Ask A Medic

Anyone know of any ski resorts that hire medics in Canada?

 

All of them?


Also,

Fuckin' finally. Been casual and temp full time a few times for the past 2½ years. Managed to lock down a permanent full time gig. Benefits, vacation time, the works. Woot woot!

 

Congrats Serge, where will you be working?

 

Right on!!! congrats man.

 

Cheers gentlemen. Working in Olds. Large town an hour north of Calgary where I live.

 

Bgl is low person gets into an MVA with an MOI that suggests head trauma, would you still administer D50 yay or nay?? this is for a facebook discussion

 

Yes, this patient needs the sugar. The brain is going to die without it so the bleed would be a moot point if no treatment is given.

My suggestion: Titrate to effect (BGL>60). Monitor your patient and be prepared to give more if BGL drops again since the dextrose doesn't last long.

If in doubt you could always call for online med control and put that decision on a doc but I can almost guarantee he is going to order something (D50, D25, etc).

 

what about giving glucogon instead? or would it take to long to work?

 

Why would you use Glucogen when you have D50 as an option? Glucogen will take a lot longer (10+ minutes) and its not a popular option since it dumps the livers supply. If you have IV access D50 would be the first choice

 

How's the best way to keep a supply of antibiotics? For long term?

 

Glucagon is an option but wouldn't be my first choice if I have a patent line (even in this situation).

Glucagon is going to take significantly longer to cause an improvement in the hypoglycemic patient. This is especially true if they have limited glycogen stores available. For example, if the patient was treated the day before with glucagon they will have no glycogen stores available to convert. While you wait around for their BGL to rise their brain is essentially starving.

Just like with D50, glucagon is only a temporary fix and they will need to get another source of sugar to maintain their BGL. If this is truly a TBI they won't be eating afterward so we will end up giving D50 anyway.

I have not seen a protocol that addresses hypoglycemia and suspected head injury. I have however seen several that call for the paramedic to treat a hypoglycemic patient with D50 even if a stroke (including bleed) is suspected. Since these are essentially the same thing (for the purposes of this discussion) the treatment should remain the same for both.

 

I've been taught that glucagon is only for use in dire situations when you can not achieve IV access.

 

I wouldn't say dire situations. But it you have poked someone 4 times it time to go to glucagon, then keep looking for an IV

 

http://m.heraldtribune.com/fullStor...ribune.com/article/20121204/article/121209875

This is the fun I had today

 

so had an interesting call last shift... get toned out for blood in urine. arrive on scene to a guy meeting us in the driveway with a robe on, hardly speaks english and he just says penis.... so we get him in the truck and try to figure out how much blood is in his urine and what not. he lifts up the robe and theres a blood spot on the robe so i just think ok blood from the urine w/e. he lifts the rest of the robe up and exposes himself with an erection and i notice something shinny at the base and my partner come up and is like o shit is that a cock ring haha. then pt goes penis and points and we r like uhhh can you not get it off?? he is like no!!! so theres about a 1/8in thick stainless steel ring around his cock and balls and hes in pain. he said he has been like this for 2 hours and that he also injected himself in the base with some german shit like viagra im guessing. so my partner grabs the ring cutter and goes to town haha after about 20 min its finally cut through on both sides. was definitely one of those calls thats like wtf really?

 

Cock AND balls? Wow.

I would love to see the narrative on that PCR.

 

OMG?? You cut it off??

fuck no...lol...I would have totally let the ER deal with that...not because I would have a problem with the dude's junk...because I would be scared I would slip up!

well that and we dont have ring cutters.

 

Anyways...


Anyone have suggestions to what to bring to eat on the rig? We are system-status

I am going broke eating out every shift. And I just went from company that did chiefly inter-facility, to now working for a county agency that is primarily 911. So sitting around and eating is making me FAT.

 

Plenty of fresh fruits and veggies.

 

Pack a cooler full of food the night before your shift and only eat what's in there during your shift.