# Last call of the day is....



## titmouse (Mar 31, 2016)

And go! As of now I am off so I got nothing.


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## TransportJockey (Mar 31, 2016)

My last call was tuesday afternoon,  possible HHNK


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## DesertMedic66 (Mar 31, 2016)

TransportJockey said:


> My last call was tuesday afternoon,  possible HHNK


How high was the BGL?


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## COmedic17 (Mar 31, 2016)

An elderly lady who pushed her life alert because she had a few too many brews and "wanted to see how quick y'all could get here".


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## titmouse (Mar 31, 2016)

COmedic17 said:


> An elderly lady who pushed her life alert because she had a few too many brews and "wanted to see how quick y'all could get here".


For real bro? Damn... You see dude people should get a civil citation for abusing 911.


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## DesertMedic66 (Mar 31, 2016)

titmouse said:


> For real *broette*? Damn... You see dude people should get a civil citation for abusing 911.


Fixed it for you


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## titmouse (Mar 31, 2016)

DesertMedic66 said:


> Fixed it for you


BROette! LOL


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## COmedic17 (Mar 31, 2016)

titmouse said:


> For real bro? Damn... You see dude people should get a civil citation for abusing 911.


A lonely elderly lady? No.


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## TransportJockey (Mar 31, 2016)

DesertMedic66 said:


> How high was the BGL?


Hi. Never got a number.  On ours that's over 600


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## NomadicMedic (Mar 31, 2016)

TransportJockey said:


> Hi. Never got a number.  On ours that's over 600



 It always makes me chuckle when the glucometer reads "hi". I always look down at it and say, "well hello there".


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## TransportJockey (Mar 31, 2016)

Lol me too. I always say its a bad thing when my meter gives me a greeting instead of a number


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## titmouse (Apr 1, 2016)

IFT Baker Act due to lack of pediatric facility at originating hospital.


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## titmouse (Apr 24, 2016)

Generalized pain 10/10... 15 minutes later, "hows the pain?", "still 10/10"... Keep in mind speaking full sentences and all. "Hey what makes the pain subside?", "Medication."...


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## DesertMedic66 (Apr 24, 2016)

ETOH who is altered wanting me to bypass the closest hospital (2 miles away) and go to one 20 miles away. He wasn't very happy when I flat out told him that's not going to happen


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## nater (Apr 25, 2016)

Last call was a car / motorcycle MVC.


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## MonkeyArrow (Apr 25, 2016)

DesertMedic66 said:


> ETOH who is altered wanting me to bypass the closest hospital (2 miles away) and go to one 20 miles away. He wasn't very happy when I flat out told him that's not going to happen


What is regional policy about choosing hospitals? In GA, one service will take you to any hospital within 50 miles (which is kinda crazy, I think).


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## NomadicMedic (Apr 25, 2016)

Last call for me last night was a vehicle rollover. Driver self extricated with no injuries, passenger unconscious with multiple lower extremity fx.


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## DesertMedic66 (Apr 25, 2016)

MonkeyArrow said:


> What is regional policy about choosing hospitals? In GA, one service will take you to any hospital within 50 miles (which is kinda crazy, I think).


As long as the hospital is the closest and the most appropriate is the regional policy. Company policy is usually patient preference but the medic has the overall decision. 

A drunk altered patient is going to the closest hospital because that is the hospital that is best suited for them. I am not going to travel 20 miles away into a city we do not cover when there is a perfectly good hospital less than 2 miles away in the current city we are in. 

We also have an ambulance diversion protocol where if a hospital is on bed delay and we have a patient who wants to go to that hospital we will either take them to a different hospital or they will sign out AMA.


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## Tigger (Apr 25, 2016)

Wildland fire standby. Cancelled before we left the station, deputies arrived and advised that "the caller confused the moon shining with trees being on fire."


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## titmouse (May 1, 2016)

ETOH patient that was extremely vulgar but I managed to pacify him and we had a good transport to the ER.


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## Akulahawk (May 1, 2016)

Last was a garden variety kid with fever.


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## Martyn (May 4, 2016)

Penile hemorrhage...I reminded my partner (21 y/o and female who was doing patient care) about the basics...if the bleeding is not controlled to apply direct pressure. You should have seen the look she gave me. I also mentioned as an after thought that if all else failed we could try a tourniquet, got another funny look from that comment as well.


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## titmouse (May 4, 2016)

Lol


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## titmouse (May 11, 2016)

Bari pt with bilateral knee pain...


