the 100% directionless thread

Piece of crap iPhone.


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Just for you
 
I'm psyched - new employee orientation next week with Rural/Metro. Gonna part time w/ them while I'm in medic school.
 
So I text my friend asking him how his first day as a medic went and he called me to tell me about an arrest he had. His partner didn't know how to administer an IO. Good thing his partner is supposed to be his mentor.


All hope is lost.
 
His partner didn't know how to administer an IO. Good thing his partner is supposed to be his mentor.

Got that beat...In the last two weeks a coworker had a firemedic place TWO IO's laterally...They were proximal to the knees, just not medial...and a second IO requires base order, which was not obtained....

Things that happen when fire is left to their own devices for a few minutes...they were calling Base to call the arrest as transport medic (by buddy) pulled up...needless to say that this went to the county...
 
Got that beat...In the last two weeks a coworker had a firemedic place TWO IO's laterally...They were proximal to the knees, just not medial...and a second IO requires base order, which was not obtained....

Things that happen when fire is left to their own devices for a few minutes...they were calling Base to call the arrest as transport medic (by buddy) pulled up...needless to say that this went to the county...

I've had an AEMT on an arrest fire off a BIG IO blatantly into the patients lateral calf... The damn package has a picture of where it goes on it...
 
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Just had a pretty good call. Got called out for "police department with a detained subject not breathing, CPR in progress".

Get on scene and find out the subject was fighting with officers. He was tazed twice with no effect (affect?). Pepper sprayed with no response to that. It took 6 officers to get him under control.

As soon as they get the handcuffs on patient goes into full arrest. Officers start CPR and get ROSC as soon as we get out of the ambulance. Patients B/P is 172/95. Pulse of 100 strong and regular. Lungs clear bi-laterally breathing at a rate of 4. Skins are hot, moist, and normal color. NPA placed, EJ placed, patient starts being bagged.

Patient starts seizing. Tonic phase would last about 30 seconds and the clonic phase would last about 30 seconds. Patient seized multiple times. Versed given with no effect.

Get patient to the ER and the patient goes into full arrest once again. Hospital gets ROSC (using no meds). Patient is RSI'ed and placed on a vent. B/P is 60/14 and pulse is 120. Skins are still the same. Patients core temp is 106.5.

Last time I saw the patient (about an hour and a half after we got him to the hospital) his B/P was 130/70 pulse rate of 130 and being transferred to ICU.
 
Proximal to the knee? Femoral?

I've had an AEMT on an arrest fire off a BIG IO blatantly into the patients lateral calf... The damn package has a picture of where it goes on it...

He was intending on going for the proximal tibia, he just went lateral instead...twice.

this was with the EZ-IO Drill BTW, it to has easy to read graphics.
 
Just had a pretty good call. Got called out for "police department with a detained subject not breathing, CPR in progress".

Get on scene and find out the subject was fighting with officers. He was tazed twice with no effect (affect?). Pepper sprayed with no response to that. It took 6 officers to get him under control.

As soon as they get the handcuffs on patient goes into full arrest. Officers start CPR and get ROSC as soon as we get out of the ambulance. Patients B/P is 172/95. Pulse of 100 strong and regular. Lungs clear bi-laterally breathing at a rate of 4. Skins are hot, moist, and normal color. NPA placed, EJ placed, patient starts being bagged.

Patient starts seizing. Tonic phase would last about 30 seconds and the clonic phase would last about 30 seconds. Patient seized multiple times. Versed given with no effect.

Get patient to the ER and the patient goes into full arrest once again. Hospital gets ROSC (using no meds). Patient is RSI'ed and placed on a vent. B/P is 60/14 and pulse is 120. Skins are still the same. Patients core temp is 106.5.

Last time I saw the patient (about an hour and a half after we got him to the hospital) his B/P was 130/70 pulse rate of 130 and being transferred to ICU.

Excited delirium?
 
Just had a pretty good call. Got called out for "police department with a detained subject not breathing, CPR in progress".

Get on scene and find out the subject was fighting with officers. He was tazed twice with no effect (affect?). Pepper sprayed with no response to that. It took 6 officers to get him under control.

As soon as they get the handcuffs on patient goes into full arrest. Officers start CPR and get ROSC as soon as we get out of the ambulance. Patients B/P is 172/95. Pulse of 100 strong and regular. Lungs clear bi-laterally breathing at a rate of 4. Skins are hot, moist, and normal color. NPA placed, EJ placed, patient starts being bagged.

Patient starts seizing. Tonic phase would last about 30 seconds and the clonic phase would last about 30 seconds. Patient seized multiple times. Versed given with no effect.

Get patient to the ER and the patient goes into full arrest once again. Hospital gets ROSC (using no meds). Patient is RSI'ed and placed on a vent. B/P is 60/14 and pulse is 120. Skins are still the same. Patients core temp is 106.5.

Last time I saw the patient (about an hour and a half after we got him to the hospital) his B/P was 130/70 pulse rate of 130 and being transferred to ICU.

Excited delirium comes to mind...I'd like to see labs from this guy. Though It sure would suck for PD if this dude was arrested for being altered and suspected of being under the influence, just to have it turn out he was stroke/head inj/post-ictal, etc
 
Excited delirium comes to mind...I'd like to see labs from this guy. Though It sure would suck for PD if this dude was arrested for being altered and suspected of being under the influence, just to have it turn out he was stroke/head inj/post-ictal, etc

That's what the hospital is thinking. When I go back to the hospital I'm gonna see if there is anyway I can follow up on the patient (I'm not aware if our company has anything in place).

It wasn't post-ictal that was caused it. I can't really go into detail about what happened earlier because there are some people who are going to be in a lot of hot water.
 
Random thought out of left field.

With the hyperthermia worthy core temp.


MDMA overdose? (Ecstasy)
 
That's what the hospital is thinking. When I go back to the hospital I'm gonna see if there is anyway I can follow up on the patient (I'm not aware if our company has anything in place).

It wasn't post-ictal that was caused it. I can't really go into detail about what happened earlier because there are some people who are going to be in a lot of hot water.

Understood...

There should be a formal relationship in place between AMR's QA/QI folks to follow up on stuff like this. It's allowed under law for such things. Now actually getting the 2 or 3 people assigned to QA/QI for the entire county is another story completely.
 
Random thought out of left field.

With the hyperthermia worthy core temp.


MDMA overdose? (Ecstasy)

I've seen heat exhaustion and dehydration in relation to MDMA, but never bonafide hyperthermia/heat stroke. The only time I've seen heat stroke is in drunk homeless people in the summer while wear 37 layers of clothing and passing out in the sun.
 
My money would be on Meth.
 
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