the 100% directionless thread

[GMCmedic]

Got my dogs Cushings medication dose cut in half due to unhealthy weight loss. Thought I might also benefit with much lower cost. 30 day supply of 60mg is $80, 30 day supply of 30mg is $76. :/

And its a moot point, supposed to watch for recurring UTIs on the lower dose and he currently has one anyway. Sigh.......I think the time has come

 

[Seirende]

Pretty radical change of careers...

I'm not currently in EMS, if that's what happens you mean. I'm hoping to get back someday, truck school is a step toward that.

 

[RocketMedic]

I view that mode as an emergency setting for if I am stricken by blindness or die.

 

[CALEMT]

Cooking breakfast and brewing coffee and the tones drop for a structure fire. 3 hours later we come back to bacon still in the pan, English muffins still in the toaster, eggs still on the counter, and coffee still in the pot. The breakfast meant to be.

 

[StCEMT]

Company guidelines say Mcgrath only on first attempt and if we take a second attempt there is more paperwork involved. We have the copilot rigid stylette which works well with a Mcgrath 3. I doubt I couldve gotten that airway with a bougie once the camera was soiled.

I usually elevate the head with sheets/towels, the few times I've had issue with that I just pop it out for a quick wipe. For most people I intubate (not difficult airways), it's a very short amount of time added. This is also where SALAD shines though.

 

[DragonClaw]

Picked up a shift. She's an FTO but her trainee called off too. Just us two.

Had a transport from hospital to group home. Guy was like 250 lbs with X1 BKA. He was also a dwarf.

We had to collapse the stretcher, but were able to barely scoot through two tight dooways/hallways into a small room with 2 beds and pts in it already. Corners were very tight. Room could barely fit 3 beds and various furniture in it. We jenga things around, Get him moved over and as were getting out of the room, the guy in charge impressively says

"Wow, y'all could do what three men could not"

Maybe it doesn't seem like much, but I was a little stroked to hear some apparently genuine praise.

Another call, hospital to psych facility. This is my first moderate psych. She was voluntary thus far. Per policy, we can't have them walk to ambo. She wanted to walk to feel better and not more anxious. When staff relayed the message, she kinda went semi-ballistic. Not violent but running around and screaming how she didn't want to go and she's not going.

Her adult son tried to calm her down. They want to remove her IV before transport but she's not holding still and keeping her distance from everyone. There's like a dozen hospital staff nearby. Corralling her gently, like making sure she doesn't actually leave. They call security but I think all the people made it worse.

The hospital staff asked us to remove her IV because they can't because she's freaking out. We said no (double basics. We know how but if she's not wanting to even be close to people I really don't want to mess with a needle in her arm anyway. )

In the room she was slamming something or hitting a wall and wailing and yelling. No people hurt. Then she was kinda running around the wing but didn't leave.

They had her as voluntary but she had paranoia and other stuff. She said she trusted her son but thought he might have "bad friends" that may get her killed for money and various things. On and on about conspiracies against her.

I've done a little more research on it and will approach things differently next time. I honestly was kinda confused. She was AOX4 GCS 15. They labeled her AMS though. But she was voluntary. How can someone in her condition consent anyway?

We'd have to let her go, or so I thought, if she went voluntarily and then changed her mind. But she wasn't okay and that didn't seem right either.

After like 30-45 minutes she calmed down to sniffling and decided to go. She was comforted greatly by her son and held his hand a lot. She was fine with it all, now. Transport happened and everything was fine.

They thought we could take her involuntarily if needed, but didn't have paperwork for it.

Talked to a sup after and we should have gotten an EPOW. He says the hospital was being lazy. My partner was in the back.

I thought about the recent psych pt who escaped an ambo and was killed via ped vs mv. I didn't want that to happen. The son rode with and she was as calm as a recently upset psych pt could be, but it didn't sit right.

Lesson learned to be adamant for an EPOW with something like this. Anything else to take away?

 

[Jim37F]

EPOW?

 

[CCCSD]

And its a moot point, supposed to watch for recurring UTIs on the lower dose and he currently has one anyway. Sigh.......I think the time has come

Sorry to hear that. As our Dogs best friends, it’s up to use to ensure QUALITY of Life, instead of quantity. It’s tough, but that’s what Love is.

