 05, 2007 3:47 AM
                      Posted By: VanHelsing (Veteran Villager)

                      extendacom, sounds like a nasty call. which area do you work in ?


                      As to the weather... Kat, my first purchase in Canada would be a pair of electrically heated socks and gloves !! just out of curiosity, how do you, for example, intubate or drip a patient when your hands are too cold to close around the scope ?







                      Date Posted: Sun Aug 05, 2007 8:41 AM
                      Posted By: stridor (Veteran Villager)

                      Man, sorry to hear that xtendacom. Those are always tough to deal with. The meanest call I was ever on involved a sexual assault of a sixteen year old.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sun Aug 05, 2007 3:04 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      The cold actually makes an intubation easier, the tubes are more stiff and insert better. IV fluid will tend to freeze in the tubing though, so we do what we can to keep them warm or delay access to where the IV will not freeze. The most common philosophy though is that extreme cold falls into the scene safety category and the priority for the patient is to be first moved to a warmer environment just like any dangerous situation.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sat Aug 11, 2007 8:42 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Night shift, Friday... very quiet.

                      Call 1 : MVA
                      Call 2 : MVA
                      Call 3 : MVA



                      Date Posted: Sat Aug 11, 2007 8:55 AM
                      Posted By: xtendacom (New Forum Member)

                      Hi VH. I work in the Knysna Sedgefield area beautiful if you want to retire or go on holiday.

                      -------------------------
                      www.parastarbags.com



                      Date Posted: Sat Aug 11, 2007 11:54 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Hey extendacom, didnt realise you were in SA, should have guessed by the types of call you do !

                      I agree, Knysna is beautiful, we used to spend all our holidays as kids in Sedgefield, great place for sailing.

                      However, my next stop is Canada, hopefully for good.

                      VH



                      Date Posted: Sun Aug 12, 2007 1:01 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Kat and I will be here waiting for you. It would be worth the drive to come see you two some time. Maybe even see how Kat's company works.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Aug 12, 2007 2:14 AM
                      Posted By: xtendacom (New Forum Member)

                      Good Luck, Best wishes, wish I were you, scary! All phrases for your new life. Seriously hope you enjoy. Canada to me seems like a lovely place. I went through those feelings of wanting to up and go as well. for now a holiday will do wonders.

                      Cheers from almost everyone on this forums prospective, you wont be going very far.

                      -------------------------
                      www.parastarbags.com



                      Date Posted: Mon Aug 13, 2007 12:53 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Sunday day shift...

                      Call 1: Unresponsive adult, medical... got cancelled on route because ambulance crew declared him P4.

                      Call 2: Assault... got cancelled on route...

                      Call 3: Medical, Adult P3.. post epileptic seizure

                      Call 4: Medical Adult, Cancelled on route

                      Call 5: Cardiac Arrest - Intubated, ventilated, did some CPR, then declared.

                      Call 6: Assault... patient hit with a brick, right parietal region. P2

                      Call 7: Assualt... could not find patient, cancelled

                      Call 8: Medical Adult, Diabetic come was the dispatch info, the reality was somewhat different, pateint sitting in the gargen, felt weak. ( groan )

                      Call 9 : MVA, 2 cars and 1 taxi. ( but it actually wasnt the taxis falut, can you believe that ? ), anyway, taxi yielded 16 patients, first car 2 children, thirs car all uninjured. But here is the scary part..
                      The car that caused the accident, had two kids age 10 and 6, the driver/father ran away after the accident leaving behind his kids. How maternal is that ??

                      Call 10: Quad bike accident, P2... waited on scene for 1 and a half hours for an ambulance to come and takeover this patient...really glad she wasnt p1

                      Call 11: MVA, no service required, all patients already removed.









                      Date Posted: Mon Aug 13, 2007 10:28 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Sigh, isn't it great getting back into the trenches? You realize that by coming here you'll be lucky to do that many calls in a month?

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Mon Aug 13, 2007 2:04 PM
                      Posted By: VanHelsing (Veteran Villager)

                      good ! atleast I wont be a burned out wreck by the time Im 31...



                      Date Posted: Mon Aug 13, 2007 3:47 PM
                      Posted By: AZCEP (Veteran Villager)

                      No burn out, but maybe rusted out.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Mon Aug 13, 2007 4:07 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Ahh, yer just jealous. BTW AZCEP, did you know that both of thos links in your tag line are dead? You may want to practice your resus skills.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Mon Aug 13, 2007 5:35 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Not burned out, not rusted out... CHILLED OUT !



                      Date Posted: Mon Aug 13, 2007 6:08 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      You know.... Frozen is the way to keep things so they don't spoil. Us Canadians do that very well!

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Thu Aug 16, 2007 4:29 PM
                      Posted By: VanHelsing (Veteran Villager)

                      In no particular order we had..

                      a MBA, which another ambulance transported.

                      2 people that inhaled castic acid fumes at a ice-cream factory... shame

                      a pedestrain, # tib/fib...

                      another pedestrain, 15year old, hit by a motorbike, that got hit by a car.

                      and our last call, was a winging, whining, suicidal,depressive, agrressive woman, who had to be transported from hospital to a loney-bin ( her words ).
                      - that said, she didnt try anything aggressive with me... but then again, i over ruled company policy and let her smoke in the back of the ambulance. ( a clinical decision, on my part !! )

                      and that was that.








                      Date Posted: Thu Aug 16, 2007 5:48 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Let's see:

                      Call #1. MVA, Rollover, 6 people. Two were transported, the driver and the female passenger who was the one that grabbed the sterring wheel, gave a mighy twist, and yelled "Let's roll the car!!!" Both were checked and released from hospital.

                      Call #2. Same female passenger 6 hours later after the owner of the car got his hands on her and thumped the ever living crap outta her.

                      Call #3. Same female passenger taken to tertiary care for facial reconstruction.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Thu Aug 16, 2007 5:56 PM
                      Posted By: jsadin (Veteran Villager)


                      It's so wrong, I know, but I couldn't help but smile when I read that kat. I'll probably be struck by lightning when I leave the house next.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Aug 16, 2007 6:31 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Tell ya what...after that first call and the huge pain in the A$$ she was being...I couldn't help but grin inwardly myself.

                      Here's an indication of what she was like.

                      We arrive on scene and the BLS crew has her on a board and collar. She's been lapsing in and out of consciousness.. When she wakes, she flails about. so BLS provider is tying her hands down when I arrive.

                      I tell him not to bother, just put her into my unit and she can flail to her heart's content. As we move to the ambulance, I assess her LOC.

                      "What's your name?"

                      "She tells me"

                      "Do you know what happened"

                      "We rolled the car"

                      "Do you know where you are?"

                      ahhh, no, I have no idea where I am" giggle giggle giggle

                      "Tell you what, quit yanking my chain and acting like a moron and we'll get along fine. Keep up with the act, and we are gonna have issues"

                      She looks at me, "Oh!! You're the mean one...aren't you!!" (my reputation for not putting up with crap is well known)

                      I chuckled, "Yep, so don't piss me off."

                      She tried a couple of stunts on the way in, like flailing with her arms and pulling at the C-Collar, then faking a decreased LOC while I held her arms down, but she was keeping her eyes slightly open and watching me. My partner askes me how things are going and I say "Great!! She's pretending to be out though in hopes that I'll let go of her arms." Right then she wakes up and says, "So let go then!!"

                      She was about two seconds from a 14ga IV in the hand, but I was laughing at her too hard.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Thu Aug 16, 2007 6:32 PM
                      Posted By: BushyFromOz (Veteran Villager)

                      Quote

                      Originally posted by: arctickat
                      Let's see:

                      Call #1. MVA, Rollover, 6 people. Two were transported, the driver and the female passenger who was the one that grabbed the sterring wheel, gave a mighy twist, and yelled "Let's roll the car!!!" Both were checked and released from hospital.

                      Call #2. Same female passenger 6 hours later after the owner of the car got his hands on her and thumped the ever living crap outta her.

                      Call #3. Same female passenger taken to tertiary care for facial reconstruction.

                      Is this a joke?

                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk



                      Date Posted: Thu Aug 16, 2007 6:35 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Nope, no joke. In one way it's funny, but others one just has to shake one's head at the tragedy of the cultural acceptance of alcoholism and the pressure to not succeed in life.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Thu Aug 16, 2007 6:44 PM
                      Posted By: jsadin (Veteran Villager)


                      Well put Kat. I hung out with a "less than savory" crowd when I was younger and it's amazing to look back and see how everyone put down those who were trying to better themselves. Glad I broke free of that pack and left it lagging way behind. Every once in a while I see one of their names in the police log.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Aug 16, 2007 7:07 PM
                      Posted By: BushyFromOz (Veteran Villager)

                      I wasn't sure which way to take it

                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk



                      Date Posted: Thu Aug 16, 2007 8:13 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      I thought it was hilarious. Darwinism failing isn't so cool though.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Thu Aug 16, 2007 8:30 PM
                      Posted By: jsadin (Veteran Villager)

                      Darwinism is only failing because we are forcing it to do so. Drop in a nice global event that takes most off the major hospitals and medical care offline and you'll see how quickly the "weak" fall by the wayside.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Aug 16, 2007 8:35 PM
                      Posted By: BushyFromOz (Veteran Villager)

                      okay, an asteroid, bruce willis and some aerosmith music in the background should just about do it then

                      -------------------------
                      Veteran Villager, Amateur Ambo

                      BushyFromOz - Village Idiot and understudy to the Village Drunk



                      Date Posted: Fri Aug 17, 2007 12:06 PM
                      Posted By: jsadin (Veteran Villager)


                      +5 for the Armageddon reference.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Aug 19, 2007 11:03 AM
                      Posted By: VanHelsing (Veteran Villager)

                      last night was quiet, although we responded to alot of calls, we ended up only transporting 3 patients, all from the same accident.

                      but it was a fun shift, with one thing and another.







                      Date Posted: Sun Aug 19, 2007 7:40 PM
                      Posted By: jsadin (Veteran Villager)


                      No sleep for moi last night.

                      Call 1: 86 y/o male SOB X 3hrs. PmHx: CAD, CHF, full code, etc etc. Facility tried to call it in as a routine transfer. I tell my partner to go w/lights. RR = 40 shallow, labored, SpO2 80% on 5ltrs via simple face mask. Pt is in a nursing home and staff states he is a new admit and they don't have his meds right (he didn't get his 40 of lasix today). Pop on an NRB - sats up to 92%. Absolute crap for veins, but I attempted once with no success (10min ride to the hospital). Nurse at the receiving facility gives me crap for not having access...I say I'll watch you and learn. She blows two in a row and they still don't have access when I leave.

                      Call 2: 23 y/o female chest/stomach pain. It's her wedding day (poor girl). Exam at hospital reveals that her stomach has herniated into her mediastinum through a diaphramatic rupture. Doc assumes it's a congenital defect that's worsened and she's scheduled for surgery. Honeymoon postponed for a bit.

                      Call 3: 92 y/o male for return to facility s/p eval after fall. Let my basic partner have that one.

                      Call 4: 41 y/o male cc chest pain, SOB, diaphoresis. Oh, and a history of anxiety attacks (ack). Working with a medic at this point, so I get the line, she gets a 12 lead. Normal sinus (shocker!).


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Aug 20, 2007 2:42 AM
                      Posted By: VanHelsing (Veteran Villager)

                      so the woman, with the herniation... was that before or after she said " I do ? "



                      ... I hope the husband new what he was getting into when he said, through sickness and in health !



                      Date Posted: Mon Aug 20, 2007 10:22 AM
                      Posted By: jsadin (Veteran Villager)


                      She was at her reception, so too late to back out now!

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Aug 20, 2007 11:11 PM
                      Posted By: Police_EMT (Junior Forum Member)

                      Quote

                      Originally posted by: Bamamedic23
                      Note to self, never get a taxi in South Africa.


                      Note to self, bring my firearm, take bus and drive myself, hopefully blocks of wood dont fall off

                      -------------------------
                      Welcome to Le'Village.


                      Village Cop, tazer ready



                      Date Posted: Tue Aug 21, 2007 2:16 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Police_emt... leave your firearm at home, they check if you are carrying weapons at the airport, and if you dont have a gun.... they give you one.


                      blocks of wood ???



                      Date Posted: Tue Aug 21, 2007 7:33 AM
                      Posted By: Police_EMT (Junior Forum Member)

                      """"they are the scariest thing that drives on our roads... To start with, they have zero regard for the rules of the road, the don't stop at red lights, they drive in the emergency lane, the dont know what indicators are for, they just slam on brakes anywhere they feel like, if they see a possible passenger.

                      Then to top it off, the vehicles are not road worthy, I have seen some that have a wheel spanner, as a steering wheel, 2 wooden blocks for brake pads ( I kid you not ), and I had the unfortunate honour of being used as a stopping device once, when driving the Ambulance, because the taxis brakes didn't work""""""VanHelsing
                      Veteran Villager

                      You Post so much , its hard to remember all the comments....LOL


                      Sounds like Bed Stuy, Brooklyn



                      -------------------------
                      Welcome to Le'Village.


                      Village Cop, tazer ready

                       08/21/2007 07:37:47|U



                      Date Posted: Tue Aug 28, 2007 12:20 PM
                      Posted By: jsadin (Veteran Villager)

                      02:30 - I'm at home sleeping soundly when my daughter wakes me up and says "Dad, someone is ringing the doorbell". I respond in my usual 02:30 doorbell answering attire (shorts, flashlight, .357magnum) to find a very distraught 17y/o female shivering and crying on my front stoop. No obvious injuries, but she states she doesn't know who she is, how she got to my house or what has happened to her tonight. I ring dispatch and have them start PD and the ambulance. I speak with her a bit more and note a light odor of ETOH. My daughter then recognizes her as a girl from her school and remembers her name (first AND last..good girl!). We transport her to pedi-ER w/o incident, but her memories are still absent. We leave all the linens from the stretcher with her in case there is any forensic evidence that needs to be gathered. Hope no one slipped the poor girl a roofie...



                      Edit for spelling faux pas

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum

                       08/28/2007 14:24:53|U



                      Date Posted: Sun Sep 02, 2007 9:56 PM
                      Posted By: jsadin (Veteran Villager)

                      Hate to follow my own post, but...

                      02:30 (again??): Dispatched for possible OD. Arrive to find heavily intoxicated 24y/o male who claims to have taken 3 klonopin in addition to mucho alcohol. Took me 45mins to decon the truck after he hurled all over it.

                      14:50 (10mins before shift change!): Two car MVA with injuries. Older female traveling on wrong side of the road crashes head on into a young male on this way to work. Full trauma workup on the young lad (full spinal, two large bores, O2, etc), female refuses any treatment? Light ETOH odor noted on female. Female driver subsequently arrested for DUI. Young lad will be ok (at least it appeared that way when we left).

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Sep 04, 2007 5:09 AM
                      Posted By: VanHelsing (Veteran Villager)

                      So there i was in the middle of nowhere ( nope im not in canada yet )...

                      And we get called to an old age home for a patient with pneumonia that needs to be transported to the nearest appropriate facility which is 150km away...

                      The dispatch info is lower left lung pneumonia according to the doctor that saw her... so clearly she has had a proper assessment done...

                      We get there, and find this 84 year old lady, totally unresponsive... with severe respiratory distress. I ask the sister, how long has she been like this ?.. " well, she was like that when i came back from my off days... 2 days ago "

                      excellent, well thanks for that...

                      So we transport her, and then when we get to the hospital, the sister in ICU says, if I was that old, and the paramedics intubated me, i would sue them. I wanted to smack her, but i didnt.

                      Then, heading back to our base.. driving merrily along the highway... and all we see ahead...is brakelights and hazard lights...hmm, an omnious sign.. and what do you know... a TAXI accident.

                      Apparently, the wheel busrt, and the driver lost control, and rolled several times. We stop, and a chap runs up to the ambulance and says, please come quickly my child is hurt very badly... bad sign # 2.

                      His assessment was correct, and in fact, the 17month old child, was now dead. So we called in any ambulances within a 100km radius ( that was a sum total of 2 ).. and triaged the 16 patients to the nearest hospital.

                      all in a days work.

                      VH
                      __________________________________________


                      ' come with me, i'll show you things that you'd wish you had never seen "



                      Date Posted: Tue Sep 04, 2007 10:20 AM
                      Posted By: jsadin (Veteran Villager)


                      Hell of a day VH.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Sep 04, 2007 10:31 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Welcome to my world.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Tue Sep 04, 2007 8:16 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Wow.... that was a bad day. You should have smacked that sister. Or at least verbally pummelled her. It is not her choice whether the old one buys the tube or not. You should have told the sister to be sure to have her advanced directive with her so that you don't have to tube her if she is unresponsive. On an evolutionary basis, that would be best.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Wed Sep 05, 2007 2:04 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Hi Grambo, actually I was saving up my 'verbal assults' for the head of the casualty( emergency room) unit.

                      How it works here is primary patients get seen in casualty (ER), stabilized and then if necessary admitted to the hospital which isn't linked to the ER. When it is a inter-hospital transfer, or has been pre-arranged by the doc, the patient get admitted directly to the wards.

                      However, this old lady was really unstable, we picked her up with a BP of 70/30..amongst other problems. So I phoned the hospital whilst I was on route and said, this is what Im bringing in, please have the casualty/ER staff on stand-by.

