Another Pain Management Thread (Multi-System Trauma)

[FLEMTP]

Since some of the specialty trucks in Florida (and other states) can carry 4 or 5 different medical gases it would be wise to know the difference. There are also several members of this forum that are just starting out an may not be aware of some of these gases when they are asked to help transport a specialty team. If you also look around at some of the home care patients you come into contact with, you may find that tank a might look like "O2" isn't Oxygen.

When you are working with medical gases, DO NOT EVER ASSUME you know what is in that tank especially if you do not know the terminology.

I guess we now know why some of the medical gases aren't widely used in EMS in the U.S.

Wow.. you know.. i didnt realize how truly anal retentive you are until i started reading some of your other posts... Your high and mighty attitude really isnt very becoming....

Besides.. i find it more entertaining to just guess at whats in various tanks.. makes live interesting and ensures i'll have a job...

(now why do i have a funny feeling ventmedic will take that as a completely true and honest statement.. and that he has NO idea what sarcasm is)

 

[VentMedic]

Wow.. you know.. i didnt realize how truly anal retentive you are until i started reading some of your other posts... Your high and mighty attitude really isnt very becoming....

Besides.. i find it more entertaining to just guess at whats in various tanks.. makes live interesting and ensures i'll have a job...

(now why do i have a funny feeling ventmedic will take that as a completely true and honest statement.. and that he has NO idea what sarcasm is)

Anal retentive? No. I would prefer some do not make a bad medical error because of misinformation you have given.

What medical director would want to give additional responsibility to someone who thinks NOX, NO, N2O and NO2 are all the same gas?

Medicine is not a joke. Mix up any of those gases and you can seriously harm a patient.

 

[FLEMTP]

Anal retentive? No. I would prefer some do not make a bad medical error because of misinformation you have given.

What medical director would want to give additional responsibility to someone who thinks NOX, NO, N2O and NO2 are all the same gases?

never said i thought they were all the same gases... i used the same abbreviation another poster used... and as I said.. i was typing a quick reply on my blackberry... sorry if that rubs you the wrong way... but deal with it.. im not here to make you happy.

It seems to me that you take things WAY too seriously.. this is the internet after all... if i want to tell people the cure for cardiac arrest is prunes... then i'll do just that... get over it...

 

[VentMedic]

never said i thought they were all the same gases... i used the same abbreviation another poster used... and as I said.. i was typing a quick reply on my blackberry... sorry if that rubs you the wrong way... but deal with it.. im not here to make you happy.

It seems to me that you take things WAY too seriously.. this is the internet after all... if i want to tell people the cure for cardiac arrest is prunes... then i'll do just that... get over it...

Are you honestly so reckless in your charting as well? Do you not understand why you can not type wrong information and just expect everyone to know what you meant?

If you tell me you are from Lee County EMS I will be very disappointed.

 

[FLEMTP]

Are you honestly so reckless in your charting as well? Do you not understand why you can not type wrong information and just expect everyone to know what you meant?

If you tell me you are from Lee County EMS I will be very disappointed.

Dude.. you need to CHILL out...seriously...get yourself a script for some xanax....

Ive been in EMS for 12 years now.. im sure if there was an issue with something i do on the job.. I think id know by now..

 

[VentMedic]

Dude.. you need to CHILL out...seriously...get yourself a script for some xanax....

Ive been in EMS for 12 years now.. im sure if there was an issue with something i do on the job.. I think id know by now..

If you have been in EMS that long you should know the importance of proper documentation and checking meds as well as medical gases. Do you know what could happen to a child that is given NO instead of N2?

Could it be that you might work for a department that has few quality standards? Again, I hope it is not Lee County EMS or I will be very disappointed and maybe some issues will have to be addressed. I also hope you are not representing the attitude of your entire agency when it comes to medical accuracy.

It are those who display a reckless disregard for knowing what they are saying and writing that have given EMS in Florida a bad reputation. It also makes one look ignorant when discussing patient care and medications with other medical professionals.

 

[FLEMTP]

If you have been in EMS that long you should know the importance of proper documentation and checking meds as well as medical gases. Do you know what could happen to a child that is given NO instead of N2?

Could it be that you might work for a department that has few quality standards? Again, I hope it is not Lee County EMS or I will be very disappointed and maybe some issues will have to be addressed. I also hope you are not representing the attitude of your entire agency when it comes to medical accuracy.

It are those who display a reckless disregard for knowing what they are saying and writing that have given EMS in Florida a bad reputation. It also makes one look ignorant when discussing patient care and medications with other medical professionals.

LMAO...maybe some issues need to be addressed? by whom? You? lol... id like to see that IF you can get the stick out of your rectum...

Like I said you need to chill out.. you REALLY need to chill out.. I feel bad for you ... I never knew someone could take something like the internet SO SERIOUS lol... its sad really...

its also sad that ive been on this forum all of 2 days.. and ive already got someone on my ignore list... i hope not everyone here is so uptight and anal retentive.. otherwise my membership here would be rather short....

 

[VentMedic]

LMAO...maybe some issues need to be addressed? by whom? You? lol... id like to see that IF you can get the stick out of your rectum...

