Arbrow06

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Posts posted by Arbrow06

  3. Posted

    I love all the input. I would love to make this a weekly thing just regular old calls that make you ponder.

    I figured the pt. was crashing being he is usually hypertensive also suffering from dehydration. His SPO2 as per NIBP was borderline hypoxic and with no history of like COPD or any sort of respiratory disease. His breathing was shallow a a bit rapid for my liking but i decided against being rough on him to BVM him which could do more bad than good. So just went with high flow oxygen. I also treated for shock which with the new protocol isn't much more than O2 and a warm blanket considering hypovolemic shock possibly. Was really puzzled and it's good that I did the best I could.

  4. Posted · Edited by Arbrow06

    So Blood Glucose at the hospital was 160. Very frail. PTA said they tried a IV but it went right through the vein. Pt. BP dropped about 5 systolic and diastolic by the time you get to the hospital (about 15 minutes). Unable to take manual BP over palp or pulse. No BP or pulse detected via NIBP at ER triage. Call was for failure to thrive ( no eating via spoon feeding for past couple days). Also note shallow breathiing.

    Post

    POSt

  5. Posted

    Here's the scenario:

    Age: 80-95

    Medical History:

    Pancreatic Cancer, Diabetes

    Symptoms:

    Hypotension, Pursed Lip Breathing, Accessory muscle use, Shallow Breaths, Unable to speak, Verbal on avpu

    BP: 90/40

    HR: 95

    Resp: 20

    O2SAT: 95%

    If you need additional info please ask away.

    I want you guys to respond with a level of care(EMT-B, EMT-I, EMT-P) and what would you do for the pt. at scene and enroute. NO DIAGNOSIS but feel free to explain your suspicions and your actions to improve the pt condition.

  8. Posted

    The other issue is there is always an issue of flu shot shortages. There may be an extra burden on the flu resources during the season when the strain mutates and if they make HCP first up that may be an issue. I also just feel that the flu shot isn't a vaccine because there's no guarantee it will prevent you from getting the flu or carrying a strain of the flu. It just lessens your chances. I wonder how my employer will deal with this as I am not getting the shot. Also I want to see what the checks are to make sure those who don't have shots wear mask and the repercussions if you don't wear mask. What if I don't wear a mask will I lose my EMT cert or what? This is just a really interesting mandate because there's options and due to HIPAA isn't there some privacy amongst what vaccinations I have etc.

    mvfire8989 likes this

  9. Posted

    You are welcome not to get the shot, and since you are young and probably healthy you will almost certainly survive. Influenza is also potentially avoidable if you either:

    A. get the vaccine B. avoid people during flu season OR C. Wear appropriate respiratory protection for the duration of the patient contact through the time when your ambulance is decontaminated.

    People can transmit influenza before they experience any symptoms. So this means that we must treat every patient as potentially infectious, and that we also may become ill and transmit this infection to our patients. You may certainly choose not to get vaccinated, I just hope you are willing to stand behind that decision and properly protect yourself from infection, and more importantly protect the patients from being infected by you.

    Agreed and as a result I will happily don a surgical mask during instances of patient care and if I develop symptoms I will take my sick but off the road until it passes. Patient care is very important to me and I will have have both hand sanitizer and hand cream to make sure that I am keeping my hands as clean as possible this season.

  12. Posted

    My main concern is patient care so if we put the ambulance behind and it gets taken out because it does take LEOs and Fire a bit to respond sometimes and I wonder if there have been any studies about which is better when you are first on scene. Parking behind the scene to block or in front for the best visibility and safety, especially with the new move over rule in NYS. At the end of the day I just feel comfortable putting my "bubble" in danger of being destroyed so that I end up stranded.

    What do people usually do when they park in front? Make someone spot?

  14. Posted

    Andrew, if your EMS shift causes you to cry - in pain or anything else - maybe you should also consider other possible professions. It's not going to get better when you're older and if you try to "suck it up" you'll wind up injured or just one of those nasty bastids in EMS we all shake our head about.

    You're young! Explore other options before you find yourself a 45 year old with a bad back dreading every day at work.

    No no not like that. I have been in EMS for 2 years and I love it. Also, being an EMT will not be a profession for me. Just what if I get the old lady who took a fall hit her head and is crapping out. Of course that shift is going to make me cry. Emotional tears not stressful ones. We can't save everyone.

  15. Posted

    The flycar and especially the ambulance in my opinion should only stop in front of the accident whether they're first on scene or not. The only thing that will provide you effective physical protection from passing traffic is a 25-ton piece of fire apparatus. If one of these fools racing their luxury SUV down the Saw Mill rams the back of 37M1 the medic will have two trucks flying at them instead of one. That's all assuming they aren't hit while grabbing their bag out of the back hatch.

    Remember always uphill and upwind of any scene both for hazmat related issues also just get in front of the accident. If your ambulance goes out because its rammed thats one less resources to save a life. On the scene the ambulance and ALS fly car are paramount because theres plenty of RMPs and fire trucks can take a decent beating but a ambulance isn't made for it. I would 100% park ahead of the scene and set up safety precautions behind the scene and if a truck hits the car with the pin I would feel bad but my safety is paramount.

  17. Posted

    Thanks guys. I'm going to buy a pair of BDU style pants. Then put the BP cuff in there. I just don't want to forget anything in a bag because sometimes when my mind gets going I am less worried about my stuff and more worried about clocking out after a shift that made me cry in pain.

  19. Posted

    "Emergencies" that come out of contract locations, such as NH's, clinic's, Doctors's Offices, etc. They can range from abnormal lab results, to Chest Pains and possible MI's.

    I've picked up my fair share of true emergencies out of rehab clinics, substance abuse shelter's, and places of that nature.

    IFT's and general hospital discharges back to residence's homes are also in there.(If a bedbound person went in on a stretcher, they need a stretchter to go home too...)

    The other big thing we do are Dialysis transports...Hundred's per day. and the patient has to go every 2 days, so that keeps crews busy.

    I work for one of those companies that we "barely have time to eat", and yes, it's miserable at times.

    What agency is that? And how do you work around being so busy? What times are the busiest for you as well?

  23. Posted

    Yeah, not so hard, until an aircraft crashes and the sky pretty much falls on your head. Why not just keep it simple so when the world turns upside down you don't have to think about it, it's one thing, you're used to it, and you don't have to worry about messing it up.

    I have done air traffic control at one point in my life albeit virtually and it is highly likely that saying 2592 you are clear for a pump test will cause chaos at a small airport. I would recommend a communication convention similar to service trucks for the sake of ATC keeping track of things and use the 2592 or whatever county designation for use with 60-control. If you are a chief and you only ever respond in the vehicle when the plane crashes I don't see this as a huge issue.

    In conclusion,

    Fire 2592 for ATC

    2592 for 60 Control

  24. Posted

    Looking at this web page http://arffwg.org/wp-content/uploads/2012/10/ARFF-Professional-Designation-Program.pdf, Airport Fire Officer seems to be a new designation for ARFF operations.

    "Airport Fire Officer 259x", "AFO 259x", "Fire 259x", "Duty Officer 259x" could be some suggestions.

    Agreed. Fire 259X is great for airport ops and then use a separate designation when dealing with 60 Control if need be. Isn't so hard to remember to use two different designators.

    dwcfireman likes this