                      So we get there, and the ER says, take her straight up to the ICU.

                      So im already a bit annoyed, because then I am going to have to hand over to the sisters, and not the doctor ( no offence ). So I ask the sisters, has the Doc been notified of this patients condition, and they tell me he is doing his rounds and he still has 30 Patients to see.

                      So now heading back to the ambulance, and the head of the casualty asks my partner, was everything ok in the ICU... he is quite a polite old chap, and is about to shrug the whole thing off... I butt in and say.. ACTUALLY No... I phoned in advance because this patients should have come thru casualty, she is extremely unstable and needs to see a doctor NOW... ( she tried to get off the hook by saying the Doctor was on his way to her ) I then informed her that the Doc was still attending to his OTHER 30 patients, and it would be quite a while before he got to her. A fact that I think she already knew, because she became awfully sheepish and appollogetic and this point... And then bought us off with free vouchers...



                       09/05/2007 02:05:21|U



                      Date Posted: Wed Sep 05, 2007 11:00 AM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)


                      Hmm, where to start?
                      Just got home from doing a 32 hour shift, taking 24 off and then went back in for a 40~~of course the 32 hr shift was fun filled and delightful w/out sleep and consisted of logging on at midnight being informed that our ALS back-up will not be available for the next sixteen hours due to staffing and transfer problems they are having (clue #1 I should have gone home) and promptly being paged out for;

                      PCR1~18 yr old assaulted by multiple assailants. Apparently pipe wrenches and bats were the weapons of choice. Non-responsive on scene, did the usual C-collar, spine board, OPA, BVM, suction, etc and rapid transport....

                      Clean up rig, restock, sit down for a light snack of pizza and get paged out for~
                      PCR2~19 yr old assault victim. Evidently all the bats and pipe wrenches were in use so weapon of choice was a knife with a six inch blade inserted in various spots......got to use a chest seal and lots of gauze.

                      Clean up rig, restock, sit down to begin paperwork and leave for~
                      PCR3~16 yr old in 8th month of pregnancy experiencing what she describes as lower abdominal pain, back pain which began about 18 hours ago and states "I think I pee'd my pants earlier this afternoon".....no prenatal attention=no knowledge of what is happening....rapid transport and a slightly grumpy EMT telling her that "No, you don't have to have a bowel movement and please don't try. Once you begin pushing we are up a crick w/out a paddle!"

                      PCR4~Paged out for Non-responsive/CPR in progress. Arrive to find very intoxicated adult male breathing at about 5 per minute.

                      While refueling ambulance we are radioed by PD that we are needed 11 miles south of our bay and 18 miles south of our current position for MVA-rollover with multiple pt's. Request that they also call another service which is about 19 miles from location in the other direction.

                      PCR5, 6, and 7~ Two adult males (40's) from above MVA and a sixteen yr old female. Female is sent w/other rig to a different hospital as she is stable and claiming rape, abduction and assault by the two pt's who will be going w/me. Both pt's were intoxicated enough that they were not badly injured in the rollover~possible Fx clavicle and ribs on one and the usual assortment of bumps, bruises and abrasions. He gets the KED and the captain's chair since he began fighting when we tried to lay him down flat. Second pt complaining of "hellfire" pain in back so he gets the LSB and immobilization procedure and the cot. Both remained stable enroute and actually visited back and forth laughing about the incident.....
                      KED pt proceeded to vomit all over my previously clean rig, walls, shoes.....then laughs about how it smells like Wild Turkey. (before I get jumped about the pt that "sat" enroute~~he fought so badly when we tried to LSB him that I figured he would do more damage than good if I insisted on keeping him on the LSB. Also both had already been up and walking around on scene before we arrived as well as this one tried to run from PD)

                      Return to bay and check map to ensure that my rez has not been transferred over to VH's territory~~ and begin a few hours of paperwork and e-reporting.....

                      Catch a very quick nap while the sun gets up and then respond to

                      PCR8~Paged out for female elder not responding well when daughter went to check on her this morning. Arrive to find her exhibiting all the signs of having suffered a stroke~

                      Damn~lucky me volunteered to be on pager today....gotta go~ will continue soon I hope.

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Wed Sep 05, 2007 12:10 PM
                      Posted By: jsadin (Veteran Villager)


                      Wow Clutzy...heck of a run!

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Sep 05, 2007 4:34 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Nah Clutzy: you don't have VH's 12 occupant taxicabs!!!

                      Sounds like a couple of very busy shifts for you.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Wed Sep 05, 2007 7:59 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Poor Clutzy. I wouldn't jump you about the seated spinal. I know you would have tried to LSB him. That was a crazy shift.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Fri Sep 07, 2007 12:50 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)


                      Ooooh, but we're NOT done yet....that was only part of the first hellshift....
                      The next morning we did standby at a youth rodeo~sent two bronc riders in with our other rig that was ALS manned. Both with head injuries and possible neck injuries from diving head first off the bronc's. Sent in a pole bender that lost her balance and departed from her horse, landing on her right hip and heard a "pop". Last one to be sent in was a guy working the chutes that got his hand stuck between the gates when a bull kicked it~~lacerated his entire palm and pushed a bone thru. Dang, didn't think bones were that white......


                      I did get a 24 hr break and then went back for more fun and excitement which included;

                      Call from CHR asking us to respond along with them (they never did show up) for a 58 yr old male that had called w/CP~arrive to find the man laying in total darkness (no power in the house) only response I can get out of him is "my chest hurts". Rapid assessment revealed a HR of 225, BP 124/86. No ALS back-up so it's lights and sirens and high flow diesel. Approx five minutes out from hospital he dropped to no HR for about 15/20 sec, came back at 69 and rapidly returned to 215. Doc in ER was a newbie~he gave 5 mg of Lopressor....that wasn't the drug of choice I was thinking of on the way in but....have not heard how this guy is doing yet.


                      Throw in a few assaults here.....not as bad as the first couple but they kept me occupied the entire trip. A diabetic hypoglycemic, a relaxing BS call that basically just wanted a ride to town (he started complaining of CP and by the time we got to town he had "liver" pain~LOL~didn't know you could feel your liver in pain)

                      Then another pucker factor call came in:
                      Call from young girl asking us to come and check out her sister that is having chest pain~~arrive to find 33 yr old female being assisted by two people down the hallway. Rapid assessment she is cyanotic around the lips, HR 33, BP 110/60, speaking in three to four word sentences. She is diabetic and has missed her last two dialysis apts. Call for intercept as soon as we get in the rig and all cell phones are DOWN and PD isn't asnwering our page on the radio. Ten minutes later we finally get thru to ALS-they intercept and I have the patches and everything on her so they begin to pace her, attempt to start an IV and we are at the hospital five minutes later.....have not heard the outcome on this one either. Got to give the gal credit, she was conscious the entire time and endured the pacing w/out any complaints even tho they were not able to get an I.V. and we didn't get capture until after 100.

                      Throw in a couple seizures and a two yr old w/broken hip (yep, two yr old) here and finish off with another SOB call and a crushed finger......


                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       09/07/2007 12:53:23|U



                      Date Posted: Fri Sep 07, 2007 2:28 PM
                      Posted By: jsadin (Veteran Villager)

                      Clutzy, you sure you haven't moved to Stridor's old stomping grounds? Good lord that's a lot of calls.

                      BTW: what med were you thinking the doc would give to your cardiac pt? From tachy to asystole, to normal, to tachy again...where the heck do you start?

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum

                       09/07/2007 14:31:17|U



                      Date Posted: Fri Sep 07, 2007 7:36 PM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)


                      Not really sure, but I was thinking Amiodarone to begin with....but I'm not a medic or a doc so I'm probably waaaaaaaaaaay off base.

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Fri Sep 07, 2007 10:38 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      I'd opt to check rhythm first but amiodarone sounds like a good bet. Adenosine would be my first choice, pending rhythm.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Fri Sep 14, 2007 2:54 PM
                      Posted By: elvismedic (Veteran Villager)

                      After a mostly uneventful 24, with an hour left in the shift we were sent out for a MVC car on fire. Now, Knowing most people see the "smoke" from the airbags we assumed that was the issue. The engine, with a medic on board, arrives on scene first and immediately requests 2 additional ambulances and aeromedical response. I arrive a few minutes behind the engine. As I approach the vehicle I am told the driver is going first and is in immediate need of extrication and aeromedical evacuation. I find the driver restrained behind the wheel unconscious and unresponsive breathing agonally. The drivers door is jammed and has to be forced with hand tools. Once open (5 or so minutes) the driver is extricated out onto a LSB and tubed by the first arriving medic. Patient to the truck and enroute immediately to the LZ (a 3 minute ride). BP enroute is 90/P Pulse 60 Resp 4-5 (15-20 assisted with BVM), pupils fixed and dilated. Try for a 14 in the L a/c miss, try for an 18 in L hand miss, at the LZ with air crew approaching the rig try one more time this time in the R hand and get an 18. Patient flown out to Level 1 trauma CTR in the capital city.

                      Patient 2 taken to LZ by mutual aid was unconscious on scene and took the brunt of the impact. I should tell you about that. Vehicle was an Audi wagon traveling north through a wooded area. I'd estimate speed at at least 65. Driver went over a small rise in the road and apparently lost control. Car slid out to the right. Slid about 200 feet went through a 6" diameter pine tree and came to rest 10 feet away from that tree against a 3" diameter oak. Needless to say the oak won that fight. Now back to patient number 2. To extricate this patient the car had to be pulled away from the tree. Patient had an avulsion from the hairline above the right eye all the way back above the ear to the occipital skull. This patient was also flown out to a level 1 trauma CTR. This patient was restrained frontseat passenger.

                      Patient 3 is the youngest is seated on the passengers side. This patient is impailed on the rocker pannel and was conscious and responsive on scene. He also was flown out to level 1 trauma ctr.

                      All 3 patients had to be extricated from the vehicle. During the initial extrication we only had 6 people on scene and the total time to extricate the patients was 25 minutes. There was massive intrusion on the passenger side the only glass that remained intact was the windshield. Oh yeah the car was on really fire although just a small fire under the hood.

                      At last check all three were alive. This was a first for my little town. We've never had three aeromedical evacuations in one day never mind 1 call.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Fri Sep 14, 2007 6:54 PM
                      Posted By: DRIVER609 (Senior Forum Member)

                      25 minutes to extricate 3? That is slick! Man, where I work the average scene time for a non-trapped trauma patient is over 20 minutes! Not sure what people are doing on scene with them, but they could learn a thing or two from you guys elvis, nice work.



                      Date Posted: Fri Sep 14, 2007 8:09 PM
                      Posted By: elvismedic (Veteran Villager)

                      Driver thanks for the compliment.

                      We only run 2 FF/EMT's, 2 FF/Medics and a BLS Captain; staff is split between 2 houses. We have a medic in each and Headquaters has the captian. Because of this we are used multi-tasking on almost every run. The drivers door was forced with a haligan and then muscled out of the way. While this was being done another FF was setting up our new jaws. I must give a glowing recomendation to Halmotro's "Core" technology. This tool is amazing. We never would have cut the car apart so fast without it.

                      In my department all of the officers captain, deputy and chief are all willing to jump in and lend a hand. That isn't always the case in other places.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Fri Sep 14, 2007 10:30 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      I must agree. The extrication, decision process, triage and treatment all seems bang on and highly efficient. Wow.... that is all I can say!

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Fri Sep 14, 2007 10:50 PM
                      Posted By: ESPARKS (Veteran Villager)

                      I'm proud of you Elvis: Sounds like you paid attention to what some of us tried to pass on. Nice response to a call from hell!
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Fri Sep 14, 2007 11:14 PM
                      Posted By: jsadin (Veteran Villager)


                      Good job to you and your crew Elvis!

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Sep 17, 2007 1:25 AM
                      Posted By: ESPARKS (Veteran Villager)

                      Is anybody else seeing an increase in CVA's ??

                      In the last several weeks I have seen seven patients that suffered from serious brain attacks. Age range from 56 to 85 , all in reasonably good health with no prior history. five of these have been fatal .

                      Today was 64 YO female neg hx, only med fosamax, had been active and suddenly felt headache and nausea . called neighbor who dialed 911. on arrival pt. able to tell us what she was feeling and showed diminished left side with slight speech delay. by the time we got to rig, <5 min she was unresponsive except to pain. by the time we reached hospital she was ready to be tubed. quick CAT showed massive intracerebral bleed.. not a good outcome.

                      Last week it was
                      1. 62 YO Female with no hx., an athlete with no medical issues or meds. woke up and collapsed while getting dressed. diagnosis large infarct to the brain stem . Removed from life support after two days & passed.
                      2. 56 YO Male with hx of htn. unknown meds. found unresponsive on floor. no signs of trauma. Cat showed big midline bleed. . passed that night.

                      Boy what i would give for a nice car crash with a little trauma!

                      I know I'm rambling but it's been a rough couple weeks. off to the woods for a couple days tuesday/wednesday.
                      Ed


                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Mon Sep 17, 2007 12:07 PM
                      Posted By: elvismedic (Veteran Villager)

                      Thanks for the compliments. But this was truly a team effort.

                      Unfortunately, since my last post the local news has reported that the driver has passed away from his injuries. Not trying to sound uncaring, but it's probably for the best. The other 2 passengers remain hospitalized one is in "fair" condition and the other is in stable condition.

                      I was talking to a one of the members who helped extricate the 2 patients that are alive. He said that to facilitate and expedite the extrication they chained the fire engine to the car and pulled the car from away from the tree.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Mon Sep 17, 2007 6:45 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Don't beat yourself up Ean.
                      Chains and firetrucks can be very effective means for removing cars from immovable objects.

                      Remember trees very seldom lose in a battle with cars or bodies.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Mon Sep 17, 2007 8:22 PM
                      Posted By: jsadin (Veteran Villager)


                      Ed, I did have an elderly female patient this weekend with a possible CVA, but other than that I haven't seen many lately. Actually, things have been fairly quiet (eeks! I said the "q" word), which means the town should implode sometime soon.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Sep 18, 2007 9:11 AM
                      Posted By: elvismedic (Veteran Villager)

                      Especially not 3 foot diameter oaks.

                      Ed in answer to your CVA question no we haven't seen an increase. In fact I cannot remember the last one I went on.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Tue Sep 18, 2007 12:55 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Todays call reminded me of a Joke...

                      Whats red and has more brains than Kurt Cobain ? ....... The wall behind him.


                      Call 1: Respiratory distress

                      Call 2: Suicide, shot himself in the head( mouth ), and literally blew his brains all over the floor.

                      Call 3: MVA ( Taxi )

                      Call 4: MAV, LDV rolled throwing the people out that were sitting in the back.

                      It rained today, first rain of the season... I suspect plenty more MVAs tonight.



                      Date Posted: Tue Sep 18, 2007 2:35 PM
                      Posted By: jsadin (Veteran Villager)


                      A little formula 409 and you'll never know he was there.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Sep 18, 2007 10:27 PM
                      Posted By: ESPARKS (Veteran Villager)



                      Jim Go in the corner and slap yourself !!!! using the Q word.

                      Another "stroke" call yesterday. turned out to be just a transient attack that cleared itself by the time we got to the hospital.

                      Followed up by a 2 veh. crash, woman stopped to turn into the island store rear ended by a full size pick up , doing 40 mph +. Pushed her midsize truck about 40 yards down the road. Thank god for a change of pace with a nice little trauma call where the pt. is a+o and talking to us. and stayed that way throughout the call.

                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Wed Sep 19, 2007 10:18 AM
                      Posted By: jsadin (Veteran Villager)


                      Sorry Ed! {slap - slap - slap!}



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Sep 19, 2007 10:33 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Call 1: MVA , 1 patient

                      Call 2: Respiratory distress, known emphysema patient

                      Call 3: Cash-in-transit Heist ( fairly common this time of year )

                      Call 4: Fall from height, 1 patient ( lower back pain )

                      Call 5: PVA- bad luck for this lady, a chap reversed out of his drive-way, didnt see her, drove over her, and then only noticed here lying on the ground... GCS on arrival 3/15, intubated without sedation, went into a PEA, then had return of a spntaneous pulse... then lost it.. lots of CPR lots of Atropine and Adrenaline, and sadly she was declared dead about 10 minutes after we dropped he off at hospital.

                      Call 6: MVA

                      Call 7: MVA



                      Date Posted: Wed Sep 19, 2007 10:39 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Cripes, you do more MVAs in a day than we do in a year.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Wed Sep 19, 2007 10:46 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      We've had a rash of MVCs in the area. One took the life of a friend/coworker/classmate. She will be missed. It was not an LODD so I never posted it and she wasn't part of EMS, she was one of the best nurses I have ever met. She is and will be sorely missed by many people.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Thu Sep 20, 2007 1:34 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Graham, condolences and prayers to all that knew her.

                      M.

                       09/21/2007 00:43:12|U



                      Date Posted: Thu Sep 20, 2007 9:38 PM
                      Posted By: jsadin (Veteran Villager)


                      Bummer Graham. My condolences.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Sep 20, 2007 10:27 PM
                      Posted By: paradude (Senior Forum Member)

                      Quote

                      Originally posted by: arctickat
                      Cripes, you do more MVAs in a day than we do in a year.


                      We'll generally have 4 or 5 in a day for some trucks, but out of those, maybe only one will be bad.

