# My first medical situation



## tom (Jul 16, 2010)

Hi,

as you can see im new here, so i didnt know what else to put, but here is my first EVER medical incident....


I was about 12, in yr 8 at school, i had just completed my First Aid Course with the Army Cadet Force. There was this diabetic in my class, and their BP and Sugar Levels had been really high recently, and they had been in and out of hospital recently. Then is RE, the collapsed and went unconcious (and hit thier head of a table, and was bleeding), i immidiatley did my AM part of AMEGR and noticed they wasnt breathing, i immidiatley checked that thier airways was clear and got a first aid kit and applied a non-absorbent sterile pad to the head wound (after clearing with antiseptic wipe) and taped on. i then started CPR and after about 2 minutes they came round, i put in recovery position until ambulance arrived. They surived and thier family and the medics praised me for my efforts and from that moment i realised i would take my medical training futher in my life.

i hope this isnt like...wierd but i am new here

Thanks
Tom


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## legion1202 (Jul 16, 2010)

Interesting?


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## Cawolf86 (Jul 16, 2010)

tom said:


> Then is RE, the collapsed and went unconcious (and hit thier head of a table, and was bleeding), i immidiatley did my AM part of AMEGR and noticed they wasnt breathing, i immidiatley checked that thier airways was clear and got a first aid kit and applied a non-absorbent sterile pad to the head wound (after clearing with antiseptic wipe) and taped on.  i then started CPR and after about 2 minutes they came round, i put in recovery position until ambulance arrived.
> Tom



Not to be a pain, I know you were 12...but....

-You started CPR on an apneic patient? That would get me in a load of trouble  Generally I check their_ pulse_ before I qualify them for CPR.

-I also am amused at managing a scalp laceration before CPR.

Good job though I guess?


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## firetender (Jul 16, 2010)

*Important Lesson*

You were twelve. That was your first exposure. It got you here, now you can really learn. 

And, you also found out that at times there really is a margin for error. Hopefully, you also learned it's nothing to take advantage of because it is fickle!


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## jjesusfreak01 (Jul 16, 2010)

I've got the same story. I had a diabetic seize in front of me in the mountains of Guatemala 2 hours from the nearest hospital. I didn't have a clue what to do and I wasn't really any help at all. Couldn't even figure out how to use the stinking glucose meter.


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## lampnyter (Jul 16, 2010)

Cawolf86 said:


> Not to be a pain, I know you were 12...but....
> 
> -You started CPR on an apneic patient? That would get me in a load of trouble  Generally I check their_ pulse_ before I qualify them for CPR.
> 
> ...



yea buy laymen are taught to just start cpr if they see someone drop like that. Plus he was covered by the good samaritan law so he couldnt get in trouble.


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## Cawolf86 (Jul 16, 2010)

lampnyter said:


> yea buy laymen are taught to just start cpr if they see someone drop like that. Plus he was covered by the good samaritan law so he couldnt get in trouble.



Are they? I have never taken a non-healthcare provider CPR course and did not know that. I assumed that all CPR courses would teach to check for a carotid pulse and unresponsiveness. Interesting.


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## Sassafras (Jul 16, 2010)

You aren't always covered by good sam law.  I know of a situation where the CPR providers were busted for not checking a pulse because he seized and collapsed in public (pt was an epilleptic) and on lookers ran over, asked the wife nothing who was waiting out the seizure and began pumping his chest, breaking ribs.  Man would have been fine with a blood test to check his med levels and O2, and instead was hospitalized with chest trauma.  Great story to hear my paramedic friend tell and how pissed off she got with onlookers who tried to argue with her that she didn't know how to do CPR because they "brought him back".


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## rescue99 (Jul 16, 2010)

tom said:


> Hi,
> 
> as you can see im new here, so i didnt know what else to put, but here is my first EVER medical incident....
> 
> ...



For a lad of 12 you managed to make adult decisions and take adult actions  when faced with a crisis. You did a great job given your age at the time.


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## tom (Jul 17, 2010)

Thanks Everyone, appreciated.



Also when i did my CPR training with the ACF we was told just to check for breath sounds, see if thier throat was clear, and see if thier chest was moving up and down. if we couldnt hear the breathing, throat was clear, and thier chest wasnt moving up and down we should start CPR


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## LondonMedic (Jul 17, 2010)

Cawolf86 said:


> Are they? I have never taken a non-healthcare provider CPR course and did not know that. I assumed that all CPR courses would teach to check for a carotid pulse and unresponsiveness. Interesting.


Plenty of nurses and EMTs wouldn't know where to find a carotid pulse if the :censored::censored::censored::censored: hit the fan, the general public are even worse mongs.


