# first call of the day is...



## titmouse (Jul 31, 2014)

Dialysis...


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## epipusher (Jul 31, 2014)

Day off so CoD.


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## TransportJockey (Jul 31, 2014)

Code


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## Handsome Robb (Jul 31, 2014)

TransportJockey said:


> Code




I figure that's probably how my first day back will start.

Refractory VF/Pulseless VT/Pulsatile VT is the most voted for.


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## TransportJockey (Jul 31, 2014)

Handsome Robb said:


> I figure that's probably how my first day back will start.
> 
> Refractory VF/Pulseless VT/Pulsatile VT is the most voted for.



Ours was a severely septic shock patient then coded and then came back and then coded again


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## UnkiEMT (Jul 31, 2014)

I took my niece down to the Caribbean sea and taught her how to swim first thing today, does that count?

Tomorrow I'll probably go for a dive...once I get over the hangover I'm planning to buy tonight.


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## chaz90 (Jul 31, 2014)

UnkiEMT said:


> I took my niece down to the Caribbean sea and taught her how to swim first thing today, does that count?
> 
> Tomorrow I'll probably go for a dive...once I get over the hangover I'm planning to buy tonight.


So you're saying last call is going to be more important than first call tonight?


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## rmabrey (Jul 31, 2014)

Overdose


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## wanderingmedic (Jul 31, 2014)

The pot of coffee, beaconing me.


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## Handsome Robb (Jul 31, 2014)

chaz90 said:


> So you're saying last call is going to be more important than first call tonight?




This right here is why I love Nevada.

There is no last call.


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## avdrummerboy (Jul 31, 2014)

Of today? A 2am transfer with a crazy lady!


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## kal0220 (Aug 1, 2014)

yesterday...seizure in the bathroom. wedged between the wall and toilet. naked from the waist down, except for socks.  tshirt and socks were soaked in urnine.  vomit and urine in his hair.  way to start the day!  at least it didn't get any worse after that!


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## titmouse (Aug 1, 2014)

Today it was IFT


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## TransportJockey (Aug 1, 2014)

Mine today was a fall w/ a broken arm. Got yelled at by the ED nurse for giving Dilaudid... Took great pleasure in telling her that my treatment modalities take precedence over her desires.


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## NomadicMedic (Aug 1, 2014)

The nurse doesn't believe in medicating fractures?


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## TransportJockey (Aug 1, 2014)

DEmedic said:


> The nurse doesn't believe in medicating fractures?



Not with narcotics. she was worried she wouldn't be able to assess mentation after we gave the narcotics... Me and my partner both went "huh?"


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## rmabrey (Aug 1, 2014)

The first run today was a psych transfer.  My first run was a fall.


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## Handsome Robb (Aug 1, 2014)

TransportJockey said:


> Not with narcotics. she was worried she wouldn't be able to assess mentation after we gave the narcotics... Me and my partner both went "huh?"




Yea since opiates automatically make you gorked no matter what. 

I've been off the box for 8 months but my first call on an ambulance was third unit into a single car rollover vs telephone pole and electrical box. We took the first patient that was extricated. Thank goodness my TO spoke Spanish.


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## DesertMedic66 (Aug 1, 2014)

First call today was a transport from a psych facility to the hospital to get the patient medically cleared because she had COPD (she had no complaint at all).

I don't remember my first call as an EMT anymore. If I really want to know I could just look in my file (types of calls you get during field training time are all documented).


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## MissK (Aug 1, 2014)

Chest pain.


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## titmouse (Aug 2, 2014)

SOB and chest pain and you know, add some obesity on top of that since I only got 5 hours of sleep.


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## rmabrey (Aug 2, 2014)

Tia


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## MonkeyArrow (Aug 2, 2014)

Lower leg pain. No fracture or other deformity confirmed by x-ray.


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## Rialaigh (Aug 2, 2014)

Standby...
and then Standby...
and then Standby....3 seperate times in the same location, 3 run reports...3 call numbers....winner winner


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## johnrsemt (Aug 3, 2014)

Domestic verbal,  oh wait,  first EMS call.,   never mind


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## Angel (Aug 3, 2014)

1 call in 24 hours....at the 15th hour...was a simple transfer.


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## rmabrey (Aug 3, 2014)

Pulled peg tube at a SNF


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## MrJones (Aug 3, 2014)

...also the last call of the day. 8 hour (round trip) transfer.


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## NomadicMedic (Aug 3, 2014)

It was a guy stung by a swarm of bees. Unconscious when the wife called 911. Neighbor had an epi pen and jammed him with it. Alert and talking when we got there. Bleeding from big hole in leg.


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## chaz90 (Aug 3, 2014)

It was nothing. Pulled a weekend daytime no hitter during the summer at a resort-ish station.


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## Anjel (Aug 3, 2014)

Double cardiac arrest. Boyfriend and Girlfriend Heroine OD in a parking lot.


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## DesertMedic66 (Aug 3, 2014)

Anjel said:


> Double cardiac arrest. Boyfriend and Girlfriend Heroine OD in a parking lot.



Well that's romantic...


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## Jim37F (Aug 3, 2014)

Mutual aid response into the neighboring city, ground level fall due to weakness. Unfortunately our patient was headed to the bathroom and couldn't hold it...it was number 2...and all over the poor guy by the time we arrived


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## chaz90 (Aug 4, 2014)

Anjel said:


> Double cardiac arrest. Boyfriend and Girlfriend Heroine OD in a parking lot.


Sounds like a trip. My record for a heroin OD flophouse remains 3. Every room we went into revealed a new respiratory/cardiac arrest.


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## exodus (Aug 4, 2014)

Unresponsive ETOH in a parking lot yesterday. I missed all the fun today though.


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## titmouse (Aug 4, 2014)

Dialysis


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## DieselBolus (Aug 5, 2014)

titmouse said:


> Dialysis



Do you really run dialysis that often? 

We only have a few dialysis patients, and unless you're :censored::censored::censored::censored:listed by dispatch, you won't get em. 

Gotta love punitive dispatching.


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## titmouse (Aug 5, 2014)

DieselBolus said:


> Do you really run dialysis that often?
> 
> We only have a few dialysis patients, and unless you're :censored::censored::censored::censored:listed by dispatch, you won't get em.
> 
> Gotta love punitive dispatching.



From what I know we only have a handful of dialysis patients, I just happen to get them


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## DieselBolus (Aug 5, 2014)

titmouse said:


> From what I know we only have a handful of dialysis patients, I just happen to get them



That's no fun. Sounds like a similar situation to my company. I find dialysis centers can be a total emotional drain. Though as long as the ambulance necessity is truly there, they are easy calls where you are absolutely making a difference in someone's life.


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## UnkiEMT (Aug 5, 2014)

DieselBolus said:


> Do you really run dialysis that often?
> 
> We only have a few dialysis patients, and unless you're :censored::censored::censored::censored:listed by dispatch, you won't get em.
> 
> Gotta love punitive dispatching.



Don't you budget for donuts for dispatch?

Every three months or so, take an appropriate amount in. Your life improves immensely.


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## titmouse (Aug 5, 2014)

Some of thise patients.really do need help though


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## DieselBolus (Aug 5, 2014)

UnkiEMT said:


> Don't you budget for donuts for dispatch?
> 
> Every three months or so, take an appropriate amount in. Your life improves immensely.



Of course! I've only been to a dialysis center once in the last six months and it was the wrong address in our page.


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## chaz90 (Aug 5, 2014)

Walked in the door to a cardiac arrest that our LUCAS didn't fit. Also, we got ROSC so we transported, whereas he promptly re-arrested, leading to one of my least favorite EMS activities of manual CPR in a moving ambulance.


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## NomadicMedic (Aug 5, 2014)

I heard that. :/ no fun.


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## titmouse (Aug 6, 2014)

Guess what? Dialysis again. LOL


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## NomadicMedic (Aug 6, 2014)

titmouse said:


> Guess what? Dialysis again. LOL




Quit. Immediately. 

Without delay. 

Leave now.


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## titmouse (Aug 6, 2014)

DEmedic said:


> Quit. Immediately.
> 
> Without delay.
> 
> Leave now.



Ha!


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## azbrewcrew (Aug 6, 2014)

Tricyclic OD


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## titmouse (Aug 7, 2014)

This is incredible. :rofl:


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## Carlos Danger (Aug 7, 2014)

azbrewcrew said:


> Tricyclic OD



Those are always fun


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## titmouse (Aug 14, 2014)

AMS to the ER


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## chaz90 (Aug 15, 2014)

titmouse said:


> AMS to the ER


Hey, not dialysis. Congratulations!


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## titmouse (Aug 16, 2014)

chaz90 said:


> Hey, not dialysis. Congratulations!


Moving on up!


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## TransportJockey (Aug 16, 2014)

Rollover w/ ejection. RSI and a quick drive to the hospital for blood before our fixed wing landed again


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## titmouse (Aug 16, 2014)

Dialysis but patient was in the hospital do call was cancelled and truck broke.


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## vcuemt (Aug 17, 2014)

Full arrest at 9am but it wasn't a DOA!


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## titmouse (Aug 21, 2014)

Wound care transport


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## EMT11KDL (Aug 22, 2014)

Back Pain


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## Anjel (Aug 23, 2014)

Anxiety


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## WildlandEMT89 (Aug 24, 2014)

Dialysis with a twist.


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## TransportJockey (Aug 25, 2014)

None yet. Been on flight since 1800 yesterday and so far all I've done is run errands and watch TV


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## titmouse (Aug 26, 2014)

Dialysis.


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## TransportJockey (Aug 26, 2014)

Urosepsis


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## FltMedicRob (Aug 26, 2014)

CVA/Stroke


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## WildlandEMT89 (Aug 26, 2014)

Chest pain and nothing but refusals since


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## chaz90 (Aug 26, 2014)

Started with CPAP and inline nebs, ended 11 hours later with CPAP and inline nebs (plus a random chest pain after, but that's not as symmetric).


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## WildlandEMT89 (Aug 27, 2014)

First ambulance on scene to major 3 vehicle mva with 2 immediate and 4 delayed. Luckily we had an engine arrive just prior to us.


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## Tigger (Aug 27, 2014)

Placental abruption. In the sticks even for us, the road wasn't on our maps. Husband came flying up to the ambulance screaming and led us in while letting us know in no uncertain times that the patient would be transported to X hospital when Y hospital is at least twenty minutes by ground and has a much more established high risk OB program. One of those "get em loaded and get going calls," we were on scene for four minutes. 

Thankfully we got a helicopter in variable weather, it would have been at least an hour emergent return.


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## Handsome Robb (Aug 28, 2014)

Tigger said:


> Placental abruption. In the sticks even for us, the road wasn't on our maps. Husband came flying up to the ambulance screaming and led us in while letting us know in no uncertain times that the patient would be transported to X hospital when Y hospital is at least twenty minutes by ground and has a much more established high risk OB program. One of those "get em loaded and get going calls," we were on scene for four minutes.
> 
> Thankfully we got a helicopter in variable weather, it would have been at least an hour emergent return.



There's one you don't see everyday.


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## titmouse (Aug 28, 2014)

Pulmonologist appt for trach replacement


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## WildlandEMT89 (Aug 28, 2014)

Possible OD pt refusal


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## Tigger (Aug 29, 2014)

Handsome Robb said:


> There's one you don't see everyday.


With twins no less.


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## titmouse (Aug 30, 2014)

Nausea wroth occasional vomiting,  ER trip


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## TransportJockey (Aug 30, 2014)

Car vs cow rollover w/ a HEMS flyout... at 0100 55 miles from my station


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## PotatoMedic (Aug 30, 2014)

So did you have steak for breakfast?


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## DesertMedic66 (Aug 30, 2014)

TransportJockey said:


> Car vs cow rollover w/ a HEMS flyout... at 0100 55 miles from my station


Did you fly out the driver or the cow?


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## TransportJockey (Aug 30, 2014)

DesertEMT66 said:


> Did you fly out the driver or the cow?


The driver. The cow will be making an appearance in our freezer once the rancher is done lol


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## DesertMedic66 (Aug 30, 2014)

TransportJockey said:


> The driver. The cow will be making an appearance in our freezer once the rancher is done lol


That's better than having a human make an appearance in the freezer....


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## TransportJockey (Aug 30, 2014)

DesertEMT66 said:


> That's better than having a human make an appearance in the freezer....


I'm sorry I can't make a comment in that. Statute of limitations hasn't expired yet


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## gonefishing (Aug 30, 2014)

Kid swallowed a silver dollar!


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## Handsome Robb (Aug 30, 2014)

Tigger said:


> With twins no less.



Wow. Someone has bad luck.



TransportJockey said:


> Car vs cow rollover w/ a HEMS flyout... at 0100 55 miles from my station



You're not allowed to post in here. Everything you run is high acuity and it makes me jealous :lol:



TransportJockey said:


> I'm sorry I can't make a comment in that. Statute of limitations hasn't expired yet



:rofl:



gonefishing said:


> Kid swallowed a silver dollar!



Poor little one. That's a huge coin!!! How old.

I'm counting down the days until I can tell y'all about my recycled virginity being broken. I just hope they're gentle.


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## gonefishing (Aug 30, 2014)

Handsome Robb said:


> Wow. Someone has bad luck.
> 
> 
> 
> ...


The coin or the kid? LOL


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## Handsome Robb (Aug 31, 2014)

Kid lol

I had a little tyke get her fingers stuck through the plastic top of a parmesan cheese bottle. Little one went nuts when I busted out the shears. Mom loosened up when she found out she wasn't going to end up spending thousands of dollars to remove her child's fingers from the cap of a cheese container haha.


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## gonefishing (Aug 31, 2014)

Handsome Robb said:


> Kid lol
> 
> I had a little tyke get her fingers stuck through the plastic top of a parmesan cheese bottle. Little one went nuts when I busted out the shears. Mom loosened up when she found out she wasn't going to end up spending thousands of dollars to remove her child's fingers from the cap of a cheese container haha.


9 with a crazy imagination.  Sucks about the parmesan bottle lol


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## rmabrey (Sep 1, 2014)

Handsome Robb said:


> Kid lol
> 
> I had a little tyke get her fingers stuck through the plastic top of a parmesan cheese bottle. Little one went nuts when I busted out the shears. Mom loosened up when she found out she wasn't going to end up spending thousands of dollars to remove her child's fingers from the cap of a cheese container haha.


Ive had that call before. No point in transporting when it can be fixed. 



In other news, yesterday was cardiac arrest in a grocery store. One shock PTA. 14 shocks by us. 8 more at the hospital. Finally called it after 3 hours from first responder cpr.  


Monday was 30% full thickness burns. Cancelled a helo requested by fire. Transported by ground (12 minutes to level 2 running hot). 

The black cloud has caught up to me


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## DesertMedic66 (Sep 1, 2014)

The last 3 shifts have just been BS calls for the majority. I don't even remember the first calls of the day. Hopefully tomorrow is an uneventful day. 

We did have a TC about a block away from our main deployment station the resulted in 2 DOAs, 1 critical, and 1 minor injury who was released on scene all from the same car. The car hit a traffic pole and split in two.


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## TheLocalMedic (Sep 3, 2014)

Got dispatched for what sounded like an grinder wreck, reports of a rollover into a tree with multiple ejections...  and it turned out to be a little non-injury bump into a fence...


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## WildlandEMT89 (Sep 3, 2014)

ETOH ALOC with heat exhaustion.


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## titmouse (Sep 3, 2014)

Dialysis


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## drl (Sep 3, 2014)

High school kid on a 5150 danger to self.


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## avdrummerboy (Sep 4, 2014)

Lift assist!

First real call, chest pains, actually a legit one too!


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## Jim37F (Sep 4, 2014)

Unconscious/unresponsive with snoring respiration and intermittent seizure activity

While that was the first call today, it was also the last call of a 24 hr overtime shift, went straight from there to my normal shift, first call of the shift was a 15 yr old who had a seizure on a school bus, but was postictal and ambulatory


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## rmabrey (Sep 5, 2014)

B/p of 60/42


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## STXmedic (Sep 5, 2014)

Nausea x3 days, two blocks from the hospital. Nothing new about the nausea today, either.


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## titmouse (Sep 5, 2014)

S/P septisimia discharge


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## jwoods (Sep 5, 2014)

Car fire


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## titmouse (Sep 6, 2014)

jwoods said:


> Car fire


Was it the Lexus on MacArthur?


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## Kiiso (Sep 8, 2014)

Dialysis !


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## LACoGurneyjockey (Sep 8, 2014)

15 month old vs full bath tub...


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## WildlandEMT89 (Sep 8, 2014)

"Overdose"


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## Tigger (Sep 8, 2014)

Hike in for a dehydrated 19 year old with a migraine in a cats and dogs kinda rain storm. They were only fifteen minutes from the trailhead and had given up. A quick pep talk and we were back up and walking (with assistance) to the ambulance. 

There is a reason I wear hiking boots and keep my rain jacket, an extra layer, and rain pants on the ambulance every shift. Except this one, where my rain pants were of course missing.


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## Jason (Sep 8, 2014)

1st call of last Sat - STEMI, that turned out not so much. But no surprise there, 25 y/oM, no Hx, however the drug use is a problem.
1st call of last Sun - Cold limb, loss of distal pulse.  
1st call of today - ACS. 
And by "call", I mean case, as I was working at the hosp.  EMS shift is later this week


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## titmouse (Sep 10, 2014)

AMS to ER. Somewhat hypotensive 100/56.


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## avdrummerboy (Sep 10, 2014)

This morning, a cancel!!! Beautiful


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## STXmedic (Sep 10, 2014)

High-risk warrant


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## Tigger (Sep 10, 2014)

A chronic alcoholic who was found "out of it" by housekeeping at a motel. She yelled and screamed at us for calling the cops despite telling us to close the door or the person who beat her up the previous night would kill her (of course she doesn't want to press charges). Asked for a hold (intoxicated, unsteady gait, rather poor mental status exam), got a refusal instead. As you wish...


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## Anjel (Sep 11, 2014)

Diff breather who left the hospital AMA 3 hours prior, because he didn't think it was that bad.


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## Jason (Sep 11, 2014)

1st call today -- AMS / Stroke/CVA.


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## TransportJockey (Sep 11, 2014)

rollover semi MVC w/ HEMS flyout


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## Rialaigh (Sep 11, 2014)

TransportJockey said:


> rollover semi MVC w/ HEMS flyout


 
One day sir I'm going to buy you a beer....and then I may kill you for your job...but just think about the free drink offer


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## TransportJockey (Sep 11, 2014)

Lol I'll always take free beer... and I'm rather hard to kill


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## Tigger (Sep 11, 2014)

90 minute incarceritis/ETOH transport. Patience lasted right up to till I started giving my report and the doctor came up behind me with "hey I'm talking to you, start over." He listened for ten seconds and then shook his head and walked away muttering. 

Sorry, not every patient is dieing to be saved.


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## titmouse (Sep 12, 2014)

S/P Bronchitis discharge


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## DesertMedic66 (Sep 12, 2014)

titmouse said:


> S/P Bronchitis discharge


You guys do a little bit of everything haha


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## Anjel (Sep 13, 2014)

Pt going to Detroit for J tube issues. Family insisted that it was blocked, but it was actually dislodged.

Daughter was kicked out of the ER because she stole a syringe and was flushing it with coke when the nurse wasn't looking. But since it was dislodged, she was just putting it straight into his pelvic cavity.


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## rmabrey (Sep 13, 2014)

Stroke.  Yesterday it was a hemorrhagic stroke.  Day before was a foot vs lawnmower with amputated great toe..........looks like that new medic black cloud has caught me.


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## TransportJockey (Sep 13, 2014)

Lift assist


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## chaz90 (Sep 13, 2014)

TransportJockey said:


> Lift assist


With a HEMS fly out?


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## titmouse (Sep 13, 2014)

DesertEMT66 said:


> You guys do a little bit of everything haha


Yes sir, indeed.


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## titmouse (Sep 13, 2014)

Today was dialysis catheter replacement


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## DesertMedic66 (Sep 13, 2014)

chaz90 said:


> With a HEMS fly out?


And RSI with a chest tube


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## Jim37F (Sep 16, 2014)

Traffic collision with rescue for a 2 vehicle TC with an overturned SUV...transported 1 patient BLS for a 1/2 inch laceration to the foot


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## titmouse (Sep 19, 2014)

Psych discharge


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## DesertMedic66 (Sep 19, 2014)

Drunk female patient who called 911 saying she was having chest pain. Get on scene and find her in her apartment completely naked and drunk.

Get her dressed up and she doesn't have any complaint aside from being wasted to the point she can't walk. Ended up having to restrain her after she tried to get off the gurney and take her cloths off multiple times.


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## CodeBru1984 (Sep 22, 2014)

29/F. Fall from bicycle during triathlon. Face impacted metal scaffolding that was along the triathlon route. Substantial laceration to the chin, dislodged right molar, copious amounts of blood both externally and in her mouth. No LOC, full recall of events, denies head/neck/back. Borderline hypertensive, tachycardic. Pale/Cool/Diaphoretic.

Due to MOI and the impact area however, we C-Spined her and called in an ALS transport unit from the city.


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## STXmedic (Sep 22, 2014)

I don't even remember...


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## Anjel (Sep 23, 2014)

STXmedic said:


> I don't even remember...


That's what old age does to you.


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## vcuemt (Sep 23, 2014)

Psych, disregarded by PD as I lifted my fist to knock on the front door


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## Medic Tim (Sep 24, 2014)

Lac to the back of my pts L hand that required 4 sutures to close. 
I always get a kick out of the "big tough guys" that are all tatted up turn into 8 yo girls at the sight of a needle.


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## titmouse (Sep 24, 2014)

ER trip, AMS with really bad congestion and cough.​


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## Anjel (Sep 24, 2014)

Yesterday was a 22 year old with a sore throat for 3 days that couldn't wait till morning to see his doc. Only lived 0.6 miles from the ER.


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## titmouse (Sep 25, 2014)

Wound care appointment.


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## Tigger (Sep 26, 2014)

I worked the overnight for some OT. Didn't turn a wheel. On my way home I came upon on T-bone rollover accident at the edge of or district. Got out and called 911 and then went over to the only patient who was pretty much fine, just freaked out. During my cursory assessment a woman ran over and just about pushed me out of the way exclaiming she was a nurse and began to refer to everyone as sweetie as she instructed everyone (including bystanders) to lay down and not move.  

I was still wearing my night uniform (agency t-shirt and ID badge). Thanks sweetie, I got it from here.


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## titmouse (Sep 26, 2014)

Severe weakness due to diarrhea. ER trip


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## azbrewcrew (Sep 27, 2014)

Psych, pt had end stage bi-polar


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## chaz90 (Sep 27, 2014)

azbrewcrew said:


> pt had end stage bi-polar



...What does this even mean?


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## azbrewcrew (Sep 27, 2014)

chaz90 said:


> ...What does this even mean?


It was meant as satire.


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## chaz90 (Sep 27, 2014)

azbrewcrew said:


> It was meant as satire.


Man, my sarcasm detector has been flat out broken for the last few weeks. Carry on everyone. Please ignore my inability to sense humor :/


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## TransportJockey (Sep 27, 2014)

Medic Tim said:


> Lac to the back of my pts L hand that required 4 sutures to close.
> I always get a kick out of the "big tough guys" that are all tatted up turn into 8 yo girls at the sight of a needle.


Hey I resemble that remark lol


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## titmouse (Sep 27, 2014)

Dialysis


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## DesertMedic66 (Sep 27, 2014)

17 year old female with a tib/fib fracture playing soccer. After 10mg of morphine she was still saying she had 9/10 pain but was laying on the gurney comfortably in no apparent distress.


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## exodus (Sep 27, 2014)

Nice way to start.


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## CodeBru1984 (Sep 28, 2014)

37 F. Unwitnessed fall on the trolley platform due to possible seizure like activity.


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## vcuemt (Sep 28, 2014)

SNF -> hospital


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## DesertMedic66 (Sep 28, 2014)

exodus said:


> Nice way to start.


12 calls total with 7 of them being ALS patients. Not a horrible way to start of medic internship


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## chaz90 (Sep 28, 2014)

DesertEMT66 said:


> 12 calls total with 7 of them being ALS patients. Not a horrible way to start of medic internship


Depends if you failed all 7 calls


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## DesertMedic66 (Sep 28, 2014)

chaz90 said:


> Depends if you failed all 7 calls


Well it was supposed to be my zero shift haha


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## surfinluke (Sep 30, 2014)

DesertEMT66 said:


> Well it was supposed to be my zero shift haha



I remember my "0" shift I had a different preceptor than who I was supposed to have. We had a car into a structure with I believe 6 patients. Great way to get started. And the preceptor thought it was my first shift and chewed me out good.


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## Angel (Sep 30, 2014)

transfer to a psych facility. lame but we had a couple code 3s so I guess that made up for it


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## titmouse (Oct 1, 2014)

Patient removed her pic line. Er trip. No bleeding.


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## Tigger (Oct 1, 2014)

No calls in two shifts aside from a monumental amount of crap to be done with the community paramedic program. I'm more tired after these shifts than any others.


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## Rick Tresnak (Oct 2, 2014)

COPD patient with a coughing Fit and Brochiospams.  Who after calming down...Refuses transport


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## DesertMedic66 (Oct 2, 2014)

911 to an assisted living facility for a male with back pain.

Said his back gave out and doesn't want to go to the hospital. Moved him from the couch to his chair and signed him out AMA.


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## titmouse (Oct 2, 2014)

Psych transport to the ER. The patient was completely out of it but he was fun.


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## titmouse (Oct 3, 2014)

S/p fall. Hospital discharge.


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## Tigger (Oct 3, 2014)

I'm not the person that wishes for calls, that's bad news. But I'm at the slow station and my vacation starts tomorrow and I have not run a call this set. Cabin fever...


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## 9D4 (Oct 3, 2014)

Pt w/ abd pain. She had an appendectomy 4 days prior and had walked almost a mile that morning to go shopping with her cousin.


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## Burritomedic1127 (Oct 6, 2014)

A DOA then right to another call for a stroke. Pt had slurred speech, pronator drift, and rapid Afib. Interesting morning for sure


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## shelvpower (Oct 7, 2014)

Yesterday
1st: Bicycle vs car... P2 patient.
2nd: Vehicle rollover with ejections 4xP2 patients.
3rd: Vehicle rollover down embankment through a concrete wall, 2xP1 patients.
Today(thus far)
1st: Vehicle versus truck, 1xP2 patient.


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## Handsome Robb (Oct 7, 2014)

First call in ten months is a mechanical fall with a fractured hip and refused pain management.


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## DesertMedic66 (Oct 7, 2014)

Handsome Robb said:


> First call in ten months is a mechanical fall with a fractured hip and refused pain management.


Now you broke your hip?! You have very bad luck haha


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## OnceAnEMT (Oct 8, 2014)

First ED walk in while I was on last night was a case of chicken breath secondary to abdominal pain. The good sir was sort of holding his breath because of the pain, family was freaking out (but negative hispanic panic). He was satting about 88%. NC O2 on board, coach breathing, solve that problem. Later Dx is kidney stone.


----------



## Handsome Robb (Oct 8, 2014)

DesertEMT66 said:


> Now you broke your hip?! You have very bad luck haha



Hahaha. I'd go ballistic. 

We're posted right now about an hour into a 16. Yesterday was pretty uneventful, we'll see what today brings.


----------



## TransportJockey (Oct 8, 2014)

Handsome Robb said:


> Hahaha. I'd go ballistic.
> 
> We're posted right now about an hour into a 16. Yesterday was pretty uneventful, we'll see what today brings.


Hope you have a nice slow.shift lol


----------



## vcuemt (Oct 14, 2014)

Hyperglycemia at an urgent care facility. 700.


----------



## DesertMedic66 (Oct 14, 2014)

Yesterday was an inferior STEMI at an urgent care


----------



## titmouse (Oct 21, 2014)

Femur fracture from fall.


----------



## Burritomedic1127 (Oct 24, 2014)

Good ole syncopal while taking a dump call


----------



## vcuemt (Oct 25, 2014)

Dialysis


----------



## Jim37F (Oct 25, 2014)

Postictal from seizure (GCS 1-1-1) incontinent (of course, fortunately only code yellow, no code brown)  laying fetal position on the floor next to his bed at the kind of SNF that makes you want to petition to ban the word "skilled"


----------



## DesertMedic66 (Oct 25, 2014)

N/V/D x 1 hour. 12mg Zofran had zero effect


----------



## Anjel (Oct 25, 2014)

You guys carry 12 of zofran? We have 8 and have to call for orders to give more than 4.