                      -Paradude-



                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Fri Sep 21, 2007 10:26 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Chuckle, yeah, but then you probably do as many calls in a week in your organisation than mine does in a year. 300-350

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Fri Sep 21, 2007 1:44 PM
                      Posted By: paradude (Senior Forum Member)

                      I work a fairly busy urban service in my first job, we do probably 50,000 calls a year there with about 12-13 trucks. My second job though, only does about 1800-2000 calls a year with two trucks. Its based in a small town where I live, and is mostly rural. (EASY MONEY!!)

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Fri Sep 21, 2007 8:28 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Yeah right dude

                      "only does about 1800-2000 calls a year with two trucks. Its based in a small town where I live, and is mostly rural. (EASY MONEY!!) "

                      If doing 1800 -2000 with two trucks is easy money ,I wouldn't want to be in a busy rural system.

                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Sat Sep 22, 2007 1:42 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Its a long weekend, I thought it would be quiet as many people leave for a holiday, Jo-burg isnt a hot tourist destination...

                      Nightshift..

                      Call 1: MVA: head on collision, 3 patients, 1 entrapment. femur #, radius/ulnar fractures, and head injuries..

                      Call 2: Pedestrain- lady has a fight with boyfriend on the highway, boyfriend drops her on the side of the road to cool off, returns 5minutes later to pick her up, and finds her dead in the fast lane.... alcohol is a nasty thing.

                      Call 3: Gun shot wounds patient ( what a novelty... NOT )

                      Call 4: drug overdose at nightclub 18years old... her future looks bright.

                      Call 5: MVA- lady decides to flip and roll her car off a bridge, as you do when you are drunk, we get there, the car is wedged semi upside down against a concrete pillar... and she is dangeling from her safty belt, with 2 very broken legs amongst other things, quiet a hectic rescue. ( not including the long trek along the river in order to get her out... we couldnt take her out the way we came in, because it was too steep and we basically slid down on our...

                      home sweet home, I cancelled my dayshift for today in leiu of some sleep.





                      Date Posted: Sat Sep 22, 2007 9:46 AM
                      Posted By: paradude (Senior Forum Member)

                      Quote

                      Originally posted by: ESPARKS
                      Yeah right dude

                      "only does about 1800-2000 calls a year with two trucks. Its based in a small town where I live, and is mostly rural. (EASY MONEY!!) "

                      If doing 1800 -2000 with two trucks is easy money ,I wouldn't want to be in a busy rural system.

                      Ed



                      Yeah, but you gotta remember that we do all of our own convalescent calls there too. So alot of those calls are discharges back to our local nursing home, or round trip transfers to doctors appointments, or to the hospital for routine x-rays. Sometimes we'll have a dialysis patient that we'll take to dialysis and bring home 3 times a week. I'd say only about half of our calls are actual emergency dispatches.

                      -Paradude-


                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Sat Sep 22, 2007 8:20 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Okay dude: but thats still a lot of calls for two trucks , even if half are grannie shuffles.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Sat Sep 22, 2007 9:28 PM
                      Posted By: elvismedic (Veteran Villager)

                      Ed my department does about 1500 911 ems calls per year and about 500 fire related calls. I usually tell family that I get paid very well to do very little.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sat Sep 22, 2007 10:23 PM
                      Posted By: paradude (Senior Forum Member)

                      Well, regardless of that, it is kind of a respite after coming off of a shift from my first job. I get alot of sleep, and lately that is when I do alot of my "Villaging". It may seem like alot of calls, but it sure is a break for me. After running 12-14 runs on my first 24 hour shift, it is nice to go to one that does about 4. How many calls does your service run?

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Sat Sep 22, 2007 11:28 PM
                      Posted By: stridor (Veteran Villager)

                      At the Job I just left we would do on average 12-15 calls on a twelve hour day shift per truck, usually three trucks. On nights would be about 8-10 calls. It was busy as balls there most all the time. I actually got a couple hours sleep on a night shift once and thought I was in heaven. University of Medicine and Dentistry of New Jersey runs constantly. But 50,000 a year with twelve trucks is plenty respectable.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sat Sep 22, 2007 11:35 PM
                      Posted By: paradude (Senior Forum Member)

                      Wow!! You guys need more trucks!!! That's enough to drive someone plum crazy! Do you ever have calls waiting? Waiting calls is how we get more trucks on the road. Then again, how long are most of your calls? Many of our stations have as much as a 20-30 minute transport time. Then you have to factor in the time took to get to the call, and the time it takes for the truck to get back to zone.

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Sat Sep 22, 2007 11:37 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Where I am now in a nice calm {notice I didn't use the Q word Jim} rural service on an island off the coast of Maine we might do 200 911 calls ,& 50-75 fire calls this year. It's sort of a retirement gig until I decide that I'm getting too old to keep up with the young kids on the job. I used to work in a large city 911 service and then on days off run away north to work motorsports events where we would have 500-700 pt contacts over the course of a week. We don't have any nursing homes or other facilities that require us to run our tails off. Our busiest time is during tourist season when we are inundated by folks from the big city that insist on doing really stupid things , if you get my drift.

                      on average it takes us around 2 hours per transport call by the time we get back to the station and ready to go again. Transport times range from 25 minutes to as much as 2 hours if we have to go south to the trauma center
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense

                       09/22/2007 23:42:21|U



                      Date Posted: Sat Sep 22, 2007 11:45 PM
                      Posted By: paradude (Senior Forum Member)

                      Believe it or not, we have a station in this service whose zone does about the same as your service it sounds like. Its average is 0.6 calls per day. They send someone out there, either to give them a break from one of the busy stations, or it is where they put someone to keep them out of sight. Think about getting paid $50,000 a year to come in for a 24 hour shift and not turn a wheel? (except to go eat) Happens alot out there. If we didn't have a nursing home, at my second job, our call volume would be about the same I think.

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Sat Sep 22, 2007 11:48 PM
                      Posted By: paradude (Senior Forum Member)

                      How do you get to the mainland where I assume your trauma center is? Or, is it on the island? A ferry would seem kind of nerve racking. Do you use air transport like helicopters, or even fixed wing?

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Sun Sep 23, 2007 10:55 AM
                      Posted By: stridor (Veteran Villager)

                      We had calls waiting all the time. Camden PD officers were all emt's and they have transported pt's in the back of cruisers with Virtua's medics on board a number of times if things got thick. We had nine trucks but the U would only come off of three crews period. It's all they could afford since we had about an eighty percent default rate. From dispatch to completion on a good day, that is to say when the er doors to Cooper trauma center weren't standing open with a line forming into the parking lot we could turn a call around in twenty. Thats dispatch, enroute, doc it, turn care over, make the litter and restock, and write the chart.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sun Sep 23, 2007 12:19 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Quote

                      Originally posted by: paradude
                      How do you get to the mainland where I assume your trauma center is? Or, is it on the island? A ferry would seem kind of nerve racking. Do you use air transport like helicopters, or even fixed wing?

                      -Paradude-


                      we cover a string of islands that are connected by bridges to the mainland with an additional dozen or so offshore islands that are reachable only by boat. These offshore calls have to be transported back to the islands by boat and then by ambulance to the hospitals. We do have lifeflight helicopter service available when the weather lets them fly,otherwise it's by ground . Our two nearest hospitals are 15-20 miles away,but they are both small community hospitals with small ER's and limited surgical capabilities. Anything major must go to one of two trauma/cardiac centers that are both hour & half minimum ride away in different directions
                      Ed.



                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Sun Sep 23, 2007 5:08 PM
                      Posted By: paradude (Senior Forum Member)

                      If we have calls waiting consistently at all, we have good amunition to hit up the county commision for staffing another unit, or even another station. That is a political rotten egg, that no politician wants to be left holding.

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Sun Sep 23, 2007 5:11 PM
                      Posted By: paradude (Senior Forum Member)

                      Quote

                      Originally posted by: ESPARKS

                      we cover a string of islands that are connected by bridges to the mainland with an additional dozen or so offshore islands that are reachable only by boat. These offshore calls have to be transported back to the islands by boat and then by ambulance to the hospitals. We do have lifeflight helicopter service available when the weather lets them fly,otherwise it's by ground . Our two nearest hospitals are 15-20 miles away,but they are both small community hospitals with small ER's and limited surgical capabilities. Anything major must go to one of two trauma/cardiac centers that are both hour & half minimum ride away in different directions
                      Ed.


                      Whew!!! I thought you guys were out there on your own. That is pretty much how we have it at the slow service I told you about. Small community hospital, and anything else is anywhere from a hour to an hour and a half.

                      -Paradude-


                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Mon Sep 24, 2007 9:17 PM
                      Posted By: CBEMT (Senior Forum Member)

                      Quote

                      But 50,000 a year with twelve trucks is plenty respectable.


                      Damn. One of the local departments here does about 40,000 with 6 trucks. 5 until two years ago.



                      -------------------------
                      Village Geek



                      Date Posted: Mon Sep 24, 2007 9:23 PM
                      Posted By: jsadin (Veteran Villager)


                      Damn! That's 18+ calls per day (24hr) per truck CB. Holy crapola. I did a 24hr shift in Fall River with 17 calls and my arse was draggin'. I can't imagine that kind of call volume all day every day....



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Sep 25, 2007 1:34 AM
                      Posted By: ESPARKS (Veteran Villager)

                      Quote

                      Originally posted by: CBEMT
                      Quote

                      But 50,000 a year with twelve trucks is plenty respectable.


                      Damn. One of the local departments here does about 40,000 with 6 trucks. 5 until two years ago.



                      " I'll take ambulances for 400 "
                      Would that be Providence??

                      :-] Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Tue Sep 25, 2007 1:47 AM
                      Posted By: ESPARKS (Veteran Villager)

                      Quote

                      Originally posted by: jsadin
                      Damn! That's 18+ calls per day (24hr) per truck CB. Holy crapola. I did a 24hr shift in Fall River with 17 calls and my arse was draggin'. I can't imagine that kind of call volume all day every day....


                      Jim : thats why all the guys from down the falls are crisp around the edges at a young age. Doing that kind of volume each and every shift is the quickest way to end up dead tired or divorced and working three jobs to pay the alimony. There is a strain in spending the entire day & night running calls. Have a younger friend that works in a system like this. just a little north of you a bit. 18-20 calls every single shift. They never shut their trucks off and very seldom do they get a meal or a chance to P, much less a chance to sit and relax for a 20 min power nap. He'll be burnt hard by the time he reaches the ripe old age of 35. If he survives !!!

                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Tue Sep 25, 2007 9:58 AM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)

                      Quote

                      I did a 24hr shift in Fall River with 17 calls and my arse was draggin'. I can't imagine that kind of call volume all day every day....


                      Yep, it's fun and exciting the first six months or so~~after that, you feel yourself sliding down the temper tantrum tube once in awhile. Getting edgy when your six yr old can't quit babbling, grabbing a slice of bread with butter or a cookie and a pop rather than sitting down for real food, holding your P until your eyeballs are swimming and then realizing, "Shoot, I'm home, I can P!".....You learn very quickly to take advantage of the "drive" time back and forth from work to clear your mind and try to make the transition back to "normal" life~put the pt's that didn't turn out as well as you would have liked them to in a little box and set them on the shelf in the back of your mind and hope they stay there while you are trying your damndest to look sympathetic when your best friend shows you her busted fingernail, or kitty scratch, or what have you....after awhile, you even quit checking the obits because you know you are going to recognize the names and that a ghost is going to come out of the box and say, "I told you to do it this way..or you should have tried..."

                      I have come to treasure the "golden" hour in my home which is at 2030 every night that I'm not at work~~it's when I grab my little guy, toss him in his jammies, turn all the lights in the house out except for one, wrap him in a blanket and snuggle him in next to me. I listen to his thoughts, fears, and exciting news until his breathing becomes slow and rhythmic and he is in slumberland.....aahhh the excelsior of the living!!

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.

                       09/25/2007 10:01:09|U



                      Date Posted: Tue Sep 25, 2007 10:11 PM
                      Posted By: jsadin (Veteran Villager)


                      Ed, I'm all about NOT being a burnt out wreck at a young age. There's got to be a way to rotate these guys/gals out of the super busy trucks at least once per month. I work 7 days a week every week, but I wouldn't be able to keep it up if I had to pull that kind of call volume all the time. I'm no good to my family a babbling psycho.

                      Clutzy, you should just stay home with the kids. Since yer not a medic, the patients are probably better off if you just leave them alone.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Sep 25, 2007 11:56 PM
                      Posted By: stridor (Veteran Villager)

                      Man the U was awesome, it was truly a ride like no other. I think I could have done it forever. We were respected and paid well for our efforts. When we needed help it was there, when a panic call went out the cavalry came running. Cops, deputy sheriffs, conservation officers, supervisors, fire, everybody who heard it. Fifteen calls per twelve hour truck was business as usual and it was like barnum and baileys, the greatest show on earth. You couldn't make the stuff up if you tried. There were folks there that done it for eighteen years. I think that it is pretty tough if you don't like to do your job but if you love to treat sick and injured, and tolerate the rest of the people then it was easy.

                      -------------------------
                      One day you'll be alone face down in a combat zone. Bullets flying all around. Medics kneel down beside you on the ground. Don't you worry bout being alone delta medic's gonna bring you home.
                      Village armourer



                      Date Posted: Sat Sep 29, 2007 3:32 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Worked from 3 - 11pm yesterday.. ( 8hrs )

                      Call 1: Dead - Motorbike accident- scooter going thru intersection got hit by taxi - declared on scene.

                      Call 2: PVA - 8years old bilateral femur fractures and possible pelvis aswell as head injury, took him to various hospitals and kept getting turned away. Most annoying.

                      Call 3: Dead - Gunshot chest, declared him on scene

                      Call 4: Seizures/post head injury - also kept gettting turned away from hospitals - still annoying.

                      Call 5: Dead - Gunshot wound chest and abdo, declared on scene.

                      Call 6: respiratory distress - 6th floor, elevator broken... get there, and patient has gone with a taxi to hospital ( why she didnt just do that before calling us, i'll never know )

                      Call 7: Man lying next to the highway, possible medical ??? get there to find a man, fairly drunk, who hurt his foot when resisting arrest from police and cant walk. stayed on scene for ages waiting for an ambulance to materialize out of thin air, and finally one did. ( actually a passing by private ambulance that stopped to help, otherwise I think I would still be waiting for that government ambo to arrive )


                      That was it, tonight I think Im going to be really busy.





                      Date Posted: Sat Sep 29, 2007 12:42 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      VH, when you get to Canada I think you're going to find yourself bored out of your skull. At least initially until you get used to a slower pace of life.

                      -be safe

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Sat Sep 29, 2007 6:36 PM
                      Posted By: jsadin (Veteran Villager)


                      VH, that's a bunch of bodies in 8hrs! What ARE you going to do with yourself in Canada?

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Sep 29, 2007 8:01 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      More importantly, Saskatchewan?

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Sep 30, 2007 1:34 AM
                      Posted By: VanHelsing (Veteran Villager)

                      I dont mind being bored, im tired of declaring all these people.

                      last night... No dead people, yipee ( some very near dead )

                      Call 1: MVA - 4 very drunk people, all signed RHT ( so they could leave before metro arrived with a breathalizer )

                      Call 2: MVA - NSR

                      Call 3: MVA - NSR

                      Call 4: MVA - bakkie (LDV) with 7 occupants, 5 ejected from back.

                      Call 5: MVA - NSR

                      CAll 6: MVA - priority one patient, extricated from his very smashed up convertible, shame.

                      Call 7: Very VERY drunk oak, tries to slide down banister rail, falls 2 flights and lands on his head ( too drunk to even put his hands out ), we get there to find him already intubated by the casino paramedic, too bad the ET tube was in his stomach, but that got rectified, and after 20mg of Midazolam, and 20mg of Morphine we took him to hospital...

                      now its bed time.



                      Date Posted: Sun Sep 30, 2007 2:51 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      20 of midazolam? Wow, now that is a high dose. How much time did you spend before leaving the scene?

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Sep 30, 2007 10:32 PM
                      Posted By: VanHelsing (Veteran Villager)

                      We were on scene for about 25minutes. The paramedic that intubated him in the first place gave him 5mg.

                      20mg is alot, and fairly unusual, but thats what he needed, the airway was a mess, after the initial attempt, if I had arrived first on scene, I imagine things may have gone a bit differently.





                      Date Posted: Mon Oct 01, 2007 2:40 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      20mg in 25 min is not too bad. I've given more....

                      I believe my record when intubating a patient (I was the one pushing meds.... doctor was intubating):

                      Versed 20mg
                      Fentanyl 200mcg
                      Propofol 50mg

                      That finally sedated sufficiently. Finally we pushed some roc and that was enough to get the tube in and that was it. We had a horrible time keeping this person unconcious.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Oct 07, 2007 5:46 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Saturday Night Shift...

                      Call 1: transfer patient to government hospital, stabbed chest/ heart. Entrance wound, posterior left clavicular, causing a peri-cardial tamponade and pneumothorax, Fascinating ECG changes. Managed to get him to the next hospital alive... I did have moments of doubt along the way !

                      Call 2: Burns patients, 2 priority ones, one had 95% burns, the other about 60%, caught in shack fire when gas bottle exploded. Sat with these 2 guys for over 3 hours trying to find a hospital that would accept them, lots of fighting, lots of unhappiness, lots of morphine.