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## tom (Jul 17, 2010)

i know what you mean by general public are mongs...


i was watching a program on virgin 1 called Trauma, and there was this guy choking at the gas station, so this other bloke did the thing where you squeeze them really tight and make it look like your :censored: them, he cleared the food but he snapped a rib and punctured a lung. the guy thought he was having a heart attack and gave him CPR and just pushed the bone futher in. when paramedics arrived they had a go at the guy, and the guy dint even have CPR traning.

But then again you dont even give CPR for heart attack (even if you are a member of the public)


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## Chimpie (Jul 17, 2010)

tom said:


> But then again you dont even give CPR for heart attack (even if you are a member of the public)



Wait... huh?


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## legion1202 (Jul 17, 2010)

what do you mean you dont give cpr? In our 911 system even if you dont know how to give cpr the dispatcher will give your instructions if you feel comfortable.. Someone once told me if someone is having a heart attack and they do not have a pulse just giving chest  compressions will help up to about 15 mins without giving rescure breaths.


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## tom (Jul 17, 2010)

for heart attack you put them in a up-right position against a wall with legs out straight, you can give asprin and you shoudl keep them talking to prevent them going to sleep


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## tom (Jul 17, 2010)

thats if theyre in Cardiac Arrest (heart stopped), read my post, the guy was still alive


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## Shishkabob (Jul 17, 2010)

tom said:


> for heart attack you put them in a up-right position against a wall with legs out straight, you can give asprin and you shoudl keep them talking to prevent them going to sleep



....


My head is starting to hurt again.




What are they teaching these people?


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## tom (Jul 17, 2010)

im british so our treatment protocoll is different


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## legion1202 (Jul 17, 2010)

Dude. let me see your medic card lol. Yes if your in arrest you perform cpr. I watch trauma very fake tv show... The guy didnt check his pulse before starting cpr. If the guy had no pulse cpr would need to be followed after calling for 911.

A heart attack protocl for us is. O2, semi fowlers or suspine if there knocked out.  IF there awake you call for oders for nitro. You can give that up to three times. Monitar v/s every 5 mins and rush them to a cardio hospital. We dont give them asprine unless ordered or they are perscribed by a doc i beleive. 

I do how ever have a question? If there in cardio shock do you put them in the shock postion? IF they had a very high blood pressure?


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## legion1202 (Jul 17, 2010)

British... Explains a few things.. Do you all have medics or is it germany that uses doctors for ems


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## Shishkabob (Jul 17, 2010)

tom said:


> im british so our treatment protocoll is different



Trust me, I know they aren't THAT radically different when it comes to an MI.


Quit BSing.  You aren't a healthcare provider and just need to stop pretending to be one.  You obviously have no clue at what you're talking about and haven't the slightest clue at patient care.

Heck, I'm beginning to doubt you've done a first aid course.


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## tom (Jul 17, 2010)

we have mostly Technicians (EMT), a large number of Paramedics, and a few Emergency Doctors (doctors that ride in ambulance)


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## Shishkabob (Jul 17, 2010)

That's cool... and you are none of the above.


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## tom (Jul 17, 2010)

Linuss said:


> Trust me, I know they aren't THAT radically different when it comes to an MI.
> 
> 
> Quit BSing.  You aren't a healthcare provider and just need to stop pretending to be one.  You obviously have no clue at what you're talking about and haven't the slightest clue at patient care.
> ...



those kind of comments are the things that make people not want to come here


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## Shishkabob (Jul 17, 2010)

What?  Calling someone out that is pretending to be a Paramedic?

Sorry for not liking fraudulent people...


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## tom (Jul 17, 2010)

prove im not a Paramedic then -.-


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## Aprz (Jul 17, 2010)

If you insist that we start listing evidence to suggest that you are not a paramedic I guess I'll start:

1) Inability to describe paradoxical movement/flail chest.

At the moment, a lot of the things you've been posting just seem too outrageous to be true.

Maybe somebody should post up a picture of an ECG strip and see if he can figure out what is it. It'll be like a game. Here's a simple one.


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## tom (Jul 17, 2010)

normal heart beat and every so often an irregular beat


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## Aprz (Jul 17, 2010)

Okay... good. We are getting somewhere. I decided to be a bit more specific on what I want. What the hell is that?  How do you get one of those?  Doesn't it look scary? 

*Edit:* ...to be a little less vague/mysterious... What is it called?!  If you caught this, would you tell your friends it was an irregular beat... or what ??? If you were to teach an EMT-Basic like me about it, cause some EMT-Basic wants to be Paramedics, how would you educate them on it?

See... you have a chance. You figured out it wasn't completely normal so far. The nice thing is this is an image, and I uploaded so you can't Google it or anything like that. I suppose you could Google certain words to figure it out, but I think it being an image makes that a lot harder, and I ain't gonna give you any clues. 

