Favorite EMS Street Tricks

Jay

Jay

Forum Lieutenant
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Good evening/morning/afternoon,

I am curious what some of your favorite "street tricks" are, the kind of stuff that they don't teach during certification but that you quickly discover in one way or another are valuable resources when it comes to saving both time and headaches.

These are a few of my favorite things (aside from cream colored ponies and crisp apple strudels):

  • Giving a little O2 to someone with anxiety as it will calm them down. A couple LPM via nasal cannula along with a smile can work wonders.
  • Looking, Listening and Feeling in one shot. This one is definitely not recommended if you are trying to certify as there is no separation from the A's to the B's to the C's.
  • Quickly making a PB&J sandwich and giving a glass of OJ to the diabetic patient as you try to convince him that he should get checked out.
Now I am curious what y'all have to say...
 
M

MDA

Forum Lieutenant
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Jay said:
  • Quickly making a PB&J sandwich and giving a glass of OJ to the diabetic patient as you try to convince him that he should get checked out.
Click to expand...

Lol, seriously?

You just make yourself at home and have time to go through their kitchen find a plate, bread, peanut butter, and jelly and whip them up a sandwich?
 
M

MrBrown

Forum Deputy Chief
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MDA said:
Lol, seriously?

You just make yourself at home and have time to go through their kitchen find a plate, bread, peanut butter, and jelly and whip them up a sandwich?
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Absolutely! Brown is always being told how nice and friendly he is and how he should just go ahead and do what needs to be done :D

It's a great way to recommend they stay at home and save transporting them provided they are not chronically hypoglycaemic or did something silly like had a seizure.
 
M

MDA

Forum Lieutenant
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MrBrown said:
Absolutely! Brown is always being told how nice and friendly he is and how he should just go ahead and do what needs to be done :D

It's a great way to recommend they stay at home and save transporting them provided they are not chronically hypoglycaemic or did something silly like had a seizure.
Click to expand...

Your whole third person persona is killing me.
:unsure:
 
OP
OP
Jay

Jay

Forum Lieutenant
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OP
OP
Jay

Jay

Forum Lieutenant
132
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0
MDA said:
Lol, seriously?

You just make yourself at home and have time to go through their kitchen find a plate, bread, peanut butter, and jelly and whip them up a sandwich?
Click to expand...
Sure. The sandwich is for me because convincing them may take some time and I am a fairly big guy that enjoys a bite every now and then.

That being said and considering that they are going to be a little out of it from their hypoglycemic condition I highly doubt that the patient will mind me playing Chef Ramsay while talking them into seeing someone with a bit more training than myself.

On a more realistic note I actually had an instructor tell me to do this the day before my state exam, during our practical drills. Lucky for me I guess the scenario didn't come up at the regional testing center.
 
4

46Young

Level 25 EMS Wizard
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MDA said:
Lol, seriously?

You just make yourself at home and have time to go through their kitchen find a plate, bread, peanut butter, and jelly and whip them up a sandwich?
Click to expand...

More often than not, someone at the residence other than the pt called 911. You just ask if they wouldn't mind bringing in a quick glass of juice, then after their BGL gets to WNL, then the PB & J to keep hopefully keep it stable. Bseides, it's easier to choke on a tube of glucose than it is on a liquid.
 
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OP
OP
Jay

Jay

Forum Lieutenant
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46Young said:
More often than not, someone at the residence other than the pt called 911. You just ask if they wouldn't mind bringing in a quick glass of juice, then after their BGL gets to WNL, then the PB & J to keep hopefully keep it stable. Bseides, it's easier to choke on a tube of glucose than it is on a liquid.
Click to expand...

Thanks 46Young for agreeing with me :rolleyes:

You are right on the ball that some areas have this in their Pro/QA because for that same reason you will be spiking up the simple-carbs and also be introducing complex-carbs to the mix.