                      Call 3: Gunshot head ( not dead yet ) no brain, no pain.

                      Call 4: Cant remember, gheesh, im tired... will update after a power nap...



                      Date Posted: Sun Oct 07, 2007 10:22 AM
                      Posted By: AZCEP (Veteran Villager)

                      Can you post the ECG? You've managed to pique my interest.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Sun Oct 07, 2007 10:44 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Bet he had S-T elevation in all 12 leads.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun Oct 07, 2007 1:12 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      I bet that Kat is right!

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Sun Oct 07, 2007 6:43 PM
                      Posted By: jsadin (Veteran Villager)


                      3 calls, only one worthy of print. 40y/o female cc OD on benzo's and alcohol. Didn't even flinch at an 18 in the hand.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Oct 08, 2007 2:03 AM
                      Posted By: ussenterprise2 (Senior Forum Member)

                      Our calls for the day are more like calls for the week, because our volume is solow.Anyway: calls for the week-

                      Monday: medevac, lady with Guillain Barre syndrome (old-never fully recovered) fell in bathroom and sustained fractured ankle. She was from Wales, flight Paramedic from England and me from England also. Had to drive as was only one licenced to drive on airport.

                      Saturday: went to do grocery shopping and came across one RCMP (police) officer in parking lot stand-off with knife-wielding drunk. Hovered in background in case was needed. Husband (jail guard) hovered also. Eventually, guy was tazer-ed and ambulance called. Took off to pick up ambulance only to find was only one responding to call. No-one else showed up. RCMP brought patient in.

                      Sunday: elderly lady fell and ?#humerus. Happened yesterday but did not feel any pain until today...

                      Not nearly as intense as it is down south, but it keeps us going.

                      -------------------------
                      "Live long and prosper....."



                      Date Posted: Mon Oct 08, 2007 3:24 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Sure i can post the ECG strip, i only have the one from my monitor, which was a 3 lead, the hospital did a 12-lead, but I didnt keep a copy.

                      PM your email adress if you want to look at it.



                      Date Posted: Mon Oct 15, 2007 4:12 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Yesterday was fairly quiet.

                      Call 1: called for backup - query silent MI, with a diabetic patient, 87 yers old. Interesting ECG again.

                      Call 2: 24year old woman, overdosed on some sleeping tablets and myprodol. We found her in a fairly stable condition.

                      And that was that, a good shift all round.





                      Date Posted: Mon Oct 15, 2007 9:40 PM
                      Posted By: jsadin (Veteran Villager)


                      Holy cow....was South Africa sleeping yesterday?

                      I had two calls during my 25hr shift Sat/Sun:

                      1) Abd pain. Former opiate addict/alcoholic with a looooong history.
                      2) Pleasantly demented 85yr old female for return to SNF. She was a most enjoyable conversationalist.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Oct 22, 2007 10:55 AM
                      Posted By: elvismedic (Veteran Villager)

                      Had an average 24 yesterday. 5 runs. Only interesting one was a 49 y/o M who decided to repair a leak in his gas tank. He drove his SUV up on ramps, set the E-brake and pulled the drive shaft. Any one pick up on what he didn't do? Yeah he never chocked his wheels. Needless to say the SUV rolled backwards over him. He self extricated and called 911 himself. We arrived and found him standing, or rather leaning against his SUV holding his R arm like it was in a sling. Removed his shirt found large areas of road rash and ecchymotic areas. Patient also complaining of R thoracic pain. Could be scapula or ribs wasn't sure. Vitals stable but because of MOI decided there was a likely hood he'd need an OR so we flew him in town to the trauma center.

                      Of coarse he had to call in the middle of the Pats game. At least it wasn't the Sox game.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Mon Oct 22, 2007 5:24 PM
                      Posted By: AZCEP (Veteran Villager)

                      69 y/o female altered level of consciousness. Patient found lying in bed, incontinent to bowel/bladder. Observed respirations at 12-14/minute with a bit of stridor noted. Radial pulse is hard to palpate. NRB goes on, and airway positioning clears the stridor.

                      Blood pressure 53/33 on the LP12. Heart rate 43-50/min showing a sinus rhythm. Capnography shows respiratory rate at 40+ with CO2 of 35-40 mmHg. Pupils pinpoint and non-reactive. Patient moved to transport unit to continue treatment. 2 mg Narcan IM, BGL = 53. No peripheral IV access. EZIO for one, and a subclavian central line for another. Patient still maintaining a patent airway as long as we help with positioning. 2 mg Narcan IV, and 12.5 gm D50 IV with an increase of BGL to 76 mg%.

                      No changes in pupillary response following the Narcan. The patient is becoming more vocal, but still does not respond to commands or pain. 0.5 mg Atropine given with slight increase in heart rate to ~70/minute. After the Atropine and about 800 mL of fluid, the blood pressure is now in the 60's. Patient is still not responding appropriately.

                      Right upper extremity with purposeful movement, left upper extremity with abnormal extension. Flight crew on scene for transport. Decision made to RSI with our full support of that decision. 20 mg Etomidate/10 mg Versed (oops, bad nurse)/100 mg Sux. Waited a good 2-3 minutes and got no response to the drugs. 10 mg Vecuronium given, again with no response after 5 minutes. BLS management discussed briefly. Nasal intubation performed by your's truly with placement confirmed by capnography/whistle/auscultation. Patient moved to the aircraft, and we were done.

                      I've never had a patient not respond to at least one of the paralytics. Maybe it had something to do with previous liver damage that we weren't informed of, but it was frustrating to watch the drugs have no effect whatsoever.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Mon Oct 22, 2007 5:42 PM
                      Posted By: medic1488 (Senior Forum Member)

                      Which line was the meds pushed through?




                      Date Posted: Mon Oct 22, 2007 6:36 PM
                      Posted By: B9member (Senior Forum Member)

                      Wow, that sure is a puzzling one AZCEP.

                      Would have to ask the same question as 1488. It should be easy enough to tell that the IO was not in the right place but you probably wouldn't be able to tell that a central line has been displaced and it certainly happens. I would think though if it is a SC line that you would have some increased respiratory distress with a fluid bolus of 800mls unless that went in the IO? Doesn't seem like you got a very good response to the dextrose either. If you also didn't get much of a BP drop from the 10mg versed on top of the hypotension existing then I would really be suspecting the line or IO is displaced. (Agree bad nurse -maybe a new FN?)

                      Did you find out what her problem was? Maybe she had some kind of metabolism disorder. I would think that if she had liver damage (hyperammonemia could fit this picture) she would have more of a problem with prolonged effect of the drugs versus no effect. Was she jaundiced?

                      A pat on the back for the nasal intubation. That flight crew doesn't do nasals?

                      I can only imagine how frustrating it was!



                      Date Posted: Mon Oct 22, 2007 6:45 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      I'm just wondering what Stridor was doing in bed with her.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Mon Oct 22, 2007 7:13 PM
                      Posted By: AZCEP (Veteran Villager)

                      The Narcan and D50 went into the IO. The central line was busy with fluid replacement. Both had good blood return on aspiration on placement. After the meds went in, I rechecked both, and they still had good return on aspiration, so I'm reasonably sure that they were both patent.

                      We did get an increased blood glucose level, so I guess that is something. This patient had Vicodin and Morphine prescriptions, and has been transported for narcotic OD's before. We worked that angle about as long as I was comfortable, then decided it must be something else. I did not notice any jaundice, but wasn't really looking for it either. My thinking was between the hypotension, and previous experiences with her, maybe the drugs just weren't clearing the way they were supposed to.

                      I've not had a chance to do any follow up as yet. Amazing how much trash gets generated when things go sideways. The flight crew was willing to wait for their drugs to work, but I wanted them out of my ambulance. We had been with this patient long enough at that point. I suggested it, they agreed it might be worth a try, and the tube was in before they could tell me not to. They wanted the oral tube, and bumped my partner out of the way to do it themselves, so I was feeling a bit snubbed.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Mon Oct 22, 2007 7:46 PM
                      Posted By: medic1488 (Senior Forum Member)

                      Do we know why she had the scripts for the vicodin and MS?



                      Date Posted: Mon Oct 22, 2007 8:45 PM
                      Posted By: AZCEP (Veteran Villager)

                      Unfortunately, no I don't know.

                      There were still meds left in the bottles from a refill two months ago.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Wed Oct 24, 2007 9:21 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Well We've had a busy week so far.

                      Monday 0 dark 30 : 80 something with irreg heart rate. Arrived to find pt with a rate of 245-260 monitor shows SVT with runs of PVC's . managed to convert with chemistry to a base rate of 85 -90 still irreg.


                      Tuesday : 10 am . tourist out exploring the rocks & ledges @ lands end and had right foot slip into crevice in rocks while the rest of her body continued down the slope. Tib/Fib spiral FX with dislocation of and tri mallolear FX to ankle. Thank goodness for Fentanyl extricated and carried 50 yards up to level ground and transported for surgery.

                      Tues. 1830 : call for 21 month old choking not breathing/turning blue.
                      Arrived to find frantic mom beating back blows on child in attempt to dislodge MACn Cheese from airway. cyanotic but exchanging some air , extreme stridor and wheezing on expiration. Turned child over arm. head down with abdominal thrust and coughed up those pesky noodles. transported due to some foreign matter aspirated. By the time we arrived at ER child was pink and calm enough to smile and talk to me.

                      Today 10:00 Call for building site accident . while en-route dispatch notified us two men trapped under wall which fell while being lifted into place manually. Called for second truck mutual aid and additional manpower and heavy rescue truck for jacks and lifting gear. Arrived to find new starter castle being framed with two pt's that had been crushed under wall both suffering back and chest trauma. this occurred on second floor of building with no stairs or access except the ladder off engine. quick assessment show #1 had flail sections of back ribs extreme lumbar pain with hugh hematoma over spine and dislocated shoulder. O2 and spinal immob. until more help arrived. Started Lifeflight our way for him and move to pt #2 with cc of low back pain L-1/2 area and resp distress. Collar & O2 for him quick vitals , stable for now ,back to #1
                      Secondary assessment shows 6 back ribs floating with crepitus and grinding with every breath lungs equal but diminished lung sounds . As cavalry arrived assigned team to pt # 1 for rapid package and extrication by way of long board and stokes which were belayed down the ladder 18 ft. to the ground. transported to LZ half mile away .
                      Pt # 2 same pkg. and extrication and transported by ground to local hosp. 30 min away.

                      Received call from trauma coordinator at hospital. Pt # 1 has lumbar 2 FX 6 FX back ribs rt. shoulder dislocation and a concussion, hemothorax rt lung and he was in surgery to repair. Full use of extremities maintained without deficits.{WHEW!}
                      #2 2 vertebral FX with a lot of soft tissue injuries and a neck sprain.

                      We just thought it would be a nice week to enjoy the weather and the world series!
                      Ed



                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Thu Oct 25, 2007 9:38 PM
                      Posted By: jsadin (Veteran Villager)


                      Holy crap Ed! Your nice, quiet service is starting to sound like Fall River.

                      Oh wait...nobody got shot or OD'd. My bad.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Oct 25, 2007 10:43 PM
                      Posted By: ESPARKS (Veteran Villager)

                      You know Jim : some days are just like being in the big city again,,,,, BUT then I look out and see the waves on the ocean and that nice clean salt air and I'm right off in wonderland all over again!

                      I did hear a few gunshots today, just a couple of guys hunting sea ducks .
                      Does a soul good to have a challenging call every now & then.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Thu Oct 25, 2007 11:24 PM
                      Posted By: elvismedic (Veteran Villager)

                      Pretty soon you'll be hearing tire chains again.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Fri Oct 26, 2007 7:19 PM
                      Posted By: jsadin (Veteran Villager)


                      Yep, that season is almost upon us.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Oct 26, 2007 8:16 PM
                      Posted By: elvismedic (Veteran Villager)

                      Luckily for us Jim; Ed will see it before we do.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Fri Oct 26, 2007 9:49 PM
                      Posted By: jsadin (Veteran Villager)


                      I do take some solace in that fact Elvis.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Oct 27, 2007 12:15 AM
                      Posted By: paradude (Senior Forum Member)

                      I'd like to see a big snow again. Chances are pretty slim in my neck of the woods.

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Sat Oct 27, 2007 11:32 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: elvismedic
                      Pretty soon you'll be hearing tire chains again.


                      Don't remind me, I just went out and bought highly aggresive studded tires for my units. That hurt the pocketbook,

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sat Oct 27, 2007 12:33 PM
                      Posted By: elvismedic (Veteran Villager)

                      Kat do you use "On-spots" up north? What success have you had with them? We have them on both ambulances and the 3 engines. The success we've had with them is mixed. You'd think the extra weight of the engines would be a benefit but I an not convinced.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sat Oct 27, 2007 1:05 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Nope, hadn`t even known they existed until you brought it up. I`ve never seen them used up here, but after watching the video of that dump truck driving away I do seem to remember chains like that dangling under our snowplows. Up til now we`ve gotten by okay with all season tires, but the last two years have seen our snowfall almost double over the 10 year average. So, I decided to get studded snow tires for the units. Really, up til the last couple of years, we never really needed anything to help with snow and ice.

                      I`d really like to hear more of your experiences with them, to me It just doesn`t look like they`d stand up to the torture we might put them through. I mean, even in the stowed position, would they stand up to 80 mph speeds over gravel or pavement without being damaged? How often does the chain wheel need to be changed? They`re definately worth further investigation.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk

                       10/27/2007 13:14:34|U



                      Date Posted: Sat Oct 27, 2007 3:00 PM
                      Posted By: ESPARKS (Veteran Villager)

                      When we bought our ambulance back in 95 , it was a choice between the on-spot chains or the IPD sway-bar package. the sway-bar pkg. interferes with the on-spot mounting. We went with the handling package and put a set of 4 heavy tread studded snows on the rear every fall. We bought an extra set of rims so the change over is relatively easy. This has been the best of both worlds. Great ride and handling all the time and good traction in ice & snow in the winter months.
                      We do have the on-spot chains on our heavy rescue truck which work OK. The only issue I see with them is that they only throw the chains under the inside dual tire and if the outer tire is riding up on the edge pack of a plowed driveway the chains don't provide much bite.
                      Most of the oil company delivery trucks here have the on-spots and their maintenance /replacement cycle is around 5 years for the chain wheels. They work well in sloppy packed snow and on glaze ice, but don't help much in deeper snow.

                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Sat Oct 27, 2007 3:44 PM
                      Posted By: paradude (Senior Forum Member)

                      Our service has toyed with the idea of using drop chains due to the spotty type of ice we normally have.

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Sun Oct 28, 2007 1:39 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      Just to put out an observation, when we owned a delivery service in SE Idaho we ran 4 full snows on our 2wd trucks. This alone made quite a difference on the snow there, especially when the finger drifts started across the road - the front tires didn't pull into them. We did have extra weight in the back at all times and did use chains when the slip factor got weird.

                      In the same area Greyhound installed, I believe, the only snow tires in their system on the SLC to W.Yellowstone run. They could raise their tag axles to put full presure on the drive tires - amazing what weight will do for traction (to a point).

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Sun Oct 28, 2007 11:14 AM
                      Posted By: elvismedic (Veteran Villager)

                      Kat our chains are permanently fixed to the truck. I believe that they aren't supposed to be used at speeds higher than 35 MPH. I don't know if it's just the model we have or not.

                      As for their performance... well I've had situation where they didnt' work at all and some where they worked great. I've noticed that if you have stopped on a steep grade they won't work because the tires have to spin to catch the chains. I've had to back down a hill and build up speed to climb it. Another issue I've had is deep snow (2+ ft). I was in the engine in a blizzard and wasn't able to get enough of a bite to climb a moderate grade. I don't know the exact weight of the truck but it carries 750 gal, and 1000 ft of 4"supply hose to give you an idea of weight.

                      Our forest fire trucks switched to an aggressive off road tire for driving in the woods. They seem to have better traction and don't need chains.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sun Oct 28, 2007 6:37 PM
                      Posted By: jsadin (Veteran Villager)


                      I've used On-Spots here and there and they've done the job when I've needed them. I'd prefer to run studded snow tires if I had my druthers.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Oct 28, 2007 8:25 PM
                      Posted By: elvismedic (Veteran Villager)

                      I feel the same way but the town is to cheap to buy tires for 2 ambulances, 3 engines, 1 ladder (quint), Special Hazards (water rescue; old HD amb.), Shift Commanders SUV(4wd), 2 DC's crown vic's, chiefs SUV(4wd), a utility body(4wd), and 2 forest fires (4wd). Most of the time we only have to put chains on the 2 forest fires trucks. We have 2 sections of town that become inaccessible during high tide storms. Most of these were summer homes but they have increasingly become year round residences.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Tue Oct 30, 2007 4:52 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      Elvis - I'd bet that when you stopped on those hills you happened to stop between the bars - I did that a few times and it was a strange feeling. Or maybe in a large truck they do act differently.

