# An MI: My Experience at 30,000 Ft.



## MMiz (Jan 7, 2005)

I just returned from a trip out to Arizona, and honestly can't believe this happened.  So here goes:

En route to Arizona, about 15 minutes after reaching cruising altitude, the flight attendant comes over the PA and states "Will anyone with medical training please come to the back of the aircraft immediately."

I looked around, and looked around.  Not a single person got up.

I got up, went to the back, and saw a man sitting on the floor against the back of the airplane, in the kitchen area.  The flight attendant had the AED out, and an amazingly stocked trauma kit.

78 y/o male, C/O Chest Pain:
Onset: 20 minutes ago
Provoke: Can't say
Quality: Heavy feeling, "very painful"
Radiate: Up and down left side
Severity: 8

Pt had no significant or related medical history, and was on no related medications.  

At this time a ICU nurse approached and also offered her services.  She agreed to push the drugs if required.  The plane carried quite a drug box, though I can't say what exactly was in it.

Pt initially presented with the following vitals:
AOX3
BP: 158/90
P: 80
R: 18
Pupils: PERL
Temp: 98.6
Patient sweating

Initially we put him on O2 via the plane's device at 4 LPM (it was 2 or 4), and continued to monitor his vitals.  Ten minutes into it I was on the intercom with the pilot relaying vitals.  I would give him vitals, he could contact whoever, and I understand they have a contract with the Mayo Clinic for on-line medical control.

Patient then vomited twice while we waited to hear word back.  We were ordered to administer 4 MG Nitro tabs x 3 per standard protocol.  

The patient then became unresponsive and I lost a pulse.  I had a faint carotid pulse.  Pt came back to with a sternum rub, and we continued monitoring vitals.  Initially (when I first went back there) we were going to continue to Arizona, but then we agreed on Denver.  It was then decided that we would do an emergency landing in St. Louis,

During this time the patient became unresponsive several times.  For the first time ever I actually grabbed the AED like I was going to use it, but never did.

I was literally sweating bullets. 

Pt was turned over to St Louis Paramedics with an abnormal EKG, but I couldn't tell what it was.  

I returned to me seat to find out the guy I was sitting next to was a new Emergency Medicine DO resident.  We talked for the rest of the flight, damn insecure doctors.

So instead of slumping away as I imagine, I volunteered.  And in return I got a few claps, a certificate from the airline, and an extra bag of peanuts.

Another life saved.


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## rescuecpt (Jan 7, 2005)

Good for you Matt!  I'm sure the patient and his family really appreciate it.  I'm so proud of you!


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## emtbuff (Jan 7, 2005)

Good Job Matt  Its amazing how often or so it seems that those with higher medical care are the slowest to respond.  In fact the other day I responded to a diffeculty breathing and the patient was unresponsive and no pulse.  I started O2 on her and waited for a BVM as we didn't bring on in oopps.  I started Bagging we got her in the rig and hooked her up to the defib I think it is the second time in two years I have had to hook some one up we annalyzed and no shock advised.  When we got to the hospital We continued to help bagging and cpr.  We also got the nurses to okay for the nurses to use a combi tube on the patient.  As our hospital staff trained in this type of air way as we are a level four hospital.  Well anyways They handed me the box with the tube and had me set it up and then I got to insert it.  This was the first time that I have had to tube a person.  
Anyways the point is that you did an awesome job and there is a first time for everything.  For the volley squad that I run with we all are still experinceing first for everything. 

Again Good Job


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## rescuecpt (Jan 8, 2005)

You're a basic and you can tube?


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## ffemt8978 (Jan 8, 2005)

Good job, Matt!

Did you ever notice that the higher someone is in the medical food chain, the less likely they are to volunteer to assist at an emergency?


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## Summit (Jan 8, 2005)

an extra bag of peanuts? w00t!


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## emtbuff (Jan 8, 2005)

rescuecpt Were you asking me if I could tube?

If so:
Yeah on our squad with our CPR For healthcare providers we are all taught to insert the combi tube.  The First Responders on up I know are taught the skills along with defib.  I am not a hundrad percent for sure if our drivers are allowed to but they are trained in healthcare provider CPR also.  We had the hospital nurses become interested in this a year back or so because they veiwed it as being easyier than inserting a ET tube.  Or however the discusion went.  I know we have used a combi tube in the ER before for the nurses that was after they had tried their ET tube so we used our combi tube I don't think it worked yet but they liked the idea of having two chance as to one.  
Besides what Level are you that you sound so surpirsed or what are your protocals about this?