Like I said you need to chill out.. you REALLY need to chill out.. I feel bad for you ... I never knew someone could take something like the internet SO SERIOUS lol... its sad really...

its also sad that ive been on this forum all of 2 days.. and ive already got someone on my ignore list... i hope not everyone here is so uptight and anal retentive.. otherwise my membership here would be rather short....

So you just came on this forum to literally BS about nothing and toss around information that is misleading, false and potentially dangerous? Using correct medical abbreviations and the correct medications or medical gases is not an option but should be expected.

Believe it or not there are those on this forum who do not take being a Paramedic as a joke. There are some professional Paramedics even in the state of Florida although it may seem they might be harder to find in some parts of the state.

 

[18G]

FLEMTP... sounds like a losing battle... I knew what you meant and Im sure others did too. Nobody should be taking what they read on this or any other forum and putting it into practice without first verifying its accuracy.

Some people I guess just like to make waves and exert their intellect in an ignorant manor.

 

[Sasha]

Seriously though, we carry fentanyl and morphine for pain management. My personal drug of choice for pain, especially multisystem trauma type pain is Fentanyl. We can give as much as we see fit provided it doesnt cause the patient to become obtunded. Our protocol states 2mcg/kg but then again we can do pretty much anything we need to outside of the protocol provided we can justify it.

I'm so jealous of your protocols.

 

[FLEMTP]

Some people I guess just like to make waves and exert their intellect in an ignorant manor.

+1 on that! B)

 

[FLEMTP]

I'm so jealous of your protocols.

Sasha ... where in florida do you work? Maybe you could come do a ride here sometime.. check it out.. im sure we'll be hiring again and could use some good medics!

 

[Sasha]

Sasha ... where in florida do you work? Maybe you could come do a ride here sometime.. check it out.. im sure we'll be hiring again and could use some good medics!

Central FL. Don't toy with my emotions. I would kill to ride with Lee County. I would kill many many people to work there.

 

[VentMedic]

FLEMTP... sounds like a losing battle... I knew what you meant and Im sure others did too. Nobody should be taking what they read on this or any other forum and putting it into practice without first verifying its accuracy.

Some people I guess just like to make waves and exert their intellect in an ignorant manor.

Did you really?

Then why didn't you correct him? If he was to administer the wrong gas on a child would you just allow him since you knew he really meant to use the other one?

Do you think stating "I meant something else and everyone should know I meant that" is a good excuse in court?

It is just as easy to type the corrrect letters on a Blackberry as it is the incorrect ones.

What about the medical error concerning epinephrine and the changes in Massachusetts not too long ago? Any one of those medics could have prevented that.

Why do some always support passing along bad information?

That is why we have "lido number the heart" and "CPAP pushes lung water" as accepted explanations.

Is it really that difficult for Paramedics in the U.S. to learn proper definitions and terminology as well as writing them correctly?

Why do you call it ignorant for someone not to want those in EMS to screw up their careers and patients or make themselves look ignorant by repeating crap they have read on an EMS forum?

I would not feel very comfortable allowing a Paramedic, who doesn't understand why correct information is important, to give Fentanyl or any other medication.

 

[Sasha]

That is why we have "lido number the heart"

I always like lido to give the heart the number 4.

 

[VentMedic]

I always like lido to give the heart the number 4.

Oops.

So much for spell check.

"lido numbs the heart"

At least I can admit I made a typo and not just state everyone should have known what I meant.

 

[medichopeful]

I feel bad for you ... I never knew someone could take something like the internet SO SERIOUS lol... its sad really...

It's NOT the internet SHE is taking so seriously. It's the subject. Did that ever cross your mind?

 

[Sasha]

Oops.

So much for spell check.

"lido numbs the heart"

At least I can admit I made a typo and not just state everyone should have known what I meant.

Yes, but I DID know what you meant with the typo, just teasing you It was a funny typo.

 

[18G]

The point is you unnecessarily went into a rant about something that wasn't even worth ranting about. If you thought he made a mistake why not just ask for clarification instead of becoming condescending and insinuating that the poster is incompetent.

And while I dont agree with the statement that "lido numbs the heart", I do understand where that over simplification comes from. Lidocaine does not numb the heart literally like numbness in an extremity, etc, but lidocaine does increase the threshold for ventricular ectopy and arrhythmia and in a sense makes the heart "numb", since it makes the heart not respond to ectopic foci. If your hand is numb, it cannot feel and will not respond. The same concept when people say "numbs the heart". They are just saying lido makes the heart less responsive to ectopic foci and arrhythmia. Not the best way to describe lidocaines mechanism, but is somewhat accurate.

CPAP does not directly "push lung water" but does contribute to making the fluid retreat out of the airways and back across the pulmonary membrane where it belongs. So again, not the best descriptor of its action, but not totally inaccurate either.

 

[FLEMTP]

Central FL. Don't toy with my emotions. I would kill to ride with Lee County. I would kill many many people to work there.

Sasha... send me a PM.. im curious to know who you work for now.. I worked in orlando previously...

And if you want to come ride along with us for a shift.. Im sure we could set it up... I think the main requirement is that you've been through HIPPA...and being a EMS provider... we ALL know that we've been bored to death with that one..