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Tue Oct 30, 2007 9:39 AM
                      Posted By: elvismedic (Veteran Villager)

                      Could be. I think mounted chains work somewhat better then the On-spots. The On-spots are powered by the tires moving forward and thus don't work from a standing start. At least that is what I was told.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Tue Oct 30, 2007 8:19 PM
                      Posted By: jsadin (Veteran Villager)

                      On-Spots

                      I've used the On-Spots from a stand still. Once the tire starts spinning, it moves the chains underneath to give you traction. Got me up a driveway that normally I would have been calling highway to tow me up.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Nov 03, 2007 9:54 PM
                      Posted By: elvismedic (Veteran Villager)

                      I was called back for storm coverage due to the Nor' Easter that was coming through. Only interesting call was one for the Darwin Awards. At around 1900 this evening we were sent out for a water rescue. Apparently our patient felt it was a good idea to go sailboarding in 50 mph winds. Needless to say lost control and fell in the ocean. Luckily for him he was spotted by some by-standers. He had no injuries except his pride.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sat Nov 03, 2007 11:18 PM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      Ok...this is going to sound stupid but it isn't really.

                      Did the guy need saving? Or did the bystanders think he needed it?

                      The reason I ask is that generally (generally, not always...there are always exceptions) when people head out under certain conditions they are on top of their game and know what they're doing.

                      Back in January '96 the east coast was hit with snow storm after snow storm. Then, in the matter of about two days, almost four feet of snow in the Washington DC area melted turning the Potomac into a raging mass of flood water.

                      Davey Hearn, a world class canoer who has competed in the Olympics, used that opportunity for training. People saw him out there and freaked thinking that he was stupid and needed rescuing. Nothing could have been further from the truth. One of the Park Police officers actually almost killed himself and Hearn by jumping onto the bow of the canoe after they waved him closer to shore.

                      Fifty mile and hour winds to many windsurfers is a dream come true. Not all are skilled to handle it. And that may be the case here. But not always.

                      Not that I was there to know for sure or anything. That's why I'm asking.

                      -be safe

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Sun Nov 04, 2007 8:19 PM
                      Posted By: elvismedic (Veteran Villager)

                      I think it originated as a good intentioned by-stander but the guy dumped his board and couldn't right it. Sea's were way up, about 10 ft, wind was steady at 50 with higher gusts. Oh yeah did I mention it was dark.

                      I see your point but there are no world class wind surfers that I know of in the area. This guy was known to some of the senior guys as someone who likes to push the envelope.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Mon Nov 05, 2007 7:04 PM
                      Posted By: jsadin (Veteran Villager)


                      24hr shift Sat-Sun:

                      Out at 4pm, back at 7pm. Out at 12:30am, back at 3:30am. Out at 4am, back at 6 am. Fire ants doing live burn training at 8am, so station was alive with activity from 7am on. Sleep? I don't need no stinking sleep.

                      At least the Pats won.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Nov 06, 2007 12:26 PM
                      Posted By: AZCEP (Veteran Villager)

                      It would seem the holiday season has hit already.

                      To follow the previous incident that I mentioned about the 60+ y/o female overdose, we've had another overdose, an overdose + structure fire, and a self-inflicted GSW to the chest in the last week.

                      The last two were suicide attempts, or successes, and the first O.D. is still questionable as to the cause.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Sun Dec 09, 2007 10:05 PM
                      Posted By: jsadin (Veteran Villager)


                      Diabetic schizophrenic at 2:30am who feels "dizzy". Admittedly non-complaint with meds. BGL = HIGH. Medic turfs the call to me which I'm just fine with (need some more patient face time). Vitals, line, fluid, etc.

                      Next is 44y/o female cc stroke like symptoms. Positive CVA history. Left side weakness, facial droop, slurred speach. Running at the intermediate level, so it's all me. Vitals, line, etc etc. Pt states she's had lucaner strokes. I'm not having any luck looking up info on them. Can anyone point me towards some info on these? I'm a bit curious.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Dec 09, 2007 11:10 PM
                      Posted By: AZCEP (Veteran Villager)

                      I think you may be mis-spelling the term.

                      Lacunar stroke returned a number of resources.

                      http://www.emedicine.com/pmr/topic63.htm

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Mon Dec 10, 2007 12:09 PM
                      Posted By: paradude (Senior Forum Member)

                      Quote

                      Diabetic schizophrenic at 2:30am who feels "dizzy". Admittedly non-complaint with meds. BGL = HIGH. Medic turfs the call to me which I'm just fine with (need some more patient face time). Vitals, line, fluid, etc


                      Although I personally don't have a problem with an EMT partner taking a patient such as this, I would most likely get in trouble if I did. Management would consider it an ALS call. They're kinda touchy about that stuff. If we let an EMT take anything more than discharges or doctor's appointments, it tends to raise eyebrows.

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Mon Dec 10, 2007 12:14 PM
                      Posted By: paradude (Senior Forum Member)

                      Quote

                      Originally posted by: AZCEP
                      I think you may be mis-spelling the term.

                      Lacunar stroke returned a number of resources.

                      http://www.emedicine.com/pmr/topic63.htm



                      Wow... Learn something everyday. Thanks Jim and AZCEP!

                      -Paradude-


                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Mon Dec 10, 2007 4:23 PM
                      Posted By: atelectasis (Junior Forum Member)

                      wow.... thats something i have never heard of.
                      Thanks for the info.!!

                      -------------------------
                      "Heroes get remembered but legends never die"



                      Date Posted: Mon Dec 10, 2007 9:01 PM
                      Posted By: jsadin (Veteran Villager)


                      Thanks AZCEP. I was definitely misspelling it, but I could only go by what my slightly out of it patient was saying.

                      Dude, our management is pretty good about that stuff. We still consider an intermediate level call as ALS and it is called into the hospital as such. Not much more that could be done for that patient besides fluids and monitoring vitals which is well within my scope. It's too bad that your management takes such a hard line.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Thu Dec 13, 2007 12:45 AM
                      Posted By: VanHelsing (Veteran Villager)

                      Dayshift 12/12/07

                      Call 1: MVA

                      Call 2: Epileptic/convulsions

                      Call 3: Respiratory arrest

                      Call 4: MVA

                      Call 5: Multiple shooting with an AK47- taxi violence, One P4, four P1s

                      Call 6: MVA

                      Call 7: Transfer, gunshot victim to another hospital for op.

                      Call 8: MVA




                       12/13/2007 00:47:47|U



                      Date Posted: Thu Dec 13, 2007 8:08 AM
                      Posted By: ESPARKS (Veteran Villager)

                      Wow Van ,it sounds like your trying to finish up your days in SA with a bang! So when are you coming to our hemisphere? Sounds like now would be a good time,

                      Heres wishing you a safe holiday and get your bags packed.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Fri Dec 14, 2007 9:29 PM
                      Posted By: jsadin (Veteran Villager)


                      Over a decade in EMS and I haven't had a single gunshot victim....Van gets multiple per day.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Dec 15, 2007 2:50 PM
                      Posted By: elvismedic (Veteran Villager)

                      Jim that's not necessarily a bad thing. I'm in a similar boat to you. I'm sure if I go work EMS on the side I'll get one sooner or later.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sat Dec 15, 2007 5:18 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Quote

                      Originally posted by: jsadin
                      Over a decade in EMS and I haven't had a single gunshot victim....Van gets multiple per day.


                      Not for much longer.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun Dec 16, 2007 3:39 AM
                      Posted By: ESPARKS (Veteran Villager)

                      Quote

                      Originally posted by: jsadin
                      Over a decade in EMS and I haven't had a single gunshot victim....Van gets multiple per day.


                      Jim all you need to do is move a little further west into the spfld / hoyloke area. after the first dozen or so it becomes pretty old school stuff.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Sun Dec 16, 2007 8:17 AM
                      Posted By: elvismedic (Veteran Villager)

                      Could try east to Brockton or south east to New Beige

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sun Dec 16, 2007 1:35 PM
                      Posted By: paramedicus (New Forum Member)

                      9am CHFer that coded and we never got back damn would CPAP would be nice

                      11am 3 story scaffolding collapse 2 trauma alerts

                      3pm man with a rash on his arm for 2 days

                      5pm guy was so drunk we had to tube him

                      6pm MVA with 2 bls patients

                      1am MVA 1DOA and 2 trauma alerts which both took about 30min to extricate

                      3am rollover MVA 1 trauma alert which was ejected

                      4am elderly woman with chest pain

                      8am go home to try and sleep

                      god I love it when season kicks up in Florida



                      Date Posted: Sun Dec 16, 2007 3:56 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      At least you missed the Tornado!!

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Sun Dec 16, 2007 4:26 PM
                      Posted By: greshmedic (Veteran Villager)

                      Quote

                      guy was so drunk we had to tube him


                      I must admit I would expect a royal arse kicking from my local hospital if I had tubed someone purely because he was drunk.

                      But I wasn't there and I work in a totally different country so I'm sure you considered less invasive options first.

                      Just seemed a bit excessive at first sight to me.



                      -------------------------
                      Before the war on terror, if I saw an unnatended package I used to think "I'll be having that!"



                      Date Posted: Sun Dec 16, 2007 7:56 PM
                      Posted By: jsadin (Veteran Villager)


                      One suicide attempt, unsuccessful. Other than that, everyone stayed inside for the storm.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Dec 16, 2007 9:33 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Started out the day @ 0003 with a "choking " call . on arrival found a woman with CP since birth that had choked on chicken earlier last night . Pt is non verbal & only method of communication was through her sister by reading eye movements.Great. Assess lungs , obvious wheezing on exhalation possible FBAO with partial airway obstruction, heavy secretions suctioned and inability to visualize anything in upper airway . Load & go ,O2 by cannula, sats [had to use big toe due to contractures of both hands] @ 89 at start up to 94%. Pt is mildly tachy @ 110 and color improving. Respiratory effort decreasing as time goes by and according to sister she is "much better". after 25 min ride and still 5 out ,i called into hospital and gave report. Back reassessing pt when suddenly she clenches up, eyes roll back and it's lights out . She stopped breathing .
                      Aw crap didn't see that one coming.
                      Suctioned and placed an opa and started bagging, told the driver to step it up & contact the hosp. with an inbound code warning . Checked carotid / no pulse so i asked her sister to help by bagging while i started compressions with one hand[very tiny adult] and pulled out the fast patches with the other hand. Monitor showed irreg. brady @ <20 bpm and negligible pulses. Arrived at ER and met by the code team decision made to paralyze and intubate. 6.0 tube by doc Her heart restarted a normal sinus rhythm after 10 minutes of CPR but decision made to put her on vent and ship up to ICU till morning .

                      This morning 10:30 at the height of a noreaster with 8-10" of snow on the ground and blowing 25-40 we get a call for 70's female NV&D X 6 hours. Enroute called for a FF with plow truck to plow the road and long 300 yd driveway into the address. we get to the top of the road & are advised by our plow not to attempt to come down. I walked in to survey the driveway and found long sweeping {think the first big hill drop on a roller coaster} downhill drive with big drop-offs on either side. Called dispatch to have them send a sand truck from the town to load it up so we could get down the hill and back out. I sent two emt's down with the plow truck and the blue bag &monitor while i waited at the top for the sander. He showed up and almost slid off into the woods with the sander. . Long slow hour trip to town due to almost 0 visibility and treacherous road conditions.
                      Went and checked on pt from earlier call. still on vent but improving!
                      One hell of a day
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Mon Dec 17, 2007 4:42 PM
                      Posted By: atelectasis (Junior Forum Member)

                      Sunday 12/16

                      1- CHF , CPAP and transport. Note: I LOVE CPAP!!! IT IS AWESOME!!!!... it works everytime.

                      2- Stabbing 3x w/ 8" butchers knife 1-abdominal LLQ, 1-L Scapula, 1-L Thigh
                      Called Level 1 trauma, rapid transport, 2x Large bore IV's enroute
                      Increased breathing difficulty w/ diminishing lung sounds, Pleural Decompression enroute

                      3- Major CVA, unresponsive, intubated enroute, ended up dying later in the day at hospital

                      4- Recurrent Seizure lady, almost emptied narcotic box on this lady trying to get seizures to stop.

                      5- Fall, BLS

                      6- MVC minor injuries BLS

                      7- Psych. Pt. attempted to hang self, pt. wife came home cut him down. Pt. A&Ox4 at EMS arrival.

                      8- homeless needs warm place to stay, BLS

                      9- N&V x3 days (4AM), hx. of pneumonia, showing signs of tachy. and hypotension, pt. very lethargic, hot to the touch. 200ml bolus enroute w/o significant changes.

                      10- pregnant female w/ abd. pain 3rd visit to ED in one day, BLS

                      11- Sleep for 1 hr.

                      12- Work trade time for another 12 hrs.


                      I love being busy... I dont love being tired !!

                      -------------------------
                      "Heroes get remembered but legends never die"



                      Date Posted: Tue Dec 18, 2007 9:39 AM
                      Posted By: paramedicus (New Forum Member)

                      Hey Gresh in response to the comment on the drunk pt we got there and FD had Immobilized the pt and he was actively vomiting and then aspirating it since FD didn't think to turn him on his side. Our suction couldn't keep up and he had no gag reflex so I decided to go with a difinitive airway.



                      Date Posted: Tue Dec 18, 2007 9:53 AM
                      Posted By: greshmedic (Veteran Villager)

                      Not a problem mate!

                      Like I said i'm sure there was more to it than met the eye.

                      But then again we don't have firefighters going around boarding everyone in our neck of the woods.

                      -------------------------
                      Before the war on terror, if I saw an unnatended package I used to think "I'll be having that!"



                      Date Posted: Sun Dec 23, 2007 7:06 AM
                      Posted By: VanHelsing (Veteran Villager)

                      I have finally learnt to accept my failing memory and make photocopies of my trip sheets !

                      20/12/07- dayshift.

                      #1: PVA
                      #2: overdose
                      #3: Maternity ( pt taken in private vehcle prior to arrival )
                      #4: fall from hight ( fractured tib/fib )
                      #5: MVA

                      21/12/2007 - dayshift

                      #1: GSW
                      #2: MVA
                      #3: hemoptysis / TB
                      #4: abdo pain/ syncope
                      #5: collapse ( on route get told its a full resus, get there to find a FES pt )
                      #6: 2 hours old newborn twins, respiratory difficult, transferred to another hospital
                      #7: MVA , 2 x ALS p1's
                      Then, at 15minutes before shift change, I get sent on a transfer which lasted 6 hours ! and 300kilometers later...
                      #8: transfer, 4 years old kid, involved in an MVA earlier, sustained a blow out fracture to right eye ( 3 walls )





                      Date Posted: Sun Dec 23, 2007 7:15 AM
                      Posted By: VanHelsing (Veteran Villager)

                      22/12/2007 - night shift

                      #1: PVA
                      #2: MVA
                      #3: Fall
                      #4: MVA ( 1 x p4, 1 x p1 )
                      #5: MVA ( nothing found )
                      #6: Collapse ( pt removed privately )
                      #7: MVA ( same spot as call # 4, a passing driver was so busy looking at the accident scene, he drove off the embankment... idiot )
                      #8: MBA
                      #9: MVA
                      #10: MVA and car on fire ( lots of patients, burn wounds, head injuries, and one closed highway )
                      #11: MVA ( NSR )

                      That was a busy night, I wonder what they have in store for me tonight.

                      AND busy because I am the only paramedic covering the entire johannesburg region from our company, its a bit silly, my longest response to scene last night was 57kms





                      Date Posted: Sun Dec 23, 2007 7:15 AM
                      Posted By: VanHelsing (Veteran Villager)

                      23/12/2007 - Nightshift

                      #1: Transfer from airport/ mercy flight, post Quadbike accident, la forte and collar-bone fracture
                      #2: MVA rollover

                      And that was that... even got some sleep in !





                       12/24/2007 00:47:49|U



                      Date Posted: Sun Dec 23, 2007 10:16 PM
                      Posted By: jsadin (Veteran Villager)


                      VH, I'm feeling a bit dense right now (and mildly intoxicated). What's a PVA?



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Dec 24, 2007 12:49 AM
                      Posted By: VanHelsing (Veteran Villager)

                      PVA = pedestrian vehicle accident

                      ( hows that hangover coming along ! )



                      Date Posted: Mon Dec 24, 2007 11:19 AM
                      Posted By: jsadin (Veteran Villager)


                      Thanks for the explanation VH.

                      FYI, no hangover this AM! As long as I'm smart and do a little prep work before bed, I'm usually spared a killer hangover. My routine is this: drink as much water as I can without feeling bloated, take two extra strength tylenol, hit the sack. Wake up 2hrs later because previously consumed water has migrated to my bladder, drink more water. Wake up 2hrs later due to same issue, drink more water and take two more tylenol. Wake up in the AM feeling ok!



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Dec 24, 2007 7:50 PM
                      Posted By: elvismedic (Veteran Villager)

                      Jim how was the Blue Label?

                      I'm in the middle of a 38. Right off the bat at 6 we had a public assist medical, a wildlife in the house, and a CO detector activation all within 5 minutes of each other. Back in quarters by 730. At 0230 out for the intoxicated diabetic. Patient 22 YO M reportedly drank 10 "drinks" he's semiconscious and puking. I love my job. He has an insulin pump, friends state his suger on the pump is over 200. Carry him out to the rig, start a line transport to the ED. At the ED the RN questions me as to why I didn't tube him. I look at her like she's nuts mostly cuz she is. Anyway, Yes patient is semiconscious but he has been able to protect his own airway so I wasn't going to tube him. Last I heard was the nurse trying to get the MD to give the order to tube the kid.

                      0930 FDGB public assist. then back there at 1300 for SOB (pneumonia)

                      1500CP at the "assisted" living center.

