CALEMT
The Other Guy/ Paramaybe?
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I was envisioning more of Rambo.
the 100% directionless thread
- Thread starter KEVD18
- Start date
I was envisioning more of Rambo.
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Best way to deal with such varmints is to use the Carl Spackler method...
Jim37F
Forum Deputy Chief
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Our station has a way of welcoming new members. Like a couple weeks ago when we got our new Captain, his first shift, we had a pedestrian on the Freeway get hit by a car, show up and PD is doing CPR on the shoulder so we're obligated to jump in until EMS arrived and pronounced the poor guy...
Today is pur new Engineers first shift, get relocated to cover another station, and whole we're there, get dispatched to a head on auto accident with person pinned (fortunately no major injuries, but the cars were wrecked).
Pretty much anytime someone new comes in we always get some sort of crazy call lol
Today is pur new Engineers first shift, get relocated to cover another station, and whole we're there, get dispatched to a head on auto accident with person pinned (fortunately no major injuries, but the cars were wrecked).
Pretty much anytime someone new comes in we always get some sort of crazy call lol
Jim37F
Forum Deputy Chief
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Hmm... spoke too soon, day wasn't quite done with us yet, gave our new Engineer a building fire as well!
Always fun when we actually get to play at being Firefighters
Nothing major, last in (4 of 4) Engine of the alarm, backed up another crew on their line, helped open up a door (boarded up abandoned storefront) for ventilation and shot some hot spots, about it.
And then the EMS gods reminded us about normal, one call where there were no City ambulances so had to wait for an AMR rig, midnight call and 0230 call, so yeah lol
Always fun when we actually get to play at being Firefighters
Nothing major, last in (4 of 4) Engine of the alarm, backed up another crew on their line, helped open up a door (boarded up abandoned storefront) for ventilation and shot some hot spots, about it. And then the EMS gods reminded us about normal, one call where there were no City ambulances so had to wait for an AMR rig, midnight call and 0230 call, so yeah lol
Jim37F
Forum Deputy Chief
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Speaking of crazy calls, one of the other Watches also has a new Captain and Engineer at my station. So yesterday they got an apartment fire... all of a block away from the station.
A fire suspected to be arson, and a the victim found inside possibly victim of homicide (residents report seeing a guy jump out of the third story window and run away..)
www.hawaiinewsnow.com
Pretty sure they got us beat on the crazy call front...
A fire suspected to be arson, and a the victim found inside possibly victim of homicide (residents report seeing a guy jump out of the third story window and run away..)
Honolulu police arrest suspect in connection with Pearl City homicide, arson
The suspect was identified as 32-year-old Scott Deangelo.
Pretty sure they got us beat on the crazy call front...
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There are two threads I've left open because the subject matter seems to attract spammers. It's like they cant resist posting some spam link in either thread, so I've been using them as a honeypot to identify and ban the spammers.
Today I was reminded that not all posts in those threads are spam...then the other one got spammed.
Today I was reminded that not all posts in those threads are spam...then the other one got spammed.
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Had to have the "BVMs save patients, not narcan" talk with my new person. It did not go very well. "Well why can't I just give narcan to see what happens?"
please no.
please no.
MackTheKnife
BSN, RN-BC, EMT-P, TCRN, CEN
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This topic has come up before. When did BVM become the default over Narcan? What caused the shift? (Haven't been in the field for a long time).
DesertMedic66
Forum Troll
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Correcting hypoxia and ventilation is covered under breathing assessment/treatments. Narcan is not.
Correct hypoxia first and then give enough narcan just to get them breathing.
PotatoMedic
Has no idea what I'm doing.
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Fixing the hypoxia sometimes is enough to get them breathing on their own again and I don't have to give narcan. Fixing hypoxia can help prevent combativeness and agitation when I do have to give narcan as well.
MackTheKnife
BSN, RN-BC, EMT-P, TCRN, CEN
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Thanx. It seemed like the posts on this topic, to me, eschewed the use of Narcan, and only advocated BVM. Understand now. Of course, correcting hypoxia is paramount (ABCs).
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It isn’t an either or proposition. If the patient is not ventilating themselves they need PPV. That can be a bridge to narcan but we aren’t going to let someone hang out with a RR of three, sats at 50, and end tidal of 70 while we get a line (I realize this is not necesssary) and get the drug drawn up.
And if they don’t need a BVM, how bad do they really need narcan?
MackTheKnife
BSN, RN-BC, EMT-P, TCRN, CEN
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Agree it's not an either/or situation. Just seems as if there has been a disdain for Narcan on this forum, in my opinion. I didn't need the potential scenario you portrayed. I'm not a rookie EMT. I full well understand what the priorities are and Narcan is an adjunct, nothing more.
And BTW, if their sats are 50%, they're getting intubated unless a few BVM ventilations gets their sats up and their RR up.
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That was the scenario that was going on with my new person…
MackTheKnife
BSN, RN-BC, EMT-P, TCRN, CEN
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Tigger, I appreciate your new person/patient, per se. However, the scenario you provided utilized BVM, RR of 3 and a Pulse Ox of 50%? That should of required intubation and Narcan immediately. I realize you are a new medic, from your posts, but seriously? Narcan effects the MU-2 receptors immediately affecting respiratory factors with respect to respiratory effort
CCCSD
Forum Deputy Chief
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Ummmm… start with a BVM to ventilate the pt. If it’s an OD, you don’t intubate prior to narcan…you DO know that, right?
E tank
Caution: Paralyzing Agent
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.....are mutually exclusive statements...
DesertMedic66
Forum Troll
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So you are going to intubate the patient, give narcan, have them wake up, and then extubate them? I’m no doctor but I see some issues with that treatment route.
MackTheKnife
BSN, RN-BC, EMT-P, TCRN, CEN
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One would assume from the scenario given that there will be an imminent respiratory arrest. RR of 3? One would also assume that the PT is already getting BVM, so intubation would be the next step. We have intubated pts in the ED with bradypnea and given Narcan which sometimes worked, sometimes didn't. And yes, when it did work, they were extubated.
E tank
Caution: Paralyzing Agent
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But here's the thing...narcotic alone does not provide reliable intubating conditions for people that do it several times a day let alone maybe a couple times a month. So that means to do it right, the patient needs need to be paralyzed which carries it's own risks. The risk of aspiration and/or a traumatic intubation when mask ventilation is sufficient would seem really unnecessary. Besides, in the time it takes to prepare for and carry out intubation, you could have him breathing well on his own with some narcan.