Absolutely appalled

[lightsandsirens5]

Holy cow! I just read through this thread for the first time and I have to admit, I must be pretty naive (spelling?). I have not even heard of many of those practices going on. Most of them are felony assult and battery are they not? Stabbing a pt with a needle? Stuffing alcohol wipes up their nose? Pinching them hard enough to leave a good bruise? We are out there to help them, not hurt them, right?

And at my service, we are not allowed to use things like sternal rubs, arm drops, inhalents (spelling? again), etc. I did not know that other places were still doing this kind of stuff.

 

[CAOX3]

Sternal rub is an accepted method of measuring LOC.

As with anything it can be taking to the extreme and the results can be dangerous.

If your leaving marks on patients trying to determine LOC then your doing something wrong.

If you cant control your emotions and feel you need to dish out some kind of punishment then EMS probably isnt for you, its raw and uncut.(and I think thats a tagline for something but I just stole it. )

 

[46Young]

Holy cow! I just read through this thread for the first time and I have to admit, I must be pretty naive (spelling?). I have not even heard of many of those practices going on. Most of them are felony assult and battery are they not? Stabbing a pt with a needle? Stuffing alcohol wipes up their nose? Pinching them hard enough to leave a good bruise? We are out there to help them, not hurt them, right?

And at my service, we are not allowed to use things like sternal rubs, arm drops, inhalents (spelling? again), etc. I did not know that other places were still doing this kind of stuff.

EMS seems to attract all types of mutants. Good news is, if you're a medic you can see to it that none of this nonsense goes on with your pts.

 

[lightsandsirens5]

Sternal rub is an accepted method of measuring LOC.

As with anything it can be taking to the extreme and the results can be dangerous.

I think that is why out MPD nixed it....I'll have to ask him.

 

[Seaglass]

EMS seems to attract all types of mutants. Good news is, if you're a medic you can see to it that none of this nonsense goes on with your pts.

All the more reason why I'd like to become one sooner rather than later. When I get stuck with medic partners like that, there's often very little that I can do to stop it.

(Not that I don't try. I do.)

 

[CAOX3]

Grow the F$#k up dumb$ss, you look like an idiot usually works for me.*

*Works for both EMTs and medics.

 

[Veneficus]

I think that is why out MPD nixed it....I'll have to ask him.

How are you supposed to check for response to painful stimuli without a painful stimuli?

It would eliminate the use of GCS completely.


Even AVPU (which I think should be removed from memory) would not be possible.

That would leave a major gap in the standard of care.

 

[mycrofft]

OOOOOo, verbal abuse, might cause emotional bruises.

We were discussing noxious stimuli yesterday, our old doc recommended eighteen gauge IV start with SNS in dorsal hand.

Lift the eyelid without warning. Can be very enlightening

 

[EMTinNEPA]

Yeah it's scary sometimes what people don't know what to document or more importantly, what in the world they are doing. I know of a guy that pushed 90mg of dopamine and then documented it.

90 MILLIgrams? As in 90,000mcg?

PUSHED? As in, drew it up in a syringe and pushed all at once as a BOLUS?

How many limbs did the patient lose?

 

[mississippimedic]

90 MILLIgrams? As in 90,000mcg?

PUSHED? As in, drew it up in a syringe and pushed all at once as a BOLUS?

How many limbs did the patient lose?

He lost all of them as he died shortly there after.

 

[EMTinNEPA]

He lost all of them as he died shortly there after.

Please tell me that this "paramedic" got hung out to dry.

 

[Veneficus]

90 MILLIgrams? As in 90,000mcg?

PUSHED? As in, drew it up in a syringe and pushed all at once as a BOLUS?

How many limbs did the patient lose?

how does your dopamine come packaged that you have 90mg to draw?

 

[mississippimedic]

how does your dopamine come packaged that you have 90mg to draw?

400mg/5mL Vials

 

[boingo]

90 MILLIgrams? As in 90,000mcg?

PUSHED? As in, drew it up in a syringe and pushed all at once as a BOLUS?

How many limbs did the patient lose?

90mg = 900mcg.....for a 90 kg pt at 10mcg/kg/min, that would be a dose for 1 minute.

 

[EMTinNEPA]

90mg = 900mcg.....for a 90 kg pt at 10mcg/kg/min, that would be a dose for 1 minute.

No, a milligram is equal to 1000 micrograms.

90mg X 1000 = 90,000mcg

90kg patient at a dose of 10mcg/kg/min

90mcg x 10mcg/kg/min = 900mcg/min

How long would it take to give the dosage this "medic" gave at 10mcg/kg/min?

60min in 1hr

90,000mcg divided by 900mcg/min = 100min

100min divided by 60min/hr = 1hr 40min

So in a few seconds, this "medic" gave the patient the same amount as over an hour and a half's worth of medication at the pressor dose.

 

[lightsandsirens5]

How are you supposed to check for response to painful stimuli without a painful stimuli?

It would eliminate the use of GCS completely.


Even AVPU (which I think should be removed from memory) would not be possible.

That would leave a major gap in the standard of care.

We are supposed to pinch the back of their hand or the skin on their arm.

And I just talked to my SEI, sternal rubs are acceptable, but the MPD highly discourages them.

 

[boingo]

No, a milligram is equal to 1000 micrograms.

90mg X 1000 = 90,000mcg

90kg patient at a dose of 10mcg/kg/min

90mcg x 10mcg/kg/min = 900mcg/min

How long would it take to give the dosage this "medic" gave at 10mcg/kg/min?

60min in 1hr

90,000mcg divided by 900mcg/min = 100min

100min divided by 60min/hr = 1hr 40min

So in a few seconds, this "medic" gave the patient the same amount as over an hour and a half's worth of medication at the pressor dose.

Yeah, time for a nap....

 

[lightsandsirens5]

He lost all of them as he died shortly there after.

As a result of the extreme OD? 'Cause if it was, that is Criminally Negligent Homicide with Willful Disregard for Life at the least, strait up Unlawful Manslaughter more likely.

 

[8jimi8]

alot of these posts are scary.


Can we conjecture why providers who have done said actions are still employed in our services?

 

[Hal9000]

I haven't read every reply in this thread, so forgive me if this has already been mentioned.

I used to sleep on a very hard bed. One night, I woke up, and my arm was completely numb. It was dark, but I rolled over and grabbed my hand with my good arm, and sure enough, it was completely "asleep." Out of curiosity, I lifted it above my face with my good arm to see if I could examine it (it was dark in my room), but I couldn't see it at all.

Without thinking, I then released my grip on it. What happened? It fell straight onto my face and gave me an instant, high-power nosebleed.

I don't think it is advisable to potentially cause this sort of harm to a patient, especially if they're unconscious.

The human arm is actually quite heavy in an unconscious patient and if you ever had to restrain it to keep from falling off the stretcher, you would know this. Also, the patient might be wearing a bulky watch, bracelet or rings that can do even more damage. You are also still a new Paramedic that is still completing your education so consider yourself very lucky that you have not injured a patient yet.

Dropping the arm across the face is like doing the witch in the deep lake test. If the person lives, they are a witch. If they are innocent, they drown. Thus, if the patient is faking being unconscious, they pull the blow away from their face. If they are actually unconscious, they may be injured.

Keep doing this practice and I can guarantee you will eventually have to answer for your actions. Your medical director may also not be so quick to back you up unless he/she is stupid enough to put it in writing as an acceptable protocol. Of course when something adverse does happen, it wouldn't be too difficult to get an expert witness like Dr. B. Bledsoe who has written several articles on the subject or someone with similar qualifications.