                      1530 GBW with N+V probably the flu but patient had similar symptoms just proir to being diagnosed with hydroencephalus (sp) Hope for his sake it is just the flu.


                      So far that's it but it's still early and the drunks have yet to hit the road. Interesting fact presented on the evening news 1:12 drivers driving after 10 pm are drunk.


                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Mon Dec 24, 2007 11:30 PM
                      Posted By: jsadin (Veteran Villager)


                      The Blue Label gets cracked tomorrow at my best friend/brother-in-laws house for Christmas day. We were best friends in high school and remained so even after I married his sister. Can't think of anyone I'd rather christen the bottle with.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Jan 02, 2008 5:08 AM
                      Posted By: VanHelsing (Veteran Villager)

                      New years eve... My shift was something taken out of a bad dream..

                      Call 1: Structural fire, 1 patient

                      Call 2: MVA

                      Call 3: Transfer patient with prolapsed cord ( nasty call )

                      Call 4: AMI/ resus/ P4

                      Call 5: Collapse

                      Call 6: Head laceration from fall after fighting with police

                      Call 7: Stab wounds from bottle

                      Call 8: MVA

                      Call 9: Gunshot head - P4 ( lady shot her neighbour thinking it was an intruder )

                      Call 10: MVA

                      Call 11: DVA

                      Call 12: Stabbed chest

                      Call 13: MVA

                      Call 14: MVA

                      Call 15: Diabetic coma

                      15 calls... I think thats a new record for me.



                      Date Posted: Wed Jan 02, 2008 9:22 PM
                      Posted By: jsadin (Veteran Villager)


                      Wow....!!

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Jan 02, 2008 10:31 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      You'll be lucky to do that in 3 months out here.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Thu Jan 03, 2008 12:43 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      Your people sure have a strange way of welcoming in the new year. I'm thinking your future neighbors are going to have a hard time believing your stories.

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Thu Jan 03, 2008 7:46 AM
                      Posted By: PARAMEDICMIKE (Senior Forum Moderator)

                      I just hope VH isn't bored when she gets to Canada. Something tells me, along with Kat's comments, that she isn't going to see the same level of excitement up there as she does in SA.

                      So, VH, when's the big move?

                      -be safe

                      -------------------------
                      -be safe
                      Aut inveniam, aut faciam.
                      "There is an incessant influx of novelty into the world, and yet we tolerate incredible dullness."

                      -Thoreau



                      Date Posted: Thu Jan 03, 2008 8:22 AM
                      Posted By: ESPARKS (Veteran Villager)

                      Quote

                      Originally posted by: PARAMEDICMIKE
                      I just hope VH isn't bored when she gets to Canada. Something tells me, along with Kat's comments, that she isn't going to see the same level of excitement up there as she does in SA.

                      So, VH, when's the big move?

                      -be safe


                      You know Mike ,I was having the same thoughts.I hope that Kat provides for stress relief needs with included perks such as snowmobiles and dirt bikes. Otherwise VH will need an occasional trip to Phiily or detroit for a few GSW's and other such mayhem.
                      Then again no one should have to keep up the call volume that she sees in S.A.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Thu Jan 03, 2008 1:54 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      She claims to be looking forward to the easy slow life we have out here.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Thu Jan 03, 2008 3:11 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Quote: "Your people sure have a strange way of welcoming in the new year. I'm thinking your future neighbors are going to have a hard time believing your stories. "
                      - I agree, so I have made copies of all my trip sheets to bring with me, ( Im thinking ahead !! )

                      Quote: "So, VH, when's the big move?"
                      the planned date is 7th Feb, but im still waiting for some paperwork.. the wheels are turning slower than I expected, but it can't be later than the 23rd Feb or else Im in big trouble from a big fluffy feline !

                      Quote: "She claims to be looking forward to the easy slow life we have out here."
                      And so I am, I wont burn out in 5 years, thats a big PLUS, and I may even have time for a social life... A What ???

                      Todays shift made up for new years...

                      Call 1: Transfer from airport to Randfontein ( 80kms ), pt with DVTs

                      Call 2: MVA, only 2 patients, both went with private transport to hospital

                      ........coffee.......food.....coffee.....food....coffee...ice-cream.....coke....



                       01/03/2008 15:12:32|U



                      Date Posted: Thu Jan 03, 2008 7:21 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      The "Big fluffy Feline" is part of that paperwork. No worries, you can't get into trouble for something that's my responsibility. BTW, called today to put a bee in their bonnets. Paperwork is getting fast tracked.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Thu Jan 03, 2008 7:48 PM
                      Posted By: jayffemt (Veteran Villager)

                      Called first thing this AM for a diabetic emergency. Pt. wanted me to check his blood glucose because his meter was in his room upstairs.

                      -------------------------
                      Only 1*



                      Date Posted: Thu Jan 03, 2008 9:29 PM
                      Posted By: jsadin (Veteran Villager)


                      So did you use the 14ga lancet??



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Fri Jan 04, 2008 12:30 AM
                      Posted By: paradude (Senior Forum Member)

                      I have had those before. Most of the time, they are alone, and their glucose is low enough that they can't get up, or climb stairs. The worst one was when this guys used to call us to go to the fridge and get him a beer because he is too drunk to get up.

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Fri Jan 04, 2008 9:44 AM
                      Posted By: jayffemt (Veteran Villager)

                      "If you're so drunk you call an ambulance to fetch you a beer"

                      Sounds like a Jeff Foxworthy "You may be a redneck" joke.



                      -------------------------
                      Only 1*



                      Date Posted: Fri Jan 04, 2008 10:37 AM
                      Posted By: paradude (Senior Forum Member)

                      You have no idea!!!

                      Get this... no paint on the walls, and no pictures except Elvis pictures. Everywhere!!!! Including the furry psycadelic ones....

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Fri Jan 04, 2008 2:53 PM
                      Posted By: elvismedic (Veteran Villager)

                      You call me for a beer your gonna wear it. It's nice to know someone is still a fan.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sun Jan 06, 2008 6:01 PM
                      Posted By: paradude (Senior Forum Member)

                      Yeah, but I bet your Elvis memorabelia(sp) is not dust covered and smoke stained. I'll bet you have paint on your walls as well as pictures of other things. I'm also willing to bet you don't smell like pee either....

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Sun Jan 06, 2008 7:16 PM
                      Posted By: elvismedic (Veteran Villager)

                      No, I don't smell like Pee, unless my 15 month old pee's on me while I'm changing him. Sometimes he's like Old Faithful.

                      As for the memorabelia, all I have is 2 magnets (1 in each locker) at work. I split my time between 2 stations. Before you ask "Elvis" is my nickname at work. It's a long story. I learned a long time ago, if your tagged with nickname you'd better embrace it cuz your stuck with it whether you like it or not.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sun Jan 06, 2008 8:51 PM
                      Posted By: jsadin (Veteran Villager)


                      24hr shift today:

                      Call 1: MVA w/entrapment. Two P3, one P2 (CAOX3, fx femur). Once fire got the door off with the jaws my medic partner and I got the pt in the back of the truck and had a basic drive. The kid made me laugh after we gave him 8mg of morphine and he was smiling like a love-struck school boy.

                      Call 2: MVA. Refusal.

                      Call 3: Eval per PD request. Refusal.

                      Call 4: Psych.

                      Call 5: 70 y/o fem, altered mental status. Warm to touch, unresponsive to commands, aphasic, combative about 5mins into transport. Just got the call from our EMS coordinator that she is confirmed to have meningitis. Waiting to hear what type.

                      Call 6: Diabetic male, admittedly non-compliant w/meds for diabetes and BP. BGL - 448. BP 160/100. Given stern warning to be med compliant next time we see him and transported to local hosp.


                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Jan 06, 2008 11:00 PM
                      Posted By: paradude (Senior Forum Member)

                      Quote

                      Before you ask "Elvis" is my nickname at work. It's a long story. I learned a long time ago, if your tagged with nickname you'd better embrace it cuz your stuck with it whether you like it or not.


                      True... Thing is, my experience tells me that most people have a reason they are endowed with a certain nickname. Mind if I enquire? Sideburns? Deep voice? Drug habit??

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Mon Jan 07, 2008 1:24 AM
                      Posted By: elvismedic (Veteran Villager)

                      Actually it's the fried peanut butter and 'naner sandwiches.

                      No really when I got hired I stopped one job on friday and started the FD the following monday. In that time I had to get fit with uniforms and get fit with turnouts. I was so busy that I forgot to get a hair cut. I didn't have the sideburns but my hair was kind of long in the back. At least that's what I was told when I found out that I had a nickname.

                      It could have been worse the guy I went to the Academy with got tagged with "S.T." This was short for "Story Teller."

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Mon Jan 07, 2008 2:27 AM
                      Posted By: paradude (Senior Forum Member)

                      Quote

                      It could have been worse the guy I went to the Academy with got tagged with "S.T." This was short for "Story Teller."


                      We got one like that. Only he was called "The Lying King". So everytime he comes out with another doozy, somebody claws at the air and goes, "RRAAARRR".

                      -Paradude-

                      -------------------------
                      The Paradude Creed: We should all work together to protect our young from being eaten...



                      Date Posted: Mon Jan 07, 2008 3:07 PM
                      Posted By: elvismedic (Veteran Villager)

                      At the time this guy had already worked for UPS, an autobody shop, worked a wrecker, and some others I cannot remember. One of the funniest days at the academy we were in the classroom, the instructor asked some question and ST answered. The instructor turned to him and asked " F-ing Duxbury is there anything you haven't done?" The whole class burst out laughing.

                      ST is just one of many nicknames for him. Others include "Pat" from SNL fame, Snack's, and Mongo.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Tue Jan 08, 2008 3:07 AM
                      Posted By: blurozez (New Forum Member)

                      So I took a personal day from work today - I'm a secretary in a local ER - so I didn't answer up to any calls today, until... There was a stabbing a few blocks from my house. PD was on scene before any other units, and they got on their radio and advised the responding fire department unit that the victim had a probable bowel evisceration (must be the new guy, the former medic, because how many strictly pd people do you know who know what the term bowel evisceration means, let alone how to pronounce and use it). I belong to a fairly small (and getting smaller by the day) volunteer ambulance corps. one of my basic emt's answered up (from about 5 miles away, stated he'd be going to the station). at that point the fd got in the radio and advised the emt that he would most likely require als. At THAT point, the paid ems service in the area got on the air and stated they were in the area. I'd been attempting to answer up but with all the traffic i just ended up getting stepped on most times i tried. the dispatcher asked my emt his pleasure on the paid service, and he ummmmmm'd and uhhhhh'd for a while, and ended up saying he'd continue responding but to send the paid guys, since they were closer. The dispatcher finally heard me and advised my emt and everyone else who was listening that the paid guys were going, and that i, a paramedic, would also be responding to the scene. ok. no big deal at this point. it really wasn't the cluster it sounded like. I got on scene and the paid guy, my former partner, asked if i had a rig coming. i told him i hadn't a clue, but i told him to load the pt in his rig, he asked if i'd come with them, i said sure, i'd like to play too!! the guy did have a 3" penetrating wound to his left upper-ish quadrant. above the navel, but not by much, and definately on the left side. that was his only wound. he did have a few loops of intestine trying to slither out of the wound, but we put wet sterlie dressing on him and that was all good. we als'd him with a few lines, o2, blankets, etc, on the way in to the trauma center. the kid is 19, is known to myself and the police. didn't see the knife, but knew the guy who stabbed him. doesn't know the guy to have any particular kind of knife, that he knew of. last i knew the kid was in emergency surgery but has a good prognosis. the kid actually wanted to know if we thought he'd be able to go to work wednesday. i said kid, your insides are on your outsides, i dont think you'll be going to work this week at all!!! he was lucid, but somewhat confused. also his priorities are a little skewed.
                      The reason i'm posting this, is i have a question about priorities.
                      The paid guys had just been dispatched, by their agencies dispatcher, to a transfer from an urgent care center to a local hospital. the patient was bls, and was in the care of a few rn's and a pa/np. the paid medic told his dispatcher he was very very close to the scene, could he offer his services. the dispatcher said no, you've already been comitted to this bls, stable transfer, this was a few minutes after the tones had gone off, and there had been no acknowledgement from any ambulance. the paid medic got on the air and stated he was available, and that's when my emt told him to proceed to the scene.

                      i was there. i had no problem with this. it's about the patient. yeah, he kinda jumped the call, but if he hadn't, who knows who may have ended up getting the rig there to transport. we were on scene for less than 5 minutes, and from tones to trauma 1 room in the er was about 30 minutes. the patient needed als and needed transport immediately.

                      what do you guys think about being "committed" to a transfer then diverting to a life and death emergency call?

                      -------------------------
                      Arrogant and right is surely better than humble and wrong



                      Date Posted: Tue Jan 08, 2008 6:22 PM
                      Posted By: jsadin (Veteran Villager)


                      Our private/non-profit service does both transfers and 911, so we occasionally find ourselves in this situation. If we are still in the service area when a 911 call comes in, we take the 911 call and let the facility with the transfer know we'll be a bit late. Only the most accute ALS transfers need to go right away. Most BLS transfers can wait an hour or so while you finish up an emergency.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Jan 20, 2008 11:39 PM
                      Posted By: CanuckEMT (Junior Forum Member)

                      Yesterday: 1 call.

                      12 y/o male, 200 lbs rolled quad with no helmet on. Called to back up our service to the south as they had no ALS on duty. Upon meeting them pt was unconscious, combative, trismus but breathing on his own. SP02 was 78%. BP was good so I gave him 5 mg midazolam. When he relaxed his sats came up to 98%. ALAS..... we were only 1.5 min from hospital at this time so I was foiled out of my first RSI. I did help in the ER though and then transferred him to the helipad for STARS to medi vac him to the Alberta Children's Hospital.

                      Today, first call was a hypothermic/trauma found in the ditch on a gravel road. Seemed to me like she was dumped out of a vehicle. On arrival she was breathing @ 8/min and shallow, no palpable radial pulse(thready brachial though). Could only get a tympanic temp on her that came in at 22.9 Celsius. Spinaled her and scooped into unit, rapid transport with early patch to hosp and also a patch for order for RSS/RSI. Being fresh I was a little unclear about temperature below 30 Celsius and medications for RSS/RSI. I was advised by the ER physician that as long as she remained satting in the 90's with NRB and didn't vomit that he wanted me to hold off on the tube. But if anything changed I had the OK. Well guess what......nothing changed, no tube again.
                      I did get quite the quiz though when the Doc was preparing for the RSI in the ER. HE quizzed me on sedative choice and dosage as well as paralytic choice, dosage and what to look for to show paralysis. He also complimented me on patching for orders when unsure (and admitting to being unsure). He has seen quite a few fresh medics jump at those kind of tubes and not get them.

                      -------------------------
                      Challenge is what makes life interesting, overcoming them is what gives it it's meaning.

                       01/20/2008 23:41:21|U



                      Date Posted: Mon Jan 21, 2008 6:43 AM
                      Posted By: ussenterprise2 (Senior Forum Member)

                      Another cardiac arrest the other day - second time we had our AED out in two weeks.

                      My nursing supervisor (from my day job) just happened to come along for the experience, although we did not anticipate a cardiac arrest when the call was paged out. Initially it was a male patient who had fallen in the bathroom and the family could not get them up.

                      On arrival at the house - no pulse, no respirations. Got the AED on and there was no shock advised. Ironically, we had both just finished the ACLS instructor course the week before.

                      Came up against a dilemma then: my boss from the hospital wanted to start an IV, but I am not covered to start IVs when I volunteer for the ambulance (and neither is he, since he is not employed as a volunteer). I operate as an EMR (first responder). It has been an on-going issue. Anyways we are not an ACLS service and do not carry cardiac meds. In the end we transported with CPR in progress, and with the help of the Fire Department volunteers.

                      When we got to the hospital, the doctor called the code immediatley because the elder had signed a DNR order during a previous hospital admission.

                      After finishing up the PCR, I went home to bed, to sleep before coming back to work night shift at the hospital.

                      -------------------------
                      "Live long and prosper....."



                      Date Posted: Mon Jan 21, 2008 9:32 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Don't you just hate when people have a DNR that we aren't informed about? We've finally got our hospital forwarding a copy of the ACD whenever one is signed.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Wed Jan 23, 2008 2:58 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      Even with the DNR's we get a runaround in the ER about what they really mean and almost always one family member bouncing off the wall who didn't know what DNR really meant.

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Tue Jan 29, 2008 7:50 PM
                      Posted By: medicmole (Senior Forum Member)

                      What about rhabdomyolysis? I seem to recall that could be a complication of frostbite.

                      edited for spelling.

                      -------------------------
                      Be who you are and say what you feel, because those who matter don't mind, and those that mind, don't matter.

                      www.saveourparamedics.com

                       01/29/2008 19:52:11|U



                      Date Posted: Tue Jan 29, 2008 8:30 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Ahh, right, widespread frostbite can cause the same complications as crush syndrome, can't it.

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Tue Jan 29, 2008 9:43 PM
                      Posted By: jsadin (Veteran Villager)


                      Good point. I don't think I would have considered the thermal injury causing rhabdo.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Jan 29, 2008 11:15 PM
                      Posted By: grambograham (Senior Forum Moderator)

                      Very good medicmole. A complication many would not think of.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Wed Jan 30, 2008 9:29 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      This story just gets more and more stunning.

