the 100% directionless thread

StCEMT said:
Somebody stole a ****ing APC and drove it through the city.....
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My first thought when I saw the video was "That's not a tank!" after clicking on the headline saying Stolen Tank lol. Not that I really expected to see an Abrams per say, but maybe someone's private collection Sherman or Patton? Def not some command track that at best has a pintle mount for a 240 or .50 if that lol
 
Jim37F said:
My first thought when I saw the video was "That's not a tank!" after clicking on the headline saying Stolen Tank lol. Not that I really expected to see an Abrams per say, but maybe someone's private collection Sherman or Patton? Def not some command track that at best has a pintle mount for a 240 or .50 if that lol
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Yea that's what I said. Either way, it has ****ed the main road through north side and I don't like it.
 
In other news, this is kind of cool, don't get to see good outcomes like this often enough.

(I wasn't on this call, it's well outside my stations area lol, but still a great example of teamwork, and a job well done)
https://www.facebook.com/video.php?v=2001996286478273
From Texas, the Gambones arrived on their vacation May 23, a day later they went snorkeling at Hanauma Bay. From her lifeguard tower, lifeguard Elizabeth Bradshaw was scanning the water and made special notice of Mr. Gambone. She recognized he was showing signs of distress, after snorkeling in and out several times, he appeared unable to make it back in to shore. Intuition told lifeguard Bradshaw to paddle out to check on him, and as she was 10 feet from making contact, Mr. Gambone went unconscious and slipped underwater. Bradshaw and partner lifeguard Jared Jovero got Gambone’s lifeless body on the rescue board and paddled him to shore.
On shore, lifeguards began cardio pulmonary resuscitation (CPR), administered one shock with an automated external defibrillator (AED). Gambone began labored breathing on his own. Honolulu Emergency Medical Services paramedic and Hawaii Kai supervisor Stacey Yoshikawa and EMT Lane Natori took over patient care. Yoshikawa successfully intubated Gambone, protected his airway, administered medications intravenously and monitored his vitals while enroute to the Queens Medical Center. The Honolulu Fire Department assisted with the CPR and then with the breathing with a bag valve mask once he got a pulse back. Firefighters helped Ocean Safety load him into the back of an Ocean Safety pick-up truck to transport him topside to the waiting EMS ambulance. Onboard the ambulance, Honolulu Firefighters assisted with ventilating, allowing Yoshikawa to communicate with the Queens physician.
On arrival at Queens, emergency room doctors and nurses began continuous monitoring of Mr. Gambone.

Today, Mr. Gambone was able to thank all the first responders for saving his life.
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Had one of the more interesting breathing problems I've ran in a while. Pale, sweaty, resp 35~, EtCO2 50, wheeze right clear left, - crackles or diminished, 120 sinus, 76% room air per fire and about 93% with some dips on the neb, and a pressure if 240/140. Couldn't get crap for a history, but I managed to piece together CHF, ESRD, asthma?, HTN?.

Neb cleaned the lung sounds up a bit, but she still looked terrible. Per family no missed dialysis, went today.

Definitely want to follow up on this one. Ended up on BiPAP and a bunch of Nitro right off the bat.
 
@StCEMT is sounds like flash pulmonary edema. Did you put her on CPAP?
 
Jim37F said:
My first thought when I saw the video was "That's not a tank!" after clicking on the headline saying Stolen Tank lol. Not that I really expected to see an Abrams per say, but maybe someone's private collection Sherman or Patton? Def not some command track that at best has a pintle mount for a 240 or .50 if that lol
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Oh man, I got so mad when I saw people saying that there was a stolen tank! Civ-military relations is a joke these days, because we non-military folks (on average) know next to nothing.
 
VentMonkey said:
@StCEMT is sounds like flash pulmonary edema. Did you put her on CPAP?
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Not immediately. The wheezes weren't that bad and improved. Then she also had no pulmonary edema that I heard, so I was unsure if she needed CPAP right off the bat and opted to try the less aggressive path first.
 
StCEMT said:
Not immediately. The wheezes weren't that bad and improved. Then she also had no pulmonary edema that I heard, so I was unsure if she needed CPAP right off the bat and opted to try the less aggressive path first.
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RR of 35 with those sats and LS I would be leaning towards CPAP.
 
StCEMT said:
Not immediately. The wheezes weren't that bad and improved. Then she also had no pulmonary edema that I heard, so I was unsure if she needed CPAP right off the bat and opted to try the less aggressive path first.
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CALEMT said:
RR of 35 with those sats and LS I would be leaning towards CPAP.
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Leaning towards? I’d be aggressive with it. The “clear” sounds could have very well been closer to a chest full of fluid, and the wheezes exacerbated by a cardiac pathology.

Sounds like a good call to learn from though. I’ve had interns who weren’t sure where to go with these sort of patients, but if any patient responds well to CPAP it is this patient.

I’ve even see the interns downplay the change in things such as SPO2, and/ or ETCO2 and it make them choose a less aggressive modality when it fact it was completely warranted.

Just recall that the ETCO2 isn’t a true ABG value, and correcting the problem before the PaCO2 and PaO2 warrant ETI in the hospital is probably our best bet. Good stuff.
 
@VentMonkey my first thought before I wrapped up my initial assessment was a PE due to how many things lined up. When I say clear, I mean I could hear air movement in all fields, not a "clear" silent chest, I've had those too. Not that a PE would not warrant use of CPAP.

In hindsight more aggressive from the start would definitely have been better. Numbers on the monitor got better, but she as a whole didn't other than reduced wheezing. I was definitely stumped on the pathology of her breathing problem though, want to follow up and see what they found.
 
StCEMT said:
Had one of the more interesting breathing problems I've ran in a while. Pale, sweaty, resp 35~, EtCO2 50, wheeze right clear left, - crackles or diminished, 120 sinus, 76% room air per fire and about 93% with some dips on the neb, and a pressure if 240/140. Couldn't get crap for a history, but I managed to piece together CHF, ESRD, asthma?, HTN?.

Neb cleaned the lung sounds up a bit, but she still looked terrible. Per family no missed dialysis, went today.

Definitely want to follow up on this one. Ended up on BiPAP and a bunch of Nitro right off the bat.
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FB aspiration is on the diff...btw...put this stuff in the ALS discussion.
 
Not to be superstitious but my partner just got a tourniquet out to play with and reaquient to it's use.
 
Finally witnessed a story worthy of "sex sent me to the ER". That was....interesting. :eek:
 
StCEMT said:
Finally witnessed a story worthy of "sex sent me to the ER". That was....interesting. :eek:
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I’ve had many of those calls. From broken penises to ripped foreskin to stuck objects in areas. One of our fire departments actually offers training to other fire departments on how to remove penis rings.
 
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