...actually to make this a bit more challenging... I'd also like you to tell me what would call this strip if that thing wasn't there? 

*Edit:* As you can imagine, I like playing this game cause I am using a lot of smilies.


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## Sassafras (Jul 17, 2010)

Aprz said:


> If you insist that we start listing evidence to suggest that you are not a paramedic I guess I'll start:
> 
> 1) Inability to describe paradoxical movement/flail chest.
> 
> ...



How did you get my patient's ECG strip? And no I have no clue what the ayche eee double hockey sticks was wrong with the dude, but I am not a medic.  I just got out of their way at that point.


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## tom (Jul 17, 2010)

that is one of your patients ECG strip? are you sure....because getting hold of them is kind of like against a patients privacy.


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## Aprz (Jul 17, 2010)

Well, this I actually kind of took off the Internet, but I got an ECG strip right next me that has one of those that I could take a picture with my phone and upload, and it wasn't a real patient. Caught it in class when we were doing ECGs on each other. 

*Edit:* Bah, no need to lecture me on privacy or HIPPA. This picture alone isn't enough to get me in trouble, and it's not my picture too.

So what is it?


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## Sassafras (Jul 17, 2010)

tom said:


> that is one of your patients ECG strip? are you sure....because getting hold of them is kind of like against a patients privacy.



I was kidding.  But it looks like what a patient was doing last night. I arrived for a schedule transport early and this man started acting like he was having a stroke as I waited on my patients and I was asked to help until 911 arrived (I was doing a solo wheelchair run so I couldn't transport this man anyway). Let me rephrase, ONE of the strips looked like that.  I know 12 leads have a bunch of different readouts, however, I need to ask more questions of medics to actually understand them.


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## tom (Jul 17, 2010)

what signs did he have of having a stroke?


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## Aprz (Jul 17, 2010)

Oh, I thought he was talking to me.  Then I thought you were telling me you were joking, and I was gonna be like I know, but it looks like I have no clue about what's going on, haha! 

I'll PM Sassafras on it. It's really not complicated at all. Not even the slightest bit.

*Edit:* Tom! What is it? Please please please! Play my game. How wrong does that sound?


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## tom (Jul 17, 2010)

Aprz said:


> *Edit:* Tom! What is it? QUOTE]
> 
> 
> 
> ...


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## tom (Jul 17, 2010)

Sassafras said:


> I was kidding.  But it looks like what a patient was doing last night. I arrived for a schedule transport early and this man started acting like he was having a stroke as I waited on my patients and I was asked to help until 911 arrived (I was doing a solo wheelchair run so I couldn't transport this man anyway). Let me rephrase, ONE of the strips looked like that.  I know 12 leads have a bunch of different readouts, however, I need to ask more questions of medics to actually understand them.



what signs did he have of having a stroke?


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## Aprz (Jul 17, 2010)

Tom, it is indeed irregular, but there are a bazillion different irregular heart beats. Which one is this? Like I said, you wouldn't just say "Oh, I caught an irregular beat" to a friend or co worker about it. You'd say "Oh, I caught a(n) ______".


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## emt_irl (Jul 17, 2010)

tom said:


> Aprz said:
> 
> 
> > *Edit:* Tom! What is it? QUOTE]
> ...


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## tom (Jul 17, 2010)

Arrhythmia


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## Aprz (Jul 17, 2010)

Hands up. Does anybody think the question I gave him is hard at all? Look at my qualifications? It's so easy a basic can do it. 

*Edit:* *makes loud bell sound when you get a question wrong* If you were playing EMT, I'd believe you, but you're playing Paramedics, and a Paramedic would know this without looking at it! Okay... maybe they would need to look at it (well, unless I describe it too them), but I am gonna put my money on you don't know what it is and you're not a Paramedic. British or not, your ECG strips aren't gonna be different.

Now, I'm not top dog of the forums, but you're not gonna get brownie points from people like me (and it looks like from others too) unless if you either start showing you're a Paramedic or just fess up that you aren't. It's okay. When I joined the forums, I just got my First Responder cert (equivalent to being below a bone head EMT). It's nice to watch people grow on here, learn, etc. Don't need false information to confuse newbies. This is a fun place for everyone, you don't have to be a Paramedic to be respected.  I am sure everyone will forgive you if either of those two things start happening. C'mon man.


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## tom (Jul 17, 2010)

Arrhythmia - medical term for irregular hearteat


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## Sassafras (Jul 17, 2010)

tom said:


> what signs did he have of having a stroke?



Non responsive with right side facial droop and drooling, staring into space, weird sluggish pupils like I'd never seen before reacting irregularly, but both eventually reacting, rapid shallow respirations and a heart rate that kept disappearing as I tried to count making me think my fingers were not placed properly.  Pulse ox down to 71%.  Hypotonic, slumped over in wheel chair. BP 90s over 50s. 