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## PArescueEMT (Jan 8, 2005)

I'm a basic, with Healthcare provider CPR and I've never been taught the Combi-tube, or any tube... THAT'S why I'm suprised about the tube.

No offense intended, I am glad to see EMS head in that Direction.


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## Jon (Jan 9, 2005)

> _Originally posted by PArescueEMT_@Jan 8 2005, 11:54 PM
> * I am glad to see EMS head in that Direction. *


 AMEN!!!


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## GorillaGirl15 (Jan 9, 2005)

On our service EMT-B's are taught and allowed to use two differnt types of tubes...


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## emtbuff (Jan 9, 2005)

GorillaGirl15  What are the two type of tubes that you are taught?


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## Summit (Jan 9, 2005)

Gorilla what two types?

I wasn't taught anything about combitubes in class, but my job allows basics to drop them and trained us on the job.


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## Chimpie (Jan 9, 2005)

Great job Matt.


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## rescuecpt (Jan 9, 2005)

> _Originally posted by emtbuff_@Jan 8 2005, 10:14 PM
> * rescuecpt Were you asking me if I could tube?
> 
> If so:
> ...


 Around here basics can only insert OPA's & NPA's.

ALS just got combi-tubes (before that it was intubation or OPA's & NPA's).  Just wondering, because not a lot of places let basics do advanced airway management yet.

For the record I'm an EMT-CC, which in NY means I can do everything EMT-P's can do except needle crich.


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## daemonicusxx (Jan 9, 2005)

in my area, P's are the only ones allowed to tube, shock or give drugs. im waiting on the results from my NR exam to see if im a P yet. but they usually try to orally intubate, if its really hard to almost impossible then they will go to the combi tube. but its rare. we have EMT-I's, but theyre not really used in the FD. they can start IV's and all the B skills (OPA & NPA).


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## Wingnut (Jan 10, 2005)

I'm in FL and we EMT-B's can intubate with a combi-tube. We never use it though because we always have a Medic to use the ET tube.


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## emtbuff (Jan 10, 2005)

daemonicusxx 
Did I read that right that you can't push the little button that says shock when directed by the defib. Or do you use a different type of defib.  If I remember right our is a life pack 12.  And yes we are allowed to shock if the defib indicates it.  
Where I run we don't have any medics and only have 3 I's which really can't do much different than a B.  Sure they can start IV's but we always think and say that We will save the veins for the hospital staff.  We also only have a couple minute ETA for the most part.


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## rescuecpt (Jan 10, 2005)

> _Originally posted by emtbuff_@Jan 10 2005, 03:42 PM
> * daemonicusxx
> Did I read that right that you can't push the little button that says shock when directed by the defib. Or do you use a different type of defib.  If I remember right our is a life pack 12.  And yes we are allowed to shock if the defib indicates it.
> Where I run we don't have any medics and only have 3 I's which really can't do much different than a B.  Sure they can start IV's but we always think and say that We will save the veins for the hospital staff.  We also only have a couple minute ETA for the most part. *


 I interpreted it as he couldn't use a manual defib, I hope all basics are allowed to use an automated defib.


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## emtbuff (Jan 11, 2005)

Yeah the defib like i mentioned is a life pack 12 and is automated.


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## rescuecpt (Jan 11, 2005)

> _Originally posted by emtbuff_@Jan 11 2005, 03:33 PM
> * Yeah the defib like i mentioned is a life pack 12 and is automated. *


 Right... and it has the manual configuration for the medics too, right?  That's what we have at the Corps.  And the Zoll at the FD does the same thing.


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## SafetyPro2 (Jan 11, 2005)

Way to go Matt! (sorry for not responding sooner, just finished reading the post today) Good thing you were on board.

Up until a few months ago, we used to be able to do ET tubes as Basics. That is, those who went through the seperate Advanced Airway class and quarterly skills review. About a quarter of our EMTs were AA certified when the State decided to take that away from BLS (we were apparently the only BLS agency in the county doing it).


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## Chimpie (Apr 29, 2005)

Hate to bring this post back from the dead but I was thinking about you guys and this post on my trip to Florida last week.  My seat was near the back of the plane  :angry: and I was watching everyone put their bags in the overhead compartments.  I looked up at the one above the row across from me and saw the symbol for the first aid bag and AED.  I just smiled and grinned from ear to ear and said, "I swear, if I have to grab that AED on this flight Matt is never going to hear the end of it."


