Search results

Two things 1. We have patients in our small rural county system that we have transported 70+ times since Jan 1st, dozens of patients that we have transported 20+ times since then. 2. This guy is 70, with a crappy medical history, poor living conditions, no PCP, medication non compliance (Im...

This is flat out not even close to the only measurement that matters. The goal is ultimately a higher level of care but the costs associated with that are very important. Making a blanket statement like "better care at any cost" is just not an appropriate or responsible way to look at healthcare...

If you show up on scene, at an MVA, and the patient is still in the car, the roadway, or anywhere near the roadway, That is the fire departments patient until handed over to you, period. Fire has control over MVA scenes including the patients until the scene is deemed safe enough for EMS to...

I find that most people that express "dislike" for the ff/ems mix may have a valid reason or two to have that dislike but generally have a dozen reasons that just don't make sense. From the vast majority of budget, management, and training standpoints it makes a lot of sense to combine the two...

This entirely, especially when the flight crew is asking. It's either enough to make a difference or it's an amount that doesn't matter.

Are any of you guys using Cardizem in the field to treat Vtach? I have heard and seen several ER physicians using it to convert Vtach (or Unidentified wide complex tachy) in the ER setting. I believe ER cast did a good podcast on this subject that brought the use of Cardizem up as well for Vtach

Just out of curiousity is anyone going to Dopamine or an Epi drip before pacing this guy? or at least thinking about it?

15 Minutes transport time, What do you do, Go!

Not to sound like Dr. House and all my patients lie :p, but Assisted living center, if shes responsible for her own meds I'm thinking it's a lot more likely shes tachy and septic then that this is full blown Vtach. Idk, big picture is regardless of what this is do you feel comfortable...

Not that impressive if shes really really septic...temp, nausea, SOB, tachy...diarrhea... I'm leaning towards sepsis and think this patient is probably really really sick with underlying infection...play the odds and guess urosepsis secondary to pylo...your right like 80% of the time with that...

I would love to hear Christopher weigh in on this EKG but I would be sorely tempted (with a 15 minute transport time) to do nothing, well, Zofran and the fluids that OP stated were given, then do nothing...

Think about the vast majority of your 911 calls this way. The VAST majority of your patients fall into two groups 1. Those that would be totally fine with no medical care at all as long as they get transport in the near future or 3. Those that are so critical that no matter what you do...

This speaks volumes to the QA departments at some of these "Critical care" services. I would hope that at our local service if you tube a patient and don't place capnography you would at a minimum be sent home a shift. Take everything else out of this story and just absorb this point...

One day sir I'm going to buy you a beer....and then I may kill you for your job...but just think about the free drink offer :D

Pericarditis sounds good to me. Depending on length of time you are with patient I would be curious as to repeat EKG's over the next hour or two, to see if things resolve or worsen from a 12 lead standpoint. My guess is this guy gets one night on an obs unit, labs are normal, discharged with...

Just as the proctor, "I found signs of a pneumo (or hemo), does this appear to be causing life threatening bleeding or respiratory distress at the moment?" They will take this as a "fix it now or fix it later question" and most will be very happy to push you towards (very life threatening) or...

My options for trigger jobs on the gun were not good. The few I found could fix the length or the pull weight, not both. I just hate the trigger all the way around. I'm not sure what ammo costs down there for you guys but a cheapo box of 9 up here is about 16 bucks. We cast all our own...

If I or a loved one is in cardiac arrest, over the age of 60, and initial rhythm is Asystole then for the love of god don't work us. If Im in bad enough shape after a car wreck to need an ambulance and not go POV there is a distinct possibility I have no decision making capacity and I actually...

Have a sig p290 Im trying to sell right now. Looking at the PX4 storm subcompact, or possibly a M+P subcompact. The P290 is a fine gun but I cannot stand the trigger pull at all... The Sig lives within arms reach and loaded at night. I have always been taught to shoot to eliminate the threat...

I hate to be this guy but if we are talking about a transport time of less then 20 minutes or so and you can keep him from decompensating with some O2, (pressures stable, etc) then slap some O2 or CPAP on him and get him to the hospital. If I'm 30 minutes plus out then a lot of this scenario...