Then when he regained responsiveness and he began complaining of heartburn with shoulder pain that moved down his arm.  Very weak, difficulty keeping eyes open somewhat like a post dictal state, but it did not seem like a seizure at the time.  

I thought "great, how did he go from stroke symptoms to heart attack?" Once responsive was able to push and pull and hand grasp equally, but seemed weak.  

Truthfully, I'm totally clueless and apparently so was everyone else. 

Medics arrived did the 12 lead and one of the strips looked a lot like the example above.


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## emt_irl (Jul 17, 2010)

ok yes Arrhythmia its the propper terminology, but hell im gonna call it here, that was a pvc!!! as wikipedia can give alot of answers to internet users i wont ask anymore


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## LucidResq (Jul 17, 2010)

tom said:


> Arrhythmia - medical term for irregular hearteat



So that's what you would tell the doctor when bringing a patient in with that strip? That would go over well. 

Dude I agree with Aprz... you're digging yourself in a hole. It's pretty darn clear that you have lied. Show a bit of character and admit to it rather than clinging to your lie and burying yourself deeper.


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## emt_irl (Jul 17, 2010)

Sassafras said:


> Non responsive with right side facial droop and drooling, staring into space, weird sluggish pupils like I'd never seen before reacting irregularly, but both eventually reacting, rapid shallow respirations and a heart rate that kept disappearing as I tried to count making me think my fingers were not placed properly.  Pulse ox down to 71%.  Hypotonic, slumped over in wheel chair. BP 90s over 50s.
> 
> Then when he regained responsiveness and he began complaining of heartburn with shoulder pain that moved down his arm.  Very weak, difficulty keeping eyes open somewhat like a post dictal state, but it did not seem like a seizure at the time.
> 
> ...



as i read that i just thought "i think its time to act fast"

http://www.youtube.com/watch?v=f8nZlwndwb4

also was it a single pvc or a string of them?


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## Sassafras (Jul 17, 2010)

I remember seeing more than episode like that as it strung along.  And yes, we were trying to act fast.  This whole situation took place in a span of about 8 minutes from realizing he wasn't acting normal to medic arrival and transferr of care to them.  When he came to he was oriented for his normallacy, but VERY tired.  I totally felt helpless but was irritated w/ a white coat that literally froze so I forced myself to keep looking, talking to him and refusing to let him go back to sleep after he regained "conciousness" for lack of a better word (eyes were open during episode so not sleeping).


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## LucidResq (Jul 17, 2010)

Tom why don't you just give us your registration number or name so I can check the HPC database? That will prove once and for all that you are a paramedic. I'd like to see some kind of proof that's really your name though, like an email from your agency-issued account or an established Facebook.  

You can PM it to me if you don't want the world to know for privacy reasons, and in a fair trade I will give you my full name and the government website you can verify my certification on.


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## tom (Jul 17, 2010)

Sassafras said:


> Non responsive with right side facial droop and drooling, staring into space, weird sluggish pupils like I'd never seen before reacting irregularly, but both eventually reacting, rapid shallow respirations and a heart rate that kept disappearing as I tried to count making me think my fingers were not placed properly.  Pulse ox down to 71%.  Hypotonic, slumped over in wheel chair. BP 90s over 50s.
> 
> Then when he regained responsiveness and he began complaining of heartburn with shoulder pain that moved down his arm.  Very weak, difficulty keeping eyes open somewhat like a post dictal state, but it did not seem like a seizure at the time.
> 
> ...





did the hospital tell you what had actually happend to him?


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## emt_irl (Jul 17, 2010)

did you ever find out the end result of it all? did you asses pupils? if so what were they?


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## Aprz (Jul 17, 2010)

LucidResq said:


> So that's what you would tell the doctor when bringing a patient in with that strip? That would go over well.
> 
> Dude I agree with Aprz... you're digging yourself in a hole. It's pretty darn clear that you have lied. Show a bit of character and admit to it rather than clinging to your lie and burying yourself deeper.


+1 Yeh, c'mon man. No hard feelings. We are giving you a chance here.  It's okay, I understand. We all sometime make ourselves bigger than what we actually are. It's understandable. 

By the way, gotta do this. *bing!* PVC is the correct answer! It's normal in people with a lot of stress, drink a lot of caffeine, etc... A lot of people don't even feel it, but if they do, they describe it as a skip beat sometime.


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## Sassafras (Jul 17, 2010)

I did not transport so unless I go back to that facility for another transport and ask I won't find out. I am interested in knowing though because I have transported this person and found him very sweet and endearing so it pulled on the heart strings a bit.


