the 100% directionless thread

Oh yeah, I had mentioned it in the chat, but a few days ago (finally) had my first fire!

http://www.staradvertiser.com/2018/...nvestigating-cause-of-fire-at-maunawili-home/

We were dispatched on the 2nd alarm, pulled up fire still shooting out the windows, initially assigned to back up one of the 1st alarm companies on their attack line, eventually had to extend one of our bundles off their hose, and I got some interior time on the nozzle, which by that time was mostly mopping up hot spots and overhaul.

But after a detail truck from another battalion dropped off fresh SCBA bottles, BC had me ride with them back to my station (which is our battalions supply depot) and bring our detail truck with more fresh bottles...SO it was also the first time in the dept. I got to drive Code 3 lol :)

And our fire was only one of several that weekend
http://www.staradvertiser.com/2018/...-cause-more-than-1-million-in-damage-on-oahu/
 
Lo2w said:
Clearing the hospital an hour before end of shift thinking it would be perfect to catch one last call close to the hospital to finish the night and get out on time. Then we catch an OD arrest on the way back...
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...and the next day started with an arrest out of the nursing home. Ended on a pedestrian struck. Told nights to find a priest and bless the truck.
 
Today's term is "succession planning." I should have written a "I got hit a buy a bus book" a long time ago but never got around to it. Now everyone wants detailed instructions on all of my admin jobs, some which people didn't even know I was doing?
 
GSW, the homeboy had 7 holes in him. None of which were life threatening.

IMG_0004.jpg
 
3rd arrest in as many regular shifts. Not sure who we pissed off...
 
Aaaaannnnnddddd forced on Christmas Eve and day. Oh well knew it was coming at least it’s at cool stations.
 
Tigger said:
Today's term is "succession planning." I should have written a "I got hit a buy a bus book" a long time ago but never got around to it. Now everyone wants detailed instructions on all of my admin jobs, some which people didn't even know I was doing?
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When I took on my current position I told myself I would write one. Eighteen months later, I haven't written a single word. I'm way too busy doing my job to write about it.
 
GSW that turned into a traumatic arrest last night. Good old fashioned roll up the sleeves and go to work kinda call.
 
Lo2w said:
First and only ROSC I've had was on something similar. Went into OR with pulses and died on the table.
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That’s the usual. I’ve seen (and worked) close to a hundred arrests so far, both traumatic and atraumatic, and only 1 or 2 actually made it through resuscitation and the post-arrest workup. And those who survived, had a messed up neuro. For anyone to successfully survive a full arrest, there has to be a statistically improbable combination of factors.
 
Qulevrius said:
That’s the usual. I’ve seen (and worked) close to a hundred arrests so far, both traumatic and atraumatic, and only 1 or 2 actually made it through resuscitation and the post-arrest workup. And those who survived, had a messed up neuro. For anyone to successfully survive a full arrest, there has to be a statistically improbable combination of factors.
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I've had a handful that got ROSC and even two neuro intact that I know for sure with one other very likely. A couple others with deficit. This year though, most never got a pulse back. I got lucky and had all those factors in my first couple arrests, but that changed quickly.
 
Lo2w said:
First and only ROSC I've had was on something similar. Went into OR with pulses and died on the table.
Click to expand...

Qulevrius said:
That’s the usual. I’ve seen (and worked) close to a hundred arrests so far, both traumatic and atraumatic, and only 1 or 2 actually made it through resuscitation and the post-arrest workup. And those who survived, had a messed up neuro. For anyone to successfully survive a full arrest, there has to be a statistically improbable combination of factors.
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I've had a couple of arrests that we recovered and left the hospital without deficits, including a few from when I was in EMS. Most have in kids or relatively young adults, and they have all been true medical etiology (no trauma or social/SI/street drugs). Trauma arrests have an incredibly low rate of ROSC, I want to say it is like 3-4% if they arrest in front of medical staff and less than 1% if they arrest PTA.

I even had one lady who we got ROSC on and was complaining in full sentences prior to arrival to the hospital.
 
See, I don’t really count ROSC as survival. These I had plenty of. Problem is, when there’s a (mostly) dead body pumped full of catecholamines, fluids, bicarb etc and zapped a few times (not to mention a caved in chest and a bleeding trachea) which briefly becomes more alive than dead, then bradies out or simply screeches to a sudden stop once again - I can’t really see it as a success.

Also, if a pt loudly complains in full sentences or fights back during CPR, you better sedate & intubate ASAP [emoji1782]
 
Typically in studies survival is described as discharge from hospital but don't account for neurological outcomes.

I haven't actually had many patients survive with poor neuro outcomes, I didn't get many codes in the field that either didnt have a good neuro outcome or we just called. In the hospital we tend to support family in withdraw of care if they patient isn't going to have a favorable outcome.
 
Watching the Hitmans Bodyguard.. and falling in love with Salma Hayek.... again lol
 
CALEMT said:
Aaaaannnnnddddd forced on Christmas Eve and day. Oh well knew it was coming at least it’s at cool stations.
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AMR grinches you?
 
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