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## emt/fr (Apr 30, 2005)

Great job Matt. Here in WI we are taught combi and glucagon in the emt-b class. Adds about another ten hours to the class.


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## MMiz (Apr 30, 2005)

> _Originally posted by Chimpie_@Apr 29 2005, 12:41 PM
> * Hate to bring this post back from the dead but I was thinking about you guys and this post on my trip to Florida last week.  My seat was near the back of the plane  :angry: and I was watching everyone put their bags in the overhead compartments.  I looked up at the one above the row across from me and saw the symbol for the first aid bag and AED.  I just smiled and grinned from ear to ear and said, "I swear, if I have to grab that AED on this flight Matt is never going to hear the end of it."
> 
> *


 LOL.

I probably think about the incident once every couple of weeks, and wonder what I could have done differently.  Maybe have the ICU nurse start an IV?  Have him take four baby aspirin?  Oh the options.

Nice to see you're thinking of me Chimp, how's Florida?


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## Chimpie (Apr 30, 2005)

Florida was great.  I'll send you an email.


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## daemonicusxx (Apr 30, 2005)

> _Originally posted by emtbuff_@Jan 10 2005, 03:42 PM
> * daemonicusxx
> Did I read that right that you can't push the little button that says shock when directed by the defib. Or do you use a different type of defib.  If I remember right our is a life pack 12.  And yes we are allowed to shock if the defib indicates it.
> Where I run we don't have any medics and only have 3 I's which really can't do much different than a B.  Sure they can start IV's but we always think and say that We will save the veins for the hospital staff.  We also only have a couple minute ETA for the most part. *


 we can use a fully automatic AED, one that uses the sticky pads. if its got the AED function, i know the 12 has that "analyze" button. im guessin that i would be able to push the analyze button and get a shock advised, and be able to shock. not sure though. its not really gonna matter cause i just passed my P test. really just waitin on the patch to come in the mail.


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## emt3225 (May 4, 2005)

> _Originally posted by ffemt8978_@Jan 8 2005, 11:38 AM
> *
> 
> Did you ever notice that the higher someone is in the medical food chain, the less likely they are to volunteer to assist at an emergency? *


 Good job Matt.....


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## TTLWHKR (May 5, 2005)

I'd be absolutely useless anywhere over 100' off the ground. In fact if I ever have to fly again, I plan to bring sedation along.  :blink:


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## usafmedic45 (May 6, 2005)

I had a very similar incident on a Lufthansa flight from Munich to Chicago.  We had been at cruising altitude for about 30 minutes when the flight attendant came back and tapped me on the shoulder (I was wearing a coat with a EMS patch on it when I got on the plane and apparently she remembered seeing the patch).  "Are you a paramedic?".  "No, I'm an Intermediate EMT. Do you need something?" "Yes, can you come look at another passenger? He doesn't look well at all."  I agreed and followed her to the back of the plane.  We were about 10 rows away when I notice this guy who is pale, sweaty, and gray.  Apparently he was having 6/10 chest pain, breathing difficulty and felt like his heart was racing.  I asked the flight attendant to page for any other medical personnel and to get me the AED, O2 and medical bag.  I checked the guy's vitals where were something along the lines of HR 194, BP 86/52, RR 36 and labored, breath sounds were rales and rhonchi 1/3 of the way up the lungs.     :blink:  

They get me the O2, and it also only went to 4 L (  ) but I figured that that is better than nothing.  I put the AED on him, just for a check of his rhythm and guess what I found:  V-Tach.  I would have just cardioverted him, but I couldn't figure out how to get the AED into manual mode.  So I started setting up for an IV when I hear someone walk up behind me.  Come to find out the guy was an Austrian dentist who spoke minimal English (and I at the time spoke minimal German) so he was going to be of little help.  They also got a doctor on the phone (I think he was English judging by the accent), but I'm not sure and I basically asked if I could follow ACLS guidelines medication wise in treating this guy and the doctor stated I could.) I told the flight attendant that I needed to speak to the crew because this guy needed a hospital ASAP.  She scurried off and I went back to starting the IV. TY I got the IV established and gave 100 mg lidocaine to try to control the VT.  Luckily, it slowed the VT a little and he would have moments where he would go into what looked a sinus rhythm with multifocal PVC's so I gave another 50 of lido and started to set up for a lidocaine drip when the second officer came back and he asked how bad it was.  My response was "Bad.  How quickly can we get on the ground?" He goes "The closest airport at the moment is Keflavik Iceland."  My response was "I don't care.  He needs a hospital, and he needs it now."  He acknowledged that he agreed with me and proceeded back to the cockpit.   