----------



## Angel (Oct 25, 2014)

we have 4mg vials and tabs but the most we can give is 16. our system is a mixture of rural/urban though so our protocols are fairly liberal in a sense.


----------



## DesertMedic66 (Oct 25, 2014)

Anjel said:


> You guys carry 12 of zofran? We have 8 and have to call for orders to give more than 4.


We carry a crap more than 12mg. The last time I looked we had 10 ODT and around 8 4mg vials. Our standing orders are for 12mg max total before base contact


----------



## titmouse (Oct 25, 2014)

Dialysis


----------



## vcuemt (Oct 26, 2014)

titmouse said:


> Dialysis


We've come full circle


----------



## TransportJockey (Oct 26, 2014)

DesertEMT66 said:


> We carry a crap more than 12mg. The last time I looked we had 10 ODT and around 8 4mg vials. Our standing orders are for 12mg max total before base contact


Do y'all not carry phenergan? I've noticed that for patients who are actively puking it works better. Zofran is amazing for nauseous patients though


----------



## Carlos Danger (Oct 26, 2014)

DesertEMT66 said:


> N/V/D x 1 hour. 12mg Zofran had zero effect



12 mg? Really? 

Zofran doesn't work in those situations.


----------



## DesertMedic66 (Oct 26, 2014)

TransportJockey said:


> Do y'all not carry phenergan? I've noticed that for patients who are actively puking it works better. Zofran is amazing for nauseous patients though


Negative. Our only option is zofran. 



Remi said:


> 12 mg? Really?
> 
> Zofran doesn't work in those situations.


I've had mixed results with doses up to 12mg. It either works extremely well or doesn't work at all.


----------



## Carlos Danger (Oct 27, 2014)

DesertEMT66 said:


> I've had mixed results with doses up to 12mg. *It either works extremely well or doesn't work at all.*



I'm not surprised that has been your experience. Studies (and overwhelming anecdotal evidence) show that repeated doses have very little efficacy.

Because ondansetron has a relatively slow onset (10-30 minutes), I think what people are often seeing when repeat doses appear to work is just the first dose finally taking effect. You see the same thing with morphine when you dose it every 3-5 minutes....people end up getting huge doses of it when the initial dose or two probably would have worked fine, had they just let it take effect before re-dosing.

Ondansetron is a great prophylactic, but not a good rescue drug at all.


----------



## DesertMedic66 (Oct 27, 2014)

Remi said:


> I'm not surprised that has been your experience. Studies (and overwhelming anecdotal evidence) show that repeated doses have very little efficacy.
> 
> Because ondansetron has a relatively slow onset (10-30 minutes), I think what people are often seeing when repeat doses appear to work is just the first dose finally taking effect. You see the same thing with morphine when you dose it every 3-5 minutes....people end up getting huge doses of it when the initial dose or two probably would have worked fine, had they just let it take effect before re-dosing.
> 
> Ondansetron is a great prophylactic, but not a good rescue drug at all.


We give zofran at 10-15 minute intervals.


----------



## teedubbyaw (Oct 27, 2014)

You can dance if you wanna

Dance dance if you wanna

Best med name ever.


----------



## Jim37F (Oct 28, 2014)

Dispatched to an unknown medical. The dispatch notes on the MDT said it was a 911 hangup and they are finding a translator to callback, arrive on scene to find an ambulatory middle aged male who spoke only Farsi, and just barely enough English to get across that he hadn't been able to urinate in like 3 days with associated abdominal pain we figured came from a full bladder unable to empty. A quick focused physical revealed nothing of note, vitals were all stable and normal limits (don't remember exact numbers, partially because nothing stood out as out of the ordinary) So we BLS'd him to the local hospital.

Why am I going into so much detail for a seemingly simple abdominal pain? Well because when we were at the same hospital dropping off a later call they tell us the guy had a dissecting AAA  Whats even crazier is that apparently after he got a Foley (to deal with the whole not being able to piss in three days thing) he AMA'd and left. Refused any treatment for the AAA...Not only that but his medical records showed he was at another hospital a few days prior, and they wanted to do emergency surgery for it and he refused that. Yikes.


----------



## jwoods (Oct 29, 2014)

Hanging
54 y/o male found in the morning by spouse, backyard tree with an extension cord


----------



## teedubbyaw (Oct 29, 2014)

jwoods said:


> Hanging
> 54 y/o male found in the morning by spouse, backyard tree with an extension cord



Good halloween decoration.


----------



## 9D4 (Oct 31, 2014)

Seizure resulting in a MVC. Then another seizure. Then an ecclamptic seizure. All in a row.


----------



## Jim37F (Oct 31, 2014)

Chest pain at the dialysis center


----------



## DesertMedic66 (Oct 31, 2014)

Nothing at all. 12 hours of watching movies on my laptop haha


----------



## 9D4 (Nov 1, 2014)

Guy got his neck slit by his ex. Lucky dude.
5 inch or so lac, she started up by the masseter muscle and hooked down right across the jugular. Could literally make out the jugular vein and she didn't nick it at all. 
Captain noticed some wax in the wound and he asked about it and the guy was like "she cut me with a candle holder". Raised my eyebrows at least.


----------



## vcuemt (Nov 1, 2014)

Scheduled dialysis run.

We get there and the patient is unresponsive (unbeknownst of course to the staff) and bradycardic.

Reroute to ER.


----------



## titmouse (Nov 6, 2014)

Today I was driving but the first call was a discharge.


----------



## DesertMedic66 (Nov 6, 2014)

Chest pain from a fall. Medic student on scene for fire decided to go down the ACS protocol and gave ASA, nitro, and O2 (not sure why, 18 bpm, sating 99% RA, clear lungs, no SOB). I decided to go down the slip and fall route and just BLSed the patient to the ER. 

Patient stated the sharp chest pain started after he hit the ground with his chest.


----------



## teedubbyaw (Nov 6, 2014)

That can be a bad mistake to make for that student.


----------



## titmouse (Nov 6, 2014)

Dialysis


----------



## vcuemt (Nov 6, 2014)

DesertEMT66 said:


> Chest pain from a fall. Medic student on scene for fire decided to go down the ACS protocol and gave ASA, nitro, and O2 (not sure why, 18 bpm, sating 99% RA, clear lungs, no SOB). I decided to go down the slip and fall route and just BLSed the patient to the ER.
> 
> Patient stated the sharp chest pain started after he hit the ground with his chest.


Not often the first thing to hit the ground is your chest.


----------



## DesertMedic66 (Nov 6, 2014)

vcuemt said:


> Not often the first thing to hit the ground is your chest.


Knees hit first followed by chest and then head


----------



## Burritomedic1127 (Nov 6, 2014)

Legit closed femur fx sp tripping on slippers in a kill nursing home.....I mean skilled nursing home


----------



## Angel (Nov 6, 2014)

vcuemt said:


> Not often the first thing to hit the ground is your chest.



Oddly enough. I know of a school around here that teaches them to treat symptoms. Ie patient has chest pain? Treat it! 
My understanding is the etiology of the complaint or actual assessment of ruling in/out various diseases isn't stressed. 
Sounds like a dangerous way to teach students. 

Anyway, my first call was basically a transfer. Super hostile slightly combative man. Spanish speaking only, suspected hypoglycemia but he REFUSED to let us touch him or even get a BP. I wasn't going to fight him so we went BLS.  Blood sugar in the ER was 30-something.


----------



## Chewy20 (Nov 6, 2014)

Refusal, refusal, big MVC, K2 smoker, Difficulty breathing. 5 calls in 24 hours, Ill take it.


----------



## Handsome Robb (Nov 6, 2014)

Yesterday was a 9 car pile-up on the freeway including a double trailer semi. 2 yellows, two greens and 10 AMAs. I was the first transporting ALS unit in and as the medical authority in our county ended up as medical group command, didn't build a huge ICS though but it's the best way to describe my roll.

Cool call actually even if I didn't end up providing any hands on patient care.


----------



## vcuemt (Nov 8, 2014)

Dialysis. Second call was the B leg.


----------



## STXmedic (Nov 8, 2014)

Shooting. Luckily the shooter was apparently a former storm trooper... 16 rounds fired, and only a single hit to the calf.


----------



## harold1981 (Nov 8, 2014)

a 48yo with a panic attack. No history, no specific complaints besides the classic hyperventilation symptoms and sats of 100%. However the EKG reveals a large STEMI (inferior, posterior, anterior and lateral) with hypotension. We stabilized him with fluids and loaded him with all the pre-PCI meds and called in the FD to assist with evacuation. So far we have a laughing and joking chap with no chest pain, no nausea, good skin condition. Just a bit out of breath. A few minutes later he goes into Vfib. and stays there for a good ten minutes before returning to life.


----------



## ERDoc (Nov 8, 2014)

Though not as sexy as a shooting or a STEMI, the first pt of the day was strep throat.


----------



## titmouse (Nov 13, 2014)

Dialysis...


----------



## Handsome Robb (Nov 13, 2014)

Yesterday was a GSW to the chest I had to dart. 

Today a lift assist.


----------



## Burritomedic1127 (Nov 13, 2014)

A "chest pain" call that turned out to be 10 mins of ear pain prior to calling 911. After reading WebMD the pt then had ear pain that radiated to her chest. A whole lot different then chest pain that radiates to the jaw/ear


----------



## DesertMedic66 (Nov 13, 2014)

1 year old near drowning followed by a 12 year old seizure patient.


----------



## Handsome Robb (Nov 13, 2014)

DesertEMT66 said:


> 1 year old near drowning followed by a 12 year old seizure patient.



Sounds like you got the pedi cloud too.


----------



## DesertMedic66 (Nov 13, 2014)

Handsome Robb said:


> Sounds like you got the pedi cloud too.


Every shift I get at least 2 pedi patients. I've already had more pedi patients in 400 hours of medic internship than I have working for over 3 years as an EMT.


----------



## vcuemt (Nov 14, 2014)

First call was for a controlled bleed. Got disregarded.


----------



## Tigger (Nov 14, 2014)

I transported myself and my partner to the hospital for breakfast. And that was it.


----------



## DesertMedic66 (Nov 14, 2014)

25 year old female who crashed on her bike going 95mph. Had a dislocated finger that she reset herself and just wanted an ice pack from us.


----------



## titmouse (Nov 15, 2014)

More than likely is gonna be dialysis today... I will confirm.


----------



## harold1981 (Nov 15, 2014)

I seem to get all the GI-bleeds in these days :-(


----------



## Handsome Robb (Nov 15, 2014)

Yesterday morning was a croupy 9 year old.


----------



## vcuemt (Nov 15, 2014)

Dialysis A leg, Dialysis A leg, Dialysis B leg, Dialysis B leg

Sorry I thought this thread was "first four calls of the day are..."


----------



## Chewy20 (Nov 15, 2014)

Acute CHFer tacking away at about 176 due to his cocaine use. Went from having trouble breathing when we showed up, to being almost dead within a minute.

I think that was my first call last night. Idk.


----------



## titmouse (Nov 16, 2014)

In the end my partner for the day did not show up so I was sent home and went mountain biking.


----------



## Handsome Robb (Nov 16, 2014)

Tonight was an A-flutter patient with chest pain.


----------



## Anjel (Nov 16, 2014)

Guy just had a cervical spinal fusion surgery. Was at a buddies.... Drank 13 beers. Bent over to pick up beer out of cooler and tumbled over onto his face. Had numbness and tingling from the neck down.


----------



## grind time medic (Nov 17, 2014)

IFT, with an elderly patient breaking in a new hire


----------



## shelvpower (Nov 17, 2014)

2 vehicle mva. One crossed the road and a GTI doing 185kmph in a 80kmph zone obliterated the poor Honda. 2 DOAs and 2 red codes. The people in the GTI was unharmed


----------



## Angel (Nov 17, 2014)

Apparently we are a shuttle service. Taking a perfectly fine couple to the airport 2 hours away. The flight company sent an ambulance instead of a black car for some idiotic reason. 
Yay me


----------



## CodeBru1984 (Nov 17, 2014)

Angel said:


> Apparently we are a shuttle service. Taking a perfectly fine couple to the airport 2 hours away. The flight company sent an ambulance instead of a black car for some idiotic reason.
> Yay me


Does that mean you had to fill out two PCRs for your "transport" to the airport?


----------



## Angel (Nov 17, 2014)

CodeBru1984 said:


> Does that mean you had to fill out two PCRs for your "transport" to the airport?



Just one since the husband is a ride along but I'm documenting why no assessment vitals ect was done and everything is "passenger" because this is absurd.
The "patient" sat in the front seat if that tells you how unnecessary an ambulance was for this transport.


----------



## CodeBru1984 (Nov 17, 2014)

Angel said:


> Just one since the husband is a ride along but I'm documenting why no assessment vitals ect was done and everything is "passenger" because this is absurd.
> The "patient" sat in the front seat if that tells you how unnecessary an ambulance was for this transport.


Simply ridiculous!


----------



## DesertMedic66 (Nov 17, 2014)

35 year old altered with a ruptured colostomy bag. You can say it was a........ S***** call


----------



## Handsome Robb (Nov 17, 2014)

SVT at 230 with a pressure of 72/xx. Almost got cardioverted but the 12mg did the trick.


----------



## TransportJockey (Nov 18, 2014)

Minor mvc. Starting my day by handing out narcotics


----------



## Burritomedic1127 (Nov 18, 2014)

Witnessed seizure while playing Goldeneye on Nintendo64


----------



## Tigger (Nov 18, 2014)

Traffic accident with person trapped at the high school. No one told us they were doing one of those DriveSmart demonstrations for the senior class and we arrived to find an ambulance already there. Said ambulance is brand new and does not have radios installed yet, and dispatch was not smart enough to air it as an "exercise page."


----------



## ERDoc (Nov 18, 2014)

Pelvic pain, "I think my baby's father gave me an STD," and a crappy sign out.


----------



## Jim37F (Nov 18, 2014)

ALOC at a SNF for a dementia patient more altered and lethargic than normal, cool and pale and despite a Hx of hypertension BP was 64/48. VOMIT - Vitals, O2, IV w/fluids, Transport


----------



## drl (Nov 18, 2014)

34-month pregnant patient from jail with possible contractions, G10/P1(!).


----------



## lightsandsirens5 (Nov 18, 2014)

Usually Dialysis or a transfer to Dr. Office for the children's nursing home in town.

Then 8-10 911 calls a day after that. Half of which are often to the same kids nursing home. :-/


----------



## Rick Tresnak (Nov 19, 2014)

Deer through the windshield, entrapment, with multiple injuries in 11 degree weather.  I HATE WINTER!


----------



## Handsome Robb (Nov 19, 2014)

Jim37F said:


> ALOC at a SNF for a dementia patient more altered and lethargic than normal, cool and pale and despite a Hx of hypertension BP was 64/48. VOMIT - Vitals, O2, IV w/fluids, Transport



Can anyone say Sepsis?


----------



## titmouse (Nov 20, 2014)

Dialysis...


----------



## Tigger (Nov 21, 2014)

Syncopal episode. Sure thing fire guys, go ahead and start a 16 on the slightly hypotensive dude with no complaints, why not right?


----------



## Angel (Nov 21, 2014)

wow lol.


----------



## shelvpower (Nov 21, 2014)

Electrocution... scaffolding touched overhead power lines... 1 DOA and one P1


----------



## STXmedic (Nov 21, 2014)

First call was... Wait, I'm on vacation!


----------



## vcuemt (Nov 22, 2014)

Dialysis!


----------



## titmouse (Nov 22, 2014)

Can you guess?


----------



## DesertMedic66 (Nov 22, 2014)

titmouse said:


> Can you guess?


Fractured uterus?


----------



## titmouse (Nov 22, 2014)

DesertEMT66 said:


> Fractured uterus?


As a matter of fact 3 days ago I was on ALS truck and we had a 24 yo (g5p4) female, 28 wks complication on 50 ml of mag with no foley. Stated having contractions every 5 to 6 minutes. Stated that it feels like she is about to get birth. Hauled *** for 40 miles (ift).. once we arrived at the receicong facility she was taked straight to the OR. The baby was delivered via c-section. If it took us a bit longer during transport we would have t9 deliver in the truck. The patient had a previous c-section which could have lead to a rupture of the uterus,  according to the OR nurse. And wrong the answer for todays call was dialysis.


----------



## Angel (Nov 22, 2014)

Dispatched to a fall on the street. Got on scene to some guy standing there, Apparently he needed a ride to the ER to refill his prescriptions so he tried to walk, then fell or tripped and called 911. Then asked why did we come lights and sirens -.-


----------



## TransportJockey (Nov 22, 2014)

Motorcyclist wreck with minor injuries


----------



## chaz90 (Nov 22, 2014)

Another of my signature arrests. Asystole from start to finish. I have now somehow not had a VF/VT arrest for the past two years...Don't even know how that's possible.


----------



## gotbeerz001 (Nov 22, 2014)

drl said:


> 34-month pregnant patient from jail with possible contractions, G10/P1(!).


That's a reeeaaaalllllllyyyyy long pregnancy.


----------



## Angel (Nov 22, 2014)

Lol I caught that too


----------



## Angel (Nov 23, 2014)

Angel said:


> Dispatched to a fall on the street. Got on scene to some guy standing there, Apparently he needed a ride to the ER to refill his prescriptions so he tried to walk, then fell or tripped and called 911. Then asked why did we come lights and sirens -.-



welp...we ended our shift with this same patient. he was assaulted, gcs of 9. lots of facial bleeding but a hair hypertensive.
its weird because if he never went to the hospital the first time i doubt the second incident wouldve occurred.


----------



## TransportJockey (Nov 23, 2014)

Yay psych call


----------



## Burritomedic1127 (Nov 25, 2014)

Quote from dispatch "Respond for the 90 yo F who is menstruating"........................


----------



## Handsome Robb (Nov 25, 2014)

IFT with saline and abx hanging  on a pump and 91% on 15lpm.

Yay pneumonia!


----------



## DesertMedic66 (Nov 26, 2014)

Yesterday it was a 7 week old who weighed 6 pounds with seizures. 

Our last call of the night was for a frequent flyer who was DOA.


----------



## teedubbyaw (Nov 26, 2014)

chaz90 said:


> Another of my signature arrests. Asystole from start to finish. I have now somehow not had a VF/VT arrest for the past two years...Don't even know how that's possible.



So did they survive?


----------



## chaz90 (Nov 26, 2014)

teedubbyaw said:


> So did they survive?


Appearing in this Sunday's episode of The Walking Dead...I had two more pronouncements this week than I had transports.


----------



## DesertMedic66 (Nov 26, 2014)

chaz90 said:


> Appearing in this Sunday's episode of The Walking Dead...I had two more pronouncements this week than I had transports.


So they are missing half their face?


----------



## Tigger (Nov 26, 2014)

chaz90 said:


> Appearing in this Sunday's episode of The Walking Dead...I had two more pronouncements this week than I had transports.


I don't think I've ever heard it that bad. I had one shift last year with 3 pronouncements and 2 refusals that I thought was bad...but not a week.


----------



## EMT11KDL (Nov 26, 2014)

Welfare check with PD, and EMS was not needed!!!


----------



## irishboxer384 (Nov 28, 2014)

Remote work- 4am awoken by rapid knocking on my door- "please come Hassan is sick!"
Hassan lying on the ground giving it the best hollywood display of a dying patient, complete with screaming and vocals. Having been through this scenario before with the locals I walk off and tell his 6 friends to bring him to the med room.

As expected all vitals wln...on palpation only complaints are mild tenderness below sternum and some mild spasming of lower abdomen. Patient c/o diarrhoea and 5/10 pain to LUQ. Pain relief, anti-diarrheals and anti-spasmodics given.

120 mins later Hassan is at breakfast smiling and laughing.

Conclusion from the past 12 months working with Africans- my baby daughter is tougher than the personnel on my project. 3 weeks to push then I can re-build my sanity.


----------



## Handsome Robb (Nov 29, 2014)

A puzzle of an unknown problem call that ended up being a schizophrenic episode.

Followed by flying out a status epilepticus patient.


----------



## Burritomedic1127 (Nov 29, 2014)

20 ft fall from ladder, landed feet first. Open tib/fib right leg with bilateral broken ankles


----------



## chaz90 (Nov 29, 2014)

Birth at ~30 weeks gestation, mom didn't know she was pregnant until she saw a head. Fortunately all was well and the kid started breathing on his own with a little bit of encouragement


----------



## MonkeyArrow (Nov 29, 2014)

In hospital, a shoulder pain pt. Vet aide who got into a tug-and-war with an animal apparently stronger than him. Tweaked something; no fractures or dislocations.


----------



## JamieN (Nov 30, 2014)

TransportJockey said:


> Do y'all not carry phenergan? I've noticed that for patients who are actively puking it works better. Zofran is amazing for nauseous patients though



I agree about the Zofran...It's good stuff. Woke up with the flu at midnight on Thanksgiving and had to take an ambulance ride. Got a tablet in the ambulance and a shot in the IV at the hospital and it worked fine.


----------



## vcuemt (Dec 4, 2014)

How has this thread gone this many days without an update? 

Accidental medical alarm activation


----------



## Burritomedic1127 (Dec 4, 2014)

Syncopal on the train, Pt was real hypotensive 56/38


----------



## Tigger (Dec 5, 2014)

Transfer from the Level IV to the city. Our community paramedic also transported our first patient direct to mental health facility, cool deal. 

The next community paramedic call happened right afterwards, he had a 40 minute response from the city back to the district for a drunk, who turned out to be schizophrenic high on meth who required ketamine to be controlled. A bit of an inglorious start, and yes that patient went by ambulance.


----------



## gotbeerz001 (Dec 5, 2014)

BGL 35


----------



## titmouse (Dec 5, 2014)

Fall from bed, 64 yo male hx of cva left sided deficiency. No contusions, states being in pain.


----------



## TransportJockey (Dec 5, 2014)

And the third rotor flyout for a badly fx open distal tib/fib


----------



## Tigger (Dec 6, 2014)

54 year old obese male. Started dead, remained dead.


----------



## Handsome Robb (Dec 6, 2014)

Tigger said:


> Our community paramedic also transported our first patient direct to mental health facility, cool deal.



We do that without Community Health Paramedics 

Today was a seizure with a history of epilepsy. Exciting stuff.


----------



## Jim37F (Dec 9, 2014)

Difficulty breathing out of a convalescent home, arrive to find patient tripoding, rapid deep breaths, normally a 4-4-6 GCS, currently 4-0-6 as she's not answering any questions...and on a simple mask at a whopping 4 LPM...


----------



## chaz90 (Dec 9, 2014)

Jim37F said:


> Difficulty breathing out of a convalescent home, arrive to find patient tripoding, rapid deep breaths, normally a 4-4-6 GCS, currently 4-0-6 as she's not answering any questions...and on a simple mask at a whopping 4 LPM...


Well, 4-1-6 at least  Rocks have a verbal response of 1.


----------



## Jim37F (Dec 9, 2014)

chaz90 said:


> Well, 4-1-6 at least  Rocks have a verbal response of 1.


Good catch. You'd think I'd have caught it since I had to translate mentally from my county's preferred E-M-V to the E-V-M  everyone else uses -_-


----------



## Tigger (Dec 9, 2014)

In line TA in front of school. The middle driver was in a rush to drop his kids off and forgot his O2 concentrator. Was satting in the 50s on our arrival but without complaint. We gave him a ride home and called it a fire refusal. Do like.


----------



## vcuemt (Dec 13, 2014)

Dialysis A leg

Guess what call two is?


----------



## titmouse (Dec 13, 2014)

vcuemt said:


> Dialysis A leg
> 
> Guess what call two is?


Ha! B2B Dialysis!


----------



## titmouse (Dec 13, 2014)

Psych transport to er today


----------



## Jim37F (Dec 13, 2014)

0200 traffic collision on the freeway, only injury was an ER physician on her way home from work who's ankle was trying to imitate a softball with how rounded it was


----------



## Angel (Dec 14, 2014)

My last call was decent  seizures, low blood sugar, but the d10 didn't stop the seizures....they had to RSI him and I'm not sure what happened after that.


----------



## Tigger (Dec 14, 2014)

Bile duct obstruction that the community hospital would not deal with till Monday.


----------



## nrfdfreal (Dec 15, 2014)

DKA


----------



## DesertMedic66 (Dec 15, 2014)

53 male who landed on his head from about a 12 foot fall. Fire tried to control bleeding with a pillow case, obviously didn't work. 

Code 3 to the trauma center.


----------



## CodeBru1984 (Dec 15, 2014)




----------



## Burritomedic1127 (Dec 16, 2014)

Pedestrian struck aka pt got their toes run over by a car


----------



## SandpitMedic (Dec 16, 2014)

CVA... Looks like a Pons bleed. Got to use the King Vision again.


----------



## Burritomedic1127 (Dec 17, 2014)

The life threatening chronic kneepain


----------



## chaz90 (Dec 17, 2014)

SandpitMedic said:


> CVA... Looks like a Pons bleed. Got to use the King Vision again.



How are you liking the KingVision? I've had mixed experiences.


----------



## DesertMedic66 (Dec 17, 2014)

48 female with 9/10 back pain after she sneezed yesterday. Patients husband is a retired medic. He wanted to know why we didn't give her pain meds. 

She was resting comfortably on our gurney and said she had no pain currently.


----------



## SandpitMedic (Dec 17, 2014)

chaz90 said:


> How are you liking the KingVision? I've had mixed experiences.



It certainly has taken some getting used to... But overall I like it. While it is a cool toy/tool, I feel like it takes away a lot of the skill involved. Very simple technique. 

It has worked every time on my first attempt where there is not emesis or excessive secretions..(knock on wood.) The lens of the camera gets blocked easily. Times like that I enjoy some good old suction and DL. 

I haven't had the chance to tube in about 5 weeks, but yesterday I used it twice in a day- two tubes in one day!


----------



## JBLS14 (Dec 17, 2014)

GOOD OLD 5150 call YAY!


----------



## TransportJockey (Dec 17, 2014)

Haven't had a call in almost 24 hours... I'm bored. Yesterday our only call was a cancel.


----------



## Tigger (Dec 17, 2014)

50yo female who recently had an ablation but was at a sinus rate of 160 and felt/looked awful. Sent to triage on arrival by the charge nurse (they were busy since the other Level II was on a divert) while there were still beds available. Such a choice resulted in quite the *** chewing for the charge by the attending.


----------



## titmouse (Dec 18, 2014)

Dialysis.


----------



## chaz90 (Dec 18, 2014)

titmouse said:


> Dialysis.



I think you have more dialysis transfers in a week than I have in the past 5 years.


----------



## DesertMedic66 (Dec 18, 2014)

chaz90 said:


> I think you have more dialysis transfers in a week than I have in the past 5 years.


I am very great full to be with a company who will not do dialysis transfers. The only time I have ever been in a dialysis center is for 911 calls


----------



## titmouse (Dec 18, 2014)

As first calls indeed.


----------



## Burritomedic1127 (Dec 24, 2014)

Stat transfer for a NSTEMI. pt's troponin was 6


----------



## vcuemt (Dec 24, 2014)

Dialysis. I hope everyone is having a safe and relaxing Christmas Eve! It's raining and 60 here in VA. :/


----------



## MonkeyArrow (Dec 24, 2014)

Shot themselves in the foot (no, literally. They were horsing around with a gun and never checked if it was loaded...)


----------



## Jim37F (Dec 24, 2014)

Shortness of Breath at a SNF...called in by the private BLS IFT company suppose to pick up the little old lady who was satting in the 70s on room air, cyanosis around the lips, fast shallow breaths, more altered than normal  (won't open her eyes or talk to you)...they put her on high flow O2 via NRB at 15lpm which brought her says up to 93%, made sure an RN was wit the patient and met us to give a report as we were walking up...Def better than some other calls from a local private company that'll do nothing until we show up


----------



## EMT11KDL (Dec 24, 2014)

Diabetic Refusal


----------



## titmouse (Dec 26, 2014)

Er trip for foley replacement


----------



## DesertMedic66 (Dec 26, 2014)

Psych. I'm BLS today so 99% of my calls will be psych holds.


----------



## STXmedic (Dec 27, 2014)

Today has been sick respiratory babies day


----------



## titmouse (Dec 27, 2014)

Ryder trauma discharge, s/p upper respiratory infection


----------



## Burritomedic1127 (Dec 27, 2014)

15 yo f 8 minute seizure due to AHC (alternating hemiplegia of childhood) with inconsistent laryngospasms. Family usually gives PO versed to break the activity but no dice today. Makes you wonder why all paramedics/agencies train and carry RSI meds


----------



## teedubbyaw (Dec 27, 2014)

Burritomedic1127 said:


> 15 yo f 8 minute seizure due to AHC (alternating hemiplegia of childhood) with inconsistent laryngospasms. Family usually gives PO versed to break the activity but no dice today. Makes you wonder why all paramedics/agencies train and carry RSI meds



That's an interesting one. How'd it go?