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## titmouse (Jun 3, 2016)

42 yo female, right hip pain s/p fall -loc


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## jteeters (Jul 7, 2016)

My last call of the weekend last weekend was a diabetic who's blood sugar was 20.  Almost identical to the one I posted about in a different thread, but this time he was A/Ox4 and not combative.  Refused IV for D50, did agree to Oral glucose and a peanut butter sandwich.  His blood sugar was 38, when we got a refusal with medical direction contact.


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## Jdog (Jul 8, 2016)

Hospital discharge - 30 YOF with end stage alcoholic liver cirrhosis. Her skin was so jaundiced that it was literally green. It was pretty sad. I've never seen it that bad in someone so young.


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## Aprz (Jul 8, 2016)

Last time I worked was Tuesday. We were dispatched to a respiratory distress call. Walked in and it turned out to be a cardiac arrest.


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## gotbeerz001 (Jul 13, 2016)

Stabbed in back of neck at base of skull and in the LL abdomen. Lost probably 3000+ mLs of blood; took 2000 mLs of fluid in the field and 4 units of blood in the ED before making it into the OR. Looks like he'll make it. 


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## CALEMT (Jul 13, 2016)

gotshirtz001 said:


> Stabbed in back of neck at base of skull and in the LL abdomen. Lost probably 3000+ mLs of blood; took 2000 mLs of fluid in the field and 4 units of blood in the ED before making it into the OR. Looks like he'll make it.
> 
> 
> Sent from my iPhone using Tapatalk



Damn!


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## Tigger (Jul 14, 2016)

Near syncope at a hair salon. 80s/40s for a pressure, and of course the patient who mentioned many times that she was a nurse wanted to drive herself.


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## chaz90 (Jul 14, 2016)

An extremely dehydrated heat exhaustion patient asked me the following at various times: Should get tested for HIV and Hep C if he was worried he'd been exposed; Where he could get free water since he didn't have any since last night; Why his IV start hurt more than tattoos; and if we were hiring. 

Answers in my head? Yeah (duh), literally anywhere (somewhere truly exotic like McDonald's for a start...), because you're thinking about it too much, and yes we're hiring, but probably not you. 

Hopefully I came across as slightly more diplomatic.


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## BASICallyEMT (Jul 15, 2016)

We got slammed all day and our last call came in as rectum pain... Pt had a hemorrhoid... It was the last day of our bid. That called summed up our entire 6 months


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## titmouse (Jul 15, 2016)

34 yo female, 6 months pregnant lower abdominal pain due to MVC


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## Akulahawk (Jul 16, 2016)

One of my last was a "didn't want to leave, couldn't stay and couldn't make up his mind" kind of dude. Left before I did...


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## Jim37F (Jul 16, 2016)

Little old lady called from one of those little assisted living places that are a converted house. (My grandpa is in a nice one in Orange County.....this one was tiny and looked rather illegal, if they had all their paperwork in order, the packrat conditions could easily change that, place was nasty). Lady called because she was worried that her blood pressure was too high, and that her roommates blood pressure was too low as well as a couple of other chronic conditions (aka why they're in the assisted living place in the first place)......oh she never actually checked any blood pressures, neither of them wanted to go to the hospital, oh and this was all at 0400...


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## DesertMedic66 (Jul 16, 2016)

Heat stroke patient going in and out of consciousness who has been working outside in the 111 degree temps with 30% humidity for 6 hours. 

Unknown temp on scene (we don't carry thermometers). Cold packs on neck, armpits, groin. Dumped water on him, took cloths off, AC full blast, and cold saline bolus. Rectal temp at the ED was 100.8.


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## DesertMedic66 (Jul 17, 2016)

First and last call of the day today: vehicle into a house at ~40mph. 2 minor injuries.


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## Tigger (Jul 17, 2016)

ATV accident waaaaaayyyy into the woods. Got the call at 2330, back at the station at 530. Guy had a clavicle and rib fractures which the helicopter crew found a bit beneath them. Sorry guys, you're taking him. It took us an hour to get to the patient by ATV, probably triple that time out with a patient in a stokes. Plus the 90 minute ground transport.


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## jteeters (Jul 18, 2016)

Last call of this shift was a syncopal episode.  kid passed out in the roadway, passerby almost ran him over and stopped to help him.  PT said he can't remember his name or where he is.  Get him in the back of the truck and he starts "remembering" things.  Wants to go to the hospital.  Deputy on scene gets a hold of kids guardian, who tells us that he ran away from home after being caught looking at homosexual porn and having his phone taken away.  He can't consent to treatment because he's a minor, and guardian decides to take him in...I had a canceled call, and a refusal yesterday.  A good day, indeed.