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## emt_irl (Jul 17, 2010)

Aprz said:


> +1 Yeh, c'mon man. No hard feelings. We are giving you a chance here.  It's okay, I understand. We all sometime make ourselves bigger than what we actually are. It's understandable.
> 
> By the way, gotta do this. *bing!* PVC is the correct answer! It's normal in people with a lot of stress, drink a lot of caffeine, etc... A lot of people don't even feel it, but if they do, they describe it as a skip beat sometime.



i get the odd one every now and then, but in work i am stressed and drink waay to much energy drinks, its really good to actually understand what it really feels like when trying to explain to noobs i let them take my radial and you can quite easily feel it.


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## Aprz (Jul 17, 2010)

Well, guys... I got work. Don't even work as an EMT yet, hehe, I sell chicken wings for $8.50/hour!  Y'all have fun. Tom, really, don't be embarrassed. It's okay. I am sure you can't be as bad as me selling chicken. Fess up man. Everyone is doing it. Peer pressure!

See ya guys.


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## MDA (Jul 17, 2010)

Aprz said:


> Well, guys... I got work. Don't even work as an EMT yet, hehe, I sell chicken wings for $8.50/hour!  Y'all have fun. Tom, really, don't be embarrassed. It's okay. I am sure you can't be as bad as me selling chicken. Fess up man. Everyone is doing it. Peer pressure!
> 
> See ya guys.



Where?! Buffalo Wild Wings?
Let me know so next time we take an LD/CCT up north I can come get some wings.

I love wings.

EDIT: OR BETTER YET... HOOTERS?!?!?!?!?! Hahaha, I had to ask.


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## Aprz (Jul 17, 2010)

If you like seeing a guy in tight shorts and tight shirt, sure. Hooters.  Nah, I work at Wing Stop. Done with my shower. Now I really gotta go!


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## Shishkabob (Jul 17, 2010)

tom said:


> Arrhythmia - medical term for irregular hearteat



Actually, no, it's not.


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## MDA (Jul 17, 2010)

Aprz said:


> If you like seeing a guy in tight shorts and tight shirt, sure. Hooters.  Nah, I work at Wing Stop. Done with my shower. Now I really gotta go!



Hahahahahahahahahahahaha. My mistake.
That's the only response I have.


I still like wings though.


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## LucidResq (Jul 17, 2010)

tom said:


> I was about 12, in yr 8 at school, i had just completed my First Aid Course with the Army Cadet Force.



Another likely hole in your story. 

I am not from the UK and know nothing about the Army Cadet force, but with some research found that age 12 is the absolute youngest they will let you join. In their basic training, the extent of the first aid they teach is essentially "when and how to call 999." 

According to their training syllabi, the kind of stuff you describe comes in to play at the "One-Star" level or higher. And a direct quote from their one-star syllabus: "A cadet would not normally complete One-Star before the age of 14 years."


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## tom (Jul 17, 2010)

LucidResq said:


> Another likely hole in your story.
> 
> I am not from the UK and know nothing about the Army Cadet force, but with some research found that age 12 is the absolute youngest they will let you join. In their basic training, the extent of the first aid they teach is essentially "when and how to call 999."
> 
> According to their training syllabi, the kind of stuff you describe comes in to play at the "One-Star" level or higher. And a direct quote from their one-star syllabus: "A cadet would not normally complete One-Star before the age of 14 years."




i went for my basic training at Westdown camp, Sailsbury Plain. By det was Old Hill, county was Staffordshire & West Midlands (North Sector) ACF. if we passed a part of training at the detachment, we would go onto the next star level training in that training area


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## malloriejune (Jul 17, 2010)

that doesnt appear to quantify your claim to being a "paramedic"


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## tom (Jul 17, 2010)

i know....


im off, its 10:30pm im tired and im on duty tommorrow


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## malloriejune (Jul 17, 2010)

lol alright pal


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## LucidResq (Jul 17, 2010)

Tom - show us the proof. What's your surname so I can check on HPC? 

Whether or not you give this information, I will be sending a few emails to West Midlands Ambulance Service as I'm sure they would not appreciate either: a) a "paramedic" employee representing them so poorly or b) an imposter falsely claiming they are a part of the service.


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## MDA (Jul 17, 2010)

I don't know if all of this is necessary.

Regardless of what he represents, potentially delving into someones real life and causing conflict with their employers because of an internet forum might be crossing the line.

Let him say what he has to say, you don't need to believe it or even waste your time. Just move on and let it be.


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## ExpatMedic0 (Jul 17, 2010)

wow......


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## emt_irl (Jul 17, 2010)

from knowing the local lingo on duty usually suggests vol ambulance service who do event cover etc non emergency work


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## Cawolf86 (Jul 17, 2010)

I will take credit for the being the first to post that he didn't make any sense!


