Pacing, versed, albuterol, atrovent, zofran, solu-medrol, epi 1:1, NS, 22, 18, 20, 20 ,20, 20, BiPap, Bvm, LSB, extrication with tool use. That was yesterday's little check sheet of Things done. Challenge accepted today! (wheres my P-med student?)
Also, found out my 84 y/o fall victim from yesterday had sustained a right radius fracture (knew about it), left tibial fracture at the distal head (strong suspicion) and 6 comminuted (?) fractures of the left scapula with no loss of integrity (surprised me and the MD). The doc (newer MD) who yesterday was somewhat critical of me having scooped-and-padded her with an improvised collar instead of an LSB and traditional collar apologized to me- she had gone home, done some research and seen Dr. Bledsoe's article and realized that 4" forward kyphosis on Grandma is a contraindication. I feel bad for not giving her more fentanyl now.
To top it off, our materials person yesterday got all mouthy about how I give away "too much pain medication" when I was discussing it with some coworkers. Apparently, because she is tough and doesn't like pain meds, I should copy some others who rarely crack the box open. When posed with the above patient (she is an EMT), she refused to even consider kyphosis or alternative packaging "it's protocol, she might have a spinal fracture, she needs a backboard" , "she doesn't deserve fentanyl, her pain isn't that bad, I fell twice as far and it didn't hurt much". No understanding of operations, anatomy or the treatments we provide. Sad, really; she idolizes the Hard Men Making Hard Decisions stereotype. I suppose I should base medical decisions off of the opinion of inexperienced EMTs, because she's "been hurt a lot".