the 100% directionless thread

Tigger said:
Our Level IV hospital needs to just go away. It's a six bed ER 40 minutes from the city. It serves a wealthy exurb, a casino town, and a large rural/frontier area. Yet they are so jaded I want to take my patients with me when I leave. Bring a patient in with anxiety and a legit dental infection: "she's just seeking and out of her drugs." Uh no, I picked her up from work and she has plenty of pain medicine left but is so freaked out by the pain that she is having involuntary contractures. The other crew brings in an uninjured teenager who was forced over the phone to be transported by mom after he drove his car off the road into a field at a decent speed. The ER called a trauma alert based on the speed and demanded the patient be spinalled in the room. This after the patient walked into the hospital...

We do all their transfers too. Oh you have elevated d-dimer with no other clinical findings? Better get an ALS ambulance here ASAP, and can they come the 2.6 miles from the station lights and sirens!?!?

HALP.
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I'm starting to think that all Lvl 4 ER admins go to a class called "abusing EMS and panicking". My hospital does that crap all the time (and the Lvl 4 is the only one we have in the county)
 
chaz90 said:
You work with two students and one preceptor/FTO on a unit? Oh my.
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Typically it's just one student. But if there's a mix-up on with scheduling (which isn't uncommon since we take riders from three basic/paramedic schools and a medical school), we won't send them home. I've had three once before. We just let them act as if they were their own crew while we supervised (luckily two of the three were on their last couple shifts and were pretty squared away).
 
TransportJockey said:
Hope you have a nice quiet shift :p
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We got hammered all day, but at night we got to sleep from 2a-5a, which is actually a really good night for our station...
 
Clare said:
I had to have a bit of a cry tonight for a patient we responded to who was at the end of their life. It was very hard dealing with the family who out of not knowing what to do thought that the Paramedics would be a good idea.

I've dealt with rape and murder victims, young people who have died under tragic circumstances and seen people with horrific orthopaedic injuries and not even really thought twice about it; yet seeing somebody at home, with their loving family, in bed, comfortable and warm and looking like they are sleeping but a bit funny, while certainly much nicer than somebody with their angulated, fractured femurs compressed into the dashboard I find it hard to deal with.

I'm going to try and get some sleep.
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These very patients are among my best patient memories, actually. I've taken some of these patients home from the hospital for their last time. You're right though. It's very different seeing people at an expected end of life time with family and friends around them. The dying in these cases aren't the patient. The other people there are. Treat all with great dignity and respect. If that means cleaning someone up, just do it. By these simple things, you can leave a lasting impression that EMS people are among the most generous, kind, and caring people around. With those people, you'll have an ally and they'll believe you can do no wrong.
 
Random but anyone know if you can use the UMBC CCEMTP class to recert your NREMT-P? Also it fulfills the requirements for the NREMT-P to NR-P transition correct?

I'm too lazy to start a thread right now haha
 
Handsome Robb said:
Random but anyone know if you can use the UMBC CCEMTP class to recert your NREMT-P? Also it fulfills the requirements for the NREMT-P to NR-P transition correct?

I'm too lazy to start a thread right now haha
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It should meet the blueprint CE requirements, but not sure if it can meet transition course requirements...
I know my CCEMTP course meets CE requirements, along with CC CEs for my FP-C
 
TransportJockey said:
It should meet the blueprint CE requirements, but not sure if it can meet transition course requirements...
I know my CCEMTP course meets CE requirements, along with CC CEs for my FP-C
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Not to derail Robb's question but what kind of CE do you have to do for your FP-C
 
FireWA1 said:
Not to derail Robb's question but what kind of CE do you have to do for your FP-C
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48 hours of Critical Care CEs, which are rather hard to find at times. But it's also a 4 year cert, so it makes it easier to spread it out.
 
TransportJockey said:
It should meet the blueprint CE requirements, but not sure if it can meet transition course requirements...
I know my CCEMTP course meets CE requirements, along with CC CEs for my FP-C
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Gotcha. I've never recerted my NREMT always just gone up a level so this is a new one for me. I can't remember if it's Nevada or the National Registry that says you can't get all your hours from the same class. Seems to me a CCEMTP course would satisfy NREMT recert hour requirements though since they require 72 hours and the class is 90 something.

Reason I asked about the transition is this is at the bottom of the UMBC FAQs.

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I was wondering about critical care CEs too, was actually the next thing I was going to ask since I plan on taking the CCP-C and FP-C after this class.
 
I say call nremt. They should know
 
So... apparently a dissecting aortic aneurysm can be caused by an AM/PM burrito.
 
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Our four am call got a little busy
 
DEmedic said:
Pediatric head injury? That is the only time I would think about using atropine and lidocaine for an RSI.
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Atropine wasn't my call, that was the flight team. It was an adult head injury that was normotensive but went severely bradycardic. I did the Lido and other RSI meds and we kept her down further with Propofol
 
Nice. I still think a smooth, well choreographed RSI is one of the more elegant skills a medic can perform. Of course, a chaotic RSI is only worth of a faccepalm.
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DEmedic said:
Nice. I still think a smooth, well choreographed RSI is one of the more elegant skills a medic can perform. Of course, a chaotic RSI is only worth of a faccepalm. View attachment 1489
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We actually hung around scene to make sure it was fine right. Three medics that work well together made it smooth. Then straight to the fixed wing for transport to a trauma center :)
 
Clare said:
I had to have a bit of a cry tonight for a patient we responded to who was at the end of their life. It was very hard dealing with the family who out of not knowing what to do thought that the Paramedics would be a good idea.

I've dealt with rape and murder victims, young people who have died under tragic circumstances and seen people with horrific orthopaedic injuries and not even really thought twice about it; yet seeing somebody at home, with their loving family, in bed, comfortable and warm and looking like they are sleeping but a bit funny, while certainly much nicer than somebody with their angulated, fractured femurs compressed into the dashboard I find it hard to deal with.

I'm going to try and get some sleep.
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I know the feeling.

Not that long ago I transported a very end stage pancreatic cancer patient to hospice. Very nice Bosnian man in his late 50s or early 60s. He didn't speak a lot of English, but enough to get by. Turns out he was a refugee from Sarajevo, Bosnia, during the war. He lost his entire family and most of his friends in mortar attacks, and managed to escape the city and get to the US somehow. I had become interested in Bosnian history when my dad was deployed over there, and so I had a general knowledge of the country and it's history, and I knew a few phrases in Bosnian. I tried saying hello, and his face completely lit up. I stumbled through a few more which he laughingly helped me better my accent on. But as we finished the transport he grabbed my hand and started crying and told me that I was the first person he had met since coming to the US in 1995 that really knew anything about his homeland and actually was interested in talking about it with him. It was just so surreal and special at the same time. The experience of connecting with dying people in a way that matters to them ranks up there in the top ten best things about the medical field, for me at least. And yet at the same time, it is rather difficult, knowing you are one of the last people they will ever see or talk to.
 
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