During my drill they were trying to trick me into thinking that he was insane but he was in-fact hypoglycemic. My only issue was that he said I wasn't being commanding enough and "telling" my patient what to do. I explained that the "patient" was a lot bigger than me and I don't command potentially insane people who can end up putting me on the second bus. The final bit of advice for me was to make the guy lunch while talking him into going for definitive care. I loved the idea. Besides, what are the alternatives, from a BLS standpoint you can give 15g of oral glucose (D-40) but how long is that going to last? Why not introduce complex carbs too? All the better if its going to take a while.
 
M

MDA

Forum Lieutenant
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46Young said:
More often than not, someone at the residence other than the pt called 911. You just ask if they wouldn't mind bringing in a quick glass of juice, then after their BGL gets to WNL, then the PB & J to keep hopefully keep it stable. Bseides, it's easier to choke on a tube of glucose than it is on a liquid.
Click to expand...


Asking a family member and doing it yourself are completely different.
 
EMT11KDL

EMT11KDL

Forum Asst. Chief
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MDA said:
Lol, seriously?

You just make yourself at home and have time to go through their kitchen find a plate, bread, peanut butter, and jelly and whip them up a sandwich?
Click to expand...

i have done it... i will admit to it
 
EMT11KDL

EMT11KDL

Forum Asst. Chief
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MDA said:
Asking a family member and doing it yourself are completely different.
Click to expand...

I asked the pt first... but most the time we have an office on scene also, they are really good at making pb j also hmmm..
 
firetender

firetender

Community Leader Emeritus
2,552
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I have every reason to trust that you first assessed the patient for allergies, including peanuts.

Don't I?
 
4

46Young

Level 25 EMS Wizard
3,063
90
48
firetender said:
I have every reason to trust that you first assessed the patient for allergies, including peanuts.

Don't I?
Click to expand...

On the one hand, if someone lives alone or if the family member goes along with it, one could infer that the pt isn't allergic to PB. On the other hand, I also get the occasional pt who eats something they shouldn't. It's usually " I forgot", "I only took a couple of bites" or "I thought it wouldn't happen this time". Job security I suppose.

That would be a good way to take a BLS conscious diabetic and turn it into an ALS billing scenario, with ETI and a few meds, and definitely a txp. $$$$$$! Just kidding.
 
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medicRob

medicRob

Forum Deputy Chief
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medicRob

medicRob

Forum Deputy Chief
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medicRob said:
Patellar Percussion


I originally learned this in nursing school, but noticed the other day when taking PHTLS that they are teaching this in EMS now.

More Info:

http://www.sma.org.sg/smj/4309/4309a5.pdf

http://www.ems1.com/ems-products/EMS-Equipment/articles/592414-Wait-a-Minute-You-Auscultated-What/
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This is a pretty good resource:

http://www.nxtbook.com/nxtbooks/elsevier/acep0707/index.php?startid=34

This is an approved practice:
"The Use of Auscultatory Percussion for the Examination of Fractures" (Lippman, 1932)
http://www.ejbjs.org/cgi/reprint/14/1/118
 
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mycrofft

mycrofft

Still crazy but elsewhere
11,322
48
48
The Litella Maneuver

http://www.youtube.com/watch?v=V3FnpaWQJO0&feature=PlayList&p=41821A7F60E4F3E2&playnext=1&index=3

As defined at Eastern Nebraska Ambulance Service, 1981, PM to Dawn shift Fri-Sat:

The Litella Maneuver, named for the character made famous by GIlda Radner on Saturday Night Live, is the act of being sent out Code3 (lights siren and distressingly fast driving), then quickly being called Code4 (shut it down and return), usually in traffic or late at night around people's houses. Accomplished in three steps:

1. Depart downtown station like a bat out of hell, driving around and against traffic in downtwon Lincoln.

2. Receive radio call, deactivate lights an siren.

3. Slink into closest place of refuge, like an alley, hospital driveway, mortuary driveway, ANYTHING, and act nonchalant.:blush:
 
mycrofft

mycrofft

Still crazy but elsewhere
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48
OK, now that the Great Peanut Butter Convention is concluded...

:ph34r:.........
 
adamjh3

adamjh3

Forum Culinary Powerhouse
1,873
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Quick trick: The big rolls of 2" tape make awesome cup-holders if you happen to be in a rig that doesn't have any.
 
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