the 100% directionless thread

Just took my almost 3 year old on a two and a half mile hike. Only 400 feet in elevation gain, bit for his little paws he did great!
 
VentMonkey said:
Spring and Autumn are where it’s at for me. Cold doesn’t bother me nearly as much as sweating profusely 4 months straight.
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This^^^

I can dress for the cold...there's only so much clothing I can remove before I get in trouble.
 
VentMonkey said:
Spring and Autumn are where it’s at for me. Cold doesn’t bother me nearly as much as sweating profusely 4 months straight.
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Don’t get me wrong I love cold weather. But I can’t lie I am enjoying my 80 degree weather at home. I live at 5,400 feet.

Where I work... now that’s another story...
 
CALEMT said:
Don’t get me wrong I love cold weather. But I can’t lie I am enjoying my 80 degree weather at home. I live at 5,400 feet.

Where I work... now that’s another story...
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No one enjoys where you work. Not even the citizens like being there.
 
If I could convince my wife to move to the west coast, I’d be back in Oregon or Washington right now. The high desert in Oregon was about as close to perfect weather as I’d ever found.
 
StCEMT said:
Yea, apparently they looked at the use and believed they were being used inappropriately too often. I didn't see the info or the patients so I'm not sure how true that is. I know I've done some unorthodox **** before. I don't agree with it, I would try to have bilateral 14's for those trauma patients I knew were MTP worthy. But we also have a tendency of taking useful things away because a small population misuses it instead of dealing with the problem children so....

I believe they're 1.25".
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Peak said:
Idk about your agency but the local 911 group here places a LOT of 14s for ‘trauma’ but will then take them to a level III or IV and who don’t meet alert criteria anyway. There is certainly misuse, but also clearly by a small number of medics (who will also bring in patients with EJs who have ropes on their forearms). The problem children are certainly a easily identifiable group here.
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How are 14g catheters used "inappropriately" compared to, say, a 16g or 18g? How does it constitute "misuse" to place one in a patient just because they don't meet alert criteria?
 
Carlos Danger said:
How are 14g catheters used "inappropriately" compared to, say, a 16g or 18g? How does it constitute "misuse" to place one in a patient just because they don't meet alert criteria?
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The insertion of 14 gauge IVs in drunk patients as ‘punishment’.
 
PotatoMedic said:
Child. Sadly I don't think I could crate train him.
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CCCSD said:
You can. It’s not illegal.
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0EEC4640-A2D9-4165-ADF6-1C067DB24083.jpeg

definitely doable, definitely, definitely...
 
Carlos Danger said:
How are 14g catheters used "inappropriately" compared to, say, a 16g or 18g? How does it constitute "misuse" to place one in a patient just because they don't meet alert criteria?
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Peak said:
The insertion of 14 gauge IVs in drunk patients as ‘punishment’.
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Not just "drunk" patients, but insertion of them in any patient as a "punishment" for something. As an aside, I have never placed a 16g catheter in any patient. I generally skipped over that... It's been 14g (only if absolutely necessary for VOLUME), 18g-24g as necessary. These days I pretty much do 80% 20g, about 10% 22g, and the balance is mostly 18g. I only place a handful of 24g a year. Not against them, just there's very few patients that require those as that's about the only PIV that works in them.
 
Akulahawk said:
Not just "drunk" patients, but insertion of them in any patient as a "punishment" for something. As an aside, I have never placed a 16g catheter in any patient. I generally skipped over that... It's been 14g (only if absolutely necessary for VOLUME), 18g-24g as necessary. These days I pretty much do 80% 20g, about 10% 22g, and the balance is mostly 18g. I only place a handful of 24g a year. Not against them, just there's very few patients that require those as that's about the only PIV that works in them.
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To be clear I have no problem with large IVs. I’ve placed 22s in neos, 20s in infants, 18s in toddlers, and 14s in school aged kids. I placed those because their presentation required the ability to rapidly infuse large volumes.

Any procedure should be indicated. Besides placing a 14 in the same person over and over just scars up their veins for the time they are actually trying to die and now we are struggling to get a 22.
 
Ask those guys in Delaware how the “pick your favorite color” IV game worked for them.

Punitive ALS should be punished with terminal license revocation.
 
NomadicMedic said:
Ask those guys in Delaware how the “pick your favorite color” IV game worked for them.

Punitive ALS should be punished with terminal license revocation.
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Wait what. They let the pt CHOOSE based on COLOR. Lord help us.
 
DragonClaw said:
Well I'm still here so 🤔

Jk.

Also. I don't know when it happened but I find the notion of counting respiration to a T kind of ridiculous. Unless the pt has abnormal breathing or a condition that warrants closer examination I just kind of gestimate based on how they're breathing and previous counting. Ah that looks like 18. 18 it is. I can tell easily if the pt conditions changes, if respiration become more labored, etc and I just kind of key into it without even needing to really think to do it.

Not to say I'm the crystal ball of respirations but it isn't like it was before

Back during my clinical days I was.... appalled and horrified providers didn't count every single breath. I guess it I get it now. Is this a milestone?

Old me would have thought I was a pt murderer (not literally) or didn't care.

Interesting development I've noticed within myself, among other things
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Personally, I wish we could jusr document WNL or within normal limits, fast (tachypnea), slow (bradypne), labored, audible, etc.. Describe it instead. I think it is a bit lame considering how narrow the normal range is. That being said, if you are doing manual sets of vitals, it isn't hard to do. I generally starting counting respirations after completetly deflating the blood pressure cuff and just stay in position as if I am getting the blood pressure. Sometimes I pick up that the patient is breathing fast even though they don't look labor. Usually they'll have something else like a fever.
 
Aprz said:
Personally, I wish we could jusr document WNL or within normal limits, fast (tachypnea), slow (bradypne), labored, audible, etc.. Describe it instead. I think it is a bit lame considering how narrow the normal range is. That being said, if you are doing manual sets of vitals, it isn't hard to do. I generally starting counting respirations after completetly deflating the blood pressure cuff and just stay in position as if I am getting the blood pressure. Sometimes I pick up that the patient is breathing fast even though they don't look labor. Usually they'll have something else like a fever.
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Pt is eupnic
 
DragonClaw said:
Wait what. They let the pt CHOOSE based on COLOR. Lord help us.
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Unfortunately yes. It is something that has been spread on social media pages. Some people are proud to say they got a 14g in drunk patient because they said their favorite color was orange.

At my ground agency we fired a guy many years ago because he was starting 14-16g IVs on every patient regardless of their complaint or how stable they were. He would often brag about getting a 14 in elderly grandmas. He was pulled into the education office and was warned about that practice. He continued to do it and was fired. Shortly after he was fired one of the local fire departments hired him.
 
DesertMedic66 said:
Unfortunately yes. It is something that has been spread on social media pages. Some people are proud to say they got a 14g in drunk patient because they said their favorite color was orange.

At my ground agency we fired a guy many years ago because he was starting 14-16g IVs on every patient regardless of their complaint or how stable they were. He would often brag about getting a 14 in elderly grandmas. He was pulled into the education office and was warned about that practice. He continued to do it and was fired. Shortly after he was fired one of the local fire departments hired him.
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That's harm to a pt at that point. Pull his patch.
 
I get it, maybe you made a good save with a great outcome. You feel good and want to brag. Maybe you got to a pt in shock in the nick of time.

Putting the biggest needle into someone for kicks isn't it.

That's so egotistical. That's not a warm fuzzy feel good.
 
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