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  1. M

    What is HOSPITAL criteria for a stemi?

    strange question but hear me out. would love to Hear from RN's someone like that to weigh in if possible. so we all know EMS criteria for a stemi.... but hospitals are, different? Were clearly just the dumb dumbs here. but you see contiguous ST elevations in 2 leads and theyre symptomatic in...
  2. M

    So you think he was REALLY dead?

    Trying to get a good topic to draw people in! Anyways, still relevant. So call comes out as an overdose with CPR in progress by Law enforcement. Show up with multiple PD units on scene to a sketchy trailer park with a Sketchy dude in his 30's with snoring respiration's and responsive to...
  3. M

    Antero-lateral infarct To Arrest.

    So just another one of my typical Call reviews / scenarios type of thing. 60yo M, A&0X4 GCS15 called for shortness of breath. Pt seems almost like a drug induced sort of Presentation, Rolling around on the bed really just "playing it up" but am on the fence weather he's just in SEVERE...
  4. M

    Tachy arrythmia Obscured by Pre-existing left bundle branch block?

    Hey, so this was a tricky one for me so figured would be good to post it here and get some more feedback! 50yo M, A&0X4. Sitting in chair complaining of difficulty breathing that was exaccerbated by going out to his garage with physical exertion. History of asthma and hypertension. He's...
  5. M

    Tell us the Times you've "F***** up" on a call

    i dunno why this thought popped into my head. Thought it would be interesting. Tell a brief one sentence summary of "**** ups" on calls. I'll go first. Applied a Traction splint to a femur fracture with No distal pulse. Cap Refill was restored but afterwards saw a semi-small lac to Thigh...
  6. M

    Should i have given versed?

    So! Scenario time sorta. 39yo M, A&0X0 GCS approx 12 (language barrier) involved in a quad accident with no helmet or gear. Mutiple system trauma but most notably GCS that declines about halfway enroute to trauma center, Pt has a LARGE hematoma to L-aspect of head that nearly doubles in size...
  7. M

    Stemi? or no?

    Female in her 50s with acute onset of dizziness, shortness of breath and nausea. Denies chest pain, syncope vomiting or further. Only hx is hypertension and Prior MI 7 years ago. She's cool, pale diaphoretic skin signs, get into back of rig and 4 lead shows run of V-tach with pulses @ 200bpm...
  8. M

    Ever seen super delayed reaction to Glucose?

    So! Get on scene for diabetic call, dude is GCS 6, Cool, pale and clammy. Wife is right there and says "he's a diabetic, checked his sugar and it was 25" boom! super easy, lets wake this guy up! Start a line, give a 250ml bolus of D10 on scene and im thinking this dude will wake right up and...
  9. M

    Critical care / Flight paramedic programs in california?

    So i DID look around and found an old thread but its dead and from like 4 years ago so i tried guys. Any info on current FP-C / CCP-C courses in california? A co-worker of mine mentioned a week long course in san bernadino and ended up testing and getting his FP-C that way but i was a bit...
  10. M

    Chest pain pt Turns into Covid & wont answer any questions

    So interesting call and wanted to see what you guys would have done and everyones feedback. Code 3 for Chest pain. arrive to find mid 70's female Standing outside of door. States chest pain since 7:30am to fire on scene and Not much else. Leaves us to go back inside to grab something in the...
  11. M

    How has your charting Changed since Covid?

    Pretty straightforward.....How has your charting changed Universally on EVERY pt, Regardless of covid Symptoms or not? Or ideas to toss around to each other for WAYS to change charting / narratives to be more inclusive? For me, Now i have a generic statement saying that i made sure i left my...
  12. M

    Where are my Kern county Medics at? (quick question)

    Hey, So quick question... Why does Kern county EMS protocols still state KMC isnt a Stemi or even a cardiac facility when the KMC Website ITSELF states that it IS?: https://www.kernmedical.com/services/cardiology/ And capable of cardiac cath's Emergent? I know these protocols are at least a...
  13. M

    Educate me more on troponin

    So. heres what i know about troponin. Its a cardiac enzyme that Appears when a pt has Damage to the heart or various other issues such as acute kidney damage, Sepsis, PE, Heart Failure or more. Normal levels are 0 to 0.4 (im assuming thats flexible depending on where / who you talk to???)...
  14. M

    Whats your "criteria" for starting iv access on a pt?

    So fairly straightforward but looking to see both sides of the story. for me i feel like i sometimes lack consistency. Overall i look at my pt's and say: Do they need meds? do they need fluids? Do i think their complaint warrants IV access in case their condition deteriorates and they need...
  15. M

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

    SO in the conquest of always learning and growing heres the question. Took an IFT. Pt came in with obvious stroke symptoms via POV and was treated with TPA, Stroke symptoms resolved and upon transfer pt was entirely asymptomatic with almost perfect vital signs, CPSS negative throughout. This...
  16. M

    Resp failure ift pt

    Hey so had a kinda interesting call today where i second guessed myself and wanted to share i guess. 80 something yo f, A&0X4 GCS15 transfer for +Flu, CHF new onset, NSTEMI , Pneumonia. pt came in originallly for difficulty breathing, transfer for higher level of care. in er pt decomps on NRB @...
  17. M

    Septal infarct > Flash Pulmonary edema > Code

    67yo M, A&0X4 GCS15 presents with Syncopal episode and Pinkish blood stain On pillow with 911 called by family. Initial BP is 80 over 40 systolic and 12 lead comes back with ST elevations in V1 & V2 with recripocral changes and Septal infarct confirmed by ER physician over phone consult. Pt...
  18. M

    What makes someone a "bad" paramedic?

    So Bit of specifics here.... i work in a county where private EMS is first in and County fire is Just BLS and assisting us. Alot of them dont like it. they're all EMT certified but just show up to open doors, maybe take vitals and carry our bags...Despite this, easily 50% think they're better...
  19. M

    STEMI Mimic?

    So 70 yo F, A&0X4 gcs15 cc of general weakness. pt has extensive cardiac hx with multiple MI's and stents placed in prior years. Pt has NO chest pain , shortness of breath, Nausea, vomiting or any other symptoms aside from weakness. SP02 96% RA, Allergy to ASA, Systolic in 180's, Pulse...
  20. M

    Super-confident EMT's Vs Humble Emt's

    We've all seen it, Not necessarily just in EMS but the medical profession in general. I get more upset or passionate about it when someone is at generally a lower Medical skill level (such as an EMT/LVN/ CNA type) but have this.... Because DR's and surgeons can get away with the god complex a...
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