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  1. EMTinNEPA

    External jugular

    At least for a cardiac arrest in the field, always EJ. You can kneel at the head, turn it to the side, stick the EJ, straighten the head out, place your advanced airway, and voila, everything ALS is from the neck up. No worrying about compressors on either side getting caught up in your tubing...
  2. EMTinNEPA

    in trouble

    Sounds like your supervisor is unfamiliar with how legal disciplinary action actually works. The first question is if you were grossly negligent. The second question is if the patient had a negative outcome. The third question is if the negative outcome was a direct result of your...
  3. EMTinNEPA

    CCEMTP Program

    CCEMTP is a decent course from what I have heard. However, the course only serves as an introduction to true critical care transport. I would only take the course to help me prepare for the CCP-C exam which, as opposed to CCEMTP which is just a completion certificate, is an actual certification.
  4. EMTinNEPA

    Pain Control

    I would rather be duped by a thousand seekers than not give pain medication to one person who needed it.
  5. EMTinNEPA

    Pulling the plug on EMS

    WARNING: The following post was authored by an extremely sleep-deprived EMTinNEPA. If anything typed sounds like the scribblings of a crazy person, that is why. This entire thread has made me lol. Nothing but two sides setting up strawman after strawman against each other. "I think...
  6. EMTinNEPA

    Alright smart people, name that EKG

    Right ventricular Smith twitters with junctional mid-stem atrial frustration beats.
  7. EMTinNEPA

    So I'm sitting in AMLS class...

    Oh. My bad.
  8. EMTinNEPA

    So I'm sitting in AMLS class...

    Magnesium sulfate can act as a bronchodilator and is associated with a lower rate of hospital admission. While is it shown to be effective in treating bronchospasm, it's not indicated in mild asthma exacerbations. Glucagon has long been an "accepted" off the label medication for a beta...
  9. EMTinNEPA

    scenario question

    Leave the helmet in place unless it makes inline cervical immobilization impossible or there is airway compromise.
  10. EMTinNEPA

    medics with attitudes

    My former service routinely had two paramedics on a truck. Now that we've merged with another service and are significantly larger, it's much less common, but it still happens. The side benefit is we now always have a supervisor or two for back-up.
  11. EMTinNEPA

    what the heck happened to my pt. today?

    Sepsis sucks. It sounds like this patient went into cardiac arrest secondary to septic shock. Was the patient tachypneic and tachycardic prior to arresting? EDIT: when you find out the specific cause of death, please let us know. This sounds like an interesting case.
  12. EMTinNEPA

    Bizarre Cardiac Case

    Jimi, you are correct that pericarditis typically presents with diffuse, global, non-diagnostic ST segment elevation. Typically, the patient will also be febrile. This presentation suggests pericardial tamponade, although one would suspect jugular venous distension. The other two components...
  13. EMTinNEPA

    "Jail Nurses Are A Pain In The Butt". OK, and here's why:

    True story on a call to the prison in our coverage area... "So what's going on with this gentleman today?" "Chest pain." "Ok. When did it start?" "45 minutes ago." "Did you do anything for him?" "We did an EKG and put a 22g in his right wrist with half normal saline KVO."...
  14. EMTinNEPA

    Medic School is like hell...with lunch breaks...

    A common conversation that took place in my class... "I would (insert intervention here)." "You just killed your patient." "Why tonight, sir?"
  15. EMTinNEPA

    burning hatred for transfers

    To be fair, I believe the "what? you're in pain?" section of his post was still part of his "it's not like I..." statement, and thus reflects what he believes to be poor patient care. As he should. I actually enjoy IFTs. When I was an EMT, I absolutely hated them until I realized that they...
  16. EMTinNEPA

    38 year-old male altered mental status

    My treatment of this patient consisted of IV fluids, O2, and 12- and 15-leads... when the patient's pressure did not respond to oxygen and fluids, I administered 2mg of Naloxone. Within a few minutes, the patient was considerably less lethargic. His pupils dilated to 6mm and his pressure rose...
  17. EMTinNEPA

    EMS and relationships

    My current girlfriend is a part-time EMT for the service I work at, which doesn't really concern me all too much since she's in PA school.
  18. EMTinNEPA

    38 year-old male altered mental status

    Sorry, all. Busy night at work. Blood glucose is 135mg/dL. 12-lead shows sinus tachycardia without ectopy and does not indicate any type of cardiac event. No headache. No blurred vision. No trauma involved here. When asked where the patient's medications are kept, the family does not know, and...
  19. EMTinNEPA

    Monitoring Mode vs Diagnostic Mode

    Basically, the short answer is that monitoring mode focuses on an accurate count of QRS complexes to provide you a heart-rate. Diagnostic mode focuses more on quality tracings and (especially) the ST segment. As far as I know, the only way to get a diagnostic quality tracing is to do a 12-lead.
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