----------



## Burritomedic1127 (Dec 28, 2014)

teedubbyaw said:


> That's an interesting one. How'd it go?



Fortunately good. For a second the call could have taken a turn for the worse. The mom wanted us to give her valium or keppra, we don't carry either just ativan and versed. Everyone agreed on versed, which is the only drug we can use for a difficult airway situation. NRB 15L blood sugar 84 temp 98.6 sats were only in the mid 80s on high flow. Still nothing, mom know tells us she has been intubated multiple times with the use of paralytics by flight crews. Got the intubation kit ready and drawing up our last dose of versed when the seizure breaks. Been having a lot of calls recently where I was getting close to needing a paralytic because it was one of the last options before a cric. Our difficult airway protocol allows for 5mg versed with a med control option for fentanyl, pretty weak. Makes you wonder if all ALS providers should be trained and have RSI available.


----------



## teedubbyaw (Dec 28, 2014)

Sounds fun. 

A lot of medical directors don't trust their medics.


----------



## NomadicMedic (Dec 28, 2014)

No nasal intubation option?


----------



## Angel (Dec 28, 2014)

Afib RVR in the 170s
Mine was a trauma broken rib (s)


----------



## Burritomedic1127 (Dec 28, 2014)

teedubbyaw said:


> Sounds fun.
> 
> A lot of medical directors don't trust their medics.



Our medical directors trust us but they don't see eye to eye. Ones old with old school approach the other is younger with more relevant progressive protocols.



DEmedic said:


> No nasal intubation option?



Could have tried but who knows with the laryngospasms. Never actually tried nasal intubation. Also currently our med control docs frown on nasal intubation (this month)


----------



## titmouse (Jan 1, 2015)

Hospital discharge


----------



## EMT11KDL (Jan 1, 2015)

Lifealert for someone to talk too


----------



## rural medic (Jan 1, 2015)

D.O.S. Leo  and JP got there fast not a long wait nice change


----------



## Chewy20 (Jan 2, 2015)

Rollover. Truck was destroyed, two pts had a few lacs on hands. Not sure how that works. Seatbelts saved them.


----------



## titmouse (Jan 2, 2015)

CT scan roubd trip for local hospital


----------



## Angel (Jan 3, 2015)

Older lady syncope. Sat her up and went out again


----------



## DesertMedic66 (Jan 3, 2015)

Motorcycle rider down at ~80mph. Non injury.


----------



## Burritomedic1127 (Jan 3, 2015)

Diabetic seizure with a hx of brain cancer. BS was 497. Followed by 2 month old resp arrest, updated to CPR in progress, to find a perfect infant laughing and smiling at EMS on scene. The best call right there


----------



## titmouse (Jan 8, 2015)

Woundcare appt


----------



## gotbeerz001 (Jan 8, 2015)

Suicide attempt. Both wrists. Both sides of neck. G'marnin!


----------



## Burritomedic1127 (Jan 10, 2015)

Priest with chest pain. Let me tell you how careful I chose my words when asking about ED meds before the Nitro.....


----------



## NomadicMedic (Jan 10, 2015)

Burritomedic1127 said:


> Priest with chest pain. Let me tell you how careful I chose my words when asking about ED meds before the Nitro.....



"Father, have you taken any meds that help to elevate the Holy Spirit, if ya know what I mean"

Priest, looking confused. "No, I don't know what you mean."

"Ehh...Never mind. Any cialis, levitra or Viagra in the last 24 hours?"

Hahah. I can see this in my mind and I'm still laughing.


----------



## Handsome Robb (Jan 10, 2015)

had a 23 day old arrest the other morning. 38 week premie. No fun.


----------



## Burritomedic1127 (Jan 10, 2015)

DEmedic said:


> "Father, have you taken any meds that help to elevate the Holy Spirit, if ya know what I mean"
> 
> Priest, looking confused. "No, I don't know what you mean."
> 
> ...


Exactly haha. Definitely had to refine my questions and lock it up


----------



## TrueNorthMedic (Jan 10, 2015)

14 y/o male playing hockey. Shoved from behind face first into the boards. No LOC (helmets are a good thing). C/O neck pain.


----------



## NomadicMedic (Jan 10, 2015)

Burritomedic1127 said:


> Exactly haha. Definitely had to refine my questions and lock it up


----------



## MonkeyArrow (Jan 10, 2015)

58 y/o female with sudden cardiac arrest. She was jogging in a park when it happened too, regular runner. No significant PMH.


----------



## NomadicMedic (Jan 10, 2015)

ROSC?


----------



## titmouse (Jan 10, 2015)

Dialysis


----------



## MonkeyArrow (Jan 10, 2015)

DEmedic said:


> ROSC?


Regretfully, no. The whole situation was just weird though. Without going into too much detail, EMS found her in her car in the parking lot of the park unresponsive. They worked her 20 mins on scene and en route to ED. We worked her an additional 45. The only thing that we don't know is downtime on scene. We guess approximately 20 minutes, which may have been a deciding factor. 

BTW For people who say don't transport codes en route and etc., transport to our ED acted as a bridge to potentially life saving, definitive treatment not available in the field. In this case, evaluation for ECMO. Yes, our ED has a protocol in place and yes, in this specific case, critical care and cardiac surgery came down to the resus bay and evaluated the pt. for ECMO. They opted not to utilize it but still...


----------



## Handsome Robb (Jan 10, 2015)

If you have mechanical CPR during transport that makes sense. If it's manual, well we all know the efficacy of that in a moving unit.


----------



## RocketMedic (Jan 10, 2015)

Burritomedic1127 said:


> Our medical directors trust us but they don't see eye to eye. Ones old with old school approach the other is younger with more relevant progressive protocols.
> 
> 
> 
> Could have tried but who knows with the laryngospasms. Never actually tried nasal intubation. Also currently our med control docs frown on nasal intubation (this month)



We actually really seem to emphasize it here at Acadian.  Even have the nasal stethoscopes and endotrol tubes.


----------



## RocketMedic (Jan 10, 2015)

DesertEMT66 said:


> Motorcycle rider down at ~80mph. Non injury.


Lucky. I had a patient a while back who suffered an ultimately-fatal head injury at 60ish when he took his new sport bike out and wheelied to show off to his family. Saddest part was his full riding kit draped across his old bike. Would likely have turned a severe trauma into a "meh".



Burritomedic1127 said:


> Diabetic seizure with a hx of brain cancer. BS was 497. Followed by 2 month old resp arrest, updated to CPR in progress, to find a perfect infant laughing and smiling at EMS on scene. The best call right there


Indeed. I love those.

I had a decent stroke last shift-25 minute onset, incontinence,  aphasia, confusion and agitation with slight weakness to left leg and right arm. Pressure 230/100, glucose 104, atrial fibrillation. Initial NIH 14, transported to stroke center. We ended up transporting her later in the shift to an available ICU, thrombolytics reduced her NIH to 2 and she was only confused as to what had happened.  Made me feel great.


----------



## Burritomedic1127 (Jan 11, 2015)

RocketMedic said:


> We actually really seem to emphasize it here at Acadian.  Even have the nasal stethoscopes and endotrol tubes.


For CHF or trismus? Do you guys carry CPAP?


----------



## WildlandEMT89 (Jan 11, 2015)

First call of last shift was a adult code. No ROSC unfortunately.


----------



## Jim37F (Jan 12, 2015)

Little old lady, slip and fall, non injury, just wanted us to help her get back up. Once we got her up and to her walker, she was moving around the house better than some other people I've seen without one lol

Next call was our first actual patient we transported, 2 year old boy with a rather painful 2* degree burn injury after spilling a mug of hot tea on himself. Our medics estimated 16% burn area, base sent us past the local hospital (whose ER is county approved for pediatric patients) to Children's Hospital


----------



## titmouse (Jan 13, 2015)

MRI appointment


----------



## WildlandEMT89 (Jan 13, 2015)

Dispatched to code. Found to be a DNR when we got on scene


----------



## Burritomedic1127 (Jan 19, 2015)

Dispatched to the unresponsive at a hospice nursing home. Pt was responsive, valid DNR, health care proxy pissed EMS/FD is there, and 3 workers who barely speak English. Wonder where the problem started....?


----------



## Jn1232th (Jan 19, 2015)

Post...Post...then post again


----------



## RocketMedic (Jan 21, 2015)

Old lady head lac.


----------



## WildlandEMT89 (Jan 21, 2015)

RocketMedic said:


> Old lady head lac.



Classic


----------



## gotbeerz001 (Jan 21, 2015)

Wife stabs husband in face with kitchen knife...


----------



## Chewy20 (Jan 21, 2015)

This was on sunday.

Auto-ped on a road that speeds are usually between 50-60mph. Never seen so many deformities.


----------



## Apple Bill (Jan 21, 2015)

Last shift, it was...nothing.  Seriously went 12 hours with no calls.  Same for the other crew at our station.  Never happens.  Full night's sleep, I woke up in the morning worried I'd slept through something.


----------



## wannabeHFD (Jan 21, 2015)

Lift assist an hour away for a 500+lbs patient to and from a doctor's office...on a manual stretcher


----------



## Jim37F (Jan 21, 2015)

Major fall (due to reported head injury) a few blocks away, gave the guy a bandaid and cold pack for the scratch on his forehead and he ambled away refusing to let us do anything else, even take a set of vitals.


----------



## Tigger (Jan 21, 2015)

wannabeHFD said:


> Lift assist an hour away for a 500+lbs patient to and from a doctor's office...on a manual stretcher



I worked a bariatric car in Boston for a few weeks every now and again. Manual stretcher of course in a Type II. And a lift assist was not automatically dispatched which was pretty much the worst. If the patient needs the "wheelbarrow" (not PC, oh well), he probably needs a lift assist. 

First call yesterday was for a drunk who wanted to get help for his alcoholism. Which is great except that it was the fourth time I'd transported him in 72 hours...


----------



## Chewy20 (Jan 21, 2015)

Tigger said:


> I worked a bariatric car in Boston for a few weeks every now and again. Manual stretcher of course in a Type II. And a lift assist was not automatically dispatched which was pretty much the worst. If the patient needs the "wheelbarrow" (not PC, oh well), he probably needs a lift assist.


 
Sounds familiar. "B" is the first letter of that company lol.


----------



## Tigger (Jan 21, 2015)

And it rhymes with rooster. I have fond memories of being forced to lie down on the bench seat to get a BP since the patient took up every inch of the space between the bench and cot due to the "wings" being extended off the LBS cot. Awful. 

That call was a 6 hour wait and return from Brockton to the BI with a 550 pound individual with a dislodged colostomy bag. I almost quit. Happily the patient sent a thank you for our "professionalism" and George bought us lunch.


----------



## DesertMedic66 (Jan 22, 2015)

Called to a local homeless shelter for an assult. No patient was found. 

2nd call was for a TC/MVC involving a car and a city bus. 2 injuries, they both signed out AMA. 

3rd call was for a possible DOA. Fire made it on scene and called it. We were stuck at the entrance gate to the apartment complex waiting for fire to come and unlock it.


----------



## Jim37F (Jan 23, 2015)

Still alarmed a seizure on my day off. Walking up to the DMV, saw a guy on the ground in full body convulsions. My first thought walking up was "Oh (word moderators wont like)!" followed almost immediately by "Really? Another seizure, my first two calls the other day were both seizures!). I didn't really actually physically do much....911 was already called and security was there, but everyone was kind of freaking out so I did find myself coaching them through "Hey relax, just keep the guy from cracking his head open on the concrete until the medics get here" "You know CPR? Awesome, but he's still breathing so...." "No, please don't shove that paper towel in the guys mouth, sure you can use it to wipe up some of the spit and drool, but if you shove it in the mouth you'll block the airway and then we'll need to find the CPR guy..." Fire and medics show up a few minutes later, tell them what I witnessed and otherwise let them do their thing. I was feeling much more like a backseat driving lookie loo lol but the DMV staff were acting like me and this other guy (the guy who actually was keeping the guy's head from cracking open on the concrete) resuscitated him from a cardiac arrest, so as soon as we gave a report to fire, DMV took us straight to the window...so that was nice lol


----------



## teedubbyaw (Jan 23, 2015)

Jim37F said:


> Still alarmed a seizure on my day off. Walking up to the DMV, saw a guy on the ground in full body convulsions. My first thought walking up was "Oh (word moderators wont like)!" followed almost immediately by "Really? Another seizure, my first two calls the other day were both seizures!). I didn't really actually physically do much....911 was already called and security was there, but everyone was kind of freaking out so I did find myself coaching them through "Hey relax, just keep the guy from cracking his head open on the concrete until the medics get here" "You know CPR? Awesome, but he's still breathing so...." "No, please don't shove that paper towel in the guys mouth, sure you can use it to wipe up some of the spit and drool, but if you shove it in the mouth you'll block the airway and then we'll need to find the CPR guy..." Fire and medics show up a few minutes later, tell them what I witnessed and otherwise let them do their thing. I was feeling much more like a backseat driving lookie loo lol but the DMV staff were acting like me and this other guy (the guy who actually was keeping the guy's head from cracking open on the concrete) resuscitated him from a cardiac arrest, so as soon as we gave a report to fire, DMV took us straight to the window...so that was nice lol



Happened just like that.


----------



## Angel (Jan 23, 2015)

had an almost 3 hour LDT...one way...
my coworkers had code 3 after code 3
(CPAP, hypoglycemic and bradycardia, CPR)
and.... we got sent out of town again.

i really wanted a critical call, but got to spend 9 hours driving instead


----------



## Sunburn (Feb 19, 2015)

I got low sat patient in a nursing home. Pretty neglected patients, shame


----------



## DesertMedic66 (Feb 19, 2015)

Our favorite diabetic patient. Calls about once a day. No good veins left (even EJ) both legs have been fractured from multiple IOs. Glucagon doesn't work every time. All we can do for him is give him glucagon and transport. So far this year he has been to the ED more than 45 times .


----------



## Chewy20 (Feb 19, 2015)

Carbon monoxide, but there was no carbdon monoxide. There goes my golden wheel.


----------



## exodus (Feb 19, 2015)

DesertEMT66 said:


> Our favorite diabetic patient. Calls about once a day. No good veins left (even EJ) both legs have been fractured from multiple IOs. Glucagon doesn't work every time. All we can do for him is give him glucagon and transport. So far this year he has been to the ED more than 45 times .


He got a hair cut!


----------



## DesertMedic66 (Feb 19, 2015)

exodus said:


> He got a hair cut!


Yes he did haha. Glucagon actually worked this time


----------



## Emergency Metaphysics (Mar 3, 2015)

91-year-old male in full cardiac arrest at a nursing home. Fatality.


----------



## Tigger (Mar 3, 2015)

Called for a fall, found a man in the snow who was not injured and appeared to be in good help. Man said he did not want to risk getting up on his own, unsure what risk he was referring to. Notice the lack of the word "patient."


----------



## NomadicMedic (Mar 3, 2015)

Emergency Metaphysics said:


> 91-year-old male in full cardiac arrest at a nursing home. Fatality.



Those usually are, 99.995% of the time.


----------



## gotbeerz001 (Mar 4, 2015)

Emergency Metaphysics said:


> 91-year-old male in full cardiac arrest at a nursing home. Fatality.


Acute TMB?


----------



## TheLocalMedic (Mar 5, 2015)

What an amazing shift...  Two super BLS calls I could turf to my partner followed by a long, long nap for the rest of the shift.  Amazing.


----------



## Burritomedic1127 (Mar 7, 2015)

Breakfast...plenty of shift left though. Ill get back to you


----------



## Angel (Mar 7, 2015)

I was gonna say it's super early for breakfast, then I realized I'm a self centered Californian lol


----------



## Burritomedic1127 (Mar 7, 2015)

Angel said:


> I was gonna say it's super early for breakfast, then I realized I'm a self centered Californian lol


Never too early or too late for breakfast! Def breakfast time here in Boston, you must be up with the birds over there


----------



## Angel (Mar 7, 2015)

I've always hated waking up before 8! Now I work a lot of graves so I hate it even more lol 
Boston must be awesome to live in though!


----------



## Burritomedic1127 (Mar 7, 2015)

Angel said:


> I've always hated waking up before 8! Now I work a lot of graves so I hate it even more lol
> Boston must be awesome to live in though!


Boston is a great city just in small doses ha. Personally, i need to be more near mountains/water. The complete opposite of the concrete jungle at work. 

Working graves you have plenty of time for sleep the next day


----------



## Burritomedic1127 (Mar 7, 2015)

I knew posting about breakfast this morning was going to backfire... first 3 calls were 15 month old respiratory difficulties, stroke within timeframe, and a fall from a roof with LOC. Might as well as just said its going to be a nice and quiet shift


----------



## Leatherpuke (Mar 9, 2015)

I'll post my last three shifts, I work 24's.

Shift 1: Grandma fell down went boom, bruised hip. Only call for 24 hours.

shift 2: 24 hours with no calls.

Shift 3: Two hour round trip transfer for a 76 y/o female with CHF, A-FIB, Diabetes, and cardiomyopathy. Only call for 24 hours. 

 I love my job.


----------



## squirrel15 (Mar 13, 2015)

Leatherpuke said:


> Shift 1: Grandma fell down went boom, bruised hip.



So was it written LOLFDGB in your narrative. 

Calls? I don't know what those are anymore. 3rd 12 in a row with nothing. Oh well.


----------



## Angel (Mar 13, 2015)

This.

Pic won't post...but it was a ~1 minute run of pulsing vtach


----------



## Tigger (Mar 13, 2015)

STEMI at a bible college. 

Good call, but not my favorite place. Everyone is so nosy there and I would like to think that our interventions have some effect on the patient and it's not just the collective prayer helping the patient. I guess I'll go back to being an ambulance driver now.


----------



## Burritomedic1127 (Mar 14, 2015)

92 yo F with sudden 9/10 left sided non radiating chest pressure half hour before she called EMS. Complaint free when we got there. Looked better than 90% of people i see in the ambulance


----------



## DesertMedic66 (Mar 14, 2015)

Spider bite to the neck with SOB.


----------



## chaz90 (Mar 14, 2015)

DesertEMT66 said:


> Spider bite to the neck with SOB.


"SOB"


----------



## captaindepth (Mar 14, 2015)

Urban outdoorsman taking "molly" down by the river with some buddies.


----------



## Leatherpuke (Mar 15, 2015)

Had a good one today ( good is a relative term but you get it)

54 y/o female found unresponsive in her kitchen at 0700, last seen at 0030 so no telling how long she was down. History of SVT and fibromyalgia, polypharmacy including coumadin. 
 Call came in as a possible heart attack but she actually had a great rhythm on the 12 lead. Left lateral eye movement, responsive to pain only, unable to talk. 

 We suspected stroke and treated as such. Turns out she had 4 separate brain bleeds including one that was too deep for surgery. Very unlikely she will make it. 

 Worst part, her daughter was the RN at the ER when we arrived. Luckily we didn't say anything insensitive. Gotta be hard to work on your mom knowing she doesn't have much hope


----------



## Angel (Mar 16, 2015)

weird frothy, gurgling respirations and rapid afib...no hx of cardiac issues though


----------



## Akulahawk (Mar 17, 2015)

IIRC - last week when doing some EMS rides - both first calls of the day were for public assistance... Unfortunately I think it'll be a while before I get a chance to hop back on the ambulance for another day of fun & frivolity. (Or something!)


----------



## azbrewcrew (Mar 17, 2015)

N/V/D x 30 min...ambulated to cot, family followed in POV to hospital. PT straight to triage. I love my job.


----------



## kirky kirk (Mar 17, 2015)

IFT


----------



## NomadicMedic (Mar 29, 2015)

A guy who was sleeping and had some muscle twitches. His baby mama though "he be havin a seizure".

Nope. He not be havin a seizure. He be signing a refusal. 

Then I be havin coffee.


----------



## NomadicMedic (Mar 29, 2015)

Double post.


----------



## Chewy20 (Mar 29, 2015)

DEmedic said:


> A guy who was sleeping and had some muscle twitches. His baby mama though "he be havin a seizure".
> 
> Nope. He not be havin a seizure.
> 
> Then I be havin coffee.


 
Those are the types of calls I have had for the past two months. Slowly going insane...


----------



## Jim37F (Mar 29, 2015)

Dispatched for a diabetic problem, 90 yo male in a convalescent home with high blood sugar according to the MCT...get there and find the patient in cardiac arrest with staff doing CPR. 20 minutes of asystole later we called it. What a heck of a way to start a Sunday (or any other day for that matter)..


----------



## Chewy20 (Mar 29, 2015)

Jim37F said:


> Dispatched for a diabetic problem, 90 yo male in a convalescent home with high blood sugar according to the MCT...get there and find the patient in cardiac arrest with staff doing CPR. 20 minutes of asystole later we called it. What a heck of a way to start a Sunday (or any other day for that matter)..


 
Surprised they were doing CPR, and not saying "Not my pt"


----------



## medicaltransient (Mar 29, 2015)

Old Lady from Dialysis to home.


----------



## TrueNorthMedic (Mar 29, 2015)

34 y/o female slipped and fell on the icy sidewalk. Tibia fracture.


----------



## Tigger (Mar 30, 2015)

Standby for a neighboring district. Happily I am a part time employee there and have an access card so we put our truck in their bay and went upstairs and watched HBO for several hours. And "borrowed" some snacks.


----------



## Burritomedic1127 (Mar 30, 2015)

High probability head bleed. Lady told her husband how bad her headache was, then she dropped. Unconscious and vomiting when we got there


----------



## Jim37F (Mar 30, 2015)

Right leg pain plus ETOH...medics decided to ride in with us because the guy was cursing us out and generally not being cooperative....they didn't want my partner alone in the back if he decided to get violent. Fortunately with more than one provider in the back, he calmed down enough that they didn't need to break out any restraints or anything, heck by the time we transfered care at the hospital he was in "I love everyone" phase lol


----------



## MonkeyArrow (Apr 11, 2015)

Unable to move left leg. Labs and x-ray mostly normal, still working her up. Interesting in that she has had recent... cosmetic procedures done in that region.


----------



## Crabby Apple (Apr 16, 2015)

Infant full arrest, asystole throughout. Didn't need any coffee after that.


----------



## Akulahawk (Apr 17, 2015)

First "call" of the day where I work was a complaint of "cough." It only heralded the theme of the day... my patients were all pretty much respiratory. They were either cough or COPD exacerbation.


----------



## Anjel (Apr 18, 2015)

Lady had a pain pump placed Friday. Vomiting today. 

Another life saved.


----------



## DesertMedic66 (Apr 19, 2015)

ETOH pulled over on the side of the freeway. Refused medical treatment. Arrested by highway patrol.


----------



## Tigger (Apr 21, 2015)

A diabetic that I previously have run who was so DKA he did not even remember going to the hospital. This time he was doing better but rather weak. He was worse off I butchered a variety of IVs, some days I guess you can't win.


----------



## Amelia (Apr 21, 2015)

Crabby Apple said:


> Infant full arrest, asystole throughout. Didn't need any coffee after that.



Im so sorry.


----------



## NomadicMedic (Apr 21, 2015)

A fall, from the bathtub. At 10:30 this morning. 

I came on shift at 1700. Call at 1900. 

Patient presented with positive Samsonite Sign.


----------



## Anjel (Apr 21, 2015)

DEmedic said:


> A fall, from the bathtub. At 10:30 this morning.
> 
> I came on shift at 1700. Call at 1900.
> 
> Patient presented with positive Samsonite Sign.



Lol fantastic.


----------



## Tigger (Apr 25, 2015)

Getting fuel at the only gas station in town and the coca cola delivery guy comes running over. 

"Uhhhhh you guys are the ambulance right? Cause uh well if you're not busy or anything a guy just ran into the bathroom and there's blood everywhere." 

"Where is he bleeding from?"

"Well uh ummm back there." 
*gestures emphatically to his hindquarters.*

"Show Med 12 out with a GI bleed,  will advise if we need fire."

As it turned out the gas station looked like a horror movie. And not just the bathroom. They had to close for a good part of the day.


----------



## Jwan (May 2, 2015)

This is how my day starts.


----------



## NomadicMedic (May 3, 2015)

That looks like more paperwork than I want to do first thing.


----------



## Carlos Danger (May 3, 2015)

Tigger said:


> Getting fuel at the only gas station in town and the coca cola delivery guy comes running over.
> 
> "Uhhhhh you guys are the ambulance right? Cause uh well if you're not busy or anything a guy just ran into the bathroom and there's blood everywhere."
> 
> ...



Gross.


----------



## DesertMedic66 (May 3, 2015)

19 year old ETOH combative/yelling/screaming who walked into a tree face first at a rave. The event medical staff called us to to transport because she is altered (no surprise). In the back after restraining her she starts to hyperventilate. I asked her what she is doing and she said "I'm gonna make myself pass out". She didn't like my response of "that's fine"


----------



## NomadicMedic (May 3, 2015)

9 year old playing around at church. 3cm lac to the forehead. Bled like a stuck pig. 
BLS. 

Now, nap time.


----------



## Tigger (May 3, 2015)

"I smoked a bunch of weed and then got yelled at by my girl friend and now my chest hurts and I can't stop crying."


----------



## Amelia (May 4, 2015)

Jwan said:


> This is how my day starts.



Holy buckets of gravy.


----------



## Amelia (May 4, 2015)

Tigger said:


> "I smoked a bunch of weed and then got yelled at by my girl friend and now my chest hurts and I can't stop crying."



Here's the most important question... how much strength did it take you to keep from laughing you bum off?


----------



## Burritomedic1127 (May 4, 2015)

Disp to the unresponsive in a car, possible overdose. 

Pt was unresponsive, no overdose, with a blood glucose of 14. Lowest number I've seen. Im assuming 10 and under would read "Lo" on the glucometer?


----------



## Jwan (May 4, 2015)

Burritomedic1127 said:


> Disp to the unresponsive in a car, possible overdose.
> 
> Pt was unresponsive, no overdose, with a blood glucose of 14. Lowest number I've seen. Im assuming 10 and under would read "Lo" on the glucometer?


 
Depending on the glucometer but yea, below reportable range but usually the pt breathing like a fish out of water will give it away!


----------



## Tigger (May 5, 2015)

Amelia said:


> Here's the most important question... how much strength did it take you to keep from laughing you bum off?


All that I had. My partner and I had done one of those spartan races the day before so we were already reallllly struggling and that was not helping things. Dude never got off the floor for the entire interaction which further increased bizzaro levels.


----------



## Amelia (May 5, 2015)

Tigger said:


> All that I had. My partner and I had done one of those spartan races the day before so we were already reallllly struggling and that was not helping things. Dude never got off the floor for the entire interaction which further increased bizzaro levels.


youre my new hero. Most likely I couldnt stay professional.


----------



## Angel (May 5, 2015)

@Jwan, please tell us/me more about that call. Im so curious


----------



## Jwan (May 5, 2015)

Angel said:


> @Jwan, please tell us/me more about that call. Im so curious



What call?


----------



## Angel (May 5, 2015)

the super brady/sinus arrest call you posted the strip of.


----------



## Jwan (May 5, 2015)

Angel said:


> the super brady/sinus arrest call you posted the strip of.



Gotcha sorry just woke up and got on shift, it actually was very boring after that, pt stated she did not want chest compressions or intubation, this strip came when she was already in hospital, transferred to ICU and she passed a few hours later.


----------



## OnceAnEMT (May 5, 2015)

I'll tell you what though, as morbid as it sounds, watching a failing heart on the monitor has been one of the most intriguing experiences in the ED, and got me interested in electrophysiology. Hoping to do some more studying this summer and pick myself up on EKGs a bit after finals. We were holding patients in the ED due to a full house up stairs, so one of our crash rooms was occupied by a terminally ill geriatric patient that was essentially brought to us to die. I checked her monitor every 10-15 minutes as I could, watching her go in and out of idiopathic until it stuck and got slower and slower. It is just absolutely mind blowing that the physics can be measured, and you can explain what is happening and where with that measurement.


----------



## Leatherpuke (May 14, 2015)

I haven't had a call for 3 shifts now. I work 24's. Going for the record.


----------



## chaz90 (May 14, 2015)

Grimes said:


> I'll tell you what though, as morbid as it sounds, watching a failing heart on the monitor has been one of the most intriguing experiences in the ED, and got me interested in electrophysiology. Hoping to do some more studying this summer and pick myself up on EKGs a bit after finals. We were holding patients in the ED due to a full house up stairs, so one of our crash rooms was occupied by a terminally ill geriatric patient that was essentially brought to us to die. I checked her monitor every 10-15 minutes as I could, watching her go in and out of idiopathic until it stuck and got slower and slower. It is just absolutely mind blowing that the physics can be measured, and you can explain what is happening and where with that measurement.


I watched a living heart go into ventricular fibrillation during a donor organ harvest operation years ago. The chest was cracked open but the heart itself wasn't deemed suitable for donation, so I saw VF on the monitor for the first time at the same time I actually saw the heart itself stop contracting in an organized manner. 

Honestly, it was one of the coolest things I've ever seen in medicine and a major reason I'm a paramedic today. I was a senior in HS at the time and knew at that moment that I definitely wanted to work in the medical field.


----------



## COmedic17 (May 14, 2015)

"Explosive diarrhea" after drinking the laxatives in preparation for a colonoscopy the following morning. Wanted us to "make it stop".


----------



## NomadicMedic (May 17, 2015)

13 year old bit by a pitbull. Dog had no rabies vax record. 

Bad news for that dog.


----------



## Amelia (May 17, 2015)

I hope the boy's ok. 





DEmedic said:


> 13 year old bit by a pitbull. Dog had no rabies vax record.
> 
> Bad news for that dog.


----------



## NomadicMedic (May 17, 2015)

Amelia said:


> I hope the boy's ok.



He was fine. Had a small (<2cm) bite on his flank. He was more scared about what his mom was gonna do.


----------



## Amelia (May 17, 2015)

DEmedic said:


> He was fine. Had a small (<2cm) bite on his flank. He was more scared about what his mom was gonna do.



Was it -his- dog??


----------



## NomadicMedic (May 17, 2015)

Nope.


----------



## RedAirplane (May 17, 2015)

20 year old male dived into a 2 ft pool thinking it was much deeper.


----------



## DesertMedic66 (May 17, 2015)

Single vehicle roll on its side at around 50mph. non injury.


----------



## YoungMedic (May 21, 2015)

Diabetic problem, RP told dispatch that we could cancel and he was feeling better (enroute).  I ended up convincing crew to go anyways.  (Have ran on this pt before) Checked him out, he was fine.  Last time i gave him D50.


----------



## emsdave (May 24, 2015)

Syncope...that happened 3 days prior yes please call me out at 230 am to tell me you THINK you fainted but I might have had the typical "few beers" 3 days ago.


----------



## NomadicMedic (May 24, 2015)

YoungMedic said:


> Diabetic problem, RP told dispatch that we could cancel and he was feeling better (enroute).  I ended up convincing crew to go anyways.  (Have ran on this pt before) Checked him out, he was fine.  Last time i gave him D50.



Wait, what? The caller called back and said to the dispatcher "I feel fine and I don't want an ambulance", but you decided to go anyway?


----------



## Tigger (May 24, 2015)

First and only call at 0230 (after a day spent doing nothhhhing) was for a seven year old male with stabbing chest pain. Arrived to find a 70 year old male who indeed was having stabbing chest pain. And an anteriolateral MI. Launched the helicopter from the house, packed him up with the help of the volunteers who did a half decent job driving us to the LZ. Waited no more than 90 seconds for the helicopter to set down, handed him over, and back to bed we went.

Also, while I think on principle that hot loads are silly and likely rather unsafe considering how infrequently some of our fire guys work with the helicopter, I can't help but feel like I'm in top gun or something when we do them and I feel extra awesome.


----------



## captaindepth (May 24, 2015)

Cardiac Alert right out of the gate. First of 12 calls for the day.


----------



## NomadicMedic (May 24, 2015)

Respiratory distress, COPD and CHF. Saw a big improvement following CPAP. Before I got the report written, another call, inferior STEMI. 

We be doin' ALS son!


----------



## Jwan (May 24, 2015)

qqqqqxi


----------



## squirrel15 (May 24, 2015)

Jwan said:


> qqqqqxi


Call me new, but huh?


----------



## Jwan (May 25, 2015)

squirrel15 said:


> Call me new, but huh?


 Total accident... Don't really even know how that got posted, my pocket did a lot yesterday including opening this app and posting apparently.


----------



## YoungMedic (May 26, 2015)

DEmedic said:


> Wait, what? The caller called back and said to the dispatcher "I feel fine and I don't want an ambulance", but you decided to go anyway?



Yes, just the week before i went to the house for same problem.  Wife was trying to shove food down his throat with a BG in 30's.  Its a low income 1 bedroom place, pt doesnt have access to meter or meds.  Considering how bad he was last time i was there, gut feeling wanted to check on him.  We were 2 mins out anyways.


----------



## Burritomedic1127 (May 27, 2015)

54 yo M complained of sudden epigastric pain and dropped, cardiac arrest. This 12 is from the first ROSC. His heart was all over the place IVR, Afib, total heart block, sinus. Cathed sucessfully and being taken off pressors in the ICU now. Really hoping for good outcome


----------



## jlw (May 27, 2015)

MVC on interstate


----------



## Sean Torres (May 27, 2015)

Discharge for a 350 lb patient to home going upstairs


----------



## NomadicMedic (May 31, 2015)

GSW to the buttock/leg.


----------



## tonkseyboy (May 31, 2015)

42 yo M...unresponsive, no cardiac hx,wife said he had had chest pain during exercise for the last few days and planned to see his Dr tomorrow.Dispatch update enroute to bystander doing CPR.We had 2 trucks consisting of 2 paramedics,and 2 EMTs,also 1 First responder and an off duty EMT.Worked him on scene and was told he had a rhythm back enroute to the hospital...later heard he was transferred to the nearest cath lab.Hoping for the best


----------



## CALEMT (May 31, 2015)

Full arrest. Worked on the person for about 25 minutes before calling it. This happened when I was just eating breakfast this morning.


----------



## chaz90 (May 31, 2015)

Time for something a little more mundane...72 YOF, near syncope and "weak." Gave her some fluid and a duo-neb secondary to a minor COPD exacerbation. She was a funny lady and I had a good time talking to her. Gotta love the bread and butter


----------



## DesertMedic66 (May 31, 2015)

Yesterday it was a 89 year old male on blood thinners who fell, hit his head, and went to the urgent care. Urgent care called us out. B/P was 170/100, HR was 38 (sinus brady with a 1st degree and a LBBB), AOx4, with a complaint of a headache.


----------



## Tigger (May 31, 2015)

First time seizure, elderly man. Initially a difficult post-ictal state, turned out to be pretty nice dude.


----------



## NomadicMedic (Jun 1, 2015)

We changed ePCR software at midnight. At 0007, cardiac arrest. No kidding.


----------



## jogirl17 (Jun 2, 2015)

25 yr F who is 19 wks pregnant with syncope in the middle of a department store!


----------



## Jim37F (Jun 3, 2015)

Traffic collision, we were the 2nd (of 2) ambulances requested. Show up,  load up the patient, and the engine medic tries to transfer the ePCR from their iPad to ours (which is a standard procedure). Well it glitched and with the ePCR app on our iPad crashing, the medic lost patience and grabbed a paper form, wrote out a quick narrative in the box provided, handed it back to m3, asked if I could finish the rest...and thus I found myself writing my for st paper PCR in little over a year lol


----------



## Smitty213 (Jun 5, 2015)

Dispatched for a female "not breathing right"; roll up on scene to find ourselves a full blown STEMI.


----------



## DesertMedic66 (Jun 5, 2015)

First 3 calls of the day all syncopal episodes with the patient being hypotensive and tachy.


----------



## cruiseforever (Jun 5, 2015)

DEmedic said:


> We changed ePCR software at midnight. At 0007, cardiac arrest. No kidding.


 
What software are you using now?


----------



## NomadicMedic (Jun 5, 2015)

iPCR. it's okay so far.


----------



## emsdave (Jun 5, 2015)

31 yo f severe pain RLQ.


----------



## cruiseforever (Jun 7, 2015)

Seizure call.  Pt. diagnosed with Angelman Syndrome.  Google is my friend.


----------



## YoungMedic (Jun 7, 2015)

Train VS. Kid, DOA. Waited on-scene for Sheriff and BNSF.


----------



## RedAirplane (Jun 7, 2015)

YoungMedic said:


> Train VS. Kid, DOA. Waited on-scene for Sheriff and BNSF.



Tragic.


----------



## WildlandEMT89 (Jun 10, 2015)

ALOC. Pt found unconscious and unresponsive at snf. Coded enroute.


----------



## JohnTheEMT (Jun 10, 2015)

Got a call for a behavioral/suicidal . pt expressed hatred for cops and uncooperative. ended up restraining him. great call


----------



## harold1981 (Jun 16, 2015)

On nights. First call out: the young woman who has been possessed by demons and got repossessed by us with the help of 2.5 mg of midazolam.


----------



## NomadicMedic (Jun 16, 2015)

So that makes you a repo man.


----------



## ERDoc (Jun 16, 2015)

20-something female with several months of pelvic pain.


----------



## sirengirl (Jun 22, 2015)

First call yesterday: 5 vehicle MVC with entrapment and 3 trauma alerts, 2 of which were peds; their parent ended up having a T-injury and a dissecting aorta.

First call today: homeless 26 year old IV drug user with chest pain, curiously on the same exact spot where he has abrasions to his ribs from falling down drunk 2 days ago.

Most recent call today: menstrual cycle. Literally just on her period. No cramps, no heavy flow. Times 4 hours. Was in the shower "freshening up" when we arrived. When we took her to triage, she suddenly began to act like she was passing out. Report still given to triage nurse, who proceeded to bang her head on her desk twice.


----------



## Chewy20 (Jun 22, 2015)

sirengirl said:


> First call yesterday: 5 vehicle MVC with entrapment and 3 trauma alerts, 2 of which were peds; their parent ended up having a T-injury and a dissecting aorta.
> 
> First call today: homeless 26 year old IV drug user with chest pain, curiously on the same exact spot where he has abrasions to his ribs from falling down drunk 2 days ago.
> 
> Most recent call today: menstrual cycle. Literally just on her period. No cramps, no heavy flow. Times 4 hours. Was in the shower "freshening up" when we arrived. When we took her to triage, she suddenly began to act like she was passing out. Report still given to triage nurse, who proceeded to bang her head on her desk twice.



1st one sounds pleasant.

2nd one is the bane of my existence.

3rd one...smh


----------



## YoungMedic (Jul 6, 2015)

elder lady, mechanical fall


----------



## CALEMT (Jul 12, 2015)

Previous night (7/10) Auto vs. Ped (kid). AMA'd kid was fine other than a little road rash on his forearm. 
Last night (7/11) Traumatic Injury, jumped out of a car at 50mph and was also ETOH.


----------



## Amber Lance (Jul 12, 2015)

First and only call yesterday... 6-hour transport through southern AZ. (6 hours there, 6 hours back.) Air conditioning broke 90 minutes into the trip. Rage ensued.


----------



## DesertMedic66 (Jul 12, 2015)

Police pursuit on the freeway. Speeds of 160mph. Rolled twice after trying to avoid spike strips. 2 minor injuries and 1 moderate. Transported the 2 minor injuries with our supervisor behind us and 4 highway patrol units as an escort since the patients were in custody on felony charges.


----------



## Jim37F (Jul 12, 2015)

78 yo F actively seizing upon our arrival. Family described her as having minor seizures throughout the day but recovered within a couple minites until this one. Medics pushed midazolam, which stopped the seizing, but she remained unconscious/unresponsive for the trip to the hospital, GCS of 1-1-1. O2 sats were in the mid to low 80s, don't remember the rest of the vitals or HAM (Hx, allergies, meds) off the top of my head


----------



## Handsome Robb (Jul 12, 2015)

Ruh roh. Someone might have a big bleed....or just be a benzo lightweight.


----------



## Tigger (Jul 12, 2015)

Abdominal pain. Working for a place far from the hospital and fentanyl was only helping a bit, so it was a loud ride.


----------



## exodus (Jul 12, 2015)

DesertMedic66 said:


> Police pursuit on the freeway. Speeds of 160mph. Rolled twice after trying to avoid spike strips. 2 minor injuries and 1 moderate. Transported the 2 minor injuries with our supervisor behind us and 4 highway patrol units as an escort since the patients were in custody on felony charges.


What did I miss?!


----------



## DesertMedic66 (Jul 13, 2015)

exodus said:


> What did I miss?!


That day was crazy. Also had one of our brand new medics call in for RSO as they were transporting because the patients friend became combative in the back of the unit.


----------



## Tunamate (Jul 17, 2015)

Shark attack. Victim surfing in the local beach which is a fair distance from the hospital. Call came in morning an


----------



## Tunamate (Jul 17, 2015)

Stupid I pad send the message before i could finish. Apologies.
Young guy 21 surfer, most likely a great white took his leg from above the knee and a sizable chunk out of the right leg. Close call, kid nearly bled out but we managed go get him to a facility in time and he's doing well


----------



## cruiseforever (Jul 17, 2015)

Tunamate said:


> Stupid I pad send the message before i could finish. Apologies.
> Young guy 21 surfer, most likely a great white took his leg from above the knee and a sizable chunk out of the right leg. Close call, kid nearly bled out but we managed go get him to a facility in time and he's doing well


 
Every time I go into the ocean I feel like  I have joined the food chain.  Never get that feeling when walking in a forest.


----------



## Tigger (Jul 17, 2015)

Diabetic refusal (he treated himself) in the northern end of our district. And then to a 15 foot fall from ladder to driveway. Did not end well.


----------



## grind time medic (Aug 1, 2015)

first 24 hours shift

-diabetic issue

second 24 hour shift

-suicidal ideations


----------



## Jim37F (Aug 1, 2015)

This was about a week or so ago but....Full arrest, CPR in progress, by an LAFD dual medic ambulance. Address was reported as the cross streets of the freeway and a main road, that was about a block away from the city line....on the LA County line, opposite side of town from the LA City line. Definitely not a usual call lol, but before we get on scene we get cancelled because they're transporting, but we see one of their BLS ambulances still on scene as we drive by a few minutes later with a bunch of Sheriffs Deputies. (We have our own PD). This was all about 2 blocks from the main hospital in that part of town btw so we figure they were in the area clearing a call but a little unsure how they got the call in the first place, but we continue about our day.

About an hour or so later while enroute to the hospital with an unrelated call, they tone out a STEMI transfer from that hospital. Well we get there and our patient goes into the bed right next to the STEMI patient so we cancel the dispatched ambulance since we're on scene already..turns out the STEMI patient is the full arrest patient from earlier. So we take the STEMI downtown to the Cath Lab, and afterwards, as we're cleaning up the rig getting ready to go back available, that same initial Rescue shows up! So we take a bit of time and ask them what on earth happened. Turns out, they "Still Alarmed" the call (happen across it by chance). As they were driving down the hill, they saw a van pull over and stop next to a bicyclist on the ground, so they called it in figuring it was an auto vs. ped, but the van driver said they merely saw the guy just up and fall off his bike out of no where, and lo and behold, he was in cardiac arrest, so we were initially dispatched for manpower but coincidentally, the BLS ambulance out of their station was close enough that when they heard the call they responded (you know what? I just realized typing it out that it *almost* sounds like LAFD Buffed a call from us lol), and with ROSC and the hospital so close the medics took their BLS guys and transported immediately rather than wait for us (not that I can blame them for this call).


----------



## teedubbyaw (Aug 10, 2015)

Teenage girl called out as seizure. Get there and she is shaking and hyperventilating. Numbness/tingling, muscle spasms. No actual seizure described before we got there. Looked a lot like a typical anxiety attack, but gut was saying something else may be going on. Pt had been swimming in one of our nasty lakes yesterday and woke up with a HA, so went to children's hospital to be safe. Could not coach her breathing down at all. 10min from hospital she had a grand-mal seizure.


----------



## exodus (Aug 11, 2015)

12 and a half hours in.... We had a cancel as soon as we started our unit, haven't turned wheels yet


----------



## DesertMedic66 (Aug 11, 2015)

exodus said:


> 12 and a half hours in.... We had a cancel as soon as we started our unit, haven't turned wheels yet


Your gonna regret saying that


----------



## exodus (Aug 11, 2015)

DesertMedic66 said:


> Your gonna regret saying that



Nah, I took an uninterrupted 4 hour nap earlier.. I'm good.


----------



## MonkeyArrow (Aug 15, 2015)

Guy locks keys in car. What did he do? Use his fist to break the window, of course. This results in a much more expensive trip to the ED, rather than calling a locksmith, calling a cab, calling an uber, calling a friend, walking home, etc.


----------



## LaceyA (Aug 17, 2015)

Yesterday it was a pt going in for heart cath


----------



## LACoGurneyjockey (Aug 17, 2015)

First call of the day, second day of internship, was a GSW to the head, chest, and arm that got flown out.


----------



## Akulahawk (Aug 17, 2015)

I think yesterday my 1st patient had a skin rash... last patient had a migraine. The 16 patients in between? Rash, cellulitis, foreign embedded object (glass in foot), the usual stuff.


----------



## teedubbyaw (Aug 18, 2015)

LACoGurneyjockey said:


> First call of the day, second day of internship, was a GSW to the head, chest, and arm that got flown out.



New job, eh?


----------



## Jim37F (Aug 18, 2015)

Convoy Ops out here in the desert (I'm on my Army Reserve Annual Training). Even though the route was supposed to stay on paved roads the entire time, during the return trip, after passing another unit that was set up alongside the only paved road in the desert for miles around, the convoy commander got convinced we were lost, apparently simply because they werent there that morning). Instead of stopping to do a map check he more or less said, "I think we're supposed to go that-a way!" And took off down a dirt road. Didn't even stop when the dirt road ended aND we were literally just driving out in the middle of the desert, until we managed to more or less blindly stumble into another units assembly area that just so happened to be (relatively speaking) next to ours....-_-


----------



## CALEMT (Aug 29, 2015)

GSW. Canceled on scene.


----------



## exodus (Aug 30, 2015)

CALEMT said:


> GSW. Canceled on scene.



I was upset you go that because we got sent to MO/52, then you got cancelled  and we got cleared back to station... With 20 mins left in shift.


----------



## DesertMedic66 (Aug 30, 2015)

DOA. Last seen alive the night before. Wife called 911 at 1300 when she got home. Rigor and lividity. We were just driving past the address when the 911 call came in.


----------



## CALEMT (Aug 30, 2015)

exodus said:


> I was upset you go that because we got sent to MO/52, then you got cancelled  and we got cleared back to station... With 20 mins left in shift.




Wait, you sure? This was yesterday 8/29... at 0530 in the morning.

First call today was rectal bleeding


----------



## exodus (Aug 30, 2015)

CALEMT said:


> Wait, you sure? This was yesterday 8/29... at 0530 in the morning.
> 
> First call today was rectal bleeding


Yup, saturday morning.  I'm 432 C Shift.


----------



## CALEMT (Aug 30, 2015)

exodus said:


> Yup, saturday morning.  I'm 432 C Shift.



Haha I know that, but we got cancelled at like 0545. They didn't clear you guys in till 29 minutes before you got off? That sucks...


----------



## exodus (Aug 30, 2015)

CALEMT said:


> Haha I know that, but we got cancelled at like 0545. They didn't clear you guys in till 29 minutes before you got off? That sucks...



Yeah, we usually don't get back until about 615 or so.


----------



## CALEMT (Aug 30, 2015)

exodus said:


> Yeah, we usually don't get back until about 615 or so.



Ah gotcha.


----------



## CALEMT (Sep 5, 2015)

Started the day off with sepsis.


----------



## DesertMedic66 (Sep 5, 2015)

CALEMT said:


> Started the day off with sepsis.


How is it working with the flight medic today?

Started off my day with a generalized seizure. Stopped seizing as soon as I drew up the meds to give IN as fire was attempting to get an IV in an actively seizing patient without much luck (not surprising)


----------



## Jim37F (Sep 5, 2015)

Traffic Collision. Non injury.


----------



## CALEMT (Sep 5, 2015)

DesertMedic66 said:


> How is it working with the flight medic today?
> 
> Started off my day with a generalized seizure. Stopped seizing as soon as I drew up the meds to give IN as fire was attempting to get an IV in an actively seizing patient without much luck (not surprising)



Ohhhh gotta love city fire. He's a cool dude, it helps that I can get along with most people.


----------



## NPO (Sep 12, 2015)

LACoGurneyjockey said:


> First call of the day, second day of internship, was a GSW to the head, chest, and arm that got flown out.


Where are you doing internship? Liberty?


----------



## LACoGurneyjockey (Sep 12, 2015)

NPO said:


> Where are you doing internship? Liberty?


Yup


----------



## LACoGurneyjockey (Sep 17, 2015)

First call of the day: cardiac arrest with esophageal varices. Witnessed arrest, asystole throughout and blue from the nipple line up. Fire had dropped a king tube and with every breath they sent a thick mist of blood spraying over their turnouts. Needless to say, that king tubes life was as short lived as the patient's.


----------



## CALEMT (Sep 17, 2015)

LACoGurneyjockey said:


> First call of the day: cardiac arrest with esophageal varices. Witnessed arrest, asystole throughout and blue from the nipple line up. Fire had dropped a king tube and with every breath they sent a thick mist of blood spraying over their turnouts. Needless to say, that king tubes life was as short lived as the patient's.



Hope you didn't walk away thinking "damn that sucked, glad it wasn't me" cause apparently that mindset makes you cold and indifferent to some people.


----------



## Tigger (Sep 17, 2015)

Lower GI bleed. 45 mile transport to the hospital. Yaaay.


----------



## DesertMedic66 (Sep 17, 2015)

OD on Lamictal.


----------



## chaz90 (Sep 17, 2015)

Patient took ~30 puffs of his albuterol inhaler in a couple hours since he "couldn't breathe." 

Clear lung sounds, RA SpO2 99%, non obstructed and hypocarbic EtCO2 waveform with a RR of ~30. Tachycardic at 130, detoxing from alcohol, and hasn't slept for 3 days. Poor guy spent most of the transport asking me for Advair. Whew.


----------



## Jim37F (Sep 18, 2015)

Monday, had a brand new partner on his first shift post being cleared off 3rd rider training. First call of the day was a 3 car traffic collision, patient in the middle car (got rear ended and pushed into the car in front), co neck and tailbone pain, so the medics pulled the guy out of the drivers seat, stood him up and *shudders* had us do a standing takedown onto a backboard. Non emergent BLS to the hospital. 

Our next call was a full arrest, arrived on scene to find PD doing compressions, but while my partner pulled out the defibrillator pads and I got the BVM, the medics did a check for, and found, rigidity and lividity, last seen by family the night before so they called it. The kicker is we 're-responded to the address a few hours later for the wife who suffered a pretty bad anxiety attack (understandable IMO) but we were able to calm her down enough to prevent an ambulance ride.

All in all we had 3 transports out of 11 calls in a 24 hrs period (shift before had 2 calls all day)


----------



## Jondruby (Sep 18, 2015)

First run in a while was a lady with severe neuropathy pain, 10/10. She looked it too, hasn't eaten all week, or taken meds because "it jsut goes right through me." she said. Eat 10 min later diarrhea; also had possibly pnuemonia hacking up green slime all the way back to the ER. GLad we could help her tho, she was a sweetie.


----------



## LaceyA (Sep 28, 2015)

Saturday......  overdose


----------



## Jim37F (Sep 28, 2015)

Psychiatric. Man called from a pay phone and apparently rambled to dispatch about how he thought he had drunken poisoned water or something. Arrived on scene to find the medics ask "do you want to go to the hospital? Yeah? Can you walk? Yeah? How come you didn't walk to the hospital  (that's two blocks away)?" Guy goes "Ok" and just ups and starts walking away that way lol so we clear the scene and go available.


----------



## harold1981 (Oct 18, 2015)

Code 3 to assist the PD at an intersection where a guy is directing traffic on the middle of the road and has possibly swallowed 'bad drugs'. He did indeed chew on a few seeds of 'Hawaiian baby woodrose' or LSA and turned psychotic. Enroute to the hospital he warns me for a few purple dots on my otherwise orange aura around me. I am most thankful offcourse.


----------



## sirengirl (Nov 8, 2015)

Pedestrian vs palm frond. 

And do not be confused, dear people, this was no ordinary, leafy, green, shady palm frond. Oh no. Not in the least. It was, in fact, a dead one. 

In fact it looked strikingly (pun intended) similar to this one. But fear not, this is not THE actual Palm frond. No HIPAA violations here.









You cannot, in fact, make this **** up.


----------



## Jondruby (Nov 16, 2015)

Yesterday, singel MVA. Skull fracture.


----------



## Jondruby (Nov 18, 2015)

Transfer difficulty breathing.


----------



## Tigger (Nov 21, 2015)

Traumatic asphyxiation. Full sized SUV rolled on a guy chasing it down the driveway as best we can figure. One of the few times the monitor is not needed to get a TOD.


----------



## LACoGurneyjockey (Nov 22, 2015)

A beautiful, healthy baby girl delivered at 3AM in a crack trailer. First uncomplicated delivery in 3 years.


----------



## MS Medic (Dec 20, 2015)

A belligerent crackhead that is a former regular that recently resurfaced.


----------



## EMSComeLately (Dec 20, 2015)

2yo febrile seizure.  2nd in 24 hours.


----------



## NomadicMedic (Jan 3, 2016)

Sepsis at a Nursing Home. Surprise.


----------



## Tigger (Jan 3, 2016)

Domestic that turned into a tylenol PM OD. A whole eight or nine tablets. 

Oh and I think we seized the motor on our second newest truck while responding. Two months ago its twin also seized.


----------



## DesertMedic66 (Jan 3, 2016)

Dry mouth


----------



## teedubbyaw (Jan 3, 2016)

DesertMedic66 said:


> Dry mouth



LORD JESUS CALL 911


----------



## DesertMedic66 (Jan 3, 2016)

teedubbyaw said:


> LORD JESUS CALL 911


Another crew went to his place several hours earlier because he "couldn't pee for 10 minutes".


----------



## StCEMT (Jan 4, 2016)

DesertMedic66 said:


> Another crew went to his place several hours earlier because he "couldn't pee for 10 minutes".


Guess his mouth wasn't the only thing that was dry?


----------



## NomadicMedic (Jan 10, 2016)

Diabetic. I had to use Glucagon for the first time in ages!


----------



## emsdave (Jan 13, 2016)

Hemorrhage 3,000ccs of it fun times. Looked like a crime scene


----------



## StCEMT (Jan 14, 2016)

I predict at 12:35 today it will be transfer to a nursing facility.


----------



## ERDoc (Jan 14, 2016)

"SVT" was given 6 and 12 of Adenosine in the field which "converted" him to afib with RVR.  Gurgling/agonal resps upon arrival.  Tachy PEA, ACLS started/LUCAS applied, ECMO team called.  CF ensues as ICU/ECMO team arrive and there is now more people in one room in the ER than in the rest of the hospital.  I couldn't even see the pt from where I was standing but the guy made it to the ICU.


----------



## MonkeyArrow (Jan 14, 2016)

ERDoc said:


> "SVT" was given 6 and 12 of Adenosine in the field which "converted" him to afib with RVR.  Gurgling/agonal resps upon arrival.  Tachy PEA, ACLS started/LUCAS applied, ECMO team called.  CF ensues as ICU/ECMO team arrive and there is now more people in one room in the ER than in the rest of the hospital.  I couldn't even see the pt from where I was standing but the guy made it to the ICU.


Even the resus bay isn't big enough to hold (all the ER nurses -1 to float), nine thousand consultants, RT, x-ray, and STAT team. Then to make it worse, everyone has to try to get hands-on and TRY to help out and get 4 packs of 4x4 when all you wanted was one sponge and constantly bump into things/people and ask for various variations of report for the ninth time. /rant


----------



## Jim37F (Jan 16, 2016)

Ah it feels good to be able to post in here again, haven't had a shift in 2 months.. 

Simple BLS, 911 call for vomiting and nausea times 2 hours, believes he "ate something that disagreed with him"


----------



## NomadicMedic (Jan 17, 2016)

20 year old female with 10/10 abdominal pain. She walked to the truck and texted on her iPhone all the way to the hospital. 

Another life saved.


----------



## Tigger (Jan 17, 2016)

Textbook COPD exacerbation. Medic student from class was riding with us, she rocked it.


----------



## cruiseforever (Jan 17, 2016)

DEmedic said:


> 20 year old female with 10/10 abdominal pain. She walked to the truck and texted on her iPhone all the way to the hospital.
> 
> Another life saved.



Did you stretcher her in?


----------



## NomadicMedic (Jan 17, 2016)

cruiseforever said:


> Did you stretcher her in?



Walked to the door, into a wheelchair, directly to triage. Do not pass go, do not collect $200. 

Stretchers are for sick people. Hahaha


----------



## Jim37F (Jan 18, 2016)

78 yo m patient who's son found him just sitting on the floor of the laundry room at home, leaning against the washing machine....although the pt has a hx of some minor dementia, the son insisted he was more confused than normal (which was already hard to evaluate due to a language barrier)...oh and he was bleeding from one ear. No signs of trauma (medics surmised maybe he was digging out some earwax and cut himself with his nail?) so we just took him to the closest hospital..


----------



## ERDoc (Jan 18, 2016)

Bounce back from yesterday who needs a work note and zofran (didn't get his script from yesterday filled yet).


----------



## TransportJockey (Jan 18, 2016)

Late stage ALS pt with respiratory distress


----------



## Scmedic08 (Jan 18, 2016)

Called for "sick pt". N/v, headache, dizziness, sob. Wasn't advised by dispatch that we were requested by fire crews who were on scene for a natural gas leak in the house. The husband said was doing starting a remodel to the kitchen last night and apparently broke a gas line on accident and wasn't aware.


----------



## Qulevrius (Jan 24, 2016)

36 y/o, CC of auditory hallucinations 2' to vaginal bleeding. Couldna made this up even if I wanted to.


----------



## DesertMedic66 (Jan 24, 2016)

2 vehicle TC. Full sized truck with mind or damage and a minivan with major damage. 45+ minute extrication time. Bi-lat femur fractures, possible pelvis fracture, full thickness laceration to elbow. Flown to trauma center.


----------



## Jim37F (Jan 24, 2016)

92 yo male, who briefly got a little lost and disoriented..........after making a wrong turn while driving through a neighborhood and didn't recognize where he was...though he apparently made it back home just fine because that's where we picked him up from..


----------



## NomadicMedic (Jan 24, 2016)

Suicide attempt. Both wrists. Blood was evvvvvvvvvvverywhere.


----------



## harold1981 (Jan 31, 2016)

A spontaneous femur fracture. The underlying cause was found to be undetected breastcancer with metastasis in the leg.


----------



## Chimpie (Feb 7, 2016)

After a brief, three year hiatus of doing any emergency medical response, I decided to join the local Medical Reserve Corps and help out at a regatta.

First call, five minutes into the day, cardiac event with CPR in progress.


----------



## wilderness911 (Feb 8, 2016)

DEmedic said:


> 20 year old female with 10/10 abdominal pain. She walked to the truck and texted on her iPhone all the way to the hospital.
> 
> Another life saved.



Nice work! It's the calls like this we can look back on in our old age and know we really made a difference in someone's life. That definitely qualifies as a good save


----------



## CALEMT (Feb 18, 2016)

Single vehicle rollover into a telephone pole. Bystander pulled the pt. C collar only, no backboard mild back pain by the time we got to the hospital. 

After we cleared the hospital ran another tc. Auto vs motorcycle (t bone). Severe damage to the bike and about 2 feet on intrusion on the passenger side per fire. Fire had everything done by the time we got there spent 5 minutes on scene load and go. My medic needle t'd the guy in the back. 

So in the first two hours ran some pretty legit calls.


----------



## Giant81 (Feb 23, 2016)

Removed a sliver from my daughters hand.  Was a bit rough, she's almost deathly afraid of needles, but made it through like a champ.  A hello kitty band-aid later, and it was all hugs and snuggles before getting ready for school.


----------



## chaz90 (Feb 23, 2016)

Syncopal episode probably secondary to an episode of SVT. Patient was very familiar with her condition and it self terminated prior to our arrival. I was pretty hopeful I'd get to use some adenosine. That's one of my favorite drugs to administer...


----------



## NomadicMedic (Feb 23, 2016)

Mine was an IFT to a facility with a working CT. 
The whole day was busy but a double medic truck did all BLS. Never opened my ALS bag. (Which was fine by me)


----------



## Smitty213 (Mar 1, 2016)

Jumped an ALS assist called in by one of the BLS IFT trucks in the city on scene at an MVA they rolled up on, crew couldn't be contacted to provide an update. Arrive on scene to a trauma code with entrapment.


----------



## Qulevrius (Mar 20, 2016)

1st call of the day: medical aid, assisted living, pt with a CC of back pain 2' to blunt force trauma (got into a fight with another tenant). Pt states 8/10 lower thoracic/upper lumbar dorsal, 8/10 neck pain, v/s are 128/62 + 56 + 16 + 96%, Hx of (surprise-surprise) Schizoaffective d/o, HTN, COPD & stuff. Oh, back and neck pain you said ? On the board you go. Yes, the c-collar stays and the cannula as well. You're welcome, thanks for flying Firstmed Ambulance...


----------



## titmouse (Mar 24, 2016)

Day started with discharges on the last shift but last call was awesome lol We get a call to a fast food joint for the county. On the way there I am already thinking what could have happened? A burn? Slip and fall? Well, we get there the pt is ambulatory, as per medic "possible UTI" as I am getting info from the medic, my partner comes be and tell me that the pt decided to leave. So I walked around the truck and see the pt crossing the street and as I tried to speak with her she tells me she is good. She walks across the street leans against a sign of a local business pull her pants down and takes a leak...


----------



## DesertMedic66 (Mar 24, 2016)

Self inflicted GSW to the head. Patient AOx4, GCS 15 and talking to us like nothing happened. Patient talked to us for the whole transport. No good IV access at all so I ended up going humeral IO. Once we got to the ED the doctor decided to RSI him and then place a central line (nurses couldn't get an IV either).


----------



## exodus (Mar 24, 2016)

titmouse said:


> Day started with discharges on the last shift but last call was awesome lol We get a call to a fast food joint for the county. On the way there I am already thinking what could have happened? A burn? Slip and fall? Well, we get there the pt is ambulatory, as per medic "possible UTI" as I am getting info from the medic, my partner comes be and tell me that the pt decided to leave. So I walked around the truck and see the pt crossing the street and as I tried to speak with her she tells me she is good. She walks across the street leans against a sign of a local business pull her pants down and takes a leak...



If the party left the area on a call like that, we won't even try and find them.  Buh bye.


----------



## titmouse (Mar 24, 2016)

DesertMedic66 said:


> Self inflicted GSW to the head. Patient AOx4, GCS 15 and talking to us like nothing happened. Patient talked to us for the whole transport. No good IV access at all so I ended up going humeral IO. Once we got to the ED the doctor decided to RSI him and then place a central line (nurses couldn't get an IV either).


Thats crazy lol


----------



## DesertMedic66 (Mar 24, 2016)

titmouse said:


> Thats crazy lol


We heard the call go out and we said "let's try to beat fire there. We figured it was just going to be a simple "yep, he's dead". Walked in and the guy said "Hey, my head hurts. Can I get some pain meds to help?"


----------



## Jim37F (Mar 24, 2016)

DesertMedic66 said:


> We heard the call go out and we said "let's try to beat fire there. We figured it was just going to be a simple "yep, he's dead". Walked in and the guy said "Hey, my head hurts. Can I get some pain meds to help?"


That's nuts. What sort of firearm/caliber was used?


----------



## DesertMedic66 (Mar 24, 2016)

Jim37F said:


> That's nuts. What sort of firearm/caliber was used?


.38 special revolver.


----------



## Sleepnheat (Mar 24, 2016)

Single vehicle MVA roll over that came to rest on the roof at +50. I was dispatched with fire. Arrived on scene and found the elderly male had already cut himself loose and was walking around. No pain/complaints. Refused transport. 

Wear your seat-belts!


----------



## wtferick (Mar 24, 2016)

11 hours in and one finally drops. Vomiting and diarrhea Glad we are ETs or we would be holding the wall.


----------



## titmouse (Mar 24, 2016)

wtferick said:


> 11 hours in and one finally drops. Vomiting and diarrhea Glad we are ETs or we would be holding the wall.


11 hours? There is only so muxh youtube one can Take.


----------



## wtferick (Mar 25, 2016)

titmouse said:


> 11 hours? There is only so muxh youtube one can Take.


X files on Netflix is all I need!


----------



## Jim37F (Mar 25, 2016)

wtferick said:


> X files on Netflix is all I need!


I just started an X-Files binge, killed the whole first season in like 3 days haha (though I use Amazon Prime video over Netflix but same difference  )


----------



## Tigger (Mar 25, 2016)

Weird lady with weird history having weird chest pain. Somewhat significant 12 lead findings, 90 minute transport to city. Yay nitro drips.


----------



## titmouse (Apr 1, 2016)

Discharge that got cancelled due to pt not being remotely ready for transport,


----------



## titmouse (Apr 2, 2016)

Picked up a shift for a discharge LDT to Key West. Drove today.


----------



## DesertMedic66 (Apr 2, 2016)

Full arrest. 4 minute down time until we started compressions. Witnessed by family who thought it was a seizure so no bystander CPR. IVR initial rhythm. Then went into V-tach so we shocked him and he went back into IVR. During transport he went into V-tach and was shocked again. Got pulses back shortly after transfer to ED bed. Patient made it to ICU so far.


----------



## titmouse (Apr 2, 2016)

Discharge to ALF.


----------



## titmouse (Apr 5, 2016)

Discharge to convalescent facility


----------



## Jim37F (Apr 16, 2016)

First call of the day? Pssh, try first call in 2 months! 

Seizure at work (some sort of industrial machinist shop). Supposedly struck his head on the way down, but no signs of trauma found, alert and talking but confused, knew his name, couldn't answer anything else, well kept answering his name when we asked if he knew where he was....ALS transport, brutally long, had to be at least a full mile to the hospital!  lol


----------



## titmouse (Apr 17, 2016)

96 yo female, weakness with no syncope.


----------



## titmouse (Apr 17, 2016)

Jim37F said:


> First call of the day? Pssh, try first call in 2 months!
> 
> Seizure at work (some sort of industrial machinist shop). Supposedly struck his head on the way down, but no signs of trauma found, alert and talking but confused, knew his name, couldn't answer anything else, well kept answering his name when we asked if he knew where he was....ALS transport, brutally long, had to be at least a full mile to the hospital!  lol


Dont you love those LDTs?


----------



## titmouse (Apr 20, 2016)

Solid day of discharges.


----------



## jcroteau (Apr 20, 2016)

Woman who gets violent nausea/vomiting and abdominal pain when she eats hot dogs.....went on a binger last night. 48 dogs went down the hatch, 48 came back up.

Picked her up on a street corner.


----------



## titmouse (Apr 20, 2016)

jcroteau said:


> Woman who gets violent nausea/vomiting and abdominal pain when she eats hot dogs.....went on a binger last night. 48 dogs went down the hatch, 48 came back up.
> 
> Picked her up on a street corner.


thats a lotta hot dog... at least 24 feet of hot dog.


----------



## NomadicMedic (Apr 20, 2016)

I think when they go in, you measure then in linear feet, coming up you measure in gallons.


----------



## Inspir (Apr 20, 2016)

ETOH on a plane


----------



## titmouse (Apr 22, 2016)

Hospital discharge


----------



## DesertMedic66 (Apr 22, 2016)

Bicycle vs bicycle. Positive LOC and repetitive questioning


----------



## DesertMedic66 (Apr 23, 2016)

Call number 1 and 2 were both respiratory arrests secondary to drug use. 1 of them ended up buying herself a tube as soon as we pulled into the ED.


----------



## k9Dog (Apr 23, 2016)

drunk urban outdoorsmen 


Sent from my iPhone using Tapatalk


----------



## STXmedic (Apr 23, 2016)

k9Dog said:


> drunk urban outdoorsmen
> 
> 
> Sent from my iPhone using Tapatalk


This can be used for 90% of my shifts.


----------



## k9Dog (Apr 23, 2016)

STXmedic said:


> This can be used for 90% of my shifts.


Same here. The beauty of big city urban EMS.


----------



## titmouse (Apr 24, 2016)

341 for Pedal edema, somewhat hypertensive due to not taking meds, with and additional 101 fever...


----------



## StCEMT (Apr 24, 2016)

Lift assist turned discovering a bgl of 31.


----------



## NomadicMedic (Apr 24, 2016)

Unresponsive. 104 temp. Trach, on a vent. Caregiver was new, "he doesn't seem right". HR 160, BP 58/34. 

Legitimate mess.


----------



## titmouse (May 1, 2016)

A refusal that turned into being detained...


----------



## Jim37F (May 1, 2016)

First call of the shift was a 2 yr old whose older brother fell out of the top bunk bed landing on top of him. 

First call of the calendar day (first call after midnight) was a gnarly auto vs ped, load and go, partial leg amputation with tourniquet and assisting ventilations with a BVM. (Of course immediately followed by a very BLS migraine headache, but went back to the same hospital so we learned the ped was still in surgery and they completed the amputation..)


----------



## TransportJockey (May 2, 2016)

Allergic reaction. Not too bad


----------



## DesertMedic66 (May 2, 2016)

Skull fracture after being punched in the face 2 days ago who was also drunk


----------



## sk8erboi9405 (May 5, 2016)

Start at 0600 out of Redlands,CA for a 12 hour BLS shift. After checking out our unit, we were dispatched to go into the bariatric unit for a pt in Big Bear. Arrived on scene for a 533 pound women at 0835. Took her to Kaiser Fontana for an appointment at 1100. Got there at 1040. After Kaiser mixed up all the paperwork and times, she had another appointment at 1330 but wasn't seen until 1455. Didn't leave Kaiser Fontana until 1645. Got her to destination at 1815. Big Bear Fire Department was kind and generous enough to feed us, as they knew we hadn't ate all day. Didn't clock out until 2040. All for our first call.

Sent from my SM-N920P using Tapatalk


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## sk8erboi9405 (May 5, 2016)

Btw, going up the mountain in the mid is excruciating. Had to take some Zofran both trips up the mountain 

Sent from my SM-N920P using Tapatalk


----------



## titmouse (May 11, 2016)

Cancelled dialysis call


----------



## titmouse (May 15, 2016)

51yo F, MVC, restrained, CC neck + back pain. C-collar, backboard to the hospital we go!


----------



## titmouse (May 15, 2016)

Right hypochondriac pain that occasionally radiates to the back... 341 for the county.


----------



## LACoGurneyjockey (May 15, 2016)

Airplane down into an orange orchard, pilot walked away with a few broken ribs.


----------



## Tigger (May 16, 2016)

Two year old with Dravet Syndrome, probably the fifth time I've run him. This time the parents got the seizure stopped before us with cannabinoids and a little Versed, in the past we've used all manner (and lots) of benzos without any luck.


----------



## NomadicMedic (May 22, 2016)

Back up medic on a Pedi arrest. SIDS. 

Just tragic.


----------



## Jim37F (May 22, 2016)

^Thats a rough first call 

Seizure, postictal on arrival, didn't want to go, but too out of it to refuse and family wanted him to go, so we transported, progressively coming around, still not happy about having gone, but he was definitely way too out of it to be competently refusing at first.


----------



## LACoGurneyjockey (May 22, 2016)

A rash for the past 4 days. Said it wasn't uncomfortable, but she didn't like the way it looks and wanted the doctor to make it go away.


----------



## Inspir (May 25, 2016)

PNES


----------



## titmouse (May 25, 2016)

Pt did not take his DM meds for four days. Glucometer greeted me.


----------



## gotbeerz001 (May 26, 2016)

First call of the day... Was me 


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----------



## Jim37F (May 26, 2016)

Ouch, what happened?


----------



## gotbeerz001 (May 26, 2016)

Blade in my Leatherman **may** have gotten buried into my forearm while (poorly) attempting to cut through a plastic bucket. 

I mean... Ninjas. I was fighting ninjas. 


Sent from my iPhone using Tapatalk


----------



## Jim37F (May 26, 2016)

Those damn sneaky ninjas


----------



## STXmedic (May 26, 2016)

Dispatched for an assault. Notes led us to expect speedballing. Patient ended up being in septic shock...


----------



## Inspir (May 26, 2016)

That awkward moment when you complete a PCR on yourself


----------



## Tigger (May 26, 2016)

Ground level fall. Pt was hyperkalemic and septic. Conscious IO, calcium, bicarb, albuterol. Small amounts of terror.


----------



## LACoGurneyjockey (May 27, 2016)

Gsw to the head, chest, abdomen, flank, and arm. Agonal with pulses on scene. Clenched down and a mouth full of blood and brain matter. Ended up cric'ing him, arrested shortly after putting him in the ER bed.


----------



## MonkeyArrow (May 27, 2016)

LACoGurneyjockey said:


> Gsw to the head, chest, abdomen, flank, and arm. Agonal with pulses on scene. Clenched down and a mouth full of blood and brain matter. Ended up cric'ing him, arrested shortly after putting him in the ER bed.


Percutaneous or open cric?


----------



## LACoGurneyjockey (May 28, 2016)

MonkeyArrow said:


> Percutaneous or open cric?


All we have available is needle cric with a 10g


----------



## BASICallyEMT (May 28, 2016)

We start at 6am got 1st call about 6:30ish for a man down. We get on scene to find a 20 y/o F passed out in her car with half eatin tacos/churros in her lap lol we advise her that shes either going with us or we will get pd on scene. We get to ER and she points out another pt in a hall bed that was also at the same party! Must of been a hell of a night!


----------



## NomadicMedic (May 28, 2016)

BASICallyEMT said:


> We start at 6am got 1st call about 6:30ish for a man down. We get on scene to find a 20 y/o F passed out in her car with half eatin tacos/churros in her lap lol we advise her that shes either going with us or we will get pd on scene. We get to ER and she points out another pt in a hall bed that was also at the same party! Must of been a hell of a night!



Why did she need to go with you? Was she unable to answer questions?


----------



## BASICallyEMT (May 28, 2016)

ALOC was what we used but she was more hungover than anything. I'm sure we saved her from a DUI. Hopefully she will learn from it.


----------



## NomadicMedic (May 28, 2016)

I'm sure she'll appreciate the unnecessary hospital bill


----------



## BASICallyEMT (May 28, 2016)

DEmedic said:


> I'm sure she'll appreciate the unnecessary hospital bill



Unnecessary? Ya drinking and driving is very unnecessary.


----------



## Tigger (May 29, 2016)

BASICallyEMT said:


> Unnecessary? Ya drinking and driving is very unnecessary.


What? You took someone with an apparent limited (if any) medical need to avoid her getting a DUI?


----------



## DesertMedic66 (May 29, 2016)

Welcome to my area out here. The fire department and police department will push for a patient to go to the ED to avoid a DUI


----------



## TransportJockey (May 29, 2016)

DesertMedic66 said:


> Welcome to my area out here. The fire department and police department will push for a patient to go to the ED to avoid a DUI


That's bassackwards. Out here they will find any reason for DUI pieces of crap to NOT go to the hospital so they can hook them and charge them.


----------



## DesertMedic66 (May 29, 2016)

TransportJockey said:


> That's bassackwards. Out here they will find any reason for DUI pieces of crap to NOT go to the hospital so they can hook them and charge them.


Tell me about. We have one police department who will catch people in the act of a crime and then the guy will say "I wanna hurt myself" and it's an instant 5150 psych hold and call a BLS ambulance to transport the subject to the hospital. 

If it's an actual DUI where they were busted while driving they go to jail. If it's someone who was slumped over the wheel of a parked car then it's let the person decide the hospital or the ED.


----------



## Jim37F (May 29, 2016)

Seizure at home. Hx of seizures secondary to TBI from a GSW to the head years ago


----------



## NomadicMedic (May 29, 2016)

DesertMedic66 said:


> Welcome to my area out here. The fire department and police department will push for a patient to go to the ED to avoid a DUI



Last I checked, gettin' hammered wasn't a medical emergency. if the cops don't want to arrest them, have a sober friend come give them a ride. But taking the intox to the ED just to avoid a DUI is a ridiculous waste of resources.


----------



## BASICallyEMT (May 29, 2016)

DEmedic said:


> Last I checked, gettin' hammered wasn't a medical emergency. if the cops don't want to arrest them, have a sober friend come give them a ride. But taking the intox to the ED just to avoid a DUI is a ridiculous waste of resources.



I agree with you. But that's just how it is out here. We seem to waste alot of resources. Not to mention the ridiculous c/c we constantly run on.


----------



## LACoGurneyjockey (May 29, 2016)

Chief complaint of "I feel cold", and upon further assessment her face looked like it was gonna fall of the left side of her head, and her left arm and leg was completely flaccid. But she just wanted a blanket...


----------



## BASICallyEMT (May 29, 2016)

LACoGurneyjockey said:


> Chief complaint of "I feel cold", and upon further assessment her face looked like it was gonna fall of the left side of her head, and her left arm and leg was completely flaccid. But she just wanted a blanket...



Code stroke!


----------



## NomadicMedic (May 29, 2016)

BASICallyEMT said:


> Code stroke!


Code Blanket.


----------



## titmouse (May 29, 2016)

Cancelled dialysis...


----------



## BASICallyEMT (May 29, 2016)

titmouse said:


> Cancelled dialysis...



I remember those days.. Lol


----------



## Tigger (May 29, 2016)

SNF induced opoid overdose. GCS of 8, great respirations at 12 with SpO2 at 96% and eT at 28. I did nothing with him since he was 93 and a chronic pain secondary to bone cancer patient.

Hospital still called a team on him and began yelling for narcan, we left...


----------



## titmouse (May 30, 2016)

Tigger said:


> SNF induced opoid overdose. GCS of 8, great respirations at 12 with SpO2 at 96% and eT at 28. I did nothing with him since he was 93 and a chronic pain secondary to bone cancer patient.
> 
> Hospital still called a team on him and began yelling for narcan, we left...


DNR pt?


----------



## Tigger (May 30, 2016)

titmouse said:


> DNR pt?


Full code.


----------



## TransportJockey (May 30, 2016)

Drowning code last night. Couldn't keep rosc


----------



## titmouse (Jun 3, 2016)

Hospital discharge


----------



## DesertMedic66 (Jun 3, 2016)

Last call last night was a drowning DOA. Incident was captured on security camera. First call today was a DOA on a hiking trail.


----------



## CALEMT (Jun 3, 2016)

Traffic collision on the interstate. Canceled on scene.


----------



## DesertMedic66 (Jun 3, 2016)

CALEMT said:


> Traffic collision on the interstate. Canceled on scene.


111 tonight?


----------



## CALEMT (Jun 3, 2016)

DesertMedic66 said:


> 111 tonight?



110


----------



## exodus (Jun 3, 2016)

Fall. Cancelled fire. PSA.


----------



## Jim37F (Jun 3, 2016)

Assault. Homeless couple sleeping a tent, boyfriend woke up suddenly beating on the gf who ran away and managed to find a payphone(!) to call the cops. Small lac (3/4") no longer bleeding on arrival, got a nice easy ride to nearest hospital.


----------



## Jim37F (Jun 4, 2016)

Off today, but first call post midnight (so still technically first call of the day  ) the chief complaint can be summarized as "Sheriff's Dept didn't want to deal with him, so they pawned him off on us instead" (guy high on meth found teaking out in a neighborhood at 4am)


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## titmouse (Jun 4, 2016)

Jim37F said:


> Off today, but first call post midnight (so still technically first call of the day  ) the chief complaint can be summarized as "Sheriff's Dept didn't want to deal with him, so they pawned him off on us instead" (guy high on meth found teaking out in a neighborhood at 4am)


Dont you just love those?


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## Tigger (Jun 5, 2016)

PD request code 3 for _maybe _a spider bite that occurred last night. Found the patient rolling around the shoulder of a four lane highway, she eventually refused and I was left confused.


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## NomadicMedic (Jun 5, 2016)

Cardiac arrest at a SNF. Worked it for a bit and terminated on scene.


----------



## gotbeerz001 (Jun 5, 2016)

Bilateral testical pain... 
But actually septic. 


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## NomadicMedic (Jun 5, 2016)

gotshirtz001 said:


> Bilateral testical pain...
> But actually septic.
> 
> 
> Sent from my iPhone using Tapatalk


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## titmouse (Jun 7, 2016)

341 for Hialeah..  48 yo F perfect vitals,  fatigue or "la fatiga" in spanish.


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## cruiseforever (Jun 8, 2016)

DOA.  Chemical suicide


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## Jim37F (Jun 8, 2016)

Traffic collision, car t-boned a school bus. Full MCI initial response, for what turned out to be only 1 patient  (driver of the car), apparently all the kids got off and walked to school prior to arrival...fire was trying to chase down where they were to assess them due to conflicting reports of complaints...but we were transporting as that was happening


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## CALEMT (Jun 9, 2016)

Pediatric seizure (febrile) mom is full blown HP and my partner and I don't speak a lick of Spanish.


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## ERDoc (Jun 10, 2016)

Weakness, falling asleep secondary to CO2 retention


----------



## shfd739 (Jun 12, 2016)

Interfacility intubated, vented subarachnoid bleed. Totally clustered by the sending ER with an uncontrolled BP and inadequate sedation.


----------



## ForgottenNoble (Jun 14, 2016)

The last day I was at the station we had a little 90cc dirt bike hit by a car not 5 minutes after I arrived at the station.


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## Jim37F (Jun 17, 2016)

Tramadol overdose. 46 yo F with a GCS of 2E, 2V, 5M, cool pale clammy, weak pulses. Within a couple min of her getting into the ER bed and gown, she woke up, vomited oncr, then went unresponsive  (GCS 1-1-1) pulse shot into the 160s, then plummeted to 50-something all within a min. ER ran a strip and called a STEMI alert, and RSI'd her, she got a chest X-Ray and was enroute to CT by the time I was finally able to get a transfer of care signature


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## LACoGurneyjockey (Jun 18, 2016)

Conscious and alert but non verbal out of the prison, disconjugate gaze and non reactive pupils seizing intermittently for the 30 minute transport, been that way for two hours before the prison decided to call.


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## NomadicMedic (Jun 19, 2016)

Unresponsive CVA, intubated in the field. Coded just after arrival in the ED. Extubated by family request in the ED and allowed to expire.


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## Tigger (Jun 20, 2016)

I honestly do not remember. Today's day in the citay had the most crap calls of a single day I can remember. Even our auto-ped that was thrown "a whole GD way" was crap, patient was a pest considering all the meth and Xanax she had chosen to ingest prior to walking out into an eight lane road.


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## NomadicMedic (Jul 3, 2016)

Cardiac arrest. ROSC on scene.


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## Apie2546 (Jul 12, 2016)

Grand mal seizure. All vitals checked out. Transported to the hospital


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## Jim37F (Jul 12, 2016)

18 yo with nausea vomiting for 5 days since drinking too much over the 4th of July, although she did have a dx of unknown type hepatitis....


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## LACoGurneyjockey (Jul 12, 2016)

VT arrest at dialysis, ROSC after 1 shock, arrested again, ROSC again after shock #2, GCS of 13 when we transferred care and by the time we cleared he was completely oriented.


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## shelvpower (Jul 12, 2016)

Double murder scene, turned out to be people that I have met before. 
That puts the number of DOA's for this cycle on 8.


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## Sleepnheat (Jul 13, 2016)

High speed single MVA w/restrained driver. On arrival, Pt is on ground outside of vehicle unresponsive, but breathing with positive LOC from bystanders. Pt becomes conscious after stimulious. C-spine and scoop. Cheif complaint of 8/10 lower back pain. Mentating x4 and strictly refuses IV or pain management. He started snap chatting 5 mins into transport. Last heard from ED possible fracture in L2


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## Qulevrius (Jul 26, 2016)

Homeless 5150 w/ SI + general malaise, extensive psych hx + scabies. 30 min into transport, she isn't threatening to ****ing kill all the ****ing gringos any longer, and sings 'Yellow Submarine' out loud.


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## Handsome Robb (Jul 27, 2016)

A two refusal MVC. That turned into a 6 refusal MVC when a pair of rubberneckers hit each other while looking at the original accident. 


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## Handsome Robb (Jul 27, 2016)

LACoGurneyjockey said:


> VT arrest at dialysis, ROSC after 1 shock, arrested again, ROSC again after shock #2, GCS of 13 when we transferred care and by the time we cleared he was completely oriented.


#canigetsomecalciumplease? 


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## LACoGurneyjockey (Jul 28, 2016)

Handsome Robb said:


> #canigetsomecalciumplease?
> 
> 
> Sent from my iPhone using Tapatalk



Amio drip kept him stable for a few hours until he was transferred, don't know the outcome.


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## RocketMedic (Jul 28, 2016)

LACoGurneyjockey said:


> Amio drip kept him stable for a few hours until he was transferred, don't know the outcome.



Most dialysis patients, especially pre-dialysis, are pretty hyperkalemic. A gram or two of calcium goes a long way. Amiodarone slows down the calcium-channel pumps and makes a little last "longer" in the cell, but it's not so much fixing the problem as it is making the temporary repair last a little longer.


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## Jim37F (Jul 29, 2016)

Previous crew of the other unit at our station was at a structure fire standby. Rather than have us new crew my unit go relieve them, dispatch in it's infinite wisdom decided to have us shuttle the oncoming crew of that unit into our rig and the 4 of us go down, they'd relieve the off going crew and we'd shuttle them back to station....somehow that made more sense.....)....but as soon as we get on air, not even a block away they get cleared off that fire and start returning so we basically drove around in a big circle with 4 guys in one ambulance lol

An hour or so later we caught a street corner post (from our station) 2 cities over for coverage before catching our first real call of the day, unconscious. Turned out to be a diabetic with low blood sugar (20 something), only responsive to painful stimuli, couldn't get a line started so they pushed Glucagon IM and we transported to the hospital where he was still altered on arrival there.


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## Qulevrius (Aug 26, 2016)

A 63 y.o. black male, hx of schizophrenia,  bipolar, substance abuse & depression. Altered, agitated & combative.  Quote of the day is 'I GOT NUTHIN' TO SAY TO YA, CRACKER'.


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## ALS AXE (Aug 27, 2016)

26 Y/OF W/ C/C OF RECTAL BLEEDING, AND IT HAPPENED EXACTLY HOW YOU THINK IT HAPPENED.....


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## Qulevrius (Sep 12, 2016)

19 y.o. s/p mva (motorcycle vs auto). Positive helmet, no head trauma/intact neurology, multiple abrasions/avulsions upper + lower extremities, the works. Treated on scene, refused transport,  fire cancelled by PD, AMA'd. Response time to clear time = 17 min flat.


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## VentMonkey (Sep 17, 2016)

Standard ALS transfer...easy monies.


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## titmouse (Sep 18, 2016)

52 yom s/p head on collision, pretty brutal car devastation (incredible engineering feat though). no neck/back pain to palpation with no deformities. C/C left knee pain. Still scored himself a backboard and c-collar ride to the ER.


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## Handsome Robb (Sep 18, 2016)

titmouse said:


> 52 yom s/p head on collision, pretty brutal car devastation (incredible engineering feat though). no neck/back pain to palpation with no deformities. C/C left knee pain. Still scored himself a backboard and c-collar ride to the ER.












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## NomadicMedic (Sep 18, 2016)

If I was in a wreck and had no pain in my neck or back and somebody tried to board and collar me, I would lose my mind.


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## DesertMedic66 (Sep 18, 2016)

DEmedic said:


> If I was in a wreck and had no pain in my neck or back and somebody tried to board and collar me, I would lose my mind.


He's combative and speaking nonsense, he must have a head injury. We need full c-spine and bilateral large bore IVs with the bag wide open. 

- Every firefighter


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## VentMonkey (Sep 18, 2016)

DesertMedic66 said:


> He's combative and speaking nonsense, he must have a head injury. We need full c-spine and bilateral large bore IVs with the bag wide open.
> 
> - Every firefighter


Let us not forget that _every patient _must receive high flow O2 as well.

-Every firefighters fire captain to every firefighter.


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## gotbeerz001 (Sep 18, 2016)

I work in two systems; one has a very progressive SMR policy and the other does not. While there are provisions for modified C-spine in the latter, I find myself constantly running into a (still) strongly pro-backboard culture; as a CYA measure (if nothing else). 

I have cringed several times as people who technically meet trauma criteria (by mechanism only) are subjected to straps, a board and bilateral IVs when a simple ride to a local hospital (or even an refusal) is one phone call away. 


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## DesertMedic66 (Sep 18, 2016)

Worked at our race track yesterday for a motorcycle race (well 15 different races). Total of 8 riders all going down at speeds of 80-120mph with no injuries. 

The only actual call I had was a dehydration. Walked up to us before his final race. Pop a line in and a fluid bolus followed by an AMA.


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## CALEMT (Sep 18, 2016)

Heroin OD. Narcan for the win.


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## DesertMedic66 (Sep 18, 2016)

CALEMT said:


> Heroin OD. Narcan for the win.


Wow. Where at? We don't get to many of those


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## CALEMT (Sep 18, 2016)

DesertMedic66 said:


> Wow. Where at? We don't get to many of those



2's area. Transient called 911 for her friend who we found in a hedge grove.


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## NPO (Sep 18, 2016)

See "last call of the day" thread...


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## Jim37F (Feb 3, 2017)

Cardiac arrest. Witnessed collapse at home but no family CPR, first engine on scene <6min, ALS on scene prior to our arrival, PT in asystole, worked him up, 3x epi, 1xBiCarb, pt went into fine V-Fib, shocked twice, base wanted us to go ahead and transport to their STEMI Center (w/out ROSC bleh, though maybe 4-5 min from transport to pt on hospital bed) worked him up there for like 20 more min, still asystole, before they called it.


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## twistedMP (Feb 3, 2017)

Psych transfer was the first call of the day today 


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## DesertMedic66 (Feb 3, 2017)

AIDS/cancer patient with the flu followed by a syncopal episode at a grocery store, followed by a stroke at a SNF.


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## Handsome Robb (Feb 3, 2017)

Explosion at a DOD contractor company. DSI, 45% BSA full thickness burns including his airway and a flight to the burn center in San Antonio. We were the assist unit. Basically got to play but not write any paperwork. 


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## NomadicMedic (Feb 3, 2017)

Handsome Robb said:


> Explosion at a DOD contractor company. DSI, 45% BSA full thickness burns including his airway and a flight to the burn center in San Antonio. We were the assist unit. Basically got to play but not write any paperwork.
> 
> 
> Sent from my iPhone using Tapatalk



Your black cloud makes mine look like drizzle.


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## VentMonkey (Feb 3, 2017)

DEmedic said:


> Your black cloud makes mine look like drizzle.


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## NysEms2117 (Feb 3, 2017)

this was a few days ago, but severe DKA + asthma attack + recent release from hospital noting pleurisy present. ETC02 at a whopping 7.


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## VentMonkey (Feb 3, 2017)

NysEms2117 said:


> this was a few days ago, but *severe DKA* + asthma attack + recent release from hospital noting pleurisy present.* ETC02 at a whopping 7*.


Classic metabolically acidotic patient.


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## VFlutter (Feb 3, 2017)

Nasal cannula ETC02 or intubated? Never seen an ETCO2 under 15 in a patient with a pulse


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## NysEms2117 (Feb 3, 2017)

Chase said:


> Nasal cannula ETC02 or intubated? Never seen an ETCO2 under 15 in a patient with a pulse


Cannula, patient looked like they were going to die any second. I was just a helper, CC-P medic partner was going into his zone doing his thing.


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## VentMonkey (Feb 3, 2017)

That's a nightmare long term management-wise in regards to intubating a patient that far into their DKA/ metabolic acidosis and requires vent management years above me and my lowly medic license. It does sound like respiratory failure though, so not much of a choice.


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## NysEms2117 (Feb 3, 2017)

VentMonkey said:


> requires vent management years above me and my lowly medic license. It does sound respiratory failure, though, so not much of a choice.


That was the look on his face too... he kinda got what the doc told him and was like "ooooookayyyyy lets give this a go"

Edit: HR was 115(if i remember correctly), sugar off the charts, breath like juicy fruit, pt was severely disoriented, and i personally think had acute hearing loss. but i wasn't in charge(rightfully so).


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## Handsome Robb (Feb 4, 2017)

DEmedic said:


> Your black cloud makes mine look like drizzle.



I wish we could've taken a picture with the King Vision as to exactly what we were dealing with in his airway. Anatomy was all but completely unrecognizable. Glad I was the assisting airway medic rather than the actual airway medic. I just suctioned for him and tried to help identify landmarks then the two of us talked briefly about what we needed to do to get the tube to pass the swollen shut chords once he got the bougie to pass. 

100% the scariest airway I've ever seen. 


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## VentMonkey (Feb 4, 2017)

Paced rhythm with runs of WCT. The Fentanyl helped a little, but I sure wish we could administer just a pinch of one of our benzo's for these patients.

Not quite symptomatic, but the pm would fail for a minute or so. I can't imagine decreasing the patients anxiety even just a smidge wouldn't help. Either way, sounds like someone is due for an upgrade of the AICD variety.


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## NomadicMedic (Feb 4, 2017)

Dispatched for a stroke. Not a stroke, but a PTSD panic attack.

At least the EMS room at the hospital had schnaks.


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## StCEMT (Feb 4, 2017)

Cardiac arrest that neither us nor fire were expecting.


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## NPO (Feb 4, 2017)

DEmedic said:


> Dispatched for a stroke. Not a stroke, but a PTSD panic attack.
> 
> At least the EMS room at the hospital had schnaks.


At least in my area, I feel like stroke is the most incorrectly EMD'd response. 

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## CALEMT (Feb 4, 2017)

NPO said:


> At least in my area, I feel like stroke is the most incorrectly EMD'd response.
> 
> Sent from my Pixel XL using Tapatalk



Same here. Probably because of all the campaigning for s/s of stroke have people paranoid.


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## VentMonkey (Feb 4, 2017)

NPO said:


> In *any *area, I feel like *all calls get *a mostly incorrect EMD'd response.


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## NPO (Feb 4, 2017)

I see what you did there. 

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## NomadicMedic (Feb 4, 2017)

We have notoriously bad emd. Calls are almost never what the original dispatch is for.


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## VentMonkey (Feb 4, 2017)

DEmedic said:


> We have notoriously bad emd. Calls are almost never what the original dispatch is for.


I'd venture to guess that this is universal with the EMD system in general. You say one word---wrong, or right---and presto! whammo! Here comes the calvary.


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## NomadicMedic (Feb 4, 2017)

VentMonkey said:


> I'd venture to guess that this is universal with the EMD system in general. You say one word---wrong, or right---and presto! whammo! Here comes the calvary.



Absolutely right. Lateral interrogation bias. 

Here's a great article from Dr Clawson, that father of Priority Medical dispatch. 

https://www.emergencydispatch.org/articles/protocolsvsguidelines1.htm


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## NPO (Feb 4, 2017)

Yes. As providers we are trained to ask "open ended questions" where the patient is to describe what's wrong.

EMD is exactly the opposite, asking closed questions, preferably yes or no. 

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## cruiseforever (Feb 5, 2017)

On a 120 mile mental health transfer right now.  Hot spots are a wonderful thing to help pass the time.


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## Jim37F (Feb 5, 2017)

Syncopated episode. Had time to get on scene, find the patient, do an eval, and extricate her off the toilet in the super tiny/narrow bathroom without getting **** everywhere (elderly lady with full diaper, had to GS carry her) and got her in the gurney as fire was showing up on scene.


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## NPO (Feb 13, 2017)

Bee sting about 30 minutes from the station in the middle of nowhere. Walk-up to a fire station.

AMA'd

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## NPO (Feb 20, 2017)

First call of the day was... From my supervisor. "can you hold over"

No. No I cannot. That would put me on a 144 hour shift and our boss would have your head for that lol.

Got off on time 

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## CodeBru1984 (Feb 20, 2017)

NPO said:


> First call of the day was... From my supervisor. "can you hold over"
> 
> No. No I cannot. That would put me on a 144 hour shift and our boss would have your head for that lol.
> 
> ...



You should have held over. I mean, it's on the supervisor at that point. 


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## Jim37F (Feb 20, 2017)

Headache X2 days out of a SNF that they gave 1 x325mg Norco an hour prior to calling because it "had no effect"


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## Nick15 (Feb 20, 2017)

Cancel since my partner was late for start of shift haha. 


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## Jim37F (Feb 20, 2017)

Nick15 said:


> Cancel since my partner was late for start of shift haha.
> 
> 
> Sent from my iPhone using Tapatalk


Here that would mean someone from the off going crew would get to run the transfer with you as our company can mandatory hold you over up to 2 hours past your scheduled off time explicitly for cases like this...they can and will give you a call without a second thought 1hr 55 min into those 2 hours...ask me how I know....

First ALS IFT run of the day proved interesting....dispatched to an Urgent care center attached to a hospital for an asthma exasperation going to a different hospital  (I think for insurance reasons? Forget exactly why she was going to that hospital vs the one the urgent care is apart of, but I digress..) We get there and the pt, whose on a breathing treatment, is starting to complain of a new onset chest pain within the last 5 min, which apparently was news to the nurse. Well they were already in the process of running their own 12 lead at this time, showed it to the doctor who was right there.....tachy at 130-140, ST elevation in V1, 2, 3, depression in V5 and 6.....doctor almost called 911 for an emergent transfer before remembering we were an ALS unit and asked if we could take her....sure can! Fortunately the same hospital they wanted her to go to originally was also the nearest STEMI Center, which the doc wanted her going like now "hurry up dudes...hurry up" while we were DC'ing the hospital equipment. ..quick call to base, transmit our 12 lead, Nitro and aspirin and O2 and we were transporting emergent to the STEMI Center...no fire aid needed lol


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## Nick15 (Feb 20, 2017)

Jim37F said:


> Here that would mean someone from the off going crew would get to run the transfer with you as our company can mandatory hold you over up to 2 hours past your scheduled off time explicitly for cases like this...they can and will give you a call without a second thought 1hr 55 min into those 2 hours...ask me how I know....
> 
> First ALS IFT run of the day proved interesting....dispatched to an Urgent care center attached to a hospital for an asthma exasperation going to a different hospital  (I think for insurance reasons? Forget exactly why she was going to that hospital vs the one the urgent care is apart of, but I digress..) We get there and the pt, whose on a breathing treatment, is starting to complain of a new onset chest pain within the last 5 min, which apparently was news to the nurse. Well they were already in the process of running their own 12 lead at this time, showed it to the doctor who was right there.....tachy at 130-140, ST elevation in V1, 2, 3, depression in V5 and 6.....doctor almost called 911 for an emergent transfer before remembering we were an ALS unit and asked if we could take her....sure can! Fortunately the same hospital they wanted her to go to originally was also the nearest STEMI Center, which the doc wanted her going like now "hurry up dudes...hurry up" while we were DC'ing the hospital equipment. ..quick call to base, transmit our 12 lead, Nitro and aspirin and O2 and we were transporting emergent to the STEMI Center...no fire aid needed lol



It wasn't really a holdover, but we do that exact same thing too. We have two units at the station, so the crew who got on before us took it even though technically they should have been second up at that time. 
But my partner showed up right as they were pulling away for the call. 


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## VentMonkey (Feb 20, 2017)

Jim37F said:


> First ALS IFT run of the day proved interesting....dispatched to an Urgent care center attached to a hospital for an asthma exasperation going to a different hospital  (I think for insurance reasons? Forget exactly why she was going to that hospital vs the one the urgent care is apart of, but I digress..) We get there and the pt, whose on a breathing treatment, is starting to complain of a new onset chest pain within the last 5 min, which apparently was news to the nurse. Well they were already in the process of running their own 12 lead at this time, showed it to the doctor who was right there.....tachy at 130-140, ST elevation in V1, 2, 3, depression in V5 and 6.....doctor almost called 911 for an emergent transfer before remembering we were an ALS unit and asked if we could take her....sure can! Fortunately the same hospital they wanted her to go to originally was also the nearest STEMI Center, which the doc wanted her going like now "hurry up dudes...hurry up" while we were DC'ing the hospital equipment. ..quick call to base, transmit our 12 lead, Nitro and aspirin and O2 and we were transporting emergent to the STEMI Center...*no fire aid needed* lol


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## CALEMT (Feb 20, 2017)

VentMonkey said:


> View attachment 3541



Just imagine if he worked in a real county that allows paramedics to practice medicine. Like having the ok to do something without asking the MICN or doctor.


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## jgmedic (Feb 21, 2017)

CALEMT said:


> Just imagine if he worked in a real county that allows paramedics to practice medicine. Like having the ok to do something without asking the MICN or doctor.



LACo EMS.....70+ years of tradition, unimpeded by progress.


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## StCEMT (Feb 21, 2017)

VentMonkey said:


> View attachment 3541


My face yesterday when we offer to jump an OD we are one exit away from and get sent 17 minutes away to something else. Whatever, still getting that sweet sweet time and a half!


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## TraumasorusRex (Mar 3, 2017)

titmouse said:


> Today it was IFT


What is IFT?


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## Jim37F (Mar 3, 2017)

TraumasorusRex said:


> What is IFT?


Inter-Facility Transport


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## Lo2w (Mar 20, 2017)

Started orientation today. Finish up reviewing the handbook and dispatch gets a call to transport a morbidly obese PT that was having respiratory issues. Facility couldn't bronch someone that large. Nurse-medic (one of the managers/owners doing my orientation) has me come with along with another EMT and a medic. I got to ride in the back and bag while they finished setting up the vent. Pretty interesting first day.


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## Daiawa (Apr 28, 2017)

VentMonkey said:


> I'd venture to guess that this is universal with the EMD system in general. You say one word---wrong, or right---and presto! whammo! Here comes the calvary.



This is most prevalent with the "are they responding appropriately" or "breathing normally" questions.One of the worst is the entrapment question, say the person cant open the driver side door, but are uninjured, instant entrapment response.


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## Never2Old (Apr 28, 2017)

First day as a paid Paramedic on my first orientation shift with a municipal 911 service. First call of the night is a 48 yo woman with chest pain with a Hx of three prior MI's, HTN and Diabetes. Arrive to find a very large Diaphoretic woman with SOB sprawled on the couch, clutching her chest and gasping that she is having 'another' heart attack, and it is worse than the last one ... and telling me that 'I knows I is going to die this time'. We made it to the hospital ER without incident. Initial pucker factor was high to say the least.


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## Fido198674 (Apr 30, 2017)

Chest pain, cancelled on scene


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## NPO (May 7, 2017)

Unknown medical aid... Possible dead body on the side of the road. 

I never looked at the body, but I felt fairly confident they were deceased based on where I found the body.....in a coroner's van. 

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## harold1981 (May 16, 2017)

Patient states he has been tortured by voodoo dolls.


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## Jim37F (May 17, 2017)

Received 911 call out of the outpatient center at our local hospital (same campus as the ER) for "numbness on left arm"...fortunately just as we went on air to respond we got cancelled by a doctor on scene advising we weren't needed.....only to end up getting a response for a 34yom having an anxiety attack at work (w/ hx of anxiety, missed a dose of his meds....yup got a ride to the ER for that..)


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## Fido198674 (May 17, 2017)

Today so far.... Post at hospital, haven't moved in four hours... Yesterday Psych transport for SI from an ER to psych facility, no precautions, voulentary... Been a nice couple boring shifts really


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## NomadicMedic (May 18, 2017)

80 year old had a mechanical fall. She snagged the tennis balls on her walker feet on the door jamb and fell over backwards. Open radius/ulna on the right wrist, a gigantic skin tear on the left. A sweet old lady, in excruciating pain. She was fragile like a bird. Before we did anything, I started a line and gave her 12.5mg of Phenergan and 4 of Morphine. (I love having phenergan) Then a splint and bleeding control got her comfortable and made for an easy transport.  We almost had to transport her daughter as well. When she saw the open fx, she almost passed out.

Aside from a couple of cancellations and a minor MVA, that was my night last night.


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## EpiEMS (May 18, 2017)

NomadicMedic said:


> Before we did anything, I started a line and gave her 12.5mg of Phenergan and 4 of Morphine. (I love having phenergan)



I wish more medics did pain control as nicely as you!


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## NomadicMedic (May 18, 2017)

EpiEMS said:


> I wish more medics did pain control as nicely as you!



Thanks. After working as a Basic where I moved and transported dozens of little old ladies with fractures and no pain management, I am especially cognizant of how important it is to get some analgesic on board quickly.


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## EpiEMS (May 18, 2017)

NomadicMedic said:


> Thanks. After working as a Basic where I moved and transported dozens of little old ladies with fractures and no pain management, I am especially cognizant of how important it is to get some analgesic on board quickly.



It's why I'd love to see Entonox or something in the U.S., especially for rural BLS providers (or services with salty folks that don't like to open the narcs).


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## Jim37F (May 18, 2017)

NomadicMedic said:


> Thanks. After working as a Basic where I moved and transported dozens of little old ladies with fractures and no pain management, I am especially cognizant of how important it is to get some analgesic on board quickly.


After lots of similar transports, including one last night where a 7 yr old boy got burned by hot water (superficial burn, but 6%bsa over pretty much his entire belly) with the medics saying "Here, keep pouring water on the dressings, and off you go, see ya", if I ever end up a medic in HI I feel like I'd have a rather low threshold to break out pain meds


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## NomadicMedic (May 18, 2017)

Jim37F said:


> After lots of similar transports, including one last night where a 7 yr old boy got burned by hot water (superficial burn, but 6%bsa over pretty much his entire belly) with the medics saying "Here, keep pouring water on the dressings, and off you go, see ya", if I ever end up a medic in HI I feel like I'd have a rather low threshold to break out pain meds



I've seen new medics medicate EVERYBODY, whether they really need pain meds or not and I've seen salty medics work months without opening the narcs. I've fallen more toward the middle, actively offering meds to people I think really need them and taking care of the ones who present as painful. Usually the people who need pain meds don't ask for them.


----------



## StCEMT (May 18, 2017)

I've had little old ladies with confirmed fractures actually refuse pain meds, those older folks can be tough. I do agree with giving them something before moving them, I learned the importance of that early on.


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## Lo2w (May 19, 2017)

Get called for a discharge out of the ED to a local nursing home. Walk in and patient is sitting edge of bed offering to walk out to the truck. Partner and I look at each other, ED staff can't give a legit medical necessity. Partner walks off, calls our office and comes back to tell the nurse we can't take it.


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## LiveForTheTones (May 23, 2017)

Pt: I'm having chest pain.
Me: Is it localized to one side? Does it feel sharp? Shooting?
Pt: It just hurts.
Me: Any hx of heart issues in the past? (as I'm applying EKG leads)
Pt: No. Why are you asking so many questions??
Me: 


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## LiveForTheTones (May 23, 2017)

LiveForTheTones said:


> Pt: I'm having chest pain.
> Me: Is it localized to one side? Does it feel sharp? Shooting?
> Pt: It just hurts.
> Me: Any hx of heart issues in the past? (as I'm applying EKG leads)
> ...



They also asked if the EKG was REALLY necessary. I was very tempted to answer: "Nope!! This is for my own amusement."


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## GMCmedic (May 23, 2017)

Dispatched via alarm company call for an unresponsive female. Get to the address and make contact to find an elderly female lying in bed with a GCS of 5 and agonal respirations. 

Dispatch advises we can disregard that patient no linger lives there :/

I RSI'd her

I still have no idea who pressed the life alert button. Patient live alone with a cat. Logic says patient did it before her condition worsened but I like to think the cat did it.

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## StCEMT (May 23, 2017)

GMCmedic said:


> Dispatched via alarm company call for an unresponsive female. Get to the address and make contact to find an elderly female lying in bed with a GCS of 5 and agonal respirations.
> 
> Dispatch advises we can disregard that patient no linger lives there :/
> 
> ...


That misinformation is scary. How did informing them that she did in fact live there go?


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## NomadicMedic (May 23, 2017)

LiveForTheTones said:


> Pt: I'm having chest pain.
> Me: Is it localized to one side? Does it feel sharp? Shooting?
> Pt: It just hurts.
> Me: Any hx of heart issues in the past? (as I'm applying EKG leads)
> ...




Get used to it.


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## GMCmedic (May 23, 2017)

StCEMT said:


> That misinformation is scary. How did informing them that she did in fact live there go?


Pretty easy. Just told them we in fact did have an unresponsive patient and to continue fire, they did as asked. 


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## VentMonkey (May 23, 2017)

Last shift I worked, first real call was a critically ill diabetic. Fire wondered why patient was so lethargic. Fam said that their glucometer tapped out at 600, ours is 500.

My accucheck was still friendly enough when I checked it. Can you say fluids, fluids, and oh yeah, more fluids. The trainee I had did pick up on the "sick vs. not sick", so that was nice.


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## Lo2w (May 29, 2017)

Combative psych to the psychiatric hospital. Our off going crew had already seen PT twice, transporting fron the nursing home to the ED and back after putting their hand through a window after getting upset with staff. Past history of ETOH abuse and various mental health issues.

Luckily when we showed up PT was fast asleep on a nice dose of meds. Slept nearly the whole way down until 15 minutes out. Then started giving me the squirrely eyes like they were sizing up the truck and me.


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## Jim37F (May 29, 2017)

Start of the 48, the day before yesterday, elderly fall at home with some skin tears to the arm.....turned from a simple BLS fall to an ALS emergent run to the hospital when pt had new onset unilateral left sided weakness, facial droop, and slurred speech......

Day 2 of the 48 (different shift at a different station just back to back), 2 17-year-olds totaled a Stingray Corvette driving down a canyon road, attempting to pass someone, overcorrected, lost control, went head-on into an SUV, fortunately, speeds were slow enough that although pieces of the car were all over the road, only 1 real patient with a nice little forehead lac.

LAST call of the shift was a bit of a doozy though, 2 hours before getting off, reported seizure, rural canyon area, fire medics said they had a 10 min response (we had like a 15-20min on the ambulance.....didn't help it was the second call in someone else's district up in the mountains...) and the kid (another 17 yr old) was still seizing.....polypharm overdose, 1-1-1 on the GCS, had to break out the BVM to assist ventilations, medic said the only reason he didn't intubate is that he was clenching his teeth so hard I couldn't even get an OPA in (NPA dropped in no prob ha) and his heart rate and BP were bad news (I was too busy bagging to really get the actual numbers off the monitor as it was facing the medic not me ha), friends only said he took LSD, but the pinpoint pupils, respiratory depression, and that he woke up in the hospital shortly after 2mg naloxone IV en route point to other drugs ha....kinda cool to see the ED Doc straight up RSI the kid


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## soflomedic14 (May 30, 2017)

Degloving of the right hand from machinery


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## Eden (May 30, 2017)

Unconscious in a store approx 60 yom.. apparently pt ( who is, according tothe store owner, a homeless) went in and complained he didnt feel well  then collapsed. ended up a code (asystole, yea sounds like vf i know) with rosc and attempted cardioversion afterwards (afib with rvr).


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## Jim37F (Jun 12, 2017)

Sudden non traumatic hip dislocation. Guy was driving along, had to take a piss, decided he couldn't wait, so he pulled over to the side, and went to go in a cup or something....and when he twisted....pop! No other trauma, didn't get hit by anything, no history of recent injuries or surgeries or anything like this happening before. Positive shortening and inward rotation and obvious deformity..getting him out of his truck and into the ambulance (then the hospital bed) was a bit of a chore as he screamed bloody murder every time he moved a little.


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## cruiseforever (Jun 12, 2017)

34 y.o. male with sudden onset of chest pain radiating into his back.  Waited an hour, when it did not improve called 911.  Monitor showed inferior MI, 6 minute scene time, Nitro and ASA.  Two minutes later he said he did not feel well.  He arrested, defib x 2.  Became AxOx4, monitor now sinus tach with no elevation, pt. is pain free.  Arrived at the ER looking good.  Doc. was skeptical of the MI until I showed him the first 12 lead.


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## NomadicMedic (Jun 12, 2017)

cruiseforever said:


> 34 y.o. male with sudden onset of chest pain radiating into his back.  Waited an hour, when it did not improve called 911.  Monitor showed inferior MI, 6 minute scene time, Nitro and ASA.  Two minutes later he said he did not feel well.  He arrested, defib x 2.  Became AxOx4, monitor now sinus tach with no elevation, pt. is pain free.  Arrived at the ER looking good.  Doc. was skeptical of the MI until I showed him the first 12 lead.



Good job! Those are the ones that make it all worth while.


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## Old Tracker (Jun 13, 2017)

Yesterday, got a call to expect a 77 yo F, who had a pulmonary embolism, kidney failure, and who needed a blood transfusion to arrive at the local Port of Entry.  No aircraft available. So, we are waiting and get a call for a 79 yo M who fell and broke his knee. Had to respond to him and take him to the hospital.

Little old lady finally showed up and second unit ended up taking her, but, lucky for them an aircraft was able to make it by then and she got flown out.


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## GMCmedic (Jun 13, 2017)

Sunday it was a trauma transfer, 14 y/o with L4-L5 spinous process fractures. 

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## NPO (Jun 13, 2017)

Jim37F said:


> Sudden non traumatic hip dislocation. Guy was driving along, had to take a piss, decided he couldn't wait, so he pulled over to the side, and went to go in a cup or something....and when he twisted....pop! No other trauma, didn't get hit by anything, no history of recent injuries or surgeries or anything like this happening before. Positive shortening and inward rotation and obvious deformity..getting him out of his truck and into the ambulance (then the hospital bed) was a bit of a chore as he screamed bloody murder every time he moved a little.


Any pain meds given? I tend to load up these patients before moving them, but I've also had hip dislocations that didn't respond to even large doses of analgesia. 

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## Jim37F (Jun 13, 2017)

NPO said:


> Any pain meds given? I tend to load up these patients before moving them, but I've also had hip dislocations that didn't respond to even large doses of analgesia.
> 
> Sent from my Pixel XL using Tapatalk


Us and BLS engine co got the guy loaded up in the ambulance and still had to wait a little bit for the medic squad to show up, but they did give 4mg of MS before sending us BLS to the hospital


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## NPO (Jun 13, 2017)

Jim37F said:


> Us and BLS engine co got the guy loaded up in the ambulance and still had to wait a little bit for the medic squad to show up, but they did give 4mg of MS before sending us BLS to the hospital


LACo... *Rolls Eyes*

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## VentMonkey (Jun 14, 2017)

An atypical AMI with right sided involvement. Initially it had presented like an epidural bleed, and came across as a "fall". Alas, the ever so reliable EMD-coding strikes again.


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## DesertMedic66 (Jun 14, 2017)

64 year old female who said she wanted to go to the hospital because she thought her home medications were being switched out for cyanide. She also thought a coke bottle she just bought was filled with cyanide.


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## NomadicMedic (Jun 14, 2017)

Chest pain transport from the local hospital to the PCI capable facility. Tridil, zofran and Morphine made for a mellow ride.


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## NPO (Jun 18, 2017)

Pseudo seizure to get pain meds. 
Fooled the jail nurse. Didn't fool me.

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## NomadicMedic (Jun 18, 2017)

Chest pain secondary to multiple AICD discharge. Guy was mostly stable with lots of ectopy and couplets of PVCs. We both gave the monitor the side eye during the transport. Guy said, "if those big beats string together my defib lights me up right?" 

Yep. That's about it. 

I had a chat with the cardiologist at the ED and he debated with his colleagues about amio or lido during the 50 minute transport, then decided to just have me transport him. 

Totally uneventful and we chatted about  remodeling projects through the entire transport. A good call.


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## Jim37F (Jun 18, 2017)

NomadicMedic said:


> Chest pain secondary to multiple AICD discharge.


I had a call like that once. Guy called cuz he thought his AICD was malfunctioning and periodically shocking him.....monitor showed runs of V-Tach and then he'd get shocked. We were like "Uh no sir, your defibrillator is not malfunctioning, it's actually working exactly as designed, if not this would be a VERY different call, why don't you go ahead and sit down on thus here gurney and we'll get the nice doc at the hospital to help you out..." The medic left the Zoll printer running and i swear we burned through an entire roll of paper


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## DocRip (Jun 18, 2017)

Unknown medical. 
Partner turns to me and says, "I hate bulls*** unknown medical calls, it's always stomach pain!"
Turned out to be a TIA. I knew better than to say anything to my partner, she's feisty.


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## harold1981 (Jul 13, 2017)

Code 3 for the male patient who has been attacked by a rattlesnake. 
We find this naked guy who is frantically searching his living room. He states that he was watching TV on the couch when he felt a snake slip into his pants and bite him in the crouch. We find no bite marks, and no snake whatsoever. Then while a police officer is searching his pants he starts screaming at the top of his lungs at the sight of an invisable snake and for us that´s the last missing piece of the puzzle, to take him in for a psych analysis of his psychotic behaviour.


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## NomadicMedic (Jul 13, 2017)

IFT of a very pleasant female with multiple PE. A nice mellow trip, hoping she stayed stable. 

She did.


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## GMCmedic (Jul 13, 2017)

IFT from critical access hospital to  big hospital. Worsening pneumonia vs cancer. My money is on lung cancer. 

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## NPO (Jul 13, 2017)

Headache x 3 days. Seen at 2 hospitals over the past 3 days, diagnosed with sinus infection. Didn't take prescribed antibiotics because she looked up the side effects online and didn't like them. Pt states she's not getting any better. Wants to go to a third hospital 2 blocks from home. 

Got off the gurney because she didn't have anyone to watch her kids. Called 911 an hour later when someone came over. 

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## EpiEMS (Jul 13, 2017)

NPO said:


> Wants to go to a third hospital 2 blocks from home.



I'll take "Things that make folks not in EMS go":





for $800, Alex.


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## GMCmedic (Jul 13, 2017)

EpiEMS said:


> I'll take "Things that make folks not in EMS go":
> 
> 
> 
> ...


Second run of the day. Well known patient that lives 2 blocks from hospital. Called because he got beat up. Arrived to find him smoking on the porch. Walked halfway out to ambulance and then started yelling at us to leave when we asked what was going on. Told us he was going to call the neighboring ambulance that is at least 35 minutes away with lights and sirens. Finally agrees to ride with us and asked to go to the hospital 2 blocks away. 

Then claimed he couldnt walk up the steps into the ambulance cause of sciatica after i watched him walk up the steps to his home......twice. 

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## NPO (Jul 13, 2017)

GMCmedic said:


> Then claimed he couldnt walk up the steps into the ambulance



I wish I could walk patients into the ambulance. It is my opinion that making a perfectly ambulatory patient get on a gurney is more dangerous than walking. But, I'm not in charge. So.

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## NomadicMedic (Jul 13, 2017)

NPO said:


> I wish I could walk patients into the ambulance. It is my opinion that making a perfectly ambulatory patient get on a gurney is more dangerous than walking. But, I'm not in charge. So.
> 
> Sent from my Pixel XL using Tapatalk




 Wait? Ambulatory patients have to get on the gurney before they get in the ambulance?


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## NPO (Jul 13, 2017)

NomadicMedic said:


> Wait? Ambulatory patients have to get on the gurney before they get in the ambulance?


Patient: I can walk.
Paramedic: No you can't. Waking is dangerous. You could die. Please get on the gurney, which is top heavy, and easily stopped by a small pebble. Also, we could drop you, or hurt our backs. But please get on the gurney before we leave your house. 

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## NysEms2117 (Jul 13, 2017)

NYSEMS2117 Parolee's 5 yr old kid in the parking lot (as i was conveniently walking into work this morning): "bad man just hurt daddy come come"
NYSEMS2117: walks to car parked on the street outside of office- finds parolee stabbed 3 times...
side note* that was one of the smartest 5 year olds i've ever met. Sent him inside to get the trooper that guards the building, was like i was talking to a 20 year old, was absolutely remarkable. 

Pt/parolee survived(after surgery) and is at the hospital.


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## Qulevrius (Jul 15, 2017)

1st call - stroke. 2nd call - abd pain. 3rd call - assault. Etc etc, it's been one of these days...


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## DesertMedic66 (Jul 15, 2017)

72 year old female with SVT that has been going on for 4 hours. Patient tried dunking her head in cold water and bearing down with no relief. After 4 hours of her doing normal chores and it not going away she called 911. Amazing BP and skins. Walked her to the ambulance. Converted her in the back with adenosine and then spent about 5 minutes deciding if she wanted to sign out AMA or not. History of SVT episodes well over 20 times in the past with conversion with adenosine on all of them. Already has an appointment next week for an ablation. 

Super nice lady who did not trust the fire department at all and looked to us to confirm everything they were saying. She is in training to run the LA marathon.


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## chrls (Jul 15, 2017)

DesertMedic66 said:


> Super nice lady who did not trust the fire department at all and looked to us to confirm everything they were saying.



This. I love this.


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## NPO (Jul 15, 2017)

DesertMedic66 said:


> Super nice lady who did not trust the fire department at all and looked to us to confirm everything they were saying. She is in training to run the LA marathon.



With age comes experience.

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## NPO (Jul 15, 2017)

Qulevrius said:


> 1st call - stroke. 2nd call - abd pain. 3rd call - assault. Etc etc, it's been one of these days...
> 
> 
> Sent from my iPhone using Tapatalk


Sounds like a good day. My day usually goes
1: unmanaged chronic condition
2: unmanaged acute illness
3: recent ER D/C with no improvement in several hours. 

Etc, etc, etc


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## Qulevrius (Jul 15, 2017)

NPO said:


> Sounds like a good day. My day usually goes
> 1: unmanaged chronic condition
> 2: unmanaged acute illness
> 3: recent ER D/C with no improvement in several hours.
> ...



It was good til about 15 min to EOS when we got cleared back & they dropped a call on us 2 mi away from station 


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## GMCmedic (Jul 15, 2017)

Slip and fall on wet floor at the local Mcdonald's. Positive LOC with repetitive questioning and confusion on place and event.

 Dx - Concussion and payday

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## NomadicMedic (Jul 15, 2017)

GMCmedic said:


> Slip and fall on wet floor at the local Mcdonald's. Positive LOC with repetitive questioning and confusion on place and event.
> 
> Dx - Concussion and payday
> 
> Sent from my SAMSUNG-SM-G920A using Tapatalk



I'm lovin it. Cha-Ching


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## GMCmedic (Jul 24, 2017)

Elderly COPD'er with legit broncospasms and poor air movement. CPAP and inline nebs saved another from a tube.

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## NPO (Jul 24, 2017)

GMCmedic said:


> Elderly COPD'er with legit broncospasms and poor air movement. CPAP and inline nebs saved another from a tube.
> 
> Sent from my SAMSUNG-SM-G920A using Tapatalk


Your opinion on IM epi for COPD?

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## NomadicMedic (Jul 24, 2017)

NPO said:


> Your opinion on IM epi for COPD?
> 
> Sent from my Pixel XL using Tapatalk



They would have to be really CTD for me to consider using Epi.  I've not had a COPD exacerbation case that has not responded to inhaled beta agonists, magnesium and corticosteroids.


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## GMCmedic (Jul 24, 2017)

NPO said:


> Your opinion on IM epi for COPD?
> 
> Sent from my Pixel XL using Tapatalk


Its in our protocol as of the last change. I have been hesitant to use it since im not very enthusiastic on the B1 agonist effects in tachycardic elderly patients. 

Im kind of at the point where CPAP > Epi 

I much prefer brethine which we stopped carrying when we added epi. 

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## NomadicMedic (Jul 24, 2017)

Breathine was the stuff. Sad that it's no longer available. 

Although, everything old seems to come around again. Like Procainamide.


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## NPO (Jul 24, 2017)

GMCmedic said:


> Its in our protocol as of the last change. I have been hesitant to use it since im not very enthusiastic on the B1 agonist effects in tachycardic elderly patients.
> 
> Im kind of at the point where CPAP > Epi
> 
> ...


Okay, so follow up; mag before epi in the elderly?

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## GMCmedic (Jul 24, 2017)

NPO said:


> Okay, so follow up; mag before epi in the elderly?
> 
> Sent from my Pixel XL using Tapatalk


Hmm how to put this? For the sake of discussion we will pretend Asthma doesnt fall under the umbrella term of COPD. 

I looked into using Mag for COPD exacerbation several months ago. Of the few small studies I found, the best conclusion was that it might potentiate the effects of other bronchodilators, but had no effect on hospital admission or length of stay. Nor was it recommended for routine use. 

I have not personally had to resort to Mag, nor have I ever had a protocol for Mag in COPD patients, only specific to asthma. Others that have actually used it may have differing results. 

I think for this particular patient it may have helped since he was having actual bronchospasms, but to answer your original question, yes I would use mag before epi in elderly tachycardic patients, but I doubt that it would be beneficial to most of that demographic. 

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## NPO (Jul 24, 2017)

GMCmedic said:


> Hmm how to put this? For the sake of discussion we will pretend Asthma doesnt fall under the umbrella term of COPD.
> 
> I looked into using Mag for COPD exacerbation several months ago. Of the few small studies I found, the best conclusion was that it might potentiate the effects of other bronchodilators, but had no effect on hospital admission or length of stay. Nor was it recommended for routine use.
> 
> ...


Thanks. Our protocols only differentiate between wet and dry difficulty breathing. With a recommended progressing of bronchodilators -> epi -> mag for dry lungs. With CPAP thrown in at discression, but we aren't required to follow that in a linear algorithim. 

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## Qulevrius (Jul 30, 2017)

2nd degree burn, 36%. Guy is an electrician who accidentally shortened a conduit, resulting in a flash fire that ignited his clothes & burned the entire front aspect, including his face. 16mg of morphine and he still felt pain. This is right after we dropped him off & started cleaning the rig:








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## NPO (Jul 30, 2017)

Qulevrius said:


> 2nd degree burn, 36%. Guy is an electrician who accidentally shortened a conduit, resulting in a flash fire that ignited his clothes & burned the entire front aspect, including his face. 16mg of morphine and he still felt pain. This is right after we dropped him off & started cleaning the rig:
> 
> 
> 
> ...


Not a big mess. Bigger mess than I feel is necessary. But good on ya for loading up the morphine. How was the airway? Do you have any tools in your back pocket for airway protection in burn patients?

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## Qulevrius (Jul 30, 2017)

NPO said:


> Not a big mess. Bigger mess than I feel is necessary. But good on ya for loading up the morphine. How was the airway? Do you have any tools in your back pocket for airway protection in burn patients?
> 
> Sent from my Pixel XL using Tapatalk



Airway was patent, he didn't inhale anything. Sinus tach, waxy skin, 10/10 which dropped to 6/10 with morphine. 1000mL NaCl via both arms, he sucked it in like a vacuum cleaner.

Just the usual regiment of OPAs and NPAs, nothing special. What did you have in mind ?


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## NPO (Jul 30, 2017)

Qulevrius said:


> Airway was patent, he didn't inhale anything. Sinus tach, waxy skin, 10/10 which dropped to 6/10 with morphine. 1000mL NaCl via both arms, he sucked it in like a vacuum cleaner.
> 
> Just the usual regiment of OPAs and NPAs, nothing special. What did you have in mind ?
> 
> ...


Anything in protocols to sedate a conscious person to secure an airway? 

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## Qulevrius (Jul 30, 2017)

NPO said:


> Anything in protocols to sedate a conscious person to secure an airway?
> 
> Sent from my Pixel XL using Tapatalk



Medics carry midazolam. It's LACo, bruv.


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## NPO (Jul 30, 2017)

Qulevrius said:


> Medics carry midazolam. It's LACo, bruv.
> 
> 
> Sent from my iPhone using Tapatalk


Oh. Disregard my questions. Carry on doing the best you can.

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## BASICallyEMT (Jul 30, 2017)




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## NPO (Jul 30, 2017)

06E01 - Person not breathing

Arrive on scene to find patient on a ventilator, phlegm in trachea required suctioning. 

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## NomadicMedic (Jul 30, 2017)

I didn't do anything til 1400. Dispatched to a fall. Patient fell out of her chair at about 0530, been on the floor since then. Family came to check and called us. 

In a nutshell it was a faitly typical elderly failure to thrive. Just a sad situation. Required more skill as a social services advocate than as a paramedic. One more reason I like doing what I do.


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## NPO (Jul 30, 2017)

NomadicMedic said:


> I didn't do anything til 1400. Dispatched to a fall. Patient fell out of her chair at about 0530, been on the floor since then. Family came to check and called us.
> 
> In a nutshell it was a faitly typical elderly failure to thrive. Just a sad situation. Required more skill as a social services advocate than as a paramedic. One more reason I like doing what I do.


These are some of our most rewarding calls involve basic care of human needs. I find them very rewarding. 






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## Akulahawk (Jul 31, 2017)

Qulevrius said:


> 2nd degree burn, 36%. Guy is an electrician who accidentally shortened a conduit, resulting in a flash fire that ignited his clothes & burned the entire front aspect, including his face. 16mg of morphine and he still felt pain. This is right after we dropped him off & started cleaning the rig:
> 
> 
> 
> ...


That's not really much of a mess... but like others have said, Good Job! on getting that guy some pain relief. He likely could have handled a bit more than that before he even started to have a problem due to the morphine. If anyone says that was too much, just tell them the patient went from 10 to 6 on the pain scale, so it probably wasn't enough... patient was still in moderate to severe pain.


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## Qulevrius (Jul 31, 2017)

Akulahawk said:


> That's not really much of a mess... but like others have said, Good Job! on getting that guy some pain relief. He likely could have handled a bit more than that before he even started to have a problem due to the morphine. If anyone says that was too much, just tell them the patient went from 10 to 6 on the pain scale, so it probably wasn't enough... patient was still in moderate to severe pain.



I probably should've mentioned that it turned to be a clusterfck because the 1st ER (the one around the corner) diverted us to a burn ctr in _another county_, that's the main reason for the 16mg. Because it would've been too much effort for the triage nurse to actually put in some thought before agreeing to receive him, before realizing that they cannot handle it.


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## CALEMT (Jul 31, 2017)

Qulevrius said:


> diverted us to a burn ctr in _another county_,



Arrowhead?


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## Qulevrius (Jul 31, 2017)

CALEMT said:


> Arrowhead?



La Palma IC


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## Qulevrius (Jul 31, 2017)

To UCI


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## GMCmedic (Jul 31, 2017)

First call was a female on meth that fell onto an entertainment center, puncturing her cheek and breaking a tooth. 

Haldol is my favorite drug. 



Run #2, sadly RSI'd a 92 year old man. 

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## cruiseforever (Aug 1, 2017)

40 yo male tried to hang himself.  Put the rope around his neck and step off the ladder.  Rope broke and he landed on his back and cracked the back of his head.  He then got up and used a heavy duty electrical cord, this time the cord held, but his wife found him dangling fron the rafters and called 911.. Cops arrived and cut him down before he lost consciousness.  Physically I think he will be ok.


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## CALEMT (Aug 1, 2017)

cruiseforever said:


> Rope broke and he landed on his back and cracked the back of his head. He then got up and used a heavy duty electrical cord,



Wow. He ain't a quitter.


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## GMCmedic (Aug 5, 2017)

Yesterday it was an unresponsive person in a car. Looked to be a mix of COPD exacerbation and opiate overdose. Im not convinced of the latter, ended in an RSI. 

Double medic unit and not my run, but im not super happy with the way the run was handled.

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## NomadicMedic (Aug 5, 2017)

Drowning. Turned into a body recovery.


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## GMCmedic (Aug 9, 2017)

Difficulty breathing at a nursing home. Get there and staff says patient is breathing better. Patient denies ever feeling SOB or any other pertinent complaints. 

BLS to the hospital, as we pull up he ask patient how she feels, she says she feels great. He walks out the side door and around to the back and shes unresponsive, leaning to her right. Take her in, advise of possible stroke, move her over. As the doc is about to tube her, she coded. NH failed to mention the period of confusion and slurred speech that was likely the TIA leading up to the stroke. 

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## Qulevrius (Aug 9, 2017)

Smoker with Hx of COPD, on O2. What could possibly go wrong... 


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## DesertMedic66 (Aug 9, 2017)

Pedi with possible croup. Fever last night. Mother treated at home. Brought patient to an urgent care with a C/C of SOB. Per doctor patient was having severe work of breathing with retractions, nasal flaring, and accessory muscle use with an SpO2 of 74% on room air. They gave decadron and racemic Epi. 

We get on scene and the kid has a nice loud strong cry with wheezing on auscultation. SpO2 of 98% on room air with a shark fin morphology capno at 38mmHg. 

Fire lost their mind with this patient and called the hospital in a panic with no vitals and no information asking for orders for meds that are in our standing orders and also telling them I will be transporting code 3 to them. I pissed them off by transporting code 2 and not allowing Mom to sit on the gurney and hold the patient.


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## Old Tracker (Aug 12, 2017)

Yesterday, the 11th had a first call that was a little strange. Just in the circumstances, not medical or treatment wise.

We use walkie talkies to get paged out and the local PD and SO share the channel.  I'd been listening to the local PD searching for a "naked" man who was seen close to some of the houses down by the Rio Grande River.  Nothing dramatic, not flashing, no weapons or anything like that.

Then we get called to check welfare on the guy after he was found. So, I'm thinking, "Great, AMS or on drugs, first thing in the morning."  Wrong, turns out this guy had been kidnapped in Mexico and been tortured with heated metal bars. The size of the burns looked to be like they possibly used 3/8ths inch rebar.  They had also tried to strangle him. He had a huge hematoma on his larnyx.  Apparently, no serious internal damage because he drank two 16 ounce bottles of water and could speak clearly.  He had burns from the heated metal on both forearms and over both clavicles, plus some minor blistering on his deltoids. On top of all that, poor guy was sunburned from being naked in the sun all morning.

We just cleaned the burns and covered them and turned the poor guy over to the Border Patrol.  Not sure what they did with him because later we had runs to the hospital and he was not brought there for further treatment.


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## VentMonkey (Aug 12, 2017)

Old Tracker said:


> We use walkie talkies to get paged out and the local PD and SO share the channel.  I'd been listening to the local PD searching for a "naked" man who was seen close to some of the houses down by the Rio Grande River.  Nothing dramatic, not flashing, no weapons or anything like that.
> 
> This guy had been kidnapped in Mexico and been tortured with heated metal bars. The size of the burns looked to be like they possibly used 3/8ths inch rebar.


Ouch, cartels?


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## Old Tracker (Aug 12, 2017)

Yep, cartels. You don't hear much about their activities out here because we are so far off the beaten path.


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## NPO (Aug 12, 2017)

12 hours in. Haven't had one yet. But I've been posted on the middle of nowhere for quite a while. 

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## Qulevrius (Aug 13, 2017)

A ~450 pounder with SVT. Cardioverted with adenosine twice on the way to the ER, 3rd time in the ER with Verced + adenosine + zaps. Verbatim quote from the pt: 'I ****ing swear to god, I never wanna do it again !'

P.S. Apparently, he was cardioverted just last week, in the same ER.


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## NPO (Aug 13, 2017)

NPO said:


> 12 hours in. Haven't had one yet. But I've been posted on the middle of nowhere for quite a while.
> 
> Sent from my Pixel XL using Tapatalk


Never transported all 24. Got a couple minor assaults. Mostly domestic issues with no treatment needed. 

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## GMCmedic (Aug 13, 2017)

Vomiting and diarrhea for a month that patient has been to 2 EDs for already. 

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## NPO (Aug 13, 2017)

34 hours into my 48, got my first call. Let me sum it up.

"Are you new? I know all of the other paramedics."

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## Medic27 (Aug 14, 2017)

GMCmedic said:


> Difficulty breathing at a nursing home. Get there and staff says patient is breathing better. Patient denies ever feeling SOB or any other pertinent complaints.
> 
> BLS to the hospital, as we pull up he ask patient how she feels, she says she feels great. He walks out the side door and around to the back and shes unresponsive, leaning to her right. Take her in, advise of possible stroke, move her over. As the doc is about to tube her, she coded. NH failed to mention the period of confusion and slurred speech that was likely the TIA leading up to the stroke.
> 
> Sent from my SAMSUNG-SM-G920A using Tapatalk


Damn that really goes to show you FAST symptoms should always be taken note of whether your a civilian or a paramedic.


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## Medic27 (Aug 14, 2017)

NPO said:


> 34 hours into my 48, got my first call. Let me sum it up.
> 
> "Are you new? I know all of the other paramedics."
> 
> Sent from my Pixel XL using Tapatalk


I hate that question, no I'm not new I know all the paramedics in the whole county. Is that a question? Haha!


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## NPO (Aug 14, 2017)

GMCmedic said:


> Difficulty breathing at a nursing home. Get there and staff says patient is breathing better. Patient denies ever feeling SOB or any other pertinent complaints.
> 
> BLS to the hospital, as we pull up he ask patient how she feels, she says she feels great. He walks out the side door and around to the back and shes unresponsive, leaning to her right. Take her in, advise of possible stroke, move her over. As the doc is about to tube her, she coded. NH failed to mention the period of confusion and slurred speech that was likely the TIA leading up to the stroke.
> 
> Sent from my SAMSUNG-SM-G920A using Tapatalk


Had a similar. Chest pain and SOB. Upon arrival all symptoms resolved. The "SOB" was actually low SPO2. I asked the nurse what she did to resolve the low SPO2 and she said she repositioned the pulse ox on the patients finger and it went up. *Facepalm* patient denies any complaints, but it's a nursing home, and it's just easier to take him to the hospital. So off we go.

Monitor because he "had" chest pain. 12 lead because I was in internship and again, he "had" chest pain. All normal. Report given to RN at the ER, including my 12 lead.

He had a STEMI 30 minutes later. Doctor reviewed my 12 lead and confirmed it was clean. Good thing too, it wasn't a STEMI center I took him to.

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## LACoGurneyjockey (Sep 6, 2017)

Wake up for back pain and generalized weakness, turns out to be a massive inferior stemi, pressure in the 70-80s and junctional in the 30-40bpm range. Follosed up, 100% RCA occlusion, went to Cath lab and now in the icu with stable vitals and a sinus rhythm.


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## GMCmedic (Oct 11, 2017)

Local urgent care, theyre throwing around words like "severe bradycardia", "almost had to intubate", "pacemaker". 

Arrive to find a 61 year old male sitting upright and alert c/o "a little dizziness". 

HR 54, BP 170/90, beta blockers on the med list.


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## rach22 (Oct 11, 2017)

I Wish I could pass my test so I could join in on this.......


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## NPO (Oct 11, 2017)

GMCmedic said:


> Local urgent care, theyre throwing around words like "severe bradycardia", "almost had to intubate", "pacemaker".
> 
> Arrive to find a 61 year old male sitting upright and alert c/o "a little dizziness".
> 
> HR 54, BP 170/90, beta blockers on the med list.


I had a clinic "diagnosed" Takotsubo Cardiomyopathy. It just so happens that's one of my personal favorite conditions. The problem is, they theorized that is developed over 20 minutes after the patient received some bad news.


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## VentMonkey (Oct 11, 2017)

NPO said:


> I had a clinic "diagnosed" Takotsubo Cardiomyopathy. It just so happens that's one of my personal favorite conditions. The problem is, they theorized that is developed over 20 minutes after the patient received some bad news.


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## GMCmedic (Oct 12, 2017)

Same shift, new day. 

Chest pain for two days. Second degree type 2 at a rate of 40 with an underlying Inferior/posterior STEMI a bp of 70 systolic. Critical monitor failure during pacing attempt. 

Rhythm converted to 3rd degree post pacing attempt. She went to cath lab but not looking good.


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## Qulevrius (Oct 12, 2017)

Call dispatched as ‘chest pain’, AOS to find a 48 y.o. homeless foreign national male sitting on a curb, w/ fire correcting the chief to ‘anxiety’, stating that the pt denied hx/meds/allergies. Pt insists on SOB, fire sends him BLS w/ no strip/scene vitals. Per pt, feels ‘pressure on chest, radiating to back’ + SOB and it’s a recurring episode. Pt presents tachypneac @ 30 with chest discomfort, carries with him a prescription from an MD in Mexico for ASA, Digoxin and some other chicken scratch.

8 min later in the ER:

Charge nurse: ‘A c/c of anxiety ? So now they diagnose too, huh ? I want the fire sequence & engine number, and get 12 leads on him stat !’

The waveform was nearly flat with maybe 3mm R’s, 140/101, 112, 31.


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## DesertMedic66 (Oct 12, 2017)

Fever of 103.7 at a SNF 1 mile away from the ED. No good IV sites and she has a A-V fistula and a medi-port. Easy transport for me.


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## GMCmedic (Oct 12, 2017)

GMCmedic said:


> Same shift, new day.
> 
> Chest pain for two days. Second degree type 2 at a rate of 40 with an underlying Inferior/posterior STEMI a bp of 70 systolic. Critical monitor failure during pacing attempt.
> 
> Rhythm converted to 3rd degree post pacing attempt. She went to cath lab but not looking good.


Patients lactate was 8 and serum glucose >700. 

That might be the sickest patient ive ever encountered that still had a pulse.


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## NPO (Oct 22, 2017)

Cardiac arrest 50 feet from a working barn fire. Volly FD showed up to put wet stuff on the hot stuff and found the patient unresponsive near the barn. Reportedly he was last seen just prior to FD arrival when his neighbor told him his barn was on fire.


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## shelvpower (Oct 22, 2017)

Diabetic emergency at a wedding. Usually an ILS/BLS ambulance would be dispatched for this but seeing that there were no busses available dispatch requested that we (ALS/Response Vehicle) go and stabilise the patient so long.

O/A: 64yo male sitting in a chair, alert and oriented. Pt states that he thinks his "sugar" is low because he feels a bit "slow". 

While my crew mate checked his BGL I attached our monitoring devices. 

Initial vital signs:
BGL: 7,8 mmol/L
SpO2: 86% on RA
RR: 20 bpm
HR: 32bpm
BP: Unrecordable with NIBP, manual BP reveals SBP of 40 mm/Hg

A quick 12 lead revealed a massive Inferior wall MI with RV involvement. With the closest hospital being 5 minutes away we made the decision to load this patient ASAP and proceed to the hospital (luckily an ambulance arrived while we were assessing the pt) . 

After we loaded the pt onto our gurney he stated that that he is really starting to feel unwell, our Lifepak also revealed that his HR increased to 200 beats per minute (average over approximately 30 seconds). Not long after this the patient had classic peri-arrest "seizures" and subsequently went into VFib. 
After approximately 5 minutes ROSC was obtained but as we stopped at the hospital he went into cardiac arrest again. 

Doctor initiated thrombolytic therapy upon our arrival at the ER but unfortunately the patient was declared deceased after 30 minutes of CPR (ROSC was obtained again during this time but the pt quickly deteriorated again)


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## NPO (Oct 22, 2017)

shelvpower said:


> Diabetic emergency at a wedding. Usually an ILS/BLS ambulance would be dispatched for this but seeing that there were no busses available dispatch requested that we (ALS/Response Vehicle) go and stabilise the patient so long.
> 
> O/A: 64yo male sitting in a chair, alert and oriented. Pt states that he thinks his "sugar" is low because he feels a bit "slow".
> 
> ...


What kind of thrombolysis was provided in the ED? And was this administered intra-arrest?


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## harold1981 (Oct 27, 2017)

Not my ´first´ call of the day, but two cases worth the share: 

1. Guy with an umbrella stuck in his nose.  
2. 110kg male covered head to toe with tattoos, stuck in the bathtub and unable to get out by himself.


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## NPO (Oct 27, 2017)

1. Nosebleed.

My EMT ran the call. I drove. Otherwise an uneventful night.


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## gonefishing (Oct 27, 2017)

"Cardiac Arrest", obvious.  Died sometime earlier.


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## CALEMT (Oct 27, 2017)

Abdominal pain with difficulty breathing. Asked for methadone once in the back of the ambulance...


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## TheRealScott (Oct 29, 2017)

Back pain for 4 days


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## harold1981 (Oct 29, 2017)

Sepsis due to a badly infected ileostomy.


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## agregularguy (Oct 29, 2017)

Car v house. Few skin tears, no complaints of pain or any other traumatic injuries. Refused to go with us to hospital


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## Old Tracker (Nov 3, 2017)

Correct street address, by dispatch, wrong town. Told to disregard the call out. 10-4.


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## NomadicMedic (Nov 4, 2017)

Unresponsive. CPR and 2 shocks. ROSC.


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## luke_31 (Nov 4, 2017)

Called out for an allergic reaction. Get on scene find a patient with a peanut allergy and no signs of a reaction to the trail mix they ate at all. Transported to one of the local hospitals and got breakfast while we were there.


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## harold1981 (Nov 5, 2017)

My week´s selection: the gentleman with a hip dislocation, a routine transfer patient that arrested unexpectedly, the guy with cramps in his toe and the guy who claims to have choked on a sip of water!


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## soloBLS (Nov 10, 2017)

2 car MVC within literally 45s of the new EMT ridealong walking in. oh the joy.


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## Qulevrius (Feb 9, 2018)

Full arrest. 2 rounds of epi, amiodarone, shocks x3, tube, ROSC. Pronounced in the ER, 20 min after drop off (as expected).


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## luke_31 (Feb 9, 2018)

Yesterday it was flu for me as my first call. I'd say about 75-80% of my calls over the last few weeks have been flu-like symptoms. Of course my day started out getting ready for JHACO inspection in the next couple months.


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## Qulevrius (Feb 9, 2018)

luke_31 said:


> Yesterday it was flu for me as my first call. I'd say about 75-80% of my calls over the last few weeks have been flu-like symptoms. Of course my day started out getting ready for JHACO inspection in the next couple months.



This flu season was rough on everyone...


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## NomadicMedic (Feb 9, 2018)

I've run on LOTS of flu this past week. Unfortunately, it gets upgraded to ALS if the patient says "my chest hurts".


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## EpiEMS (Feb 9, 2018)

NomadicMedic said:


> Unfortunately, it gets upgraded to ALS if the patient says "my chest hurts".



You can't turf to BLS if it's unlikely to be ACS-related?


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## NomadicMedic (Feb 9, 2018)

EpiEMS said:


> You can't turf to BLS if it's unlikely to be ACS-related?



Yep. Sure can.


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## luke_31 (Feb 9, 2018)

Qulevrius said:


> This flu season was rough on everyone...


It certainly has been sounding like it. Most every shift when I stop by our ER for whatever reason the tracker board is completely full of flu-like symptoms.


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## Qulevrius (Feb 9, 2018)

luke_31 said:


> It certainly has been sounding like it. Most every shift when I stop by our ER for whatever reason the tracker board is completely full of flu-like symptoms.



Word. We had multiple ERs down to sat, for over 2 months, on a regular basis.


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## Flummox (Feb 9, 2018)

I'm just a student but my worst nightmare has become something my instructor told us during our first lab. He was orienting a guy on his first shift and they get a call for a patient with hx of CHF who took a fall in her bedroom. They arrive on scene and she's diaphoretic and SOB...and also 500 pounds. The bariatric ambulance was out of service and in another county, so they made the fatal error of trying to jerk her onto a hydraulic cot using an orca blanket. New guy lifted with his back too much and threw out his lumbar.  His first day was also his last. 

Pretty sure I'm permanently traumatized into thinking this will be my first call too, haha. But since that story I've religiously practiced proper deadlift and squat form.


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## StCEMT (Feb 10, 2018)

Asthma. Could hear hear her from the door, definitely working to breathe. Loud wheeze, tripoding, rate of about 25-30. Duo neb from the house, CPAP with neb in the truck, and 2g of mag hung en route. Only got more lethargic as we went, respiratory effort went down, and still was hearing wheezes as we got there. Switched to BVM once she started slumping over. Not quite the magic I was hoping to work, but she was properly prepped for intubation for the ED staff and at least still responsive upon arrival so I'll take it.


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## NomadicMedic (Feb 10, 2018)

StCEMT said:


> Asthma. Could hear hear her from the door, definitely working to breathe. Loud wheeze, tripoding, rate of about 25-30. Duo neb from the house, CPAP with neb in the truck, and 2g of mag hung en route. Only got more lethargic as we went, respiratory effort went down, and still was hearing wheezes as we got there. Switched to BVM once she started slumping over. Not quite the magic I was hoping to work, but she was properly prepped for intubation for the ED staff and at least still responsive upon arrival so I'll take it.



No Epi in your protocols?


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## Old Tracker (Feb 10, 2018)

Old people brain phart question. What is passing on the NREMT? 70% or is it higher.


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## NomadicMedic (Feb 10, 2018)

Old Tracker said:


> Old people brain phart question. What is passing on the NREMT? 70% or is it higher.



There is no passing score. It’s pass/Fail.


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## RocketMedic (Feb 10, 2018)

Flummox said:


> I'm just a student but my worst nightmare has become something my instructor told us during our first lab. He was orienting a guy on his first shift and they get a call for a patient with hx of CHF who took a fall in her bedroom. They arrive on scene and she's diaphoretic and SOB...and also 500 pounds. The bariatric ambulance was out of service and in another county, so they made the fatal error of trying to jerk her onto a hydraulic cot using an orca blanket. New guy lifted with his back too much and threw out his lumbar.  His first day was also his last.
> 
> Pretty sure I'm permanently traumatized into thinking this will be my first call too, haha. But since that story I've religiously practiced proper deadlift and squat form.



That's why firefighters exist lol. On a serious note, "jerking" people up is a terrible idea for exactly this reason.


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## StCEMT (Feb 11, 2018)

NomadicMedic said:


> No Epi in your protocols?


Technically IM epi protocol is only for peds, although situations like this I highly doubt I would be faulted for going that route. Just self report it, a little blurb on why, and that would likely be the last of it.

Realistically though, we were less than a mile when I DC'd the CPAP, time was a bit short then.


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## Carlos Danger (Feb 11, 2018)

StCEMT said:


> Technically IM epi protocol is only for peds, although situations like this I highly doubt I would be faulted for going that route. Just self report it, a little blurb on why, and that would likely be the last of it.
> 
> Realistically though, we were less than a mile when I DC'd the CPAP, time was a bit short then.


No epi in your protocols for status asthmaticus in extremis? That is utterly insane. Far, far more reason to use epi in that scenario than mag.


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## StCEMT (Feb 11, 2018)

Remi said:


> No epi in your protocols for status asthmaticus in extremis? That is utterly insane. Far, far more reason to use epi in that scenario than mag.


Not in the adult section. Could I have done it then afterwords written a "this is what I did and this is why" and been fine? Yes. However, I double checked my book to make sure, it's not written for adults.

Now that I am thinking about it, I am gonna pitch this at the clinical meeting next month. There are a few other things I want to toss in the mix and this one would be relevant and simple.


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## Lo2w (Feb 15, 2018)

Run down the street, get into the apartment, which looks like it just wrapped on shooting an episode of hoarders, and the "patient" goes "Can you plug my space heater in?"

"Ma'am do you have anything medically wrong with you today?"

....


----------



## Qulevrius (Feb 16, 2018)

A 37 weeks prego, 29 y.o. gravida x3, with less than 4 min between contractions. No complications, water broke just as we were rolling her into the ER, started crowning in the elevator to the L&D. 2 min after dropping her off the gurney, she gave birth to a healthy baby boy. We dodged a major bullet there...


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## Jim37F (Mar 29, 2018)

So kind of sorta a no hotter shift, but not really?

We were out of service all morning long on a drill, not sure if any calls came in our district tho, none came in in the afternoon/night, but I had to holdover for a few hours and got a call....ironically we were out doing drivers training and it was a still alarm at our station! Someone drove in with chest pains/weakness. Irregular heart beat, no was slowish but okay...medic didn't like the 12 lead (he said there was signs of a heart block) but EMS took her to the local hospital tho


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## MMohler (Mar 29, 2018)

How is the ems system out there? private ambulance, ao, FD?


----------



## PandaNin (Mar 29, 2018)

Arrive, put on seat belt, tones, 75yo male, tried cannabis edibles for first time.  C/C "I don't feel well"

He tried one, no effect.  tried another, nada, ate the rest of the box, yummy chocolate....  Uhoh.  AMA'd with a recommendation his wife buy some Doritos.


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## Jim37F (Mar 29, 2018)

MMohler said:


> How is the ems system out there? private ambulance, ao, FD?


County run Third Service. Medic+EMT staffed. No SSM, have their own stations (tho most are co-located at fire stations, some of those are completely separate buildings only sharing a parking lot, others they have their own section in the fire station to themselves), a couple stand alone EMS stations, and a few where they have crews quarters at the hospital.

Although AMR is also around (only private company on the island), they do IFTs, staffed all sorts of mixed BLS, ILS, ALS, and CCT units, they do back up City&County EMS for 911s. 

Federal Fire Dept, which covers the military bases has their own ambulances staffed with two dual role FF/PMs, but they only have like 4 ambulances island wide.


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## Jim37F (May 21, 2018)

Reported gun shot wound. Arrived on scene to find PD advising EMS already took off with the patient in their ambulance.


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## Emily Starton (Jun 18, 2018)

coffee... off today


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## NPO (Jun 28, 2018)

PD requested EMS for a 24 year old who got dizzy when they pulled him over. Patient refused. 

That was 8 hours ago. Netflix is our friend.


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## Jim37F (Jun 28, 2018)

Unauthorized burn for what turned out to be a camp fire on the beach. Put out with the very cutting edge technique of "bucket filled with water" (from the ocean...surf line significantly closer than where the engine was parked lol) and stirred with a shovel.

First EMS call was Chest pains...from what is now a frequent flier as we have responded to this guy at least 3 times in the past couple of weeks now.


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## NPO (Jul 17, 2018)

Fatality MVA roll over. One DOA one we had to follow the blood trail to find.


----------



## Bullets (Jul 17, 2018)

Fatal house fire


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## luke_31 (Jul 17, 2018)

Possible heat but never made it on scene. Our air evac unit beat us to the scene and transported to the helipad by our hospital where another unit picked them up to get them to the ER


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## Lo2w (Aug 7, 2018)

On my PRN IFT:

As usual the schedule is screwy, the medics aren't in and its just me (EMT) and the other truck's EMT. Dispatch drops a trip from the nursing home that had been scheduled overnight for abnormal labs. Dispatch asks us to go over (right down the street) and see what's going on and take it if we can.

Get over walk in, see the PT on a vent ... Walk out and find the RN. PT is vent dependant so we have the conversation that No, I'm not bagging the vent pt 30 minutes across town to the hospital they want. So I give the RN their choice of 3 closer I feel comfortable bagging to. So phone call to dispatch to update and "O by the way, patient is not only vent dependant but a bariatric patient...".

So new plan is for us to get our bari cot, get the medic who just walked in and get this $#%& show rolling. We get the cot and the medic but our next surprise is no vent circuits for our travel vent....


----------



## Qulevrius (Aug 7, 2018)

Lo2w said:


> On my PRN IFT:
> 
> As usual the schedule is screwy, the medics aren't in and its just me (EMT) and the other truck's EMT. Dispatch drops a trip from the nursing home that had been scheduled overnight for abnormal labs. Dispatch asks us to go over (right down the street) and see what's going on and take it if we can.
> 
> ...



No way in hell I’d agreed to that. Bagging a vent dependent pt, just because a sh*tty SNF RN decided it’s a good idea ? El oh el...


----------



## Lo2w (Aug 7, 2018)

Qulevrius said:


> No way in hell I’d agreed to that. Bagging a vent dependent pt, just because a sh*tty SNF RN decided it’s a good idea ? El oh el...



We don't have vents on my 911 so I've bagged plenty of SNF patients who were vent dependant.


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## Qulevrius (Aug 7, 2018)

Lo2w said:


> We don't have vents on my 911 so I've bagged plenty of SNF patients who were vent dependant.



So have I. What I’m getting at is that a 911 call for a vent dependent pt is one thing. But a *scheduled* private call from a SNF, with an incompetent/indifferent nurse trying to BLS it ? I’d have had a field day with her...


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## Lo2w (Aug 7, 2018)

Qulevrius said:


> So have I. What I’m getting at is that a 911 call for a vent dependent pt is one thing. But a *scheduled* private call from a SNF, with an incompetent/indifferent nurse trying to BLS it ? I’d have had a field day with her...



Ehh...we couldn't confirm who actually **** the bed. SNF claims they informed our dispatch of patient needs and equipment.


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## Qulevrius (Aug 7, 2018)

Lo2w said:


> Ehh...we couldn't confirm who actually **** the bed. SNF claims they informed our dispatch of patient needs and equipment.



Either way, a BLS unit was sent for an ALS transport. Between the SNFs and the dispatch, someone always gets stuck on stupid. Doesn’t mean we have to


----------



## Lo2w (Aug 7, 2018)

Qulevrius said:


> Either way, a BLS unit was sent for an ALS transport. Between the SNFs and the dispatch, someone always gets stuck on stupid. Doesn’t mean we have to



No but in the end we got it done. Dispatch was updated, we got the right cot and proper level of service.


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## Lo2w (Aug 27, 2018)

Dispatched for a possible OD. Arrive to find police with a very naked, possibly psych patient. Patient was found in a car sleeping by the owner. Owner pulls my partner aside to inform my partner that the patient may have the vehicle owner's vibrator on and/or in his person.

The day only got better...


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## Jim37F (Oct 17, 2018)

Dispatched to a public assist/lift assist, which is non-emergent single engine no EMS response...a couple blocks away while sitting at a red light we see an EMS unit responding emergent turn down the street our call is on, pull up on scene a min later, sure enough they were at the same address completing refusal paperwork.


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## PotatoMedic (Oct 17, 2018)

Jim37F said:


> Dispatched to a public assist/lift assist, which is non-emergent single engine no EMS response...a couple blocks away while sitting at a red light we see an EMS unit responding emergent turn down the street our call is on, pull up on scene a min later, sure enough they were at the same address completing refusal paperwork.


Least you didn't have to do anything!!!


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## Qulevrius (Oct 18, 2018)

A legit VAN positive stroke. Nearest neuro/cath was in downtown LA, right through Homeless Central. What a doozie...


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## NPO (Oct 18, 2018)

Qulevrius said:


> A legit VAN positive stroke. Nearest neuro/cath was in downtown LA, right through Homeless Central. What a doozie...


What's a VAN?


Also, what hospital?


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## Qulevrius (Oct 18, 2018)

NPO said:


> What's a VAN?
> 
> 
> Also, what hospital?



Vision + Aphasia + Neglect. Took him to the Presbyterian.


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## NPO (Oct 18, 2018)

Qulevrius said:


> Vision + Aphasia + Neglect. Took him to the Presbyterian.


Interesting. Not one I've heard of before. How does it compare to the LAPSS, CPSS, and RACE?


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## Qulevrius (Oct 18, 2018)

NPO said:


> Interesting. How does it compare to the LAPSS, CPSS, and RACE?



They’re all testing for pretty much the same neuro deficits. The only difference is that VAN focuses on primary assessment of arm drift; if positive, continue with the rest. Mostly useful with large vessel occlusion.

Edit: we stuck around for the head scan, he had a good bleed to L hemisphere. Not big enough to drain, but big enough to shut down his R side.


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## NPO (Oct 18, 2018)

Interesting. 
We use CPSS and RACE.
CPSS being the qualitative scale, and RACE bring quantitative scale, mostly to identify LVO.
But, were doing away with RACE anyway.


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## Qulevrius (Oct 18, 2018)

NPO said:


> Interesting.
> We use CPSS and RACE.
> CPSS being the qualitative scale, and RACE bring quantitative scale, mostly to identify LVO.
> But, were doing away with RACE anyway.



Cincinnati and RACE/FAST are way more comprehensive, VAN is used as a rough & dirty primary indicator. It tests for a major deficit and, if positive, a more in depth assessment is done. Suffice to say, if anyone uses VAN alone to ID a stroke, they’re eventually in for a big, nasty surprise.


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## StCEMT (Oct 18, 2018)

That's why I tend to go with a MEND exam style assessment. If it is a left side looks like a wet noodle stroke, I might shorten it up a bit. But I've caught stuff before things like the Cincinnati would have been negative for by using a longer assessment.


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## Tigger (Oct 18, 2018)

StCEMT said:


> That's why I tend to go with a MEND exam style assessment. If it is a left side looks like a wet noodle stroke, I might shorten it up a bit. But I've caught stuff before things like the Cincinnati would have been negative for by using a longer assessment.


The MEND is my go to initial exam. I think starting something that will catch cerebellar involvement makes sense. Pretty easy for things to slip through a lot of the other screening tools, to the point that we now teach BLS to BE-FAST, with the B being balance and the E being eye (gaze) deviation (though that's more of an LVO thing). Things like RACE, CPSS, VAN, etc are meant to be used after a CVA is identified and more to drive destination decision in theory. 

My regular job switched to making us do NIH scales. Bleh. Takes forever and is difficult. So I do the MEND for anyone I am vaguely suspicious of stroke for and if something is positive I can do the NIH during transport.


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## NPO (Oct 18, 2018)

I'll look into MEND. The other day I had to explain to my EMT partner how I knew a guy was having a stroke when his CPSS was normal.


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## PotatoMedic (Nov 1, 2018)

We use CPSS and VAN.  If CPSS is positive AND there is arm drift proceed to VAN.  But I have had the VAN miss LVO's.  I have also had the CPSS miss CVA's that I have still called prehospitally that were LVO's.


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## DesertMedic66 (Nov 1, 2018)

Ground job we use mLAPSS. For my flight job we just use CPSS.


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## Jim37F (Nov 1, 2018)

Medics here use LAPSS as far as I can tell. For us, first responder fire, they want us to test army drift, grip strength, feet push pulls, equal facial symmetry and that stuff, while the medics take all that, plus things like age, blood glucose, history, etc into consideration before calling a stroke alert or not.

We started going down that road yesterday on our first call of the day, came in as a seizure, 69 yo F, unconscious on arrival, opened eyes at her name but didn't really respond, pulse ox was 78%...started some high flow O2 and she started coming around and talking, initially only A&Ox1 to name, did those neuro checks ^ but they came up good. Idk if she was just postictal and hypoxic but by the time we got her into the ambulance she was talking and oriented 93 and generally a lot better off looking, so no stroke alert lol


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## StCEMT (Nov 1, 2018)

Tigger said:


> The MEND is my go to initial exam. I think starting something that will catch cerebellar involvement makes sense. Pretty easy for things to slip through a lot of the other screening tools, to the point that we now teach BLS to BE-FAST, with the B being balance and the E being eye (gaze) deviation (though that's more of an LVO thing). Things like RACE, CPSS, VAN, etc are meant to be used after a CVA is identified and more to drive destination decision in theory.
> 
> My regular job switched to making us do NIH scales. Bleh. Takes forever and is difficult. So I do the MEND for anyone I am vaguely suspicious of stroke for and if something is positive I can do the NIH during transport.


I think it is a good blend. It's not so time consuming that it is unnecessarily long, but it is thorough. I can knock it all out in a couple minutes.


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## DrParasite (Nov 1, 2018)

Jim37F said:


> Dispatched to a public assist/lift assist, which is non-emergent single engine no EMS response...a couple blocks away while sitting at a red light we see an EMS unit responding emergent turn down the street our call is on, pull up on scene a min later, sure enough they were at the same address completing refusal paperwork.


The question you should have asked them is, what were they dispatched for?  They could have been dispatched for a fall, or an unconscious, or a person down.  different people call 911 reporting different complaints..... even more fun when several people are all calling 911 from inside the same room with the different complaints, speaking to several call takers.

BTW, worked a shift last tuesday, where the toddler kept me up for most of the night..... ended up with a no hitter, and slept like a baby!!!


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## RocketMedic (Nov 3, 2018)

First call was an old man with a GI bleed. Transfusion made that better....90/60 P130 to 118/72 P80 and pinked up considerably. Field blood transfusions (low titer O Positive) are amazing.

Last call was a status febrile seizure 14 month old we intubated with an initial capno of 143. 

It’s been a good day


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## Jim37F (Nov 3, 2018)

First and only call last shift came at 0230. 92 yo F, slip and fall at home, bumped her head and tailbone. He of Dementia A&Ox1 as normal, EMS only really needed Basic Lifting Service from us, which was made much easier by the fact the house had an elevator! Tiny thing, but just large enough for the gurney in chair mode with someone accompanying. Def a big, swanky house. I was wondering if it was one of those places converted into mini SNF/care home, but only people we saw were the patient and her caretaker, so prob not.  Def retirement goals lol


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## Qulevrius (Nov 5, 2018)

Industrial accident. A 40 y.o. M who was descaling/cleaning a silo, was wearing his safety harness but not clipped onto a safety line. Cue in nitrogen leak, he lost his balance & fell from anywhere between 30 to 50 ft, plus inhaled whatever fumes that the cleaning chemicals produced. Extremely difficult airway with a clenched jaw and frothy mouth, facial trauma, blown pupil in 1 eye and a nearly full deviation in the other, flail chest with a pneumo, plus rapid decompensation.


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## NPO (Nov 6, 2018)

Called to a rural residence for a male with high blood pressure, a headache and a "Cath" that wasn't working. 

Dispatch was prompted for additional information. They provided that the "Cath" was a foley catheter, and that the patient was a quadriplegic. 

I suspected autonomic hyperreflexia. Neat.

On arrival patient had a BP of 180/110 (normally below 100 due to condition), was profusely diaphoretic and complaining of a headache. Catheter was indeed fully obstructed for at least 6 hours. The catheter was flushed, and symptoms resolved. Transported for a new catheter placement (old was was quite filthy).


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## Qulevrius (Dec 12, 2018)

18 F, playing a video game at home with boyfriend. She wins, he gets mad & stabs her in a thigh with a kitchen knife, 1-1.5” lac. Then he freaks out & calls 911. 4x4 and AMA’d with great prejudice.


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## Jim37F (Dec 12, 2018)

16 YOM, at the high school health office for a "fever" and ALOC... find out the kid (who looked all of 90lbs soaking wet) had smoked some CBD oil from a vape pen... his pupils looked like dinner plates, but he was A&Ox4, and EMS released the kid to his parents who were there


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## Qulevrius (Dec 12, 2018)

Jim37F said:


> 16 YOM, at the high school health office for a "fever" and ALOC... find out the kid (who looked all of 90lbs soaking wet) had smoked some CBD oil from a vape pen... his pupils looked like dinner plates, but he was A&Ox4, and EMS released the kid to his parents who were there



We have this crap all the time at HP High (pun intended). Asked the last one why’d he do it in school, he replied “because I was depressed.”

...‍ palmface x10


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## NPO (Dec 12, 2018)

First call was a priority 3 (no L&S) call to a nursing home for vomiting and constipation. 

60s year old female seated in a wheelchair chair at the nurses station. Apparently it started several days ago, but no one can confirm because they "haven't been there".

Heart rate was 130-150, AFib. RR 40, SPO2 95% on 3L, ETCO2 15, BP 150/90, WBC 23k.

So she got alerted.


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## Qulevrius (Dec 12, 2018)

NPO said:


> 60s year old female seated in a wheelchair chair at the nurses station. Apparently it started several days ago, but no one can confirm because they "haven't been there".



Classic.


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## Jim37F (Dec 13, 2018)

It's always the other shifts fault, the one that just got off and the staffer there just relieved...even at 9:13pm...


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## DesertMedic66 (Dec 13, 2018)

My last call was Nov 28...


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## NPO (Dec 13, 2018)

Jim37F said:


> It's always the other shifts fault, the one that just got off and the staffer there just relieved...even at 9:13pm...


My partner got in trouble one time for getting mad at a nurse who gave the shift change excuse. He said "How many times a day do you do shift change? Do you work 2 hour shifts?"


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## NPO (Dec 13, 2018)

Second call: 
Drunk guy jumped in the very cold river. We've got warm IV fluids and self-activated heat blankets, so we got to do active warming. Neat. 88* when we pulled him out, 97.8 when we got to the ER. 

Also, first time I've gotten to use my PFD lol.


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## Jim37F (Dec 13, 2018)

First call of today's shift: elderly (80s yo) F diabetic with low sugar. Low, as in that's what the Glucometer read, which reads as low as 25mg/dl, so hers was lower than that...

Altered, responsive only to pain, skin slightly flushed, cool and damp, extremely thread radial and brachial pulses, could barely feel them, rate at 110, O2 sat 95%, respirations 12 and a lil shallow, pupils sluggish and dialated, BP was 112 over something, temp was low, 94.6°F. All we could do as sub-BLS first responders Fire was put her on O2 (12 LPM via NRB) for borderline low sat and altered and wait for EMS (who was only a couple min behind us). They have D50 and she woke up enough to walk (with assistance) to the gurney, got her into the ambulance, and EMS said thanks for the assistance, and we cleared the call lol


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## ZombieEMT (Dec 13, 2018)

Called to local group home for male resident with bruise on back, unknown cause by staff and patient. Staff report bruise noted 4 days prior. House manager returned after vacation and reports the patient should have been sent out 4 days prior when noticed. Requesting 911 transport now, stating “its the law.”


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## NPO (Dec 14, 2018)

ZombieEMT said:


> Called to local group home for male resident with bruise on back, unknown cause by staff and patient. Staff report bruise noted 4 days prior. House manager returned after vacation and reports the patient should have been sent out 4 days prior when noticed. Requesting 911 transport now, stating “its the law.”


ITS THE LAW


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## NPO (Dec 14, 2018)

First call: 2 alarm structure fire. Set up rehab. No transports.


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## ZombieEMT (Dec 14, 2018)

I wish it was the law because then when we arrive at the ED I have something to pass along to staff, instead of them standing and looking puzzled. 



NPO said:


> ITS THE LAW


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## NPO (Dec 14, 2018)

ZombieEMT said:


> I wish it was the law because then when we arrive at the ED I have something to pass along to staff, instead of them standing and looking puzzled.


Once, when asked "Why did you bring them here" (as if we have a choice) a coworker told the nurse "Because McDonald's was on divert."


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## ZombieEMT (Dec 14, 2018)

NPO said:


> Once, when asked "Why did you bring them here" (as if we have a choice) a coworker told the nurse "Because McDonald's was on divert."




My response was closer to “because the staff are just stupid as....” I certainly made her understand how I felt. However, I do certainly like your response as well.


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## GMCmedic (Dec 14, 2018)

DesertMedic66 said:


> My last call was Nov 28...


November 18th. 

I'm a magnet for grounded aircraft.


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## Lo2w (Dec 21, 2018)

Jim37F said:


> It's always the other shifts fault, the one that just got off and the staffer there just relieved...even at 9:13pm...



We were in the middle of working a code at the nursing home and got the classic, "I don't know, its not my patient" line when we asked for history.


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