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## ExpatMedic0 (Jul 17, 2010)

haha ya nice one. The PVC thing made me laugh.
Do you think he is a driver or just a young kid interested in EMS?


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## emt seeking first job (Jul 19, 2010)

Am I missing something here. I am an EMT. I passed the test but have never treated a patient.

Did'nt the OP write he bandaged the head wound before any rescue breathing ?

In my class the main instructors mantra was airway-airway-effing airway...

Also, all my instructors who had ever done CPR, nobody had a patient that was brought back in the field EVER. Furthermore, some meidcs that were instructirs said they had gotten people's pulses back and breathing but they were never responsive.

But to me, a complete noob, the managing the head laceration in a dead giveaway.....

Its like a bad monty python sketch, they fix the guys bowtie first or something...lol


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## MusicMedic (Jul 19, 2010)

tom said:


> for heart attack you put them in a up-right position against a wall with legs out straight, you can give asprin and you shoudl keep them talking to prevent them going to sleep



This right here PROVES he is not a Medical Provider

ive never heard of this ever... and asprin/ talking to them and  preventing them from going to sleep? really? really? 


this kid is a troll, he is F'ing with us

Mods, you might wanna take a look at him!


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## Aprz (Jul 20, 2010)

I had fun with the guess what that is game.


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## jjesusfreak01 (Jul 20, 2010)

MusicMedic said:


> This right here PROVES he is not a Medical Provider
> 
> ive never heard of this ever... and asprin/ talking to them and  preventing them from going to sleep? really? really?



Huh, haven't you ever watched a movie where someone was severely injured? The most important part of treatment is keeping them awake. If they are awake, they aren't dead, so if you base all of your treatments on keeping them awake, then they should be fine. I prefer to keep a good stock of amphetamines and ammonia capsules handy for this purpose.


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## emt seeking first job (Jul 21, 2010)

1) CPR in movies does not mirror CPR in the field.

2) The patient was unresponsive to begin with,,,


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## Sasha (Jul 25, 2010)

jjesusfreak01 said:


> Huh, haven't you ever watched a movie where someone was severely injured? The most important part of treatment is keeping them awake. If they are awake, they aren't dead, so if you base all of your treatments on keeping them awake, then they should be fine. I prefer to keep a good stock of amphetamines and ammonia capsules handy for this purpose.



Really? Because I was taught that if they want to sleep, let them sleep, just check their responsiveness. If they have any kind of injury and are going to go unresponsive, they're going to do it regardless of if you're sitting there going "Stay awake man! Don't go towards the light!" or not. 

PS, don't use movies to back up your argument. I once saw someone empty out a pen of it's ink cartridge and shove it randomly into his trachea because his head was trapped in a tank of water on one of the SAW movies.... doesn't mean it's proper or somthing that will work.


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## Veneficus (Jul 25, 2010)

Sasha said:


> PS, don't use movies to back up your argument. I once saw someone empty out a pen of it's ink cartridge and shove it randomly into his trachea because his head was trapped in a tank of water on one of the SAW movies.... doesn't mean it's proper or somthing that will work.



Awesome point, don't do something because you see it on "House" either.


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## MrBrown (Jul 25, 2010)

now now folks lets give the chap a break, I mean he's not a Paramedic but I'm no helicopter doctor .... and yet you let me get away with it 

"Hey Brown, its a go"
"Aw bloody hell Oz, what is it?"
"Sounds bad Brown"
"Hmm, an RTA perhaps ... oh no, not a one under?"
"Worse, its the HPC!"
"Oh dear...."


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## Lifeguards For Life (Jul 25, 2010)

jjesusfreak01 said:


> Huh, haven't you ever watched a movie where someone was severely injured? The most important part of treatment is keeping them awake. If they are awake, they aren't dead, so if you base all of your treatments on keeping them awake, then they should be fine. I prefer to keep a good stock of amphetamines and ammonia capsules handy for this purpose.



No it's not. and you shouldn't do that.


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## Sassafras (Jul 25, 2010)

I read jesusfreaks post as sarcasm. Not literal.


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## Lifeguards For Life (Jul 25, 2010)

Sassafras said:


> I read jesusfreaks post as sarcasm. Not literal.



oops. maybe.


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## MrBrown (Jul 25, 2010)

jjesusfreak01 said:


> Huh, haven't you ever watched a movie where someone was severely injured? The most important part of treatment is keeping them awake. If they are awake, they aren't dead, so if you base all of your treatments on keeping them awake, then they should be fine. I prefer to keep a good stock of amphetamines and ammonia capsules handy for this purpose.



Thats an awesome idea mate, level of consciousness is a great indicator of cerebral perfusion!

Why I do believe that may just qualify you for an orange jumpsuit with "PARAMEDIC" written on it!