                      Young girl found frozen to death on Sask. reserve

                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Thu Jan 31, 2008 10:30 PM
                      Posted By: arctickat (Senior Forum Moderator)

                      Sorry, been out of town a couple of days, appearantly the RCMP has been looking for me to conduct an interview. Gonna try to keep my head down, maybe they'll give up and go away. Sure wish my trip to Daytona has been a week earlier. Here are a couple of news updates...although CBC seems to feel some facts aren't all that important. For example, the police didn't take him to hospital.

                      Sask. reserve where 2 sisters died tried to ban alcohol: chief

                      They tried this after a string of alcohol related MVC fatalities. It never happened.

                      No decision yet on charges in child deaths, RCMP says

                      I can't really say anything besides what is already published as you are all aware. Now that it's a criminal investigation and the names are public, I've removed all of the posts that make reference to the call and am simply putting forth published articles.

                      Sorry guys, it was in interesting case study, I hope you understand.



                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk

                       01/31/2008 22:32:44|U



                      Date Posted: Fri Feb 01, 2008 1:52 AM
                      Posted By: grambograham (Senior Forum Moderator)

                      Drinking when he had kids to look after. That is some good priority setting right there.

                      -------------------------
                      If you can keep your head while all else around you are losing theirs'............................... You probably haven't checked with your answering service!



                      Date Posted: Fri Feb 01, 2008 7:51 PM
                      Posted By: elvismedic (Veteran Villager)

                      Just goes to show the maturity level of some 20-somethings. But then again you have to question WHY the children were left with dear old dad? Especially since he apparently is a known alcoholic.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Wed Feb 20, 2008 9:33 AM
                      Posted By: AZCEP (Veteran Villager)

                      Something must have gotten into the water supply this weekend.

                      Saturday:
                      55 y/o male no past medical history to speak of, chest pain. Doesn't want to be transported by ambulance, just wants us to check him out. Vitals, cardiac monitor = something amiss. 12 lead = lateral MI. Transported without incident.

                      66 y/o male Hepatic CA history, chest pain. Wishes he didn't have to be transported, but can't get out of bed due to weakness. Vitals and twelve lead later, anterolateral ischemia. NSTEMI diagnosed by the cath lab.

                      Sunday:
                      45 year old male, no significant history other than obesity. Short of breath, vitals relatively stable, 12 lead with S1-Q3-T3 pattern. Lateral ischemia also noted. Emboli shower diagnosed on angiogram.

                      50 year old female, chest pain. Only history of a "failed stress test" and a "clean" angiogram a month ago. Posterior MI on 12 lead. Circumflex 98% occluded according to the cath lab/ICU.

                      Monday:
                      55 year old male, no history whatsoever. Walks into the station with chest pain for the last "10-15 minutes". Vitals, cardiac monitor shows sinus with bigeminy. Palpable pulse in the 40s. Start to gather history, goes into pulseless V-tach. Shocked twice at 360j, brief period of compressions performed, ROSC with sinus and atrial ectopy. Lidocaine bolus/infusion, transported without further incident. ER staff upset that they didn't get to "do anything".

                      I think I'm switching to bottled water.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Sat Feb 23, 2008 11:09 AM
                      Posted By: jsadin (Veteran Villager)


                      Wow! Quite the cardiac weekend you had AZCEP. I'm glad you mentioned the S1-Q3-T3 as it made me go look it up to see what the heck you were talking about.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Mon Feb 25, 2008 2:05 AM
                      Posted By: ussenterprise2 (Senior Forum Member)

                      AZCEP- not trying to be clever here, but why lidocaine instead of amiodarone?

                      -------------------------
                      "Live long and prosper....."



                      Date Posted: Mon Feb 25, 2008 6:18 PM
                      Posted By: AZCEP (Veteran Villager)

                      Mainly because it has a quicker onset, and the patient's blood pressure would tolerate it. Worked like a charm.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Tue Feb 26, 2008 5:55 AM
                      Posted By: ussenterprise2 (Senior Forum Member)

                      OK - thanks

                      -------------------------
                      "Live long and prosper....."



                      Date Posted: Mon Mar 03, 2008 1:56 PM
                      Posted By: VanHelsing (Veteran Villager)

                      This wasnt my patient, I heard about it on handover...

                      Guy gets stabbed mulitple times by wife, and when asked why she stabbed him.. " he suggested we get a divorce. "

                      Well she wont get a divorce, probably a nice long jail sentence, from what it sounds like, he probably didnt survive the suggestion. RIP dude



                      Date Posted: Tue Mar 04, 2008 10:27 PM
                      Posted By: DocHarris (Senior Forum Member)

                      Got to see first hand just how well the placebo effect can work (well sorta)
                      I was on clinical rotation on a med-surg floor working with an RPN. After taking vitals on this patient and reporting to the nurse I passed on that the patient was asking for morphine for the chest pain she'd been admitted for. The nurse told me that she felt the patient had been exhibiting drug seeking behaviour and that the standard progression with her was she'd get her three doses of nitro on standing order and then say it still hurt and the Dr. would come in and sign for a morphine dose. Repeat once per shift.

                      Well after her second dose of nitro the nurse I asked the nurse what her standing order for nitro was (thinking it was different then mine) as she was about to give the third dose and the patient's BP was down to 68systolic (can't remember diastole). Turns out ours are the same and she wouldn't be getting the third dose.

                      While the nurse was off checking her order, the patient began complaining to me that it was so hard to get anyone to give her anything for her pain and that she hurt so much. I explained to her what nitro was and that it was a very effective drug for her condition and that she shouldn't worry too much that everyone was doing what they could for her. By the time the nurse got back "all her pain was gone."

                      I've heard so many times how effective therapeutic communication can be in a tangible way, but it was really cool to see it.

                      - Matt

                      -------------------------
                      - Matt Harris
                      Primary Care Paramedic

                      "A sucking chest wound is nature's way of telling you to slow down."



                      Date Posted: Sun Mar 09, 2008 7:14 PM
                      Posted By: jsadin (Veteran Villager)


                      Call 1: fx L hip (1am-4:30am)

                      Call 2: diabetic reaction (6am-8am)

                      No sleep the night before either due to a sick doggie (what does one do for doggie diarrhea? Ed?). We managed to sneak in a nap today, but with station duties and whatnot it wasn't much of one.




                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Mar 09, 2008 11:33 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Quote

                      Originally posted by: jsadin
                      Call 1: fx L hip (1am-4:30am)

                      Call 2: diabetic reaction (6am-8am)

                      No sleep the night before either due to a sick doggie (what does one do for doggie diarrhea? Ed?). We managed to sneak in a nap today, but with station duties and whatnot it wasn't much of one.


                      Depending on the size of the dog 1/2 [armpit warmer] to 1 whole [lab] pepto bismol tablet q 12 hrs. if there is no blood in stool. not to exceed 3 doses without seeing the vet. then a day or two of bland white rice and maybe a little ground turkey/chicken cooked and drained. if severe dehydration maybe consider some ringers for fluid challenge if the dog won't drink on it's own..
                      Luckily our vet is a good friend and nearby neighbor. Most times she will give me the above advice and it does the trick. Remember dogs will eat many things and the more decayed the better. the pepto and plain white rice will clean them out and stop the explosive squirts. Good luck !
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Mon Mar 10, 2008 10:56 PM
                      Posted By: Fade2Black (Junior Forum Member)

                      Call 1 : 30 yo Female unable to get out of bed
                      Call 2 : SOB
                      Call 3 : MVC rollover 5 occupants 3 injured 2 not transported
                      Call 4 : Seizure
                      Call 5 : Unknown Medical = anxiety attack
                      Call 6 : Unresponsive Male = ETOH +++++++++++ unresponsive on arrival at hospital

                      Busiest shift I've had in a long time.

                      -------------------------
                      I'm sick, I need a cure...vitamin b cocktail followed by an amp of glucose and a drop of adrenaline. Not as good as beer but it's all I got.



                      Date Posted: Tue Mar 11, 2008 11:56 AM
                      Posted By: medicmole (Senior Forum Member)

                      Dispatched for a collapse with decreased level of consciousness. When we arrive <5 minutes later the husband tells us she is no longer responding to him.
                      We find a 58 yo female in cardiac arrest. Begin CPR and attach AED. 1 shock given at 200j followed by 2 minutes of CPR, after the 2 minutes of CPR the patient has HR – 76, BP – 90/65, Resps of about 6/min. 12 lead at the hospital shows no changes, I haven’t had the chance to follow up to see what the labs showed or how she is doing neurologically.
                      It feels good to get one back and it is a nice reminder that good CPR and electricity can have a positive outcome for the patient.


                      -------------------------
                      Be who you are and say what you feel, because those who matter don't mind, and those that mind, don't matter.

                      www.saveourparamedics.com

                       03/11/2008 11:57:25|U



                      Date Posted: Tue Mar 11, 2008 6:42 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Strong work Mole: remember to write down the date in your calendar. Then when your having a bad week ,think back to this call.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Wed Mar 12, 2008 9:00 PM
                      Posted By: jsadin (Veteran Villager)


                      Hi Ed,

                      Thanks for the advice. We started the rice/bland diet regiment and it worked well. I never thought I'd be so happy to see a formed poop.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Mar 12, 2008 10:34 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Quote

                      Originally posted by: jsadin
                      Hi Ed,

                      Thanks for the advice. We started the rice/bland diet regiment and it worked well. I never thought I'd be so happy to see a formed poop.


                      Yup It's a beautiful thing :-]
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Thu Mar 13, 2008 1:56 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      A friend and medic once told me "End organ output is a good thing."

                      Congrats on your accomplishment, Jim!

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Thu Mar 13, 2008 9:54 PM
                      Posted By: jsadin (Veteran Villager)


                      It's the little things in life (at least that's what the wife tells me!).





                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Mar 16, 2008 6:39 PM
                      Posted By: jsadin (Veteran Villager)


                      Call 1: 83 y/o male, rectal bleed (just before dinner...yum)

                      Call 2: 89 y/o female, rectal bleed (ok, not funny anymore)

                      Call 3: 73 y/o male, SOB

                      Call 4: 54 y/o male, SOB/CP

                      At least there were no calls between 9pm and 8:30am.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sun Mar 16, 2008 8:14 PM
                      Posted By: B9member (Senior Forum Member)

                      Call #1: Short IFT of 50 y.o. female, stable having first MI. Symptoms for a couple of days. (Note to self.....get cholesterol levels under control now!)

                      Call #2: Second IFT between 2 hospitals I've never been to before. Large intra-cranial hemorrhage pt who I should have just RSI'd and intubated. Didn't appreciate the transport and became hypertensive. Treated with narcotics and labetalol. They were preparing to intubate him as we left the receiving facility...they were grumbling about the fact that the sending hospital had not intubated him in the 6 hrs they had the pt. (He had a hemiparesis but was maintaining his airway and because he couldn't speak had a lower GCS of 10). I kicked myself for not tubing and totally sedating him considering how bad his bleed was...anyway..lesson learned for next time.

                      Call #3: Scene call MVA victim. T-boned at an intersection. Straightforward call. Pt stable. Unfortunately got back from previous call at 0330hrs and this call came at 0800hrs. (Out all night!)

                      Call #4: Returning from call #3 activated for auto vs ped. Female in her 20's hit by SUV at her work. Only visible injury a femur fracture but pt c/o abdominal pain and is altered. HR 140's and BP 80/palp. Throw her in the helicopter fast and intubate straight away. Wide open fluids.
                      Absolutely no color (literally white as a sheet) by the time we get to hospital. She starts to brady down en route to the ER. They code her ~20 minutes including blood products. They get a pulse back and send her to the OR which she survives but she was too critical and already in DIC from a split liver as well as having a head bleed. She died within a couple of hours after arriving in the ICU. Just goes to show... no matter where you are or what you are doing, if your time is up your time is up.

                      Now I have a couple of days off to recuperate, rejuvenate and basically prepare for the next shift.



                      Date Posted: Mon Mar 17, 2008 11:28 AM
                      Posted By: clutzycowgirlEMT (Senior Forum Member)


                      I had a fairly relaxing shift~~

                      Call 1~ 27 yr old female stepped out of jacked up pickup unto patch of ice-Fx left ankle
                      Call 2~ 8 yr old male stepped out into street on ice~in front of car-bilateral femur fractures (one open), possible collarbone Fx, sore and rigid abdomen~transport with intercept.
                      Call 3~ 49 yr old female with altered LOC-hypoglycemic-treated with oral glucagon and transported as it was "after hours" at the clinic and she was out of her med's.
                      Call 4~ 55 yr old Inmate (frequent visitor) at the jail having panic attack and wanting "get out of jail free" card- left at jail in capable hands of LE.
                      Call 5~ 32 yr old male with hand caught in canvas press~ severe lacerations and crushing injury once removed (will probably lose a couple of fingers)
                      Call 6~ 22 yr old male vomiting blood for several hours~ history of cirosis but didn't figure out that it was the drinking that causes it~transport
                      Call 7~ 9 mo male with difficulty breathing~diagnosed with asthma but mom "forgot" to give him his treatments and meds for "a few days". Child in this family died on me last year due to an asthma attack.
                      Call 8~ 94 yr old female was on her way from front door of casino to bingo hall when she felt "weak and cold" all of a sudden and collapsed. A&Ox3, no cardiac or significant prior medical history, doc told her she was healthier than most horses~HR 53.
                      Call 9~ 33 yr old female at jail who had been beaten severely in the holding cell (drunk tank) before LE could get the others off of her~C-collar, spine board, etc

                      Not too bad of a shift considering everyone got "spirit" money ($300) to follow their High School Basketball team to the state play-offs~~Glad the rowdier bunch left town~~

                      -------------------------
                      EMT&SAR "so others may live"
                      Clutzy~~the original Village Clown
                      All I ask is the chance to prove that money can't make me happy.



                      Date Posted: Mon Mar 17, 2008 9:33 PM
                      Posted By: jsadin (Veteran Villager)


                      Call #7 makes me want to drive out to ND and give someone a parenting lesson. Grrr.....



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue Mar 18, 2008 5:21 PM
                      Posted By: roblanious (Veteran Villager)

                      I agree with #7. Some people just should not have kids.

                      I know you told us in other threads but what kind of shift do you work? This looks like a typical 8-12 hour shift here in the City.

                      By the way, what did you do for #8?

                      -------------------------
                      Greatness is not standing above our fellows and ordering them around, it is standing with them and helping them to be all they can be.
                      G.Arthur Keough (1909-1989) Educator



                      Date Posted: Wed Mar 19, 2008 10:17 PM
                      Posted By: jsadin (Veteran Villager)


                      If I remember correctly, Clutzy is doing 40hr shifts. North Dakota is not quite as busy as your home town Rob.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Sat Mar 22, 2008 3:54 AM
                      Posted By: roblanious (Veteran Villager)

                      40 hour shift! Holy Moses! What the F@#&! Who works those things? Who makes people work those? I worked 32 hours straight once because of a blizzard keeping my relief from coming to work. I stunk and actually passed out at the end of my shift (that was what ended the shift). The calls sound similar though to city calls.

                      -------------------------
                      Greatness is not standing above our fellows and ordering them around, it is standing with them and helping them to be all they can be.
                      G.Arthur Keough (1909-1989) Educator



                      Date Posted: Mon Mar 24, 2008 1:21 PM
                      Posted By: elvismedic (Veteran Villager)

                      At 1030 am dispatched to a car in the water. It's in my first due area so even though we take the ambulance we're really designated the rescue company. I don my survival suit enroute and arrive on scene to find a vehicle almost completely submerged (we could only see the roof from the "B" post back and couldn't see the door tops). I enter the water (about 35 F) and attempt to look into the vehicle under water but I can only see about 6" in front of my face. So I try to feel around and don't feel anything. Long story short, between the forest fire with its 20 ton winch and a tow truck the vehicle (a minivan) is removed from the water, found to be stolen from a local repair garage, and most importantly was unoccupied.

                      # 2 was around 1500 for a fall in a nursing home parking lot. A visitor got tripped up by her dogs fell + LOC less then 15 sec with short term memory problems. Collar and board and off to the ED.

                      #3 was around 2200 for the 63 yo M recently traveled back to the US from China C/O Severe SOB. Arrive to find patient in bed supine dyspneic and tachypneic, with marked hypotension (70/0, with sats in the mid 70's, COAX4. No medical problems. Pt arrived home from china on the 22nd and was starting to feel poorly just prior to the flight. Also important to note the rest of his party (4 adults) also feel ill. IV established bedside, on 15 L o2 Sats improved to low 80's. After 500 cc's BP increased to 80/40. Patient +NVD, +chills, +rhonchorous Breath sounds (fluid sound thin), Transport. Our guess at a diagnosis is acute onset pneumonia.

