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Just curious about what type of patients you prefer to deal with. I know some people are trauma junkies, but I also know some that don't like the sight of trauma.
EMS Patients
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SafetyPro2
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I tend to prefer trauma because GENERALLY you know better what's going on and have better options for field management. Of course, it's not always clear cut...last night we had what at first seemed to be a simple trip/fall that ended up being due to a medical condition (diabetic with hypoglycemia).
OP
OP
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I agree...
In trauma, you treat what you see. With a medical condition, you base your treatment on so much more. Also, with a medical problem, you have a greater chance of being wrong.
In trauma, you treat what you see. With a medical condition, you base your treatment on so much more. Also, with a medical problem, you have a greater chance of being wrong.
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I work a 12 hour shift usually. It's from 7 PM - 7 AM. My ideal shift is:
8:00 - Medical w/ ALS on scene
10:00 - Trauma with / ALS on scene
11:00 - Patient Transfer
1:00 - Psych Patient Transfer
Then the rest of the night is mine. This is how is used to be back when I started a few months ago, but now that it's summer we've been a bit more busy.
8:00 - Medical w/ ALS on scene
10:00 - Trauma with / ALS on scene
11:00 - Patient Transfer
1:00 - Psych Patient Transfer
Then the rest of the night is mine. This is how is used to be back when I started a few months ago, but now that it's summer we've been a bit more busy.
OP
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That was suprising. I wasn't expecting a Medical-Geriatric as a preferred patient.
rescuecpt
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I like medical-peds. I'm pretty good with the little kiddles, and I have more sympathy for them than I do for adults, especially because lately I've come across a lot of adult fakers.
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Had a call last night that I wish was yours, then. 6yoF c/o N/V for 2 weeks (on and off). She'd been to the doctor, who prescribed antacid 500mg and ranitidine. Mom calls us about midnight because daughter is "sick" (language barrier). Three of us walk in the room, and the patient doesn't even open her eyes to look at us.
One member does SAMPLE history with mom (who only spoke spanish), and I proceed to do the assessment with the third member as the recorder. Patient was conscious, but lethargic. Pupils were equal and reactive, but sluggish. Family denies any possibility of poisoning. Pulse initially 150, but dropped to 80. B/P 100/60, Respirations 14, Skin was PWD, and PO2 on room air was 89%, and there was no blanching of the skin when we pinched it.
I just had that sinking feeling that she was about ready to crash on us, so I called for ALS and we began transport. I know that I probably could have made it to the hospital, but transporting a dehydrated kid who just seems too far out of it made me uneasy.
rescuecpt
Community Leader Emeritus
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Calling ALS was the right thing to do. How did it turn out?
OP
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Don't know.
OP
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Found out later that the hospital said there was nothing wrong with here, and wanted to know why she was transported in the first place.
To top it off, I was questioned by my ambulance driver (not an EMT, but is Advanced First Aid certified) about why 1) I didn't transport to the closest hospital (his favorite and basically a clinic with some beds. I mean, if I fell over in their ER with an AMI, I would want my ambulance to transport me to a different hospital.) and 2) Why I called for an ALS unit because he didn't think the kid was sick.
I don't care. I'll continue to listen to my gut instinct, because it is MY license and livelihood on the line, not his.
To top it off, I was questioned by my ambulance driver (not an EMT, but is Advanced First Aid certified) about why 1) I didn't transport to the closest hospital (his favorite and basically a clinic with some beds. I mean, if I fell over in their ER with an AMI, I would want my ambulance to transport me to a different hospital.) and 2) Why I called for an ALS unit because he didn't think the kid was sick.
I don't care. I'll continue to listen to my gut instinct, because it is MY license and livelihood on the line, not his.
rescuecpt
Community Leader Emeritus
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Continue to do what is best for your patients. I remind myself of that everyday, and it helps get through a lot of the politics and other doodie that goes on on the squad and at the corps.
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Had a call last night that I wish was yours, then. 6yoF c/o N/V for 2 weeks (on and off). She'd been to the doctor, who prescribed antacid 500mg and ranitidine. Mom calls us about midnight because daughter is "sick" (language barrier). Three of us walk in the room, and the patient doesn't even open her eyes to look at us.
One member does SAMPLE history with mom (who only spoke spanish), and I proceed to do the assessment with the third member as the recorder. Patient was conscious, but lethargic. Pupils were equal and reactive, but sluggish. Family denies any possibility of poisoning. Pulse initially 150, but dropped to 80. B/P 100/60, Respirations 14, Skin was PWD, and PO2 on room air was 89%, and there was no blanching of the skin when we pinched it.
I just had that sinking feeling that she was about ready to crash on us, so I called for ALS and we began transport. I know that I probably could have made it to the hospital, but transporting a dehydrated kid who just seems too far out of it made me uneasy. [/b][/quote]
I can't see how you did anything wrong on this one. I read the posts after that one, and wonder how anyone could question your actions. If I didn't call ALS on that call, I would have been written up, and possibly even worse.
I can't understand how the driver would question your medical decisions. When it comes down to it, you're absolutely right, it's your license.
OP
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I have a simple philosophy I operate by when treating patients.
"If they're MY patient, we play by MY rules."
As far as the driver goes, he's been on the department for something like 40+ years, and has never been an EMT (to my knowledge). Just one of those people that thinks it's always been this way, so there is no reason for change. :angry:
OP
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Found this article in this month's issue of Prehospital Perspective. You may have to register to view it, but it's free.
Anyway, this article goes on to describe how peds patients are in some ways easier to assess than adults. The author goes on to list several "Red Flags" when dealing with peds.
Anyway, this article goes on to describe how peds patients are in some ways easier to assess than adults. The author goes on to list several "Red Flags" when dealing with peds.
Firechic
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I enjoy a good adult medical call. Some can be quite challenging and it's fun to use the ole noggin on those.
A rule I live by: It's always better to overtreat than undertreat.
Besides my full-time EMT job, I work as a per diem track medic for a local moto-X track. Most of our pts are trauma, and alot of these kids try to hide their obvious pain so they can finish the race - for fear of their dads ripping into them for being soft. The track has now given the medics the ability to disqualify a racer if we suspect the injury is worse than the rider is letting on. If these riders had their way, they would be trying to finish the race with an amputated leg!
Besides my full-time EMT job, I work as a per diem track medic for a local moto-X track. Most of our pts are trauma, and alot of these kids try to hide their obvious pain so they can finish the race - for fear of their dads ripping into them for being soft. The track has now given the medics the ability to disqualify a racer if we suspect the injury is worse than the rider is letting on. If these riders had their way, they would be trying to finish the race with an amputated leg!
I have a simple philosophy I operate by when treating patients.
"If they're MY patient, we play by MY rules."
As far as the driver goes, he's been on the department for something like 40+ years, and has never been an EMT (to my knowledge). Just one of those people that thinks it's always been this way, so there is no reason for change. :angry: [/b][/quote]
I have also heard and also been taught the kids can crash a heck of alot faster than a adult.... so had that been me ther word have been no question...ALS ASAP..meet me here or see ya on the road... no way am i going to take any chances
jim