TransportJockey
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Out playing storm spotter. Looks like we might get a tornado tonight
the 100% directionless thread
- Thread starter KEVD18
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Drax
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Ford look great while sitting still. As soon as they start to move its a different story
If they can move.
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Three transports out of the same wing of a nursing home today, each increasing in severity. Hung Dopamine for my first time ever pre-hospitally at least...Yay I guess?
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I've had five calls this year where we've had dope running, including one today. Went for dizziness, found a 93 year old symptomatic bradycardia in bed. Went to go get the butt bucket to bring her out to the truck and come back to find the volunteers hollering and her to be pulseless. Eek.
No math for us, we gotta pump so even dumb EMTs like me can get it running!
No math for us, we gotta pump so even dumb EMTs like me can get it running!
I got you both beat. And even with air ride it goes down goat paths like it ain't no thang.
How whacker would it be if I said that is my new background on my phone..? :unsure:
I used to love dopamine and think it was the easiest drug ever with the 10% rule. Until I got torn a new :censored::censored::censored::censored::censored::censored::censored: after an instructor set my tubing to 10 drops before I noticed and I set the drip thinking I was still on 60. I always do the math now...
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To be fair I was real bored at the station one day and did a "insta-shoot" before a storm rolled in. So I guess that's slightly to pretty whackerish. I must have looked pretty stupid trying to get the angle right and the lights flashing just so.
DesertMedic66
Forum Troll
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You can say I'm a little whackerish also. Waiting in the taxi zone for a med flight to land. I didn't notice until about a month ago that I got just the right angle for the ambulance logo to say "America" haha.
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JPINFV
Gadfly
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From what I briefly read, it sounds like was very much premeditated. They probably were after simply shooting a couple of Police Officers. They then walked over to a Wal-Mart, exchanged gunfire with a shopper near the entrance. One of the duo got injured in that exchange and the shopper was killed. Then the two went further into the store where the woman shot the guy and then herself. Total dead: 5, 3 of which didn't need to die.
The two shooters have been described as being very militant.
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It's downright scary how many active shooters we've had somewhat recently in our state alone. Middle school, two hospitals, this, we had the IHOP shooting a while back. It's getting bad.
If I could go to a paramedic school and teach med math (particularly for drips), I would teach using a systematic method WHILE using realistic, standard, common concentration, dose, and patient's weight (if the drug is dose dependent). Feel free to use shortcuts before or after solving the math. Using a shortcut before can give you an idea of what the answer should be around before you solve it, or you can use a shortcut to double check your work after you've solved it.
I think using unrealistic things will lead to people being less comfortable/confident with drips and less likely to recognize when something is (in)sane. I think they will be more hesitant to use it, or they will not recognize a mistake when it happens because they haven't practiced using the standard/common way.
I've practiced med math so much that I know things like that dopamine is typically 400 mg in 250 cc, or it's 1,600 mcg per 1 mL, or 80 mcg per 3 gtt using a 60 gtt drip set. I know that diltiazem is usually 125 mg in 125 cc, or 1 mg per 1 cc. I know that nitroglycerin is 50 mg in 250 cc, or 1 mcg per 0.3 gtt. I know for a person around my weight, or the average weight, every 5 mcg/kg/min of dopamine should be around 12-13 gtt/min (12-13 mL/hr if using an IV pump). I will recognize when something is abnormal or unusual eg a nitroglycerin drip that isn't divisible by 3 should catch my attention. This is because I have practiced it using realistic scenarios over and over. This is how I think it should be done.
And for the record, if your instruct is still using standard tubing: 10 gtt, 15, gtt, 20 gtt, or 60 gtt, you can still use your tricks, and then divide by whatever to turn it into that drip set.
Convert 60 gtt drip set to 10 gtt drip set, divide by 6. (60/10 = 6)
Convert 60 gtt drip set to 15 gtt drip set, divide by 4. (60/15 = 4)
Convert 60 gtt drip set to 20 gtt drip set, divide by 3. (60/20 = 3)
So technically you can still cheat... Do your trick eg you want 5 mcg/kg/min on a 70 kg patient (13 gtt/min with a 60 gtt drip set), divide what you would get with the 60 gtt drips set to convert it into a 10 gtt drip set (13/6 = 2 to 3 gtt/min).
If you can convert any other drip set into a 60 gtt drip set, you can easily figure out mL/hr too because whatever gtt/min with a 60 gtt drip set equals the same as mL/hr eg 13 gtt/min with a 60 gtt drip set equals 13 mL/hr (mL/hr would remain the same regardless of drip set used, and this is probably useful for determining if IV pump values are sane or you can quickly input it into the IV pump manually if you don't have the IV pump do the math, however, I have numerous recommendation that you let the IV pump do the math so I wouldn't advise manually inserting mL/hr into an IV pump unless you are copying the value from an IV pump that already did the math eg for an IFT transfer). As an EMT on a CCT unit, I usually can reverse the math to figure out the dose the patient is getting. For example, if a patient is getting 1.5 mL/hr with a nitroglycerin drip, I know they are likely getting 5 mcg/min or if they are getting 6 mL/hr then they are getting 20 mcg/min.
Anyhow, I think I made my point. I believe practicing with unrealistic values does more harm than good.
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Rhonda
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My ford is nice except we have zero room up front. My partner and I are both 6' so some days it's rough. On another note LVMPD are on very high alert. This is no bueno.
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Y'all run Type IIIs right? Some of our Fords have absolutely no space but the newer model years (still pre-08 so newer is a loose term, have a decent amount of space and I can recline my seat past 45* if I slide it forward a little bit. I'm only 5'9" though....in boots.
Rhonda
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I believe so. My truck is an older one. The newer ones have more room up from to fully recline. My knees are already touching the dash with my seat pretty much at a 90 degree angle. Tall girl problems
We have a couple of E450s which are our frontline ALS trucks, despite being relatively old, they have tons of room, in fact, in one of them, you can roll the seat all the way back, then recline to the seats limit, and still have a couple of inches between the back of the seat and the bulkhead.
Outside of a IH built medium rescue, these are the first trucks I've ever used that I really fit in.
Outside of a IH built medium rescue, these are the first trucks I've ever used that I really fit in.
TransportJockey
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Is that fifty? I used to run standby days at the track in the one you could recline nearly all the way. I loved that one
Yeah.
I primarily run 39, which isn't as roomy up front (still better than any 350 build I've ever been in, type II or III) but I think is MUCH better laid out in the box.
TransportJockey
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I can count on one hand the amount of times I actually transported lol. I was more concerned with comfort up front since when I was there I did almost exclusively standbys