The rest of the flight went as uneventfully as could be expected when you are stuck on a plane with an unstable cardiac patient and only an effectively non-Anglophonic Austrian dentist as your partner (basically the patient got no better but no worse).  But the real fun started once we got on the ground in Iceland.  The medics came on board to get the patient and they looked at me after I reported what I had done and go "Are you a doctor?"  "No."  "Please come with us."  So I get off the plane and find myself being questioned by a couple of very grumpy Icelandic cops.  Apparently the medics thought I violated some sort of rule by giving the lidocaine (they didn't seem to grasp that I had been talking to a doc prior to doing it).  Needless to say I wound up being questioned for the better part of two hours- during which time my flight left  :angry: - until they got in touch with the medical control doc that Lufthansa.  So I was a little pissed when the cops told me that I was free to go.  I had no idea how I was going to get home.  So I walk to the information desk and the lady made a phone call and then two IcelandAir  employees came up to me and proceeded to explain that they were terribly sorry for my inconvenience and that Lufthansa had arranged for me to catch a flight to Frankfurt on board an IcelandAir plane that was leaving in a few minutes.  So I was hustled aboard that aircraft and went back to Frankfurt where I was put aboard a Lufthansa aircraft bound for Chicago.  The nice thing was I got upgraded to first class on board both those flights.  I also received a letter from Lufthansa a few days later thanking me for my assistance and apologizing again for any inconvenience and letting me know that the man lived.  All in all it wasn't a bad experience and I would have to say I would not hesitate to offer assistance again.

So I have to say by far if you have to help out on board an overseas flight, two things:  Try to do it aboard a Lufthansa flight and don't agree to a divert to Iceland.   :lol:


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## Chimpie (May 6, 2005)

Your flight left?     I would have been so irrate that I would have been arrested.


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## usafmedic45 (May 6, 2005)

I can't say I blame them for leaving.....there's no reason to delay that many people because of one person.  I wasn't irate, I was just concerned about how I was going to get home.


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## Chimpie (May 6, 2005)

> _Originally posted by usafmedic45_@May 6 2005, 11:06 AM
> * I was just concerned about how I was going to get home. *


 I would be too.  LOL


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## Jon (May 6, 2005)

That is a cool story. did you get free tickets?


Jon


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## usafmedic45 (May 7, 2005)

> _Originally posted by MedicStudentJon_@May 6 2005, 08:57 PM
> * That is a cool story. did you get free tickets?
> 
> 
> Jon *


 Nah, just the ones for a flight home.  But I can show that letter I received and get an upgrade to first class if there is space available.    :lol:


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## TTLWHKR (May 7, 2005)

> *Apparently the medics thought I violated some sort of rule*



I rcv'd an official reprimand by mail for putting a pressure dressing & splint on the leg of a guy who was in an auto accident in NYS. Didn't tell anyone I was w/ EMS; I just had a large first aid box. I have to give the state trooper my name, he asked how I knew to apply the dressing, all I said was "I have some training". He took my license plate #, and it's an EMS plate. So I get a letter in the mail two months later stating that I was on probation for acting as an EMT outside of the commonwealth of PA. 

Since when is it illegal to provide first aid?   :angry:  Ba%$@rds


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## ffemt8978 (May 7, 2005)

usafmedic45,

I have a question for you about your scope of practice.  You stated you were an EMT-I, but you're obviously familiar with the ACLS protocols for cardioinversion and first line cardiac drugs.  Aren't both of these things outside of your scope of practice?

I realize that you got the doc to sign off on it, but I was just wondering what made you ask in the first place.

Good job on the save, BTW.


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## MMiz (May 7, 2005)

> _Originally posted by ffemt8978_@May 7 2005, 10:48 AM
> * usafmedic45,
> 
> I have a question for you about your scope of practice.  You stated you were an EMT-I, but you're obviously familiar with the ACLS protocols for cardioinversion and first line cardiac drugs.  Aren't both of these things outside of your scope of practice?
> ...


 That's exactly what I was thinking.

I was actually signed up to take a summer-long ACLS course for Basics, but had to cancel due to time constraints.  After my experience, I wondered how having that knowledge would have impacted my experience at 30,000 feet.

Also, I didn't even think about placing the AED on the live patient, as it's not in our protocols.  I still don't think I would have done it.