 

[NomadicMedic]

This may be an unpopular opinion, but any psych patient that is being the slightest bit uncooperative goes in 4 points.
If they are very anxious or uncooperative, I request the sending facility administer some meds.
If not, I either get orders for meds or they don't go.

Plain and simple.

I did LOTS of psychs during my time in King County. (We had the contract with West Seattle Psych to take the mandatory holds to "Psych Court" at Harborview.) I watched too many people get hurt wrestling with psych patients. It was a common occurrence and any complaints fell on deaf ears.

Now that I'm a medic, I'm much happier if I can sedate a patient that wants to eat both me and my partner.

 

[PotatoMedic]

West Seattle Psych...

Oh the memories. The only way to tell staff and patients apart were if they had shoelaces.

 

[NomadicMedic]

One of my not so proudest moments happened at psych court.
I was working overtime as the EMT that hung out in the holding room with the patients as they waited for their turn in front of the judge. (They were all on stretchers in 4 points.)

I was just killing time, reading a book and one of the guys was telling me that he was hearing voices in his head and they were caused my my Nextel. I looked up and told him, “if you go to the water department and pay a disconnect fee, they’ll shut off the voices in your head,” I went back to my book.

a few week later I found out that guy went to the water department and threw a huge fit (and subsequently went back to west Seattle psych) when the clerk behind the counter wouldn't shut off the voices in his head.

...like I said, not my proudest moment.

 

[DragonClaw]

You know what's exciting. Finally getting dispatched code 3. You know what kills me, medic killing it by refusing for me to drive code (he didn't drive, either). I'm not sure where y'all put hospital to hospital subarachnoid hemmorages (apparently multiple), to me it was cool to finally get code 3, but he sure nipped that in the bud.

I honestly can't contain the disappointment

 

[luke_31]

You know what's exciting. Finally getting dispatched code 3. You know what kills me, medic killing it by refusing for me to drive code (he didn't drive, either). I'm not sure where y'all put hospital to hospital subarachnoid hemmorages (apparently multiple), to me it was cool to finally get code 3, but he sure nipped that in the bud.

I honestly can't contain the disappointment

It’s not as exciting as it seems. You’re in a vehicle that doesn’t stop quickly, everyone on the road is deaf, blind, and dumb. Oh by the way you hit anyone or get hit by anyone it’s automatically your fault because you’re supposed to drive with due regard. When I first started driving lights and sirens it was a miracle that I never hit anything. I was working in Los Angeles and let’s just say that people don’t look where they are going. Sorry you didn’t get to go code 3, but after your first couple times you’ll realize how unsafe it really is.

 

[DragonClaw]

It’s not as exciting as it seems. You’re in a vehicle that doesn’t stop quickly, everyone on the road is deaf, blind, and dumb. Oh by the way you hit anyone or get hit by anyone it’s automatically your fault because you’re supposed to drive with due regard. When I first started driving lights and sirens it was a miracle that I never hit anything. I was working in Los Angeles and let’s just say that people don’t look where they are going. Sorry you didn’t get to go code 3, but after your first couple times you’ll realize how unsafe it really is.

So what, never get experience? It's safer.

I know we have to be cautious and safety adverse, but what the heck man

This guy is the epitome of bare minimum burned out salty medic. After out first call, asked him how my driving was. Some people have different preferences.

I went out of my way to try and be a good courteous partner.

There's 2 things I ask people I ride with. To make sure to ask. Food allergies and if they speak Spanish. Spanish only calls are common. He said he didn't speak Spanish.

Guess who is on the phone in full Spanish convos?

 

[DragonClaw]

The others were right about him. He is an a-hole.

 

[CALEMT]

So what, never get experience? It's safer.

I don't really see where he specifically or inadvertently said that.

Honestly lights and sirens aside what is the major difference between code 3 and code 2? It really isn't all its cracked up to be. Take it from someone whose been in a TC... on duty... driving... code 2... it sucks.

Also the maturity level comes into play. You're so eager to "run hot" how many things are you going to be doing wrong without even realizing it? Furthermore, running calls in So Cal (traffic, lights, etc.) where you'd think code 3 is all the difference in times is in fact not the case. I've ran calls at the same location code 3 vs code 2 and the time difference is well... there isn't any.

The time will come, don't get me wrong the first couple times will be exciting. After that it just becomes "meh"

 

[DragonClaw]

I don't really see where he specifically or inadvertently said that.

