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  1. E tank

    No Ambulances Available

    I suspect "call radio" will become code in Chicago for "no one's coming".
  2. E tank

    Medical Travel Companions

    A medical savy advocate that knows how to navigate the system if the need comes up during transit is a commodity that people will apparently pay for.
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    No Ambulances Available

    SFFD had something similar going on a few years ago...SF has always had private back up the county provider whether it was the old 3rd service system or now with the fire department. Been out of there for a while, but I think they've integrated the privates even more for 911 calls, even when...
  4. E tank

    Fake Overtime

    Wonder why this makes news....as if he's the only one...odds are this guy will be the body hanging from the stake as a warning to the hundreds of employees that are doing the same thing...
  5. E tank

    IFT Post stroke pt - does ems need to get tpa administration time?

    What betrays a lack of understanding is a receiving nurse leaving something apparently so important (and irrelevant to) the transferring ambulance crew. What? If the crew gave an answer, would she take their word for it if it was that critical? She was out to bust someone's chops and this was...
  6. E tank

    freezing up and choking during skill drills

    There are mass casualty drills and there are patient simulations. Categorically different. What is true is that neither approximates the real thing to any meaningful degree. They do "break out" the material resources from storage...they demonstrate available assets, but not much more. Patient...
  7. E tank

    Resp failure ift pt

    ETCO2 from a bipap set up wouldn't be as reliable as an ETT tube, so I wouldn't be too surprised at your readings. That said, she's in respiratory failure which in part means she isn't eliminating her CO2 where it would be detected by your monitor. There could be a diffusion barrier defect...
  8. E tank

    Sick person by LEO

    Oh...forgot the very common pericardial effusion that can lead to tamponade , but not necessarily. Hematoma around the aortic root can contribute to impaired coronary flow in the absence of the dissection involving the coronaries directly. Just did one of these on Thursday night, coincidentally....
  9. E tank

    Sick person by LEO

    Funky ekg's not an uncommon presentation for an ascending aortic dissection. The dissection begins in the ascending aorta and over time can extend anterograde to the iliacs and retrograde to the aortic root. annulus, and into the coronary arteries. Impaired perfusion to the SA, AV nodes and the...
  10. E tank

    freezing up and choking during skill drills

    Big difference between performing in a contrived scenario for the purposes of evaluation and it being just you and the patient somewhere. Totally different cognitive pathways...Understand and anticipate your difficulty in the evaluation setting and do what you have to do to get by. Every...
  11. E tank

    Sick person by LEO

    In terms of QRS widening, I wouldn't put this into the same category as delayed or slowed depolarization as in potassium toxicity, it being a conduction defect.
  12. E tank

    City of Cleveland denying PTSD support for EMS workers

    What does that mean?
  13. E tank

    3YO Male, Sick

    So, the only way you can know that your patient has an adequate cardiac output is by a PA catheter or an echo. Got it. So, based on "could reflect poor cardiac output" in a kid with a bp of 90/40, what, besides giving fluid, should the medics on this call do assuming they got an IV? What does...
  14. E tank

    3YO Male, Sick

    You sure do...blood pressure, peripheral pulses. loc and distal skin signs, all of which were reasussuring with this patient. A HR like this in a dehydrated, febrile kid shouldn't be surprising at all. Anyone even considering attempting converting this kid by any means should not be in the...
  15. E tank

    3YO Male, Sick

    I'm not seeing the urgent need for an IV right then and there. And I would not make any attempt at getting that HR down other than giving fluid (if fortunate enough to have an IV) Are folks really thinking about intervening on that?
  16. E tank

    3YO Male, Sick

    I got one, Spud...just get the kid to the hospital and don't even try...febrile, dehydrated kid with a HR of almost 300...flat veins and a jacked up mom? Askin' for trouble...
  17. E tank

    3YO Male, Sick

    This, and this are contradictory statements.
  18. E tank

    Coagulopathic/Bleeding Disorder Education?

    Chronic consequences of the disease aside, acute/emergent bleeding in these patients shouldn't necessarily be treated any differently than someone on, say, coumadin, for BLS EMS purposes. If someone has hemophilia, statistically, they are likely being treated in a network of specialized...
  19. E tank

    Pride-Ego-Humble-Patient Centered Care

    Couple of things going on here, I think...with regard to the OP, sounds like the IV was more important that getting the HR down which isn't bravado, but a lack of experience and/or training. That said, having the ability to give meaningful amounts of fluid quickly when dealing with impaired...

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