HELP -- Following Paramedics

[Bieber]

Is pain not your indication for pain relief?

For me it would be. However, according to my protocols, I can give up to 2 mcg/kg of fentanyl for chest pain, abdominal pain, or isolated trauma by standing orders. Anything else and I need to call a doc so he can evaluate whether or not I'm competent to make a decision on my own. Around here, I can't imagine getting an order for pain meds for any patient with the chance for having non-isolated injuries (car crash, etc.). Oh, on that note, I can't even determine triage for trauma patients. They either gotta have the right mechanism or a doc has to triage them.

 

[firetender]

BIG difference?

For our American colleagues, what do you notice that is the same or different from how you work?

My interpretation of the show is that it wants to give a true, technically accurate depiction of what really happens in emergency medical services there; from the practitioners' points of view.

It could have been a simple, artistic decision but what knocked me out was that the show actually STARTED with a paramedic's description of the hardest part of the job; having to face the emotional traumas of the job alone, at night. I suspect that was not included without the agreement of the medic.

Johnny and Roy are turning over in their re-run graves!

I'm not surprised that no one else picked up on this. It's not that I'm bragging about how perceptive I am. It's more about recognizing that the US culture of the paramedic is so deeply ingrained in most that this slice of life wasn't even on anyone's radar screen!

Just the fact that a medic was looking into himself and being honest is momentous in itself. Why? Because he is ON-DUTY, even in front of the camera. Here, to show that kind of human vulnerability would mean he would be placed under scrutiny to ascertain if he's really up to the job!

I just was speaking to an EMT. In her service, technically, when medics are traumatized on the job, there is referral available for them to talk it over with a professional. Functionally, anyone who walks through that door is treated as if they were damaged goods by their peers and supervisors for a long time to come!

The second thing that struck me is he made a point of saying that back at the station, with his mates, he got support; they understand. It was at home, alone that the impacts disturbed him. Perhaps I'm reading in to this a little deeper than necessary, but that tells me that when he gets back to his station and shares about a disturbing call, all the talk not all about BS Gallows humor, and "Tough it Up's!"

I'm wondering, Brown, do medics over there actually talk to each other about stuff that rocks their world as if it mattered?

If so, that is one HUGE difference!

 

[samiam]

Lasix

I was surprised that they could give lasixs is that a standing order or do they need med control?

 

[MrBrown]

I was surprised that they could give lasixs is that a standing order or do they need med control?

We have no medical control.

These videos are 2005, lasix is being removed here later this year

 

[TransportJockey]

I was surprised that they could give lasixs is that a standing order or do they need med control?

I've never seen a place where it's not standing orders... although it shouldn't be on a truck anymore anyways.

 

[medic417]

I've never seen a place where it's not standing orders... although it shouldn't be on a truck anymore anyways.

Wrong. People just need to be properly educated. It has a place on the truck. Why do we in EMS insist on doing everything based on the lowest level rather than requiring all to reach for the stars.

 

[TransportJockey]

Wrong. People just need to be properly educated. It has a place on the truck. Why do we in EMS insist on doing everything based on the lowest level rather than requiring all to reach for the stars.

I can think of a big red reason we don't. big red with many wheels.

 

[Bieber]

Oh, and yet another thing I've noticed as I've been watching these episodes is that it appears that very few patients get an IV bag. Plenty of them get an IV and a lock, but that's all it is... an IV and a lock. No bag of normal saline TKO, and even the drugs are given via the lock itself.

Do any of you here in the U.S. do that? Around here, I think we MIGHT have locks, but I've never seen anyone use them and we'd have to draw a flush from an IV bag anyway so it kind of defeats the purpose. I know at the hospitals patients don't get a bag unless they're needing fluids, no clue why we insist on giving everyone a bag because I can count the number of times I've needed to give someone fluid (or been able to by protocol...) over the last four or five months on one hand.

 

[the_negro_puppy]

Oh, and yet another thing I've noticed as I've been watching these episodes is that it appears that very few patients get an IV bag. Plenty of them get an IV and a lock, but that's all it is... an IV and a lock. No bag of normal saline TKO, and even the drugs are given via the lock itself.

Do any of you here in the U.S. do that? Around here, I think we MIGHT have locks, but I've never seen anyone use them and we'd have to draw a flush from an IV bag anyway so it kind of defeats the purpose. I know at the hospitals patients don't get a bag unless they're needing fluids, no clue why we insist on giving everyone a bag because I can count the number of times I've needed to give someone fluid (or been able to by protocol...) over the last four or five months on one hand.

For us IV fluids are only indicated for hypovolemia, so we dont give out fluids that often.


Episode 2 is good, iuts whos a range of cases include and arrest and a trauma. Even has a case where a man has sliced his finger not requiring sutures to give a broad view on ambulance work, rather than just all flashy CPR and trauma jobs.

It seems there are 6 episodes at least.

http://www.youtube.com/watch?v=2fX78DUFFVc&feature=related

 

[MrBrown]

We use locks and our flushes are 10ml ampoules of 0.9% NaCI except for cardiac arrest where you give a good, hard 50ml flush.

 

[reaper]

I use locks and flushes all the time. Rarely hang a bag.

 

[Bieber]

I'm going to have a better look at the what I think is a lock in our box tomorrow and maybe ask my partner about it as well. Of course we don't have preloaded flushes, so it'd be wasting a bag either way to use one, but maybe I can find out why we don't carry them.

EDIT: Actually, now that I think about it, we DO have locks, but they're not exactly the best and we don't have any preloaded flushes for them. We just have them so the hospitals can disconnect our IV bags and access the line without having to go through the hub of the catheter.

 

[TransportJockey]

I'm going to have a better look at the what I think is a lock in our box tomorrow and maybe ask my partner about it as well. Of course we don't have preloaded flushes, so it'd be wasting a bag either way to use one, but maybe I can find out why we don't carry them.

If it's like my service, "Because we've always just hung bags" I've asked several times about flushes and locks.

 

[lightsandsirens5]

I'm not surprised that no one else picked up on this. It's not that I'm bragging about how perceptive I am. It's more about recognizing that the US culture of the paramedic is so deeply ingrained in most that this slice of life wasn't even on anyone's radar screen!

Just the fact that a medic was looking into himself and being honest is momentous in itself. Why? Because he is ON-DUTY, even in front of the camera. Here, to show that kind of human vulnerability would mean he would be placed under scrutiny to ascertain if he's really up to the job!

Hey! I noticed it! You just beat me to saying it. But then you know me.....the non typical US EMT who cries about seemingly the simplest things.