first call of the day is...

My week´s selection: the gentleman with a hip dislocation, a routine transfer patient that arrested unexpectedly, the guy with cramps in his toe and the guy who claims to have choked on a sip of water!
 
2 car MVC within literally 45s of the new EMT ridealong walking in. oh the joy.
 
Full arrest. 2 rounds of epi, amiodarone, shocks x3, tube, ROSC. Pronounced in the ER, 20 min after drop off (as expected).
 
Yesterday it was flu for me as my first call. I'd say about 75-80% of my calls over the last few weeks have been flu-like symptoms. Of course my day started out getting ready for JHACO inspection in the next couple months.
 
Yesterday it was flu for me as my first call. I'd say about 75-80% of my calls over the last few weeks have been flu-like symptoms. Of course my day started out getting ready for JHACO inspection in the next couple months.

This flu season was rