# WTF?



## ffemt8978 (Jun 23, 2004)

Was just listening to the scanner and heard another ambulance paged out for possible suicide attempt.  Law enforcement arrived on scene and advised the subject injected 1000 cc's of insulin.  :huh: 

I may not be an expert, but I do know it takes a long time to give 1000 cc's of anything via IV, much less IM.


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## SafetyPro2 (Jun 23, 2004)

I sure hope that was a mistake on the PD's part. That's a full litre, or just over a quart, of fluid.


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## ffemt8978 (Jun 23, 2004)

It had to be a mistake on PD's part, or the patient was lied about how much they took.  I don't think you can even purchase 1000 cc's of insulin, even with a prescription.


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## MMiz (Jun 24, 2004)

I think it's safe to say thats a mistake by PD... hopefully.

Even more likely, it's a mistake by the dispatcher.  We have PD radios in our units, the first responding unit calls on-scene on both our dispatch and theirs.  It's funny to hear what some calls go out as.

I wish I could remember some.


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## ffemt8978 (Jun 24, 2004)

PD, "Tell EMS that the guy took 1000 cc's of insulin."  So the dispatcher had nothing to do with it.

The more I think about it, I believe the PD meant to say 1000 UNITS of insulin, which is still way more than you can get with a normal prescription.


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## ffemt8978 (Jun 24, 2004)

Does anybody know how many units are in a standard vial of insulin?


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## rescuecpt (Jun 24, 2004)

A typical dose for diabetes is 300 to 600 mg per day, divided into two or three doses.  There are usually 100 units/mL, so 1000 units would be roughly 10ml, which doesn't take a long time to push, and can definitely do LOTS of damage.

However, there are a couple different types of insulins, although when you're talking something that gets pushed with a needle your options are much narrower than when you're talking oral treatments.


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## cbdemt (Jun 25, 2004)

There are 100cc in a standard bottle on insulin.  10 bottles wouldn't really take that long to push...  but I would still bet there was a mistake somewhere along the line.  Even one bottle pushed at once would still cause some big problems... for example, 1 unit of fast acting insulin (humalog, ultra lente, lente, R, etc.) will drop the blood glucose level of a 150lb pt aprox 40mg/dl in somewhere around 1/2 hr.  Of course this varies from patient to patient, but it gives you an idea. 

Interesting way to try to off yourself!


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## ffemt8978 (Jun 27, 2004)

Thanks for the info.

I always wondered how diabetics calculated how much insulin they needed.


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## ffemt8978 (Jul 20, 2004)

Okay, I have a new one for you.

Responded to a single vehicle MVA with rollover.  One of our EMT's, despite me telling them not to, attempted to check pupil response with a little pen light WHILE THE PATIENT WAS LOOKING DIRECTLY INTO THE SUN!

This EMT then tells me that the right pupil is a little "sluggish" to react, and I'm thinking, "How can you tell?  It's gotta be about pinpoint as it is."

Are newer EMT's forgetting the big picture in an effort to strictly comply with procedure, or is this person just lacking some common sense?

Either way,  :angry:  :angry: 

Well, I'm done ranting for now (at least until the next call with this EMT).


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## Chimpie (Jul 20, 2004)

Sounds like the EMT just needs a little more field experience.  Experience leads to common sense.  Just be patient.

Chimp


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## rescuecpt (Jul 20, 2004)

On Saturday I worked with a great new EMT.  He couldn't hear blood pressures, he was off on a pulse by more than 20 points, he did ABSOLUTELY nothing without being told to (for example, take the front of the stretcher and HELP me wheel the patient into the ER).

I emailed the Chief in charge of medical training and told her we need to chat about someone (didn't mention his name in the email, just incase someone else saw it).  This punk has already been cleared to ride alone!  I don't know how that happened.


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## ffemt8978 (Jul 20, 2004)

That's the part that I'm afraid of, is that this EMT will be on a call with no help and totally mess it up.

Every time I try to explain something to her, she gets very defensive and tells me I'm wrong.  I know I'm not a people person, but I've been doing this for a few years.

So now I just report it to the EMS Training Officer and let him deal with it.


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