Oh man that hurt, I shouldn't do that in the future.  Brown needs to sit down quick!


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## Sparky79 (Jul 25, 2010)

Sassafras said:


> I read jesusfreaks post as sarcasm. Not literal.




Yep, seemed pretty clear to me also.


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## jjesusfreak01 (Jul 25, 2010)

Sparky79 said:


> Yep, seemed pretty clear to me also.



Yup, seems pretty clear to me also...


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## MusicMedic (Jul 25, 2010)

jjesusfreak01 said:


> Yup, seems pretty clear to me also...



Yup, seeming pretty clear to me also.......


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## Aprz (Jul 25, 2010)

MusicMedic said:


> Yup, seeming pretty clear to me also.......


Yup, seeming pretty clear to me also....................

Does anybody else notice a pattern going on here?


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## Stephanie. (Jul 25, 2010)

Aprz said:


> Yup, seeming pretty clear to me also....................
> 
> Does anybody else notice a pattern going on here?



Yup, seeming pretty clear to me also.................................


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## lampnyter (Jul 25, 2010)

all i know is laymen arent taught to check a pulse lol.


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## jjesusfreak01 (Jul 25, 2010)

lampnyter said:


> all i know is laymen arent taught to check a pulse lol.



Tis true for adult resuscitation...they assume that adults arrest due to cardiac problems vs. children who arrest after respiratory problems. Therefore, laymen are taught to check for children but not adults.


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## Melclin (Jul 25, 2010)

Never have I seen a thread more worthy of an epic face palm.


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## lampnyter (Jul 25, 2010)

jjesusfreak01 said:


> Tis true for adult resuscitation...they assume that adults arrest due to cardiac problems vs. children who arrest after respiratory problems. Therefore, laymen are taught to check for children but not adults.



yea but when an adult sees a child drop, especially if its their kid, they are going to be freaking out and i doubt they will check for a pulse


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## jjesusfreak01 (Jul 26, 2010)

Well yeah, but what do we mean by "drop"? A kid in cardiac arrest secondary to a respiratory problem will probably have been showing obvious signs of the respiratory distress. If they just drop they are probably having a syncopal episode not related to cardiac arrest, unless they have some sort of congenital defect. I suppose non life-threatening syncope is where there could be a problem, ie, people starting cpr on someone not in distress.


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## lampnyter (Jul 26, 2010)

yea thats what i mean, they really should teach to check for pulse in everybody because they could be doing cpr on a person not in cardiac arrest


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## jjesusfreak01 (Jul 26, 2010)

lampnyter said:


> yea thats what i mean, they really should teach to check for pulse in everybody because they could be doing cpr on a person not in cardiac arrest



And the worst part is, in my CPR class the only real difference was the instructor telling us to check for a pulse. I did a hybrid course (online/in person) and was in a class with a bunch of people getting first aid and standard CPR certs, and checking for a pulse was the only thing they taught differently, and they only took 2 seconds to make the distinction.

What could it hurt? Tell them to check for a pulse for a few seconds. If they feel a pulse, then they don't give unnecessary CPR, and if they don't feel a pulse, it's no different than what they were taught before, except CPR is held off for a few seconds.


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## Doc_D (Jul 26, 2010)

Its alright man, my first real medical situation the soldier had 2 GSW (Gun Shot Wounds) to the hip and foot and a shrapnel wound in the other leg which caused a femoral bleed. I was scared, but it all worked out. Put a tournakit on him, packed some kerlix in his wounds, put some ace wraps around it, got a saline lock in and evac'ed him. He survived, sure did i over react and lose my cool? Yes. But its your first medical experience.


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## lampnyter (Jul 26, 2010)

jjesusfreak01 said:


> And the worst part is, in my CPR class the only real difference was the instructor telling us to check for a pulse. I did a hybrid course (online/in person) and was in a class with a bunch of people getting first aid and standard CPR certs, and checking for a pulse was the only thing they taught differently, and they only took 2 seconds to make the distinction.
> 
> What could it hurt? Tell them to check for a pulse for a few seconds. If they feel a pulse, then they don't give unnecessary CPR, and if they don't feel a pulse, it's no different than what they were taught before, except CPR is held off for a few seconds.



i agree 100%. i am a cpr/aed teacher and whenever im teaching alone i tell them to try to check for a pulse but dont make it a priority


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## akflightmedic (Jul 26, 2010)

lampnyter said:


> i agree 100%. i am a cpr/aed teacher and whenever im teaching alone i tell them to try to check for a pulse but dont make it a priority



If the two of you are in agreement, then you have obviously not read any of the evidenced based research which led to such changes and if you teach against the protocol, you really should not be an instructor.


