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Ask A Medic

Discussion in 'Off-Topic Discussion' started by medic2230, Jun 2, 2011.

  1. Nov 18, 2013 at 2:46 PM
    #1321
    medic2230

    medic2230 [OP] Ditch Doctor

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    Cooking at the station.

    [​IMG]
     
  2. Nov 18, 2013 at 5:13 PM
    #1322
    futuretacoowner

    futuretacoowner Well-Known Member

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    :jellydance: The station I did my preceptorship at was looking at making a deck in back and getting a grill and a patio set and what not. Dont worry wasnt gonna be with company money or anything.
     
  3. Nov 20, 2013 at 6:56 PM
    #1323
    MotoTacoma

    MotoTacoma Adrenaline Addict

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    thats pretty awesome...
     
  4. Nov 27, 2013 at 5:02 PM
    #1324
    futuretacoowner

    futuretacoowner Well-Known Member

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    You have a hypoglycemic pt presenting with stroke like symptoms do you push D50 or no?
     
  5. Nov 27, 2013 at 5:19 PM
    #1325
    TacoMX

    TacoMX TW's Official anti body-lift pundit

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    Our protocols say to treat a suspected cva pt for hypoglycemia if their bgl is below 50mg/dl
     
  6. Nov 27, 2013 at 5:44 PM
    #1326
    Mitch

    Mitch Somebody call for a Wambulance?

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    Always. The blood sugar could be a factor





    Same here
     
  7. Nov 27, 2013 at 5:47 PM
    #1327
    mtnmedic

    mtnmedic Well-Known Member

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    Treat the hypoglycemia first. Some differential diagnosis skills should tell you pretty quickly what you have.
     
  8. Nov 27, 2013 at 6:00 PM
    #1328
    futuretacoowner

    futuretacoowner Well-Known Member

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    Reason I ask is that the drug profiles I was given while in school said that a stroke was a contraindication, and while looking at different protocols it said bgl under 80(U.S.) and under 4(Canada) to give d50. Just goes to show that you don't learn everything in school I suppose.
     
  9. Nov 27, 2013 at 6:25 PM
    #1329
    Mitch

    Mitch Somebody call for a Wambulance?

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    I've always believed that you learn a base in school and learn more while on the job. I wouldn't give the D50 orally but can hurt to give it IV
     
  10. Nov 27, 2013 at 8:31 PM
    #1330
    futuretacoowner

    futuretacoowner Well-Known Member

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    I believe that also, but sometimes I need that little reminder
     
  11. Nov 30, 2013 at 2:00 PM
    #1331
    TacoMX

    TacoMX TW's Official anti body-lift pundit

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    exactly.

    If you have a pt on scene w/ no Hx of DM, and now they are all zonked out, sudden onset, facial droop, weakness, hemiplegia....I would lean toward stroke and probably not give D50...unless it was very low.

    Even in an ischemic stroke D50 can worsen the cerebral infart by drawing oxygen from the non-infarcted tissues to try and metabolize the sudden influx of sugar.
     
  12. Nov 30, 2013 at 2:22 PM
    #1332
    Mitch

    Mitch Somebody call for a Wambulance?

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    I agree with this. I think it would depend on the overall situation. And if you have any questions I would make a call to the on call docs and put it in their hands
     
  13. Dec 12, 2013 at 3:34 PM
    #1333
    TeamSarcasm

    TeamSarcasm Flawless Escalation to the Ludicrous

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    The better coast

    http://mobile.nytimes.com/2013/12/08/us/in-mass-attacks-new-advice-lets-medics-rush-in.html

    What are your guy's thoughts on this?
     
  14. Dec 12, 2013 at 3:38 PM
    #1334
    Mitch

    Mitch Somebody call for a Wambulance?

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  15. Dec 12, 2013 at 4:11 PM
    #1335
    scmedic85

    scmedic85 Well-Known Member

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    This is the future of EMS operations in the 'tactical' environment and I feel very comfortable going into the 'warm' zone in this type of situation. Our current approach to mass shootings costs lives.

    I would actually argue that you are safer in this scenario than other day to day calls. Here, you are being escorted by police officers whose primary duty is providing protection to you while you triage victims. On your typical day to day call these officers are not going to be as alert and prepared even if they are present. Any scene has the potential to turn violent...

    I attended the EMS World Expo in Las Vegas, NV this year and watched a demonstration by Las Vegas Fire Department. They aren't even using ballistic protection (vests) and I think their approach makes sense.
     
  16. Dec 13, 2013 at 1:35 PM
    #1336
    futuretacoowner

    futuretacoowner Well-Known Member

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    Nope I am not trained for this and it is not what I signed up for. I do however love the idea of cross training LEOs. When I was at the paramedic academy we had LEOs from all over and get trained medically. Some of them can do more than I can as a Primary Care Paramedic. I know a few officers that were Medics before turning to police for various reasons, why not have them go. I have much more of a possibility of helping someone if I am ALIVE.
     
  17. Dec 13, 2013 at 1:39 PM
    #1337
    metrick1215

    metrick1215 Pirate Medic

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    anyone elses states/counties pulling things off the truck or delaying usage even though they work?? The reason i ask is over the past couple years they have pulled things in our county that the state allows... For instance we can not RSI in my county but the next one over can. Some of our transport times are to long to not have this (some being 30 min to the closest hospital.) Also we have now put the IO gun as a last resort, and we just received King Vision on the trucks. Also told not to use the kings unless there is no other option...
     
  18. Dec 13, 2013 at 5:10 PM
    #1338
    Ryan DCFS

    Ryan DCFS Elevator guy

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    The RSI thing is probably based on the statistics of usage/attempts/failures/efficacy. If RSI is only used 10 times a year out-of-hospital, and only one of those patients ever left the hospital, then it doesn't neccessarily make sense to keep it within the protocols (from the perspective of the county/company - I personally think it's important in areas with long transports).

    The king tube is considered a BLS airway if the EMT is trained and allowed by their county - intubation is the only definitive ALS airway. King tube is still an amazing tool and undeniably better than any other BLS airway or combitube.

    IO is always a last resort. I'm not going to drill anyone who doesn't need a line RIGHT fucking now and there's no option., I've also seen people start IV's in less time than it takes to set up/start an IO, but they have their place.
     
    Last edited: Dec 13, 2013
  19. Dec 18, 2013 at 4:53 AM
    #1339
    TacoMX

    TacoMX TW's Official anti body-lift pundit

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    Text book "shark fins" on ETCO2 wave form on a pt w/ bronchospasm secondary to COPD exacerbation.

    [​IMG]
     
    Last edited: Dec 18, 2013
  20. Dec 19, 2013 at 4:15 PM
    #1340
    Mitch

    Mitch Somebody call for a Wambulance?

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    Nice. What monitor is that on? I like the time stamps
     
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