What made you think of putting the AED on the patient?  Is that common practice?  (That goes out to everyone)

I got a booklet thanking me for my service, some frequent flyer miles, and a coupon for a sandwich at the airport... and a round of applause


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## MedicPrincess (May 7, 2005)

> _Originally posted by MMiz_@May 7 2005, 04:28 PM
> * Also, I didn't even think about placing the AED on the live patient, as it's not in our protocols.  I still don't think I would have done it.
> 
> What made you think of putting the AED on the patient?  Is that common practice?  (That goes out to everyone)
> *


 On my test for AED check off I was asked contraindications for the AED:

1.  Use on a Trauma Patient
2.  Use on a child under 8, or if you have adapters under 1
and
3.  A conscious patient.


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## Jon (May 7, 2005)

> _Originally posted by EMTPrincess+May 7 2005, 06:26 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (EMTPrincess @ May 7 2005, 06:26 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MMiz_@May 7 2005, 04:28 PM
> * Also, I didn't even think about placing the AED on the live patient, as it's not in our protocols. I still don't think I would have done it.
> 
> What made you think of putting the AED on the patient? Is that common practice? (That goes out to everyone)
> *


On my test for AED check off I was asked contraindications for the AED:

1.  Use on a Trauma Patient
2.  Use on a child under 8, or if you have adapters under 1
and
3.  A conscious patient. [/b][/quote]
 To make a point about #2 - Use of an adult AED on a child less than 8is actually allowed and discussed by AHA in BLS courses.... If you can shock the kid with an AED, the kid is dead before, might not be afterwards.

Also, everyone loves to use the "8 year old" dividing line.

I belive the divinding line technically is 45-50 kgs - as EVERYTHING in medicine goes by weight.

Jon


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## usafmedic45 (May 9, 2005)

Lidocaine is within my scope of practice as an EMT-I (as is atropine and epinephrine and manual defibrillation) and cardioversion is included in my training as a respiratory therapist (and some services allow EMT-I's to cardiovert- we were taught to do this at a service I used to work for as well as to pace patients but the protocols had not been fully approved at the time I left).  

As for putting the AED on a conscious patient that's a relative contraindication- in this case I felt that it was better to be able to see his rhythm than to not.  (Also the trauma issue is also a relative contraindication (only to be used if you think a medical event caused the incident that caused the traumatic injury)).  But to answer the question about placing defib pads on conscious patients, no it's not common practice, unless you feel that you are going to be needing them shortly.   :lol:


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## rescuemedic7306 (May 9, 2005)

> _Originally posted by MMiz+May 7 2005, 04:28 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (MMiz @ May 7 2005, 04:28 PM)</td></tr><tr><td id='QUOTE'><!--QuoteBegin-ffemt8978_@May 7 2005, 10:48 AM
> * usafmedic45,
> 
> I have a question for you about your scope of practice. You stated you were an EMT-I, but you're obviously familiar with the ACLS protocols for cardioinversion and first line cardiac drugs. Aren't both of these things outside of your scope of practice?
> ...


That's exactly what I was thinking.

I was actually signed up to take a summer-long ACLS course for Basics, but had to cancel due to time constraints.  After my experience, I wondered how having that knowledge would have impacted my experience at 30,000 feet.

Also, I didn't even think about placing the AED on the live patient, as it's not in our protocols.  I still don't think I would have done it.

What made you think of putting the AED on the patient?  Is that common practice?  (That goes out to everyone)

I got a booklet thanking me for my service, some frequent flyer miles, and a coupon for a sandwich at the airport... and a round of applause [/b][/quote]
I always stick the AED on Cardiac patients concious or not (we use a Zoll which allows us to get a strip thru the pads) just in case they decide to do the 'fish' thing...then we're all ready to perform our magic!  B) 

And...ditto on the save!


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## rescuecpt (May 9, 2005)

> _Originally posted by rescuemedic7306_@May 9 2005, 02:15 AM
> * I always stick the AED on Cardiac patients concious or not (we use a Zoll which allows us to get a strip thru the pads) just in case they decide to do the 'fish' thing...then we're all ready to perform our magic!  B) *


 When I was a basic we had an obese pt who was having an MI that we couldn't get any vitals on (no apparent breathing, no pulse, no BP).  We put the AED on, turns out he was not shockable because he still had a pulse... I was reprimanded by the County for breaking AED protocols and had to meet with the County training officer to discuss why I did what I did (we forgot to write on the PCR that we suspected loss of pulse prior to hooking up the AED).

It's much nicer now to be able to throw on the 3 lead and know for sure.    The hardest part was riding as a basic while in my CC class, when I didn't have a preceptor and wasn't allowed to do ALS I felt so naked.


