first call of the day is...

Remi said:
I'm not surprised that has been your experience. Studies (and overwhelming anecdotal evidence) show that repeated doses have very little efficacy.

Because ondansetron has a relatively slow onset (10-30 minutes), I think what people are often seeing when repeat doses appear to work is just the first dose finally taking effect. You see the same thing with morphine when you dose it every 3-5 minutes....people end up getting huge doses of it when the initial dose or two probably would have worked fine, had they just let it take effect before re-dosing.

Ondansetron is a great prophylactic, but not a good rescue drug at all.
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We give zofran at 10-15 minute intervals.
 
You can dance if you wanna

Dance dance if you wanna

Best med name ever.
 
Dispatched to an unknown medical. The dispatch notes on the MDT said it was a 911 hangup and they are finding a translator to callback, arrive on scene to find an ambulatory middle aged male who spoke only Farsi, and just barely enough English to get across that he hadn't been able to urinate in like 3 days with associated abdominal pain we figured came from a full bladder unable to empty. A quick focused physical revealed nothing of note, vitals were all stable and normal limits (don't remember exact numbers, partially because nothing stood out as out of the ordinary) So we BLS'd him to the local hospital.

Why am I going into so much detail for a seemingly simple abdominal pain? Well because when we were at the same hospital dropping off a later call they tell us the guy had a dissecting AAA o.O Whats even crazier is that apparently after he got a Foley (to deal with the whole not being able to piss in three days thing) he AMA'd and left. Refused any treatment for the AAA...Not only that but his medical records showed he was at another hospital a few days prior, and they wanted to do emergency surgery for it and he refused that. Yikes.
 
Hanging
54 y/o male found in the morning by spouse, backyard tree with an extension cord
 
Seizure resulting in a MVC. Then another seizure. Then an ecclamptic seizure. All in a row.
 
Nothing at all. 12 hours of watching movies on my laptop haha
 
Guy got his neck slit by his ex. Lucky dude.
5 inch or so lac, she started up by the masseter muscle and hooked down right across the jugular. Could literally make out the jugular vein and she didn't nick it at all.
Captain noticed some wax in the wound and he asked about it and the guy was like "she cut me with a candle holder". Raised my eyebrows at least.
 
Scheduled dialysis run.

We get there and the patient is unresponsive (unbeknownst of course to the staff) and bradycardic.

Reroute to ER.
 
Today I was driving but the first call was a discharge.
 
Chest pain from a fall. Medic student on scene for fire decided to go down the ACS protocol and gave ASA, nitro, and O2 (not sure why, 18 bpm, sating 99% RA, clear lungs, no SOB). I decided to go down the slip and fall route and just BLSed the patient to the ER.

Patient stated the sharp chest pain started after he hit the ground with his chest.
 
Dialysis
 
DesertEMT66 said:
Chest pain from a fall. Medic student on scene for fire decided to go down the ACS protocol and gave ASA, nitro, and O2 (not sure why, 18 bpm, sating 99% RA, clear lungs, no SOB). I decided to go down the slip and fall route and just BLSed the patient to the ER.

Patient stated the sharp chest pain started after he hit the ground with his chest.
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Not often the first thing to hit the ground is your chest.
 
Legit closed femur fx sp tripping on slippers in a kill nursing home.....I mean skilled nursing home
 
vcuemt said:
Not often the first thing to hit the ground is your chest.
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Oddly enough. I know of a school around here that teaches them to treat symptoms. Ie patient has chest pain? Treat it!
My understanding is the etiology of the complaint or actual assessment of ruling in/out various diseases isn't stressed.
Sounds like a dangerous way to teach students.

Anyway, my first call was basically a transfer. Super hostile slightly combative man. Spanish speaking only, suspected hypoglycemia but he REFUSED to let us touch him or even get a BP. I wasn't going to fight him so we went BLS. Blood sugar in the ER was 30-something.
 
Refusal, refusal, big MVC, K2 smoker, Difficulty breathing. 5 calls in 24 hours, Ill take it.
 
Yesterday was a 9 car pile-up on the freeway including a double trailer semi. 2 yellows, two greens and 10 AMAs. I was the first transporting ALS unit in and as the medical authority in our county ended up as medical group command, didn't build a huge ICS though but it's the best way to describe my roll.

Cool call actually even if I didn't end up providing any hands on patient care.
 
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