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## Jim37F (Jul 18, 2016)

Last call was a seizure, 10 min drive to get there, and then another few minutes to navigate the multi building condo complex (we were only given the street address, and there were no building numbers or unit signs or anything saying, "hey to find this condo, go this way") that was on the side of a sloping hill, just enough that Every. Single. Walkway. had stairs, some were little groups of 3 or 4 in a staircase, but most were that annoying, just close enough, but just far enough apart to break your stride...made trying to get the gurney in REAL fun as we didn't know this was the layout until we were stuck in the middle of it. Finally find the right building...and lo and behold there's a relatively straight pathway back out to the driveway where we parked (we came in through a more or less main entrance) -_- 

Despite all that the Pt was still very postictal and disorientated when we made pt contact, had to spend a couple minutes just coaxing the 6'5" 220lb pt into the stairchair, go down from the second story of the condo, which due to the hill, was another flight of stairs down to the main stair littered pathway...it was easiest just to wheel the stair chair all the way to the ambulance, then I stayed with the patient while my partner and a couple firefighters recovered the gurney from where it was left inside the condo complex....20 min drive to the hospital later guy was still only just barely recovering his mental state, though still not acting appropriately per family


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## gotbeerz001 (Jul 19, 2016)

69 yom increasing SOB x 2 hrs + increasing abd pain. Pt also dizzy; no CP, nausea/vomiting/recent illness. Hx of only colon CA; Rx Norco PRN (took one with no relief). Pt had 4.5' of colon removed 10 days ago with abd pain normally 4/10 but now 8/10. Initial vitals: 128/78, 132 HR, 88%, 32 RR. Pt afebrile. L/S clear in apices, diminished in bases; improved to 98% with NRB with minimal improvement in distress. Pt vitals after move to gurney: 86/48, 140  HR, 97%, 30RR. 12L non-STEMI. Minimal improvement to BP after fluid bolus. 

I suspected he had abd bleed creating pressure on his diaphragm. Turns out he had abd bleed PLUS multiple bilateral PEs. 


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## titmouse (Jul 20, 2016)

90 yo lady. Vomiting and abdominal pain. Chicken soup.


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## Kevinf (Jul 20, 2016)

69 YoM for a Psych 302 (involuntary commit) due to homicidal ideations and violent outbursts from the crisis ward of the city hospital to the closest VA hospital (33.5 miles away) for psychiatric treatment. Had soft restraints and a third rider ready after verbal judo failed and the patient refused transport without grievous harm to himself or others. The supervising physician was paged by the nursing staff to obtain orders for chemical restraints but the doc decided to keep him for another 24 hours under observation at their hospital. Cancelled on scene by staff, cleared, and went to Arby's.


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## NomadicMedic (Jul 22, 2016)

Kevinf said:


> 69 YoM for a Psych 302 (involuntary commit) due to homicidal ideations and violent outbursts from the crisis ward of the city hospital to the closest VA hospital (33.5 miles away) for psychiatric treatment. Had soft restraints and a third rider ready after verbal judo failed and the patient refused transport without grievous harm to himself or others. The supervising physician was paged by the nursing staff to obtain orders for chemical restraints but the doc decided to keep him for another 24 hours under observation at their hospital. Cancelled on scene by staff, cleared, and went to Arby's.



Arby's was my favorite part of this post.  brown sugar bacon FTW.


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## gotbeerz001 (Jul 22, 2016)

SVT. Converted on the 12. 


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## DesertMedic66 (Jul 23, 2016)

Boxing match. Boxer got TKO by his opponent. Out cold for about 30 seconds. 1 of the 3 ring Doctors on duty checked him out and then had us baby sit and take vitals every 10 minutes for 30 minutes before he was allowed to leave.


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## Annika (Jul 25, 2016)

Last call of my day came in as an unresponsive, but turned out to be a homeless man who had been ****ting himself for the past week and then smeared his own feces all over his body and his beard. Refused to speech to us or move at all but was fully alert. horrible conjunctivitis and oh god don't even get me started not that smell, I've had patents that smell but this was a whole nother level of hell that has been lingering in my nose for hours and of course in the rig for the next week (sorry Tuesday crew). We had to towel off and disinfect his arm many times before we got the IV in because he. was. covered. in. dung. Not to mention the blast I had disinfecting the rig afterwards, gives a whole new meaning to the expression "****ty call".