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## Strike3 (May 10, 2005)

It makes me sick to see you guys talking about who got what save, and "another live saved" ********...

I hate that EMS wants a freakin' pat on the back everytime some doesn't die in our care. We do our jobs as a service to the community, not for the glory of saving a life. All the freakin' Ricky Rescues on here are ridiculous. \

Go to work. Do your job. Have some fun while you're there. Go home safe. Don't look for praise and publicity. Don't go around bragging about what you did. All you did is your JOB. It's kinda like a mailman doing a touchdown dance everytime he puts a letter in someones mailbox. It looks immature, self important and stupid.

We're supposed to do our jobs to help other people. NOT our ego's.

Congrats on doing your damn job.   




As for the original post here....The plane PT...You should have given 4 baby asprin as soon as you asessed the PT. That's protocol in any system, for any active cardiac PT for any basic.  I know it's easier to look back on things and see things different, but the asprin and O2 should be second nature. You shouldn't even have to think about it once you verify that the PT hasn't had any recently, and has no allergies to it.

I'm glad you weren't like half the EMS people I work with, that hide from anything if they're "off duty".   Congrats on that.


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## Jon (May 10, 2005)

> _Originally posted by Strike3+May 10 2005, 01:21 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (Strike3 @ May 10 2005, 01:21 PM)</td></tr><tr><td id='QUOTE'> As for the original post here....The plane PT...You should have given 4 baby asprin as soon as you asessed the PT. That's protocol in any system, for any active cardiac PT for any basic. [/b]_


_

first off, In PA, I'm not allowed to give ASA as a BLS provider.

<!--QuoteBegin-Strike3_@May 10 2005, 01:21 PM
*Go to work. Do your job. Have some fun while you're there. Go home safe. Don't look for praise and publicity. Don't go around bragging about what you did. All you did is your JOB. It's kinda like a mailman doing a touchdown dance everytime he puts a letter in someones mailbox. It looks immature, self important and stupid.*[/quote]

To turn your anology on yourself, Football players do touchdown dances after good scores. They don't after every play. Saving a life is a "good play" while taking grandma to dialysis is a "routine play"

after a bad call, most folks I know second guess themselves, and feel bad about how they could have saved the patient. After a good call, we are happy that we saved a life.

Feel good about your job, so you don't end up sounding cynical and burnt-out.

Jon


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## rescuejew (May 10, 2005)

Honestly, dude, EMS is our JOB and glory-hounding is inappropriate in my opinion, but you cant Monday-morning quarterback this guys care decisions either. You werent there.   He's an EMT-Basic and regardless of training variances, he still hasnt had as much training as a Paramedic.  I dont think he posted what he posted to say "Look at me, I saved a life.."  I think it was more: "This was a weird experience and my pucker-factor was acting in hyperdrive.."  Knocking this kid down, or anyone else for that matter doesnt make them better EMTs or you a better teacher...forums like this are how people learn about other systems, other protocols and pt care tips, along with humor.  Sure there's a fair bit of paragod syndrome here, but if your skin is so thin and you cant handle it, what the hell are you doing here????


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## MedicPrincess (May 10, 2005)

> _Originally posted by Strike3+May 10 2005, 01:21 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (Strike3 @ May 10 2005, 01:21 PM)</td></tr><tr><td id='QUOTE'> You should have given 4 baby asprin as soon as you asessed the PT. That's protocol in any system, for any active cardiac PT for any basic. I know it's easier to look back on things and see things different, but the asprin and O2 should be second nature. [/b]_


_
WOW...so you have worked in every EMS system there is.  I am impressed!!  

Asprin is not part of the protocols for a Basic here either.




<!--QuoteBegin-Strike3_@May 10 2005, 01:21 PM
*All the freakin' Ricky Rescues on here are ridiculous. \*[/quote]

Welcome to EMTLife man.  However, if this is your usual take on a bunch of people who share a common intrest getting together and talking about it, hoping to learn from one another, I cant say I hope you stick around to long.....

And what made you join a forum like this if you have such a problem with what we are doing here?

I know these guys have helped me figure things out more than once.


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## rescuecpt (May 10, 2005)

EMS is not my job.  I take it very seriously, but it's not my job.

People on this forum are here to share experiences, good and bad, so that we can learn from each other and have people to talk to who understand what we go through.  If you don't like it, don't post.  If you want to be a part of a supportive community, stick around.


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## TTLWHKR (May 10, 2005)

Isn't Ricky Rescue an extrication doll?