                      #4 At 0030 after just returning from the previous call we are sent out for a CO detector sounding. The engine arrives on scene first and reports readings of 115 ppm on the first floor. The home is evacuated. The FF's don airpacks and make entry. I go evaluate the three family members. The first one I assess is a 3 Y/O M who has no complaints. Place him on the CO oximiter and get a reading of 5%. Next is mom who gets the same eval and a reading of 3%, and finally the dad receives the same treatment and has 3% CO.
                      Further eval by the FF's obtains readings of 350ppm at the source and readings of 150ppm in the parents bedroom. While talking to mom she said that she did have a slight headache and went to bed early because of it. She said once in bed she couldn't fall asleep which was strange for her. Luckily for them their CO detector went off or they'd be dead today. According to the gas company the gas fired hot water heater suffered an acute vent blockage causing the exhaust gases to backup into the home.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Mon Mar 24, 2008 2:43 PM
                      Posted By: DocHarris (Senior Forum Member)

                      Hey Elvis with that patient who'd returned from China, I was wondering how accurate a sat reading would be with a BP that low. Would the fingers, toes, or earlobes perfuse enough to obtain an accurate waveform on that sat monitor?
                      - Matt

                      -------------------------
                      - Matt Harris
                      Primary Care Paramedic

                      "A sucking chest wound is nature's way of telling you to slow down."



                      Date Posted: Tue Mar 25, 2008 10:31 AM
                      Posted By: elvismedic (Veteran Villager)

                      Doc you're correct about the low sats caused by the low BP. Our main concern was his low BP because even if he had a sat of 100 really how saturated is his blood? The only thing I might have done differently is try to get a waveform but at the time I just didn't think of it. I also could have tried to get an ETCO2 but we were pretty sure that it was an pneumonia.

                      This patient needed IV antibiotics or RSI, neither of which I am able to do. I going out on a limb here but I think the ED tubed him.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Tue Mar 25, 2008 11:01 AM
                      Posted By: DocHarris (Senior Forum Member)

                      ETCO2, I hadn't thought of that one. Thanks for the insight!

                      -------------------------
                      - Matt Harris
                      Primary Care Paramedic

                      "A sucking chest wound is nature's way of telling you to slow down."



                      Date Posted: Wed Mar 26, 2008 9:42 PM
                      Posted By: elvismedic (Veteran Villager)

                      To me it's just another took in my toolbox that could help the ED diagnose whats going on faster. Admittedly, though, the ED I took the patient to doesn't have capnometry or capnography capability without calling in Respiratory. Sad to say.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sun Mar 30, 2008 11:30 AM
                      Posted By: elvismedic (Veteran Villager)

                      Just got an update on my March 24 #3 post. We learned that this patient died of "massive organ failure" secondary to strep B infection. He was admitted to the ICU of our transporting hospital and then transfered 24 hours later to Mass General when it his condition hadn't improved.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Sun Mar 30, 2008 12:17 PM
                      Posted By: DocHarris (Senior Forum Member)

                      Had a really interesting and really sad patient on clinical rotation with Respiratory Therapy on Friday.
                      20y/o female in acute care on a Med/Surg floor getting ready to be transferred down to the rehab floor. She's been in hospital (a big Toronto one and our little community one) for over four months. We were just there for tracheostomy maintenance so I didn't find out her whole story until I had a break to sit down and read her chart. Pretty rough story, it's been sticking with me for the last few days.

                      Back in December, pt entered the local ER with her parents with apparent complications to the flu (trembling, high fever). Condition rapidly deteriorates and she begins seizing and goes into a coma. She becomes unable to maintain her airway and is trached, intubated and shipped off to the big T.O. hospital for treatment.

                      Six weeks later she regains conciousness. She's quadrilpelegic, blind, still trached and oh yeah, as her substitute decision makers her parents had no choice but to abort her 12 week old pregnancy.

                      Fast forward to now, she's regained a good deal of her sight, use of her arms (though weak) and it looks like the tracheostomy will be out in about two weeks. Despite all this, she was friendly, positive and optimistic. That was probably the hardest part of it all.

                      The diagnosis on her chart was ADEM or Acute disseminated encephalomyelitis. I'll save you the trouble here's the wiki definition of it:

                      http://en.wikipedia.org/wiki/Acute_disseminated_encephalomyelitis

                      Acute disseminated encephalomyelitis (ADEM) is an immune mediated disease of brain[1][2][3]. It usually occurs following a viral infection but may appear following vaccination, bacterial or parasitic infection, or even appear spontaneously. As it involves autoimmune demyelination, it is similar to multiple sclerosis, and is considered part of the Multiple sclerosis borderline[4][5]. The incidence rate is about 0.8 per 100,000 people per year[6]. Although it occurs in all ages, most reported cases are in children and adolescents, with the average age around 5 to 8 years old[7][8][9]. The mortality rate may be as high as 5%, full recovery is seen in 50 to 75% of cases, while up to 70 to 90% recover with some minor residual disability[10]. The average time to recover is one to six months.
                      ADEM produces multiple inflammatory lesions in the brain and spinal cord, particularly in the white matter. Usually these are found in the subcortical and central white matter and cortical gray-white junction of both cerebral hemispheres, cerebellum, brainstem, and spinal cord[11], but periventricular white matter and gray matter of the cortex, thalami and basal ganglia may also be involved.


                      -------------------------
                      - Matt Harris
                      Primary Care Paramedic

                      "A sucking chest wound is nature's way of telling you to slow down."



                      Date Posted: Tue Apr 15, 2008 9:52 AM
                      Posted By: VanHelsing (Veteran Villager)

                      So I get dispatched to a collapse on the side of the street... finally find the patient propped up against the wall.

                      My initial view is lots and lots of foam coming out the mouth... Ok then, get out my car..

                      A quick history reveals an 19year old homeless boy, who had severe tooth ache, and was told if he drank brake fluid it would make the pain go away. So he obeyed, as we all would, no doubt... then collapsed.

                      He is not responding, GCS 10, but still breathing adequately. He gets high flow oxygen, afer removing as much spit as possible, lungs clear bilaterally. Circulation is good, peripheral pulses present and equal. Blood pressure is 160/110, ECG shows a sinus brady od 50b/m

                      Now the whole time, im thinking, gheesh, this looks like organophosphate poisoning... but brake fluid is not an organophos.... is it ???

                      unfortunatly, the ambulance was on another call, so I sat there waiting, thinking and monitoring...I gave him some thiamine and dextrose while thinking, HGT was a bit low and he probably hadnt had a decent meal... ever.

                      more organophos signs start appearing... after his HR dropped to 45, lungs got abit wet and he started lacrimating... I decided I'd try some atropine even thyough the 4 people I had phoned to ask if brake fluid was organophos said it wasnt.

                      well, atropine worked, vitals returned to normal, chest cleared and although his GCS didnt improve he looked better.

                      So i did some research on the web and after searching long and hard... aviation hydrolic fluid has an organophosphate base, and a sub-category under that heading was BRAKE FLUID.

                      so I learnt something new, via trial and luckily not error.

                      for more info on organophosphates please PM me, im now an expert after all the reading I had to do !! in fact... i'll head to the student center and post it there...

                      VH








                      Date Posted: Tue Apr 15, 2008 10:44 AM
                      Posted By: arctickat (Senior Forum Moderator)

                      Very nice deductive reasoning, well done VH. At least my OGP poisonings have it clearly labeled on the bottle.


                      -------------------------
                      Si is est non infractus , operor non restituo is.

                      Village Drunk



                      Date Posted: Tue Apr 15, 2008 3:38 PM
                      Posted By: DRIVER609 (Senior Forum Member)

                      Very rude of him not to have a clearly labelled bottle sitting next to him! I've been lucky too, all mine have been decent enough to be on farms and have the bottle with them.

                      Nice job



                      Date Posted: Tue Apr 15, 2008 9:52 PM
                      Posted By: jsadin (Veteran Villager)


                      Awesome work VH!

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Wed Apr 16, 2008 1:25 AM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      Good Work! A perfect example of treating the patient, not the book.

                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Wed Apr 16, 2008 2:43 AM
                      Posted By: roblanious (Veteran Villager)

                      Wow. I would have missed that one. I must bow down to you. Good job.

                      -------------------------
                      Greatness is not standing above our fellows and ordering them around, it is standing with them and helping them to be all they can be.
                      G.Arthur Keough (1909-1989) Educator



                      Date Posted: Wed Apr 16, 2008 8:58 AM
                      Posted By: AZCEP (Veteran Villager)

                      You were treating what the patient was presenting with, as you should have been.

                      I must admit that I was not aware that an OP base could be used for brake fluid, but then I don't discuss options with my local aircraft service technician either. Typical automotive brake fluid isn't made the same way, so there would be other problems associated with an ingestion.

                      Good information there VH.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Tue May 06, 2008 11:07 AM
                      Posted By: VanHelsing (Veteran Villager)

                      I seem to have had lots of dead people on my last cycle ( im off now, finally )...

                      A taxi... 7 dead, and 6 x P1's. Nasty call, lots of deformities, decapitations, and general brain matter all over the place.

                      Then a guy fell off a construction bridge and died.

                      And another MVA, truck overturned killing the driver, passenger entrapped.

                      And just to add insult to unnecessary injury 2 suicide attempts.

                      well atleast Im off now.



                      Date Posted: Tue May 06, 2008 8:05 PM
                      Posted By: jsadin (Veteran Villager)


                      I haven't had 7 dead patients this year....VH gets that in a day. Even after all this time in the forums, it still amazes me.

                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue May 06, 2008 11:36 PM
                      Posted By: ESPARKS (Veteran Villager)

                      And when she gets to canada she won't either. I bet she could teach ALL of us a few things about horrible calls and how to cope with it. God bless you VH and keep safe!
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Wed May 07, 2008 3:24 PM
                      Posted By: VanHelsing (Veteran Villager)

                      Ed, I wish I knew how to cope ! we only get a recommendation for counselling if we see more than 30 dead people in a month ( ie about 20 working days ).

                      What really concerns me ( about this country ), is that it didnt even make the news, I wanted to find a link to the taxi accident, and its not mentioned. Another call last week, where 4 elderly ladies had their throats cut in their home ( 3 died, 1 managed to get to hospital ) also wasnt news worthy... Im sure in a 1st world country, that would have made front page.





                      Date Posted: Sun May 18, 2008 6:22 PM
                      Posted By: jsadin (Veteran Villager)


                      Had a call last night to evaluate a young gent involved in a bar fight. Arrived on scene to find state PD as well as four local POs. It turns out we knew the lad and he just had some skinned knees from wrestling with the other party. I'm kneeling next to him bandaging his knees and he looks down at me and says "while you're down there.....". I smiled back up at him and said "not on your best day". Got the female state PO to smile anyway.



                      -------------------------
                      "What the f***? Over..."
                      Village Handyman
                      Igitur qui desiderat pacem, praeparet bellum



                      Date Posted: Tue May 27, 2008 12:47 PM
                      Posted By: elvismedic (Veteran Villager)

                      Had a call yesterday for the hypothermic female. Weather was breezy, air temp was in the 70's with humidity levels in the 60% range.

                      We were called mutual aid for the unknown medical comming in by the USCG. When we arrived on scene we were up-dated that it was for hypothermia. The back story is that a husband and wife went out in a small craft to enjoy the holiday. Well they fell asleep and drifted off shore. The boat never sunk and the passengers never had to enter the water. However the spray over the bow was too much for the bilge couldn't keep up and both were soaked by the spray. Resulting in Hypothermia for the wife.

                      Treatment was what you'd expect; warmed IV fluids, dry off, thermal blanket (silver space), monitor and transport. I tried to get a tampanic temp but it just read "low." Patient was a diabetic and her sugars trended up from 450 to 480 during transport. On our arrival she was shivering violently and after treatment she stopped shivering. Oh yeah I should mention that the water in Cape Cod Bay is about 50 F. I don't know what her core temp was at the ED as I was called out for another run.



                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Wed May 28, 2008 8:56 AM
                      Posted By: ESPARKS (Veteran Villager)

                      Ya goota love the start of stupid tourist season. Memorial day is when we get all our water rescue gear checked and ready to go. we've already had a couple of stranded kayacker's and a sailboat on the rocks. The biggest problem with the highlanders is that they don't have a clue they're in trouble until it's coming up on dusk and they realize they don't know which little island they went by last. Then they get out their handy dandy cell phones and expect US to know where they are and to come rescue their sorry
                      @sses. You would think some of these morons could afford a chart and a gps unit
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Wed May 28, 2008 10:20 AM
                      Posted By: elvismedic (Veteran Villager)

                      If it called tourist season why can't we shoot them? I love the people who spend hours on route 3 to go to the Cape to sit in traffic the whole time. One Memorial Day weekend we had a garbage trucks load catch fire. To put it out they had to dump the load and run water shuttles up the highway while it was shut down. Talk about a bunch of PO'd tourists... it was great.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Wed May 28, 2008 6:44 PM
                      Posted By: EFHALVERSON (Senior Forum Member)

                      I hear locals at the ski hill and the workers (and myself) say the same things, but it would be very hard for me to get paid for skiing and my patrollers to ski for free if they weren't here.

                      I keep telling people the worst thing about my job at the hill is they won't let me carry a gun. The boss says that's because we wouldn't have any customers left. I try to compromise with the idea of a paintball gun - different colors for different infractions and the Patrol Director gets an automatic. Three strikes and you're out. Still no - he knows I'd freeze them first.


                      -------------------------
                      My opinion of the human race isn't that high to start with and it just P!@@#* me off when they live up to my expectations of them.



                      Date Posted: Wed May 28, 2008 9:04 PM
                      Posted By: elvismedic (Veteran Villager)

                      Oops I knew I forgot to put them in a warm place. Luckily for me all we get is people asking for directions to the beach. The main tourist spot is a little further south in Plymouth.

                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Fri May 30, 2008 8:19 AM
                      Posted By: AZCEP (Veteran Villager)

                      It's a little late, but here's my activity for the Memorial day weekend.

                      Saturday:
                      MVA rollover. Single patient with a head injury. Flown to the trauma center.

                      Sunday:
                      Reported MVA with nothing found.
                      Difficulty breathing transported without incident
                      Abdominal pain, possible drug seeker

                      Monday:
                      MVA rollover with ejection. 3 patients. Head injury-agonal on arrival, and two green tagged for the second in unit. Patient number 1 worked for a bit, went into PEA arrest, called after 15 minutes without response.
                      Difficulty breathing turned into chest pain with radiation to left arm. Pain relieved with NTG. Transported without incident.
                      Reported MVA-vehicle off the road. Turned out to be a flat tire.
                      Domestic disturbance that we are still trying to figure out why we were there. :? "Patient" didn't want to go to the hospital. Boyfriend wanted her taken. Sheriff's office notified. We left.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Fri May 30, 2008 4:12 PM
                      Posted By: roblanious (Veteran Villager)

                      We don' t worry about tourist season here. Nobody in their right mind would want to come visit here. In fact, they all drain out.

                      -------------------------
                      Greatness is not standing above our fellows and ordering them around, it is standing with them and helping them to be all they can be.
                      G.Arthur Keough (1909-1989) Educator



                      Date Posted: Fri May 30, 2008 9:10 PM
                      Posted By: AZCEP (Veteran Villager)

                      They all end up somewhere between southern CA/AZ/NM for the summer.

                      Then in the winter they all stay waaaayyyyy too long.

                      -------------------------
                      Arguing with a zealot is somewhat easier than tunneling through a mountain with your forehead

                      www.fieldmedics.com/forums
                      www.capem.org



                      Date Posted: Wed Jun 04, 2008 1:41 PM
                      Posted By: elvismedic (Veteran Villager)

                      I don't know if this should be here or not but here it goes. Last night I was called to a local low income housing facility for shortness of breath. The patient meets us outside in no apparent distress but states she's having troube breathing. Her travel bags are packed and ready for a prolonged stay. Her history is significant for DVT's which have lead to PE's. Room air sat is 95%, ETCO2 ranges from 38 to 44, lungs were clear all fields; BP, P, R, are within normal limits. The point to all this background is that when we placed her on the monitor it appeared that she was positive for S-1, Q-3, but negitive for T-3. Considering her history of DVT's and PE's we assumed she was in the early stages of a PE. At the ED the nurse gave me the impression that I was FOS because I couldn't catch the afore mentioned S-1, Q-3, T-3 on paper. What I am wondering is is this a common occurance in this type of case?


                      -------------------------
                      Village Piper.

                      Don't do anything you don't want to explain to the Paramedics.



                      Date Posted: Wed Jun 04, 2008 2:16 PM
                      Posted By: p3medic (Senior Forum Member)

                      The S1Q3T3 is suggestive, but not diagnostic. The presence of, or lack thereof does not the diagnosis make. And low income housing? Was she in the 600,000K area of your town? ewww.....How white trash! LOL



                      Date Posted: Wed Jun 04, 2008 8:21 PM
                      Posted By: ESPARKS (Veteran Villager)

                      Quote

                      Originally posted by: elvismedic
                      . At the ED the nurse gave me the impression that I was FOS because I couldn't catch the afore mentioned S-1, Q-3, T-3 on paper. What I am wondering is is this a common occurance in this type of case?


                      Ean while I've known you to be full of scotch, your usually a pretty good clinician. Always go with your gut and what your pt"s history and presentation appear to be.
                      Ed

                      -------------------------
                      Take care and play safe out there !!!

                      The dean of common sense



                      Date Posted: Wed Jun 04, 2008 9:49 PM
                      Posted By: elvismedic (Veteran Villager)

                      P3 I know it's hard to believe but yes there is low income housing even in Deluxbury. I realize that no one sign automatically leads to a diagnosis but considering her history and the chance of a sign I will always air on the side of caution.

                      Thanks Ed I appreciate your sentiments. And yes some times I'm full of scotch, other times I'm full of hot air, and then some times I'm full of both.

                      -------------------------
                      Villa