first call of the day is...

IFT from critical access hospital to big hospital. Worsening pneumonia vs cancer. My money is on lung cancer.

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Headache x 3 days. Seen at 2 hospitals over the past 3 days, diagnosed with sinus infection. Didn't take prescribed antibiotics because she looked up the side effects online and didn't like them. Pt states she's not getting any better. Wants to go to a third hospital 2 blocks from home.

Got off the gurney because she didn't have anyone to watch her kids. Called 911 an hour later when someone came over.

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Wants to go to a third hospital 2 blocks from home.

I'll take "Things that make folks not in EMS go":
nick-young-confused-face-300x256_nqlyaa.png

for $800, Alex.
 
I'll take "Things that make folks not in EMS go":
nick-young-confused-face-300x256_nqlyaa.png

for $800, Alex.
Second run of the day. Well known patient that lives 2 blocks from hospital. Called because he got beat up. Arrived to find him smoking on the porch. Walked halfway out to ambulance and then started yelling at us to leave when we asked what was going on. Told us he was going to call the neighboring ambulance that is at least 35 minutes away with lights and sirens. Finally agrees to ride with us and asked to go to the hospital 2 blocks away.

Then claimed he couldnt walk up the steps into the ambulance cause of sciatica after i watched him walk up the steps to his home......twice.

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Then claimed he couldnt walk up the steps into the ambulance

I wish I could walk patients into the ambulance. It is my opinion that making a perfectly ambulatory patient get on a gurney is more dangerous than walking. But, I'm not in charge. So.

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I wish I could walk patients into the ambulance. It is my opinion that making a perfectly ambulatory patient get on a gurney is more dangerous than walking. But, I'm not in charge. So.

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Wait? Ambulatory patients have to get on the gurney before they get in the ambulance?
 
Wait? Ambulatory patients have to get on the gurney before they get in the ambulance?
Patient: I can walk.
Paramedic: No you can't. Waking is dangerous. You could die. Please get on the gurney, which is top heavy, and easily stopped by a small pebble. Also, we could drop you, or hurt our backs. But please get on the gurney before we leave your house.

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NYSEMS2117 Parolee's 5 yr old kid in the parking lot (as i was conveniently walking into work this morning): "bad man just hurt daddy come come"
NYSEMS2117: walks to car parked on the street outside of office- finds parolee stabbed 3 times...
side note* that was one of the smartest 5 year olds i've ever met. Sent him inside to get the trooper that guards the building, was like i was talking to a 20 year old, was absolutely remarkable.

Pt/parolee survived(after surgery) and is at the hospital.
 
1st call - stroke. 2nd call - abd pain. 3rd call - assault. Etc etc, it's been one of these days...


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72 year old female with SVT that has been going on for 4 hours. Patient tried dunking her head in cold water and bearing down with no relief. After 4 hours of her doing normal chores and it not going away she called 911. Amazing BP and skins. Walked her to the ambulance. Converted her in the back with adenosine and then spent about 5 minutes deciding if she wanted to sign out AMA or not. History of SVT episodes well over 20 times in the past with conversion with adenosine on all of them. Already has an appointment next week for an ablation.

Super nice lady who did not trust the fire department at all and looked to us to confirm everything they were saying. She is in training to run the LA marathon.
 
Super nice lady who did not trust the fire department at all and looked to us to confirm everything they were saying. She is in training to run the LA marathon.

With age comes experience.

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1st call - stroke. 2nd call - abd pain. 3rd call - assault. Etc etc, it's been one of these days...


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Sounds like a good day. My day usually goes
1: unmanaged chronic condition
2: unmanaged acute illness
3: recent ER D/C with no improvement in several hours.

Etc, etc, etc


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Sounds like a good day. My day usually goes
1: unmanaged chronic condition
2: unmanaged acute illness
3: recent ER D/C with no improvement in several hours.

Etc, etc, etc


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It was good til about 15 min to EOS when we got cleared back & they dropped a call on us 2 mi away from station :P


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Slip and fall on wet floor at the local Mcdonald's. Positive LOC with repetitive questioning and confusion on place and event.

Dx - Concussion and payday

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Slip and fall on wet floor at the local Mcdonald's. Positive LOC with repetitive questioning and confusion on place and event.

Dx - Concussion and payday

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I'm lovin it. Cha-Ching
 
Elderly COPD'er with legit broncospasms and poor air movement. CPAP and inline nebs saved another from a tube.

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Elderly COPD'er with legit broncospasms and poor air movement. CPAP and inline nebs saved another from a tube.

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Your opinion on IM epi for COPD?

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Your opinion on IM epi for COPD?

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They would have to be really CTD for me to consider using Epi. I've not had a COPD exacerbation case that has not responded to inhaled beta agonists, magnesium and corticosteroids.
 
Your opinion on IM epi for COPD?

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Its in our protocol as of the last change. I have been hesitant to use it since im not very enthusiastic on the B1 agonist effects in tachycardic elderly patients.

Im kind of at the point where CPAP > Epi

I much prefer brethine which we stopped carrying when we added epi.

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