the 100% directionless thread

[MrJones]

I've found this site to be an excellent reflection of the various types who inhabit virtually every station. You have the clueless but well meaning newbies (you know - the ones that will turn out to be excellent EMTs and Paramedics but don't yet have the experience), the newbies who should be in any career field except EMS, the burned-out old timers, the know-it-alls who want everyone to know they know it all, the born teachers, and every type in between.

Makes for some interesting threads....

 

[chaz90]

Yup. Seems to be a cross section of the industry in general, with perhaps some self selection based on the fact that everyone here at least cared enough to type in a Google search and register for the site at one point.


Sent from my iPhone using Tapatalk

 

[Jim37F]

I've found this site to be an excellent reflection of the various types who inhabit virtually every station. You have the clueless but well meaning newbies (you know - the ones that will turn out to be excellent EMTs and Paramedics but don't yet have the experience), the newbies who should be in any career field except EMS, the burned-out old timers, the know-it-alls who want everyone to know they know it all, the born teachers, and every type in between.

Makes for some interesting threads....

hmm I wonder where I fall in? Some days I feel,like the clueless newbie, others the know it all lol

 

[PotatoMedic]

Toradol is an awesome drug for kidney stones. I've seen more people get relief with it...

1.5mg/kg of lidocaine in a 100ml bag dripped in over 5min will within 30 minutes drastically reduced if not get rid of your pain. And it lasts about 24 hours. Most people get relief in 10 minutes.

 

[luke_31]

I got to help throw people out of an aeroplane today

And you even got paid to do it.

 

[Qulevrius]

hmm I wonder where I fall in? Some days I feel,like the clueless newbie, others the know it all lol

I'm just gonna quote someone on this board (can't remember who it was) and say that every time you become too confident in doing your job, there will be that one pt who will tremendously humble you. We're all being clueless at some point.

 

[luke_31]

I'm just gonna quote someone on this board (can't remember who it was) and say that every time you become too confident in doing your job, there will be that one pt who will tremendously humble you. We're all being clueless at some point.

Don't remember who said that either, but I've found that to be very true. Heck I'll ask for a second opinion from other providers I work with just to be sure, even when I'm positive I know what I saw or heard.

 

[Qulevrius]

Yeah. Everyone makes mistakes, regardless of experience. Just a few days ago, an IV wouldn't get a flow. Had to distract the medic momentarily, and release the tourniquet. No need to embarrass a coworker...

 

[StCEMT]

After getting my **** stomped in the dirt all weekend, its back to the normal daily grind. I am so happy I have a chill clinical tomorrow, I will most certainly be planting myself on that couch and resting all these aches and blisters.

 

[TransportJockey]

1.5mg/kg of lidocaine in a 100ml bag dripped in over 5min will within 30 minutes drastically reduced if not get rid of your pain. And it lasts about 24 hours. Most people get relief in 10 minutes.

I have never heard of that. If I ever get another one of these, I will ask for it.

 

[PotatoMedic]

I have never heard of that. If I ever get another one of these, I will ask for it.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3141707/

A co-worker at the hospital I work at found this yesterday after we talked to the doctor at the er about it after he gave it to a patient.

 

[Carlos Danger]

1.5mg/kg of lidocaine in a 100ml bag dripped in over 5min will within 30 minutes drastically reduced if not get rid of your pain. And it lasts about 24 hours. Most people get relief in 10 minutes.

In combination with what other drugs?

Is there any reason to give it over 5 min, vs just a nice slow push?

 

[PotatoMedic]

No other combination. The logic behind it was the lidocaine has minimal first pass metabolism so it really is not metabolized. The kidneys love to filter it out so any dose will be filtered out in about 8 minutes and now you have lidocaine just saturating the ureters helping to numb the site reducing pain.

And the reason for a slow drip is to reduce any chance you will have any kind of cardiac affects from the lido. My guess is a slow push would be fine.

 

[CodeBru1984]

Spending my Monday morning teaching BLS airway management.

Sent from my iPhone using Tapatalk

 

[Tigger]

Shaken awake by my preceptor yelling at me that there is a dead guy in the station weight room and it's time to work an arrest with two non-medical fire vollies.

I have to work on with delegation but otherwise internship is enjoyable. Missed a bunch of good calls in our district while transporting some rather annoying patients, hopefully the tides will turn.

 

[NomadicMedic]

Shaken awake by my preceptor yelling at me that there is a dead guy in the station weight room and it's time to work an arrest with two non-medical fire vollies.

I have to work on with delegation but otherwise internship is enjoyable. Missed a bunch of good calls in our district while transporting some rather annoying patients, hopefully the tides will turn.

My preceptor did the same thing. I worked several "codes" on a turnout coat laying on the floor in the station.

 

[Carlos Danger]

No other combination. The logic behind it was the lidocaine has minimal first pass metabolism so it really is not metabolized. The kidneys love to filter it out so any dose will be filtered out in about 8 minutes and now you have lidocaine just saturating the ureters helping to numb the site reducing pain.

And the reason for a slow drip is to reduce any chance you will have any kind of cardiac affects from the lido. My guess is a slow push would be fine.

Do you have a link to anything that explains that proposed mechanism in more detail? It is an interesting concept.

First-pass metabolism is only a problem for PO meds, which are absorbed in the gut and then enter the portal circulation to be partially metabolized before entering the systemic circulation and reaching their site of action. So it isn't a factor in dosing IV medications. And the elimination half-life of lidocaine is about 2 hours, not 8 minutes.

However, about 10% of lido is excreted un-metabolized, so it may be that the unchanged drug results in enough of a concentration in the urine to have a local anesthetic effect in the ureters. The analgesia is also probably largely a result of lido's reduction in neurotransmission in afferent sensory pathways and its mild smooth muscle relaxant effects, which is why it is a useful adjunct in other types of visceral pain.

 

[cruiseforever]

Very lucky motorcyclist. Just minor injuries.
http://bringmethenews.com/2016/06/2...air-after-unsecured-water-toy-falls-off-boat/

 

[StCEMT]

I can now cross PHTLS off of my list. Probably would have done better had I not spent the entire weekend working out with those guys on base (and not so tired), but still got them letters for my alphabet soup. Now onto AMLS then that P.

 

[NysEms2117]

@StCEMT did you take those cert classes through the NAEMT website? if so do you have to be an NREMT to take them or can you just take on thats in your area?