Medics what happens when you don't know the treatment

[rhan101277]

Do you just call for med control? Also do you wonder if you made the right decision with your interventions? I mean there are so many things that can go wrong with someone, that takes a specialist to figure out. But I am sure those are far and few between. Just wanted to get some feedback.

 

[Ridryder911]

One should have at least an idea of the general diagnosis of what is wrong with the patient. I will admit, I will be the first to call for consultation on a questionable treatment or differential diagnosis that each treatment could contradict each other.

To call because you don't know is okay, but as long as you can give a good detailed hx. and physical in a brief synopses. Again, you will have to paint a clear picture.. as well as be able to be looking in a specific area.

R/r 911

 

[BLSBoy]

Can' go wrong getting your basics, IV, O2, monitor, perhaps draw labs for the hospital if they accept them.

Calling medical control is mandatory here, so you will always have a doc to help ya figure out a toughy.
Thats what a more experienced partner, and constant learning are for.

Improving your knowledge base!

 

[mikie]

Calling medical control is mandatory here, so you will always have a doc to help ya figure out a toughy.

Not to steal the topic...

Every patient needs a med control consult?

 

[BLSBoy]

In Jersey, we call med control on every pt to at least give them a heads up on what we have, and what we have done. The doc can order more interventions, or we can ask for more, or we can just leave it at that. Usually no more then a 3 min call.

 

[reaper]

That's more of a hospital report, then med control. Med control is more of calling specifically for orders or advice on a treatment.

 

[BLSBoy]

Sounds like it, but is the same number and speak to the same doc (or nurse if she is closer)

 

[BEorP]

Sounds like it, but is the same number and speak to the same doc (or nurse if she is closer)

Do you do this on scene or during transport?

 

[KEVD18]

entry notification is one thing, but calling a doc for every call is ridiculous. up here, we only call the doc for orders for med control options and we only call in entry notes for priority 1 calls or calls that require a special team(trauma team, security for the combatives etc etc).

as previously mentioned, iv, monitor, o2(only if its actually needed on my truck thank you). detailed history and physical etc. basically treat the imminent life threats and head for the H. but around here, you can throw a rock in any direction and it will bounce off three hospitals. transports in boston average 5 minutes so the folks up heres arent all that worried about having all the i's dotted and t's crossed before getting to the H like you rural guys.

 

[rhan101277]

Yeah I am only in basic class, but its amazing how much can be wrong with someone and how much you are expected to know. Of course we aren't as well trained as doctors, but having some idea on what to do for proper treatment is necessary. I always finding myself wanting go learn more than just the "basics" which is why I am taking A&P. A&P is where tons of stuff gets unloading on you. I mean its entirely possible for a bullet to miss vital organs, and still hit important nerve's like your phrenic nerve, vagus nerve etc. I guess it isn't our job to diagnose, but with certain injuries I think I would find myself going through several different things that could cause a specific sign or symptom. But as everyone is said, just manage life threats, there is only so much you can do in the back of a truck.

 

[Hastings]

I ask my Basic.

Honestly.

 

[Comedic]

I ask my Basic.

Honestly.

I second that lol...

 

[daedalus]

I ask my Basic.

Honestly.

Dialoge from a call with a new medic


"Hey Daedalus" -from back of rig
"Whats up new medic" -from me driving
"i wanna start an IV, what do you think"
"sure, why not, the nurses usually appreciate that around here"
"where are the damn angio caths"- New medic
"in the orange pelican box, next to the Dextrose boxes" -me
"ohhhhh"

Im in charge
jk
but the above conversation did actually take place. hehe

 

[Hastings]

Dialoge from a call with a new medic


"Hey Daedalus" -from back of rig
"Whats up new medic" -from me driving
"i wanna start an IV, what do you think"
"sure, why not, the nurses usually appreciate that around here"
"where are the damn angio caths"- New medic
"in the orange pelican box, next to the Dextrose boxes" -me
"ohhhhh"

Im in charge
jk
but the above conversation did actually take place. hehe

Yeah. I mean, it sounds funny and all, but I'm a very young medic with limited experience, with a Basic partner who is 40 years old and has been doing this for 25 years. A new medic can really benefit from their experience, regardless of the difference in level. I have enough humility to be open-minded in such a case.

 

[Jeffrey_169]

Just ask

As some of the others stated, tx your basics and H's and T's.

The main thing is don't be affraid to ask for help when you need it.

 

[eric2068]

In our county we have to call in with every patient for a heads up, but as far as treatment, we are a small service, and we have really good set of protocols, and a really great group of docs. So if we have a question, we can get medical control to confirm treatment, but usually we just treat and either tell the docs what we did when we get to the ER, or let them know on our call in. The only thing I routinely call in for is narcs. I will say though we have a great training program and QA/QI system. I guess what it boils down to where you work, and your local protocols.

 

[MOflightmedic]

In my opinion, it's hard to go drastically wrong if you work off of your protocols, support the ABC's, contact medical control when needed, and last but not least--"first do no harm".

 

[MedicPrincess]

I ask my Basic.

Honestly.

I've been known to do that. So far my regular partners have been EMT's less time than I have been a Medic, which isn't to long, so I generally call Med Control.

My Medical Director also provides us with mulitple contact numbers so we can call him, any time of any day and run it by him is we want as well

 

[DT4EMS]

In my opinion, it's hard to go drastically wrong if you work off of your protocols, support the ABC's, contact medical control when needed, and last but not least--"first do no harm".

Great advice. I will add.................
When I started, I was nervous too. The trick is......... if you "think" it is ALS (CP, SOB, ALOC etc.) buy yourself some time to think by getting into the normal routine of O2, EKG, IV. That routine gives you a couple of minutes to formulate your plan while doing things that don't take a lot of thought process.

If you get into a routine you will be calm and calm others. There were many calls where I went..... "Man I have no idea what is wrong" , you know the person with a zillion complaints but I treated what I found (ABC related) and it never let me down.

 

[Brooks416]

I've been known to do that. So far my regular partners have been EMT's less time than I have been a Medic, which isn't to long, so I generally call Med Control.

My Medical Director also provides us with mulitple contact numbers so we can call him, any time of any day and run it by him is we want as well

I have been a basic for over 10 years now in a very rural area where ALS is a dream not a reality on most days in our county. I have worked numerous codes with just a driver and only getting ALS backup 2 minutes out from the hospital. It is hard when we get a new intermediate or medic that was only a basic for 2 months, if that much time, and they want to spend too much time on scene doing " ALS things" when I can see from 5 feet away this is a bag and drag. I give my basic thoughts of the situation then assist. At times it is hard but they tend to learn.