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  1. rhan101277

    FDNY suspended medics reinstated

    http://www.ems1.com/paramedics/articles/2009956-FDNY-Suspended-medics-being-reinstated/ These are the medics that did a poor assessment and didn't bring the gear you normally should bring to an emergency call to the patients side. What do ya'll think?
  2. rhan101277

    Continue CPR or not?

    it was a dual chamber pacemaker, it looked a little different than a pacemaker would since no polarization/depolarization or voltage changes were taking place across the myocardium. Thanks for all the comments, it makes me feel better. I have stopped a code before but this was different. It...
  3. rhan101277

    Continue CPR or not?

    Well he continued to ask me if she was dead or not a few times. I repeated she is pulseless and apneic. She did have PEA at 80 but it was a pacemaker rhythm. She did not have positive signs of death and I think the family just wanted to let her go naturally.
  4. rhan101277

    Continue CPR or not?

    85 y/o female, initial call comes out as hemorrhage - rectal bleed. Upon arrival daughter meets us at the entrance to the nursing home. Upon entering the pt room she is on the floor w/ staff performing compressions. Pt looks pale, she is pulseless, anpeic. I prepare to take over chest...
  5. rhan101277

    77 y/o female respiratory distress

    ASA is in our protocols for CHF. The thinking is that people with CHF have ventricular dysfunction and blood will pool, administering ASA reduces the risk of further clots developing.
  6. rhan101277

    77 y/o female respiratory distress

    I administered CPAP, ASA, NTG and her RR was lower by the time we reached the ER but she was still in distress. Her chest xray showed fluid as well. Spoke with the doctor and he said new onset CHF or fluid overload and that my treatment was correct. This was not a classic CHF. Where the...
  7. rhan101277

    77 y/o female respiratory distress

    no cough, she is compliant with medications and has not missed any dialysis appointments. Did not get a room air sat. Good mentation. 12 lead does shows LVH.
  8. rhan101277

    77 y/o female respiratory distress

    You are called for a patient with sob. You arrive to find the fire department on scene with the patient on a NRB at 15L/m. Pt is sitting in a chair and leaning forward in obvious distress. She denies any pain, RR is 46 labored and shallow. Pt blood pressure is 220/120, HR is 98 NSR on the...
  9. rhan101277

    Ankle dislocation + distal fibula fx

    We can reduce dislocations in the field but only when distal pulses are not felt. Also I would be concerned about performing one with an associated fibula fx.
  10. rhan101277

    Ankle dislocation + distal fibula fx

    Had this the other day, just decided to lay in on a pillow and use some seat belts. Fall from stairs, -loc, pain 6/10, pms intact. No other trauma noted. Just wanted to get some thoughts on splinting, I didn't believe there was much more I could do and it isn't often that I am splinting...
  11. rhan101277

    82 y/o female respiratory distress

    Don't know about the BiPAP settings this was done at the ER. We only have CPAP, we need to get BiPAP prehospital though.
  12. rhan101277

    82 y/o female respiratory distress

    I need to follow up on this patient but when we arrived she was placed on BiPAP and immediately began improving. Our protocols state that cpap is contraindicated due to increased intrathoracic pressure for bp's below 90. I did learn from this call though. I did not perform a 12 lead because I...
  13. rhan101277

    82 y/o female respiratory distress

    You are dispatched for the above call, when you arrive at the house you find the fire department is arriving the same time as you. Upon entering the house and making patient contact you find the patient sitting up in the bed in severe respiratory distress. You quickly place the patient on 15L...
  14. rhan101277

    83 y/o N/V + Fever

    This was a DNR on a physicians order sheet not a standard DNR where items they want or don't want done are checked. If it is on a order sheet I am going to honor it after I verify w/ staff.
  15. rhan101277

    83 y/o N/V + Fever

    The patient had a DNR on the physician orders paperwork. Not a normal kind of DNR w/ two physician signatures where it shows what they would or would not like done. Families need to be made aware and nursing home staff aware that these exist/
  16. rhan101277

    83 y/o N/V + Fever

    Yeah I am going to try to find the outcome. I treated with fluids, high flow oxygen and diesel gas. I did get to thinking I am glad I went to a good paramedic program, because for some it would be easy to jump on adenosine or cardioversion. I always try to remember if I have any doubt to the...
  17. rhan101277

    83 y/o N/V + Fever

    When I first saw the rash, I am calling it that, I thought it would be an allergic reaction because they were hives. I dismissed that when she said they were there for 2 days, but when we got to the ER they had gotten worse. I did some reading online and several medications can cause rashes...
  18. rhan101277

    83 y/o N/V + Fever

    the patient started on Levaquin on 11/28 the rash the patient had that was there for "2 days" spread like wildfire and looked like hives all over. I think pt was allergic to levaquin, but this was the least of his worries and I didn't notice it spread until we were at the hospital. 18g Left FA...
  19. rhan101277

    83 y/o N/V + Fever

    I wanted to get some feedback and see how other might treat this patient I had. You are dispatched to a local nursing home for above complaint. Pt in a DNR You arrive and obtain the following vitals: Staff report temp 102.2 axillary, 88% SPo2 room air pt baseline gcs 9, non verbal...
  20. rhan101277

    43 Y/O female seizure

    I am not sure, I was not able to get that information.

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