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## MrBrown (Jul 26, 2010)

akflightmedic said:


> If the two of you are in agreement, then you have obviously not read any of the evidenced based research which led to such changes and if you teach against the protocol, you really should not be an instructor.



Have you even had your Instructor background check yet AK? 

Seriously, it'll be pretty obvious if they get enough cardiac output back to produce a pulse.  Not even Ambo's check for a pulse anymore unless the rhythm looks capable of producing output or there are sctua signs of a cardiac output.


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## LondonMedic (Jul 26, 2010)

jjesusfreak01 said:


> What could it hurt? Tell them to check for a pulse for a few seconds. If they feel a pulse, then they don't give unnecessary CPR, and if they don't feel a pulse, it's no different than what they were taught before, except CPR is held off for a few seconds.


If they feel a pulse - whose pulse will it be? <_<


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## lampnyter (Jul 26, 2010)

I didnt really think it was a big deal. I guess i wont teach them to look for a pulse anymore.


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## akflightmedic (Jul 26, 2010)

lampnyter said:


> I didnt really think it was a big deal. I guess i wont teach them to look for a pulse anymore.



It actually is a big deal and I strongly suggest you review the "whys" of how we teach. It also makes me question your instructor course because you did not know this information beforehand. Just voicing an opinion in the hopes it motivates you to go read the research and change your instruction to conform to the guidelines so we can continue to produce properly educated students.


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## lampnyter (Jul 26, 2010)

akflightmedic said:


> It actually is a big deal and I strongly suggest you review the "whys" of how we teach. It also makes me question your instructor course because you did not know this information beforehand. Just voicing an opinion in the hopes it motivates you to go read the research and change your instruction to conform to the guidelines so we can continue to produce properly educated students.



I knew it wasnt protocol to teach them, I just thought it would be useful for them to know. I mean, they take a pulse for a child but not for an adult, if they can do one, why not the other?


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## jjesusfreak01 (Jul 26, 2010)

akflightmedic said:


> If the two of you are in agreement, then you have obviously not read any of the evidenced based research which led to such changes and if you teach against the protocol, you really should not be an instructor.



Is it because they want to avoid the reluctance to act that may come with checking for a pulse and being unsure?


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## Sassafras (Jul 26, 2010)

Quite honestly the arrest I did last night I did a brief 2 second pulse check (radial which was stupid but it's only my second arrest and I kind of went into radial pulse check like I do on other pts).  There was nothing more I could do until my partner got in the room to help me move the pt to the floor (odd positioning of pt) which took a couple more seconds due to distraut family so why not check the pulse?  I knew what I was getting ready to do and that's all the information I was able to gather in the moment anyway.  No pulse time for CPR and away we went.  The bigger problem I see (and yes I'm n00bing here) is keeping the head in a neutral position.  Ventilations or not depending on the organization you take CPR with, don't matter if you can't keep the head neutral.  I ended up clamping my knees around the head to keep the airway open enough for ventilations to go into the lungs as every chest compression had it flopping forward.


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## the_negro_puppy (Jul 27, 2010)

Sassafras said:


> Quite honestly the arrest I did last night I did a brief 2 second pulse check (radial which was stupid but it's only my second arrest and I kind of went into radial pulse check like I do on other pts).  There was nothing more I could do until my partner got in the room to help me move the pt to the floor (odd positioning of pt) which took a couple more seconds due to distraut family so why not check the pulse?  I knew what I was getting ready to do and that's all the information I was able to gather in the moment anyway.  No pulse time for CPR and away we went.  The bigger problem I see (and yes I'm n00bing here) is keeping the head in a neutral position.  Ventilations or not depending on the organization you take CPR with, don't matter if you can't keep the head neutral.  I ended up clamping my knees around the head to keep the airway open enough for ventilations to go into the lungs as every chest compression had it flopping forward.



I also find maintaining head position difficult. Doing that plus getting a good seal is a challenge. On my first arrest there was so much vomit that even with suction my partner couldn't properly go for an LMA se we used OP + Bag until ICP came and tubed approx 5 minutes later.

Had my 2nd arrest on saturday night, was driving to the airport to pick up a transfer patient and came across a few cars pulled over in a tunnel. We got flagged down and saw a bystander doing one arm cpr to a driver of a car that was sitting up against the wall of the tunnel, they were on phone asking for ambulance as we drove past. We got guy out and started our stuff, but within around 5 mins we had extra units and our medical director on scene (ER trained doctor) No dice again though. Looks like guy had a massive MI while driving,


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## Sassafras (Jul 27, 2010)

We think ours was gone by the time we arrived too. From medic alert button to arrival of first responders was five minutes but we think pt had been down a little bit before daughter found and hit medic alert button. Still warm though. And still sad. Not sure I'll ever completely get over death and not sure I want to.


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