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## exodus (Jul 26, 2016)

Black lives matter protest... That was boring.


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## Handsome Robb (Jul 26, 2016)

gotshirtz001 said:


> SVT. Converted on the 12.
> 
> 
> Sent from my iPhone using Tapatalk


We don't even give 6 anymore. Only 12.


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## Jim37F (Jul 29, 2016)

Structure Fire standby in our first in district (although FD doesn't auto dispatch us on the initial alarm so we were last unit on scene). Single story, single family dwelling, fire contained to one bedroom, but no occupants (neighbors report the house is known to have squatters though), no patients, stood around for a few minutes watching fire cut holes in the roof before being cleared back to quarters ~15 min before shift change.

(my partner was a night shifter, he didn't have a partner and my partner only worked the first half of my 24hr shift so dispatch was actually smart enough to simply put him on my shift, anyways he was still awake and remarked he wondered what the heck all the sirens were about since the call was only a couple blocks from our station lol)


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## luke_31 (Jul 29, 2016)

Altered heat patient. Got off a bit over an hour late on the call.


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## Handsome Robb (Jul 31, 2016)

Polypharm overdose that we hung pressors on then sedated, paralyzed and intubated.

Yay for 4 hours of paperwork!

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## NPO (Aug 14, 2016)

Last call was a "sick person" at a SNF.

Pt found in respiratory arrest. Pt was in fluid overload an had a pool of bloody frothy fluid in her mouth. In SNF for recovery for plural effusion. Pt went into full arrest shortly after.

The SNF did put the pt on 2lpm though. God bless 'em.


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## NomadicMedic (Aug 14, 2016)

NPO said:


> Last call was a "sick person" at a SNF.
> 
> Pt found in respiratory arrest. Pt was in fluid overload an had a pool of bloody frothy fluid in her mouth. In SNF for recovery for plural effusion. Pt went into full arrest shortly after.
> 
> The SNF did put the pt on 2lpm though. God bless 'em.



Not my patient. 
I just came on shift. 
They were fine 10 minutes ago. 
They just stopped breathing. 

Lies. Lies. All lies.


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## DesertMedic66 (Aug 14, 2016)

Motorcycle vs vehicle TC at 30mph. Open radius ulna Fx. Splint and lots and lots of pain meds. 5 minutes after arrival at the ED the patient was being sent to CT then X-ray then OR.


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## jteeters (Aug 29, 2016)

For the second shift in a row, Cardiac arrest. Last shift, it was in the home.  Last seen normal at midnight, and the call came out at 0500.  ACLS protocol followed, 20 mins of CPR, 5 rounds of epi, an intubation.  Asystole for the duration.  Called on scene.  This time, at a local nursing home.  90 y/o, family wants everything done possible to resuscitate.  CPR in progress PTA x 20 minutes, Asystole on our arrival, worked for an additional 20 minutes and called.  Now, I've acquired the moniker, "Angel of Death"...not sure how to feel about that one.


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## Chris07 (Aug 30, 2016)

Handsome Robb said:


> Yay for 4 hours of paperwork!



For every hour of "play" comes 4 hours of "work"


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## shelvpower (Sep 4, 2016)

Our first call was also our last call of the night shift. 
Self inflicted GSW to the head with a .45 acp pistol (bloody nice 1911 by the way). 
Thought the guy was DOA when we saw the massive amount of blood, CSF and brain matter coming out of a fist size hole in his head but he still had agonal respirations and a HR of 55 with very very faint central pulses. 
Needless to say he coded on us 20 minutes later. Sinus bradycardia -> VFib-> Paddle Wack - > PEA - > Asystole. 

Definitely think the walls and the roof in that room will need a repaint.


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## VentMonkey (Sep 17, 2016)

Possible ovarian rupture. Amazing what a little fluid, pain control, and (most importantly) comforting words can do.


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## jteeters (Sep 18, 2016)

Transfer from local hospital to JoMo, Pt sustained a skull fracture and has a subdural hematoma and a pulmonary contusion.  The initial call was for an unresponsve Pt who they believed was hit by a car.  Pt was extremely intoxicated. He's intubated, on a Diprivan drip at 20ml/hr and a banana bag.  Get him moved over to the cot, and he starts to wake up, receives a bolus dose of Diprivan at the ER.  We depart, and he attempts to wake up twice more while en route to receiving facility.  Got back just in time for shift change and to finish my paperwork...Ugh.


