the 100% directionless thread

RocketMedic said:
10cm x 4 cm x 2cm deep scalp lac due to a slip and impact with a sharp wooden moulding. Fentanyl time!
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The only thing I can give morphine (it's all we have) for outside of chest pain is isolated extremity fracture. :sad:

In my system your patient would have gotten zero pain control even if she was not altered.
 
JPINFV said:
Screw that. Get the brightest colored stethoscope you can find. Mine is practically lipstick red, and no one will ever steal it because it stands out like a sore thumb. After I lost my black Cardio 3 (didn't survive a holiday weekend in the newborn nursery of all places), I had my heart set on a neon green or neon pink Littmann Cardio 3, but alas, it doesn't come in those colors.
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This is also my philosophy. It works and people know what my steth looks like, so if someone was going to steal it and want to use it, they'd have to move :ph34r:

Mine's also laser etched.

I think we should start a new TV show based on the one called "cheaters" but instead we track down people who steal and use stethoscopes and confront them in middle of patient care. :rofl:
 
Jambi said:
The only thing I can give morphine (it's all we have) for outside of chest pain is isolated extremity fracture. :sad:

In my system your patient would have gotten zero pain control even if she was not altered.
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Welcome to outdated protocols :glare:

Although there is talk about the county looking at adding in fent.
 
DesertEMT66 said:
Welcome to outdated protocols :glare:

Although there is talk about the county looking at adding in fent.
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One one hand, it makes me sad...on the other, well, I've seen some real "special" medics that couldn't assess their way out of a paper bag.
 
Jambi said:
One one hand, it makes me sad...on the other, well, I've seen some real "special" medics that couldn't assess their way out of a paper bag.
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I wish we would go away with a county medical director and go to a company one. It would be a lot easier to make sure medics are competent if you only have to look over a couple of hundred at max opposed to a thousand.
 
DesertEMT66 said:
I wish we would go away with a county medical director and go to a company one. It would be a lot easier to make sure medics are competent if you only have to look over a couple of hundred at max opposed to a thousand.
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the problem is, is how big this county is. Heck even our AMR divisions are big compared to many other places. It works against personal attention, and thats not including ALS fire...

I think the whole company/division medical directors would work (they exist, but don't really work in the capacity), or even splitting up the county into regions.

I can also see there being a problem with accountability as well when the company or agency can simply get rid of a medical director because he or she causes too many problems. Call it politics. Can you imagine how things would go over at CalFire if such a medical director started bringing down the QA/QI hammer and pulled people off duty because of problems? That MD would be gone quickly, and stuff like pulling out a still-inflated King Airway because the medic forgot to check cuff patency prior to use will still happen, as will two LATERALLY placed IO's (the second started without the required BSO) with the excuse of, "he's tired because we've been up and on a fire will still happen, or those patients that go >15 minutes without a pulse/rhythm/meds/shock check because they're now on their 8th intubation attempt...and then they get all pissed because the transporting medic is unwilling to just accept the patient as is, and insists the fire medic ride in with them...

I'd want to wash my hands of those fiascos too.
 
TRSpeed said:
Emt fire captains calling for als orders. Haha damn cal fire
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I've honestly never seen any firefighter call for orders, it's always been the ambulance medic.
 
Jambi said:
The only thing I can give morphine (it's all we have) for outside of chest pain is isolated extremity fracture. :sad:

In my system your patient would have gotten zero pain control even if she was not altered.
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That's why I love it out here at EMSA. We can actually help our patients. A little hemostatic gauze for bleeding control, gentle pressure, a 20G IV and 2x 75mcg doses of fentanyl made a very uncomfortable trip into a pleasant meeting. 20 staples later...
 
Jambi said:
The only thing I can give morphine (it's all we have) for outside of chest pain is isolated extremity fracture. :sad:

In my system your patient would have gotten zero pain control even if she was not altered.
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We have morphine and fentanyl that we can use at our discretion. Max of 30mg of MS and 300 of fent.
 
Anjel said:
We have morphine and fentanyl that we can use at our discretion. Max of 30mg of MS and 300 of fent.
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I really do miss a liberal pain management protocol. That's one area where we are lacking. Fentanyl is our only choice, with a max dose of 200 µg before calling for additional orders. And God forbid you ask for a little benzo on top of that.
 
Anjel said:
We have morphine and fentanyl that we can use at our discretion. Max of 30mg of MS and 300 of fent.
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My pain management protocol basically says "if theyre in pain, given them drugs". Up to 20mg of morphine or 3mcg/kg of fent. Paramedic discretion.
 
Jambi said:
and you get fancy gauze! that's it, I'm moving...
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PM me, AMR is hiring here for the changeover.Transfer time?
 
TransportJockey said:
My pain management protocol basically says "if theyre in pain, given them drugs". Up to 20mg of morphine or 3mcg/kg of fent. Paramedic discretion.
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New Mexico got that right I think.
 
RocketMedic said:
New Mexico got that right I think.
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This isn't NM in general, just the Evil Empire division protocols for where I work. And we now have IN fent and MS too
 
TransportJockey said:
This isn't NM in general, just the Evil Empire division protocols for where I work. And we now have IN fent and MS too
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Wait, the evil empire is doing something right?! :mind blown:

:rofl:
 
DesertEMT66 said:
Wait, the evil empire is doing something right?! :mind blown:

:rofl:
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It helps we have a progressive medical director and myself and a few others with a similar mindset were in the initial hiring group (I've been here since day 14). Lol we get to make the place what we want
 
DEmedic said:
I really do miss a liberal pain management protocol. That's one area where we are lacking. Fentanyl is our only choice, with a max dose of 200 µg before calling for additional orders. And God forbid you ask for a little benzo on top of that.
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We're at .2 mics/kg for fent and .2mg/kg for MS which is nothing to right home about. However just about everyone who could benefit gets 1-2mg of versed on standing orders which seems to make a huge difference.
 
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