Honestly lights and sirens aside what is the major difference between code 3 and code 2? It really isn't all its cracked up to be. Take it from someone whose been in a TC... on duty... driving... code 2... it sucks.

Also the maturity level comes into play. You're so eager to "run hot" how many things are you going to be doing wrong without even realizing it? Furthermore, running calls in So Cal (traffic, lights, etc.) where you'd think code 3 is all the difference in times is in fact not the case. I've ran calls at the same location code 3 vs code 2 and the time difference is well... there isn't any.

The time will come, don't get me wrong the first couple times will be exciting. After that it just becomes "meh"

"You must be this unhappy/unexcited/discouraged to ride this ride?"

What's the point of getting dispatched for something where our contract really leans toward doing what this hospital network wants If we don't?

We weren't pt loaded, why didn't he drive and show me how it's done.

Road conditions were good, traffic light to moderate. But he had no problem chauffeuring him around all day. That's dangerous too. Less so, but I don't think I have to remind anyone here about driving a regular POV and the danger. But here I am driving a box around, you know, for a living.

Sorry I like what the job includes. And we all know, yeah I want to drive code. Not sorry.

 

[DragonClaw]

In conversation, could barely get a word from him. he doesn't even want to be a medic. He's just trying to finish his degree.

Okay some people aren't talkers, okay. That's fine.

Even when trying to discuss moving pts or anything on the job it was like blood from a stone. Just mumbles and there's questions I asked him like 5 times because he was too busy watching a TV show.

He said he'd be furious if a partner tried to bonus. He "only takes 2 calls" a shift.

 

[Tigger]

"You must be this unhappy/unexcited/discouraged to ride this ride?"

What's the point of getting dispatched for something where our contract really leans toward doing what this hospital network wants If we don't?

We weren't pt loaded, why didn't he drive and show me how it's done.

Road conditions were good, traffic light to moderate. But he had no problem chauffeuring him around all day. That's dangerous too. Less so, but I don't think I have to remind anyone here about driving a regular POV and the danger. But here I am driving a box around, you know, for a living.

Sorry I like what the job includes. And we all know, yeah I want to drive code. Not sorry.

There are precious few reasons to drive emergent to a hospital with no patient in back. "Training" is not on that list.

In conversation, could barely get a word from him. he doesn't even want to be a medic. He's just trying to finish his degree.

Okay some people aren't talkers, okay. That's fine.

Even when trying to discuss moving pts or anything on the job it was like blood from a stone. Just mumbles and there's questions I asked him like 5 times because he was too busy watching a TV show.

He said he'd be furious if a partner tried to bonus. He "only takes 2 calls" a shift.

These partners are annoying. You will encounter many like him. I'd encourage you to remember the other side. I work part time at our local AMR op and have been around since 2013. There are still lots of people I've never worked with, and plenty of people who I've never even met. I think I'm pretty easy to work with, but some days I don't really want to chit chat with someone I've never met. Sometimes I'm there straight from another job or a class and am exhausted, which doesn't improve things. And to be honest, few things drive me insane faster than a partner that will not appreciate the value of some music, the radio at a low volume, and a book.

This probably makes me sound like a meanie. That ain't me, sometimes I'm just tired.

 

[DragonClaw]

There are precious few reasons to drive emergent to a hospital with no patient in back. "Training" is not on that list.

These partners are annoying. You will encounter many like him. I'd encourage you to remember the other side. I work part time at our local AMR op and have been around since 2013. There are still lots of people I've never worked with, and plenty of people who I've never even met. I think I'm pretty easy to work with, but some days I don't really want to chit chat with someone I've never met. Sometimes I'm there straight from another job or a class and am exhausted, which doesn't improve things. And to be honest, few things drive me insane faster than a partner that will not appreciate the value of some music, the radio at a low volume, and a book.

This probably makes me sound like a meanie. That ain't me, sometimes I'm just tired.

Okay, fair point. Not pt loaded. I'll give you that. That doesn't seem unreasonable, especially given the increased risk.


But from 1 hospital to another? The guy had been drinking, smoked some weed, fell down and hit his head a few hours ago

And like I said, I get it. I'm chatty, so you know what I did when I realized here wasn't? I left the ambo on post so he could nap and do whatever in peace. When driving together, I minimized questions or talking, barely talked.

I really tried to be accommodating.

I spoke to a sup about it. Partly. We'll talk more when I'm back at ops. But he's already on the thinking we should have run code when requested. We'll see.