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## NomadicMedic (Sep 18, 2016)

I still think proprofol is a lousy drug for transporting intubated patients. :/


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## jteeters (Sep 18, 2016)

DEmedic said:


> I still think proprofol is a lousy drug for transporting intubated patients. :/



After this experience, I absolutely agree.  At first, I was kind of freaking out (new Medic syndrome...I'm not perfect, don't judge me HAHA).  Doesn't see, like they could give him enough to keep him down.  Even at the receiving ER.


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## NomadicMedic (Sep 18, 2016)

Fentanyl, Ativan and rocuronium.


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## jteeters (Sep 18, 2016)

I thought about giving him some Roc, but since the Propofol drip was already running, I just gave him a bolus.  It did the trick.


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## jteeters (Sep 18, 2016)

DEmedic said:


> Fentanyl, Ativan and rocuronium.



Although, I'm definitely open to the suggestions you have.  Teach this newbie some good. Haha.


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## VentMonkey (Sep 18, 2016)

DEmedic said:


> Fentanyl, Ativan and rocuronium.


This. Our standard for sedation in transit is typically Fentanyl, and Versed; paralytic seem case dependant, IMO (see below).

Diprivan does have its place, and is great for some neuro cases. Apparently it's quite the neuroprotective agent for seizures, and stat ep patients; so I've been told.

Diprivan is a mild sedative, commonly used in the ICU as many attendings like to perform assessments on these patients when they make their daily rounds so that they can wean, and inevitably extubate them.

As far as paralysis goes, this is yet another on going debate depending on who you talk to, and is really done on a case by case basis.

Most of our scene call patients get a short acting paralytic (i.e., Succs), unless some event leading to their condition prevents them from being a candidate for it, such as a suspected eye injured patient, in which they would most like receive a longer acting, and more appropriate paralytic in Rocuronium. 

If there's nothing barring us from giving said patient the depolarizing NMBA, it's Etomidate---> Succs--->ETI--->Fentanyl--->Versed. We're usually at the local hospital within a reasonable amount of time, and again, a lot of hospitals that I have seen seem to be moving away from the longer acting paralytic agents.

Also, for TBI patients on ground IFT, I may ask the RN if they would like the longer acting paralytic, as most of our IFT's (LDT's) are in the 2 hour range. So for them, if they are on Diprivan started by the sending facility, we may  judiciously titrate the Diprivan up, give a non-depolarizing NMBA, dim the lights, try ear plugs if we have them, and coast along. These patients needs to be normotensive with a MAP (>/=) 60 mmHG, and VERY WELL oxygenated; these are thee mainly goals with any head injured patient.

I also try and adjust my vent settings to match the patient's condition, and/ or paralysis/ non- paralysis. Hope this helps, jteeters.


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## jteeters (Sep 18, 2016)

VentMonkey said:


> This. Our standard for sedation in transit is typically Fentanyl, and Versed; paralytic seem case dependant, IMO (see below).
> 
> Diprivan does have its place, and is great for some neuro cases. Apparently it's quite the neuroprotective agent for seizures, and stat ep patients; so I've been told.
> 
> ...



Thank you for that.  I greatly appreciate it.  I'm always happy to learn more.


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## VentMonkey (Sep 18, 2016)

jteeters said:


> I'm always happy to learn more.


As am I.


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## NPO (Sep 18, 2016)

33 y/o complain of diarrhea all day. Reported "more than a hundred times" since this AM. Patient is immunocompromised due to other history and believes he contracted a disease common in Africa due to contaminated drinking water. I asked why he thinks he has it, and he said because he participated in risky sexual behavior that "could have potentially exposed him to oral-fecal-contamination."

Patient had a 102.1* fever and a HR of 150


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## CALEMT (Sep 18, 2016)

Full arrest. Got pulses back.


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## CALEMT (Sep 18, 2016)

NPO said:


> sexual behavior that "could have potentially exposed him to oral-fecal-contamination."



Eat da poo poo!!!


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## gotbeerz001 (Sep 18, 2016)

SVT... Again, converted on the 12 


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## VentMonkey (Sep 19, 2016)

gotshirtz001 said:


> SVT... Again, converted on the 12
> 
> 
> Sent from my iPhone using Tapatalk


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## VentMonkey (Sep 19, 2016)

Bah! Twas a fist bump back, gotshirtz001.


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