the 100% directionless thread

Holy cow Rob is on a mission!
 
NVRob said:
I love my partner to death, we work really well together, to the point that the FD just messes with our flow when they are around. With that said, don't question me in front of Fire, SO and family when I tell you to put the 50kg 17 year old that took 1000 mg of amitriptyline on the monitor, please. Also, definitely don't get mad when I tell you "just do it, I'll explain later". If I remember correctly 20 mg/kg is definitely getting up near the LD50...

In his defense she was without any complaint, A&Ox4 and vitals were WNL except for her HR at the time of our initial contact.

I have my reasons, don't need to vocalize or justify them to you. I'm especially not going to tell you that it's because she could very well go into respiratory and/or cardiac arrest on us, amongst other gremlins that could happen, in front of her mother, that's for damn sure. I think he figured it out when we went back to check on her and she's intubated, with pressors hanging with two ICU nurses and a RRT getting ready to take her upstairs.

Where are these cute EMTs? I want o...Oh wait... :D
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You give bi carb?
 
NYMedic828 said:
Officially appointed as an FDNY probationary firefighter.

Nothing can possibly ruin my day.
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:beerchug:

Good for you man! Glad to hear it, even if you are going to the dark side ;) You've been busting your hump for this for a long time comin'. Been considering it myself lately. Stay safe out there.
 
lightsandsirens5 said:
You give bi carb?
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Standing orders for known TCA toxicity with profound hypotension, seizures, dysrhythmias (sustained or ectopy), cardiac arrest or any combination of the above. Never given it, came real close on the first two I saw though.
 
Anjel said:
Holy cow Rob is on a mission!
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He picked the wrong time to :censored::censored::censored::censored::censored: about it. You've been at work for an hour... We ran our asses into the ground for twelve then got held over for an hour for central coverage then a priority 3 constipation call. Put the damn bags in the warmer. :angry:
 
NVRob said:
:beerchug:

Good for you man! Glad to hear it, even if you are going to the dark side ;) You've been busting your hump for this for a long time comin'. Been considering it myself lately. Stay safe out there.
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Can always work EMS on my 5 days off a week. Best of both :beerchug:
 
NVRob said:
:beerchug:

Good for you man! Glad to hear it, even if you are going to the dark side ;) You've been busting your hump for this for a long time comin'. Been considering it myself lately. Stay safe out there.
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You should come over to the dark dark side with me ;)
 
Chase said:
You should come over to the dark dark side with me ;)
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Oh ya? If I can't get a good career medic spot nailed down it's crossed my mind.

No offense to nurses but I'd rather work in a single role medic or dual role FF/medic position than in a hospital. Although Tommerag had a pretty legit setup before he took his new job if any of y'all remember him.
 
Chase said:
TCA Overdoses are no joke they cause all kinds of badness. Did you get a 12 lead?

I think the LD50 is higher than 20 mg/kg but not sure
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I had one a couple of months ago. TCA and a ton of ETOH. Played possum at first, then decided to start fighting me and my partner in the rig when it became clear she wasn't going to be left alone. That was my last patient assault in 2012 (and no, I didn't bother pressing charges) took 2 of us and 2 PD to get her restrained. She calmed down a little w/ 2 of Ativan IN (didn't like it at ALL though). Had a fun conversation with the doc about why I wanted provisional orders for more Vitamin A for this 50 kg girl. Didn't do a prehospital 12-lead (in hindsight, I should have). And were some R-wave changes on 3-lead by arrival at Hopsital. Mild trend down in B/P, but not hypotensive. In hindsight, was borderline for bicarb orders.

Bought a tube rather quickly after getting to the ED.
 
I had a TCA OD a few months ago. Found her unresponsive, hypotensive, bradycardic with a wide QRS. Quickly intubated without any paralytics. 2 amps of bicarb while en route to the ED.

She was still on a vent when I went back to check the next day. She was flown to Johns Hopkins. No idea on her outcome.
 
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Maybe it's a regional thing.. but I havnt seen a pt on TCAs here. They don't seem to be widely used in this area
 
shfd739 said:
Maybe it's a regional thing.. but I havnt seen a pt on TCAs here. They don't seem to be widely used in this area
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Yeah, I've only seen a handful. Definitely isn't very prevalent around here.
 
"[Insert my name here], why aren't you going to grad school now?"

"Because I want to make some money first?"

I hate having to explain this...I want to work, darn it...
 
Chase said:
We hand them out like Tic Tacs
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I used to manage a psych clinic. The doc gave me a medication to help me sleep.

It was. TCA. I didn't know. I wasn't very happy, when it came up on a drug test.
 
Had a job interview today, but at the end found out that I don't meet all their requirements, and don't have the funds readily available to get those requirements met. Also he wanted us to make a snap decision on whether or not we want the job, and if we didn't meet the requirements at this time, to commit to getting them met within a couple weeks. There were a couple other red flags as well, like the job sounding 'too good to be true' and some things that he seemed to be glossing over, and when asked about them, gave a quick answer (Under 10 words) and then waved more flashy 'benefits' at me and change the subject instead of discussing my concerns.

At least the temp job I have isn't over yet so I still have time to keep looking. I just wish he had presented the job requirements up front, and taken the time to answer my questions.

Also, I didn't contact them, they contacted me after seeing my resume online.
 
Anjel said:
I used to manage a psych clinic. The doc gave me a medication to help me sleep.

It was. TCA. I didn't know. I wasn't very happy, when it came up on a drug test.
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Huh? Who tests for TCAs? Was it trazadone? Who the hell would abuse trazadone.
 
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