Ya know, Rescue Randy's Cousin...


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## TTLWHKR (May 10, 2005)

> _Originally posted by Strike3_@May 10 2005, 01:21 PM
> * NOT our ego's.
> 
> *





Hello Kettle?

This is the pot.


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## CodeSurfer (May 10, 2005)

> _Originally posted by EMTPrincess+May 7 2005, 06:26 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (EMTPrincess @ May 7 2005, 06:26 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MMiz_@May 7 2005, 04:28 PM
> * Also, I didn't even think about placing the AED on the live patient, as it's not in our protocols. I still don't think I would have done it.
> 
> What made you think of putting the AED on the patient? Is that common practice? (That goes out to everyone)
> *


On my test for AED check off I was asked contraindications for the AED:

1.  Use on a Trauma Patient
2.  Use on a child under 8, or if you have adapters under 1
and
3.  A conscious patient. [/b][/quote]
 AED is contraindicated in SD if the patient has a pulse.  There is you can have v-tach with a pulse... and some of the AED's (the really moron proof ones) would shock that rhythm even if the patient was still alive is what i'm told.  I dont know if anyone has ever tried it.


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## ffemt8978 (May 10, 2005)

First of all, everyone needs to settle down a bit.

Strike3, your statement about giving 4 baby aspirin to an active cardiac patient being protocols in any system for any basic is incorrect.

When I was certified in Iowa, EMT-B's were not allowed to give any ASA to a patient.  Samething for when I was certified in South Dakota.

Here in Washington, we give 2 baby aspirin (162mg) as a basic only if our medical control has written it into our standing orders.  However, our protocols change if we have an EMT-IV on scene.  We have to get an IV line first, then patient assist NTG, then the aspirin.

I do agree that O2 and aspirin should be given immediately to any patient displaying cardiac chest pain, AS LONG AS IT IS WITHIN YOUR PROTOCOLS.

As far as the rest of your post goes, if you don't want to be recognized for saving somebody's life, so be it.  It is not for you to rain on another person's parade if that's what they want.

This forum was created as a place for people in EMS to come and chat about experiences or feelings they've had working in EMS.  We don't come here looking for praise, but rather seeking information and companionship with people who understand what we do.


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## rescuemedic7306 (May 10, 2005)

> _Originally posted by CodeSurfer+May 10 2005, 05:47 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (CodeSurfer @ May 10 2005, 05:47 PM)</td></tr><tr><td id='QUOTE'>
> 
> 
> 
> ...


AED is contraindicated in SD if the patient has a pulse.  There is you can have v-tach with a pulse... and some of the AED's (the really moron proof ones) would shock that rhythm even if the patient was still alive is what i'm told.  I dont know if anyone has ever tried it.[/b][/quote]
Fortunately the AED we use has a 'monitoring' mode, even when pads are connected, so we don't have a problem sticking it on people to get a strip and to be ready. As for ASA, we have a local protocol to give it to CP pts unless (and this is an exact quote) 'They are actually putting an aspirin in their mouth as you walk through the door or they can produce a letter from their MD saying they are allergic to it'.


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## Jon (May 10, 2005)

thats nice...but what does a set of pads cost??? $20? $30? They are expensive.

Jon


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## rescuemedic7306 (May 10, 2005)

25 smackers I believe...but we get them discounted through the hospital, so it's not such a problem......

Oh, and it goes on their bill  h34r:


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## Strike3 (May 10, 2005)

Football players celebrate everything! Seen the NFL lately?  That was my point. 

I was in no way saying that what he did was wrong...not at all. I just was frustrated hearing the "look at me" comments. I think that's my biggest pet peever about EMS. The paragod thing is such a downfall.

I apologize for the ASA comment. I was taught that all basics could do it, which is why there were questions on it for the NREMT test.  I'm not burnt out by any means, if anything, I'm still fairly new. I just think that I see too much glory and not enough humility.


I applaude you for stepping foreward, and I wish I saw more of that from others.


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## Chimpie (May 10, 2005)

> _Originally posted by Strike3_@May 10 2005, 06:50 PM
> * I applaude you for stepping foreward, and I wish I saw more of that from others. *


 Just as long as you don't comment about it afterwards right?


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## Jon (May 10, 2005)

> _Originally posted by Strike3_@May 10 2005, 08:50 PM
> * I applaude you for stepping foreward, and I wish I saw more of that from others. *


 Amen.


I don't stop at EVERY accident, but if it either looks bad, I get flagged down, or I actually wittnessed it happen, I will at least stop and make sure everyone is ok, and call 911 with my cell phone if requested, but only after confirming injuries / no injuries.

And if football players celebrate everything, why can't we?

Jon


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## rescuecpt (May 11, 2005)

> _Originally posted by Strike3_@May 10 2005, 08:50 PM
> * The paragod thing is such a downfall.
> 
> I'm not burnt out by any means, if anything, I'm still fairly new. I just think that I see too much glory and not enough humility. *


 You sound burnt out, maybe you've had some bad experiences with paragods, but it's not fair to come on here and within your first 4 posts insult almost everyone here.  I hope you will stay and contribute and boast about some of the good things you do.  Any save is a good save and in my "real job" I don't make a huge impact on people's lives, only their wallets - what does it hurt for me to come here and share my happiness about the thing that I love doing and that I do purely for the good of others?  Nothing.


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## TTLWHKR (May 11, 2005)

> _Originally posted by MedicStudentJon_@May 10 2005, 08:35 PM
> * thats nice...but what does a set of pads cost??? $20? $30? They are expensive.
> 
> Jon *


 Our peds pads cost 85 bucks a pop!


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## rescuemedic7306 (May 11, 2005)

yup, Ped pads are $100 dollaroonies...so we don't use them too often I can tell you!


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## CodeSurfer (May 11, 2005)

> _Originally posted by rescuemedic7306_@May 11 2005, 02:20 AM
> * yup, Ped pads are $100 dollaroonies...so we don't use them too often I can tell you! *


 Thats because of that damn teddy bear resistor! 

But its a good thing they arent used often, and not just because they're expensive. (Come on do you think I'm that heartless?) :lol:


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## rescuejew (May 11, 2005)

Strike3:
Welcome to emtlife!


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## TTLWHKR (May 11, 2005)

Now I hope Jon isn't hooking them up to elmo and baking cookies!

That'd be quite a bill for a couple, red furry cookies.

Maybe I should have put a trade mark on that.


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## MMiz (May 12, 2005)

I'm not going to hold back, I read this post early this morning, and I've been thinking about it throughout the day.



> It makes me sick to see you guys talking about who got what save, and "another live saved" ********...



I didn't save anyones life, and never have actually.  Sometimes I hold up my hands and say "These hands save lives," but usually they just cart dialysis patients around.  I haven't done anything life-saving quite yet, but I've held lots of hands and calmed lots of old ladies.  Does that count?



> I hate that EMS wants a freakin' pat on the back everytime some doesn't die in our care. We do our jobs as a service to the community, not for the glory of saving a life. All the freakin' Ricky Rescues on here are ridiculous. \



I have yet to see a member that has walked around with the "Hero" belt.  I shared my story because I have relatively few stories to share, and I thought it was a pretty unique story.  Again, I didn't save any lives, just helped out when I could.



> Go to work. Do your job. Have some fun while you're there. Go home safe. Don't look for praise and publicity. Don't go around bragging about what you did. All you did is your JOB. It's kinda like a mailman doing a touchdown dance everytime he puts a letter in someones mailbox. It looks immature, self important and stupid.



No one is bragging, they're sharing experiences with others.  Maybe you should have read my post where I said I put the 25 y/o guy on a ped N/C, or all the other not-so-exciting things I've posted about.  

Also, when my partner does something great, above the call of duty, I sure as hell let them know they did a good job.  They don't need and, and it might get old, but I find it's usually a friendly thing, and people like to know when they're doing something good.  It's all about being positive.



> Congrats on doing your damn job.
> I wasn't doing my job, in fact I wasn't working.  I paid $500 to sit in a plane ticket like the rest of the people on that plane.  I waited for others, possibly more qualified to volunteer, and when no one did, I got up.  Know what I got for squatting in the back of the plane and doing all this stuff?  Not much, but I'd do it again.  I didn't get in EMS for the money, I did it because I care.  I still do care about every one of my patients, and I cared about that man on the airplane.
> 
> 
> ...


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## rescuecpt (May 12, 2005)

AMEN Matt.  You're MY hero.


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## usafmedic45 (May 12, 2005)

Well said Matt.


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## Jon (May 12, 2005)

Well said


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## rescuejew (May 12, 2005)

Matt: Dont know you too well yet buddy, but with a heart like that, you can treat me anytime...


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## Chimpie (May 12, 2005)

Well put.


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## MedicPrincess (May 12, 2005)

High Five Matt!!!  Very nicely said.


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## Wingnut (May 12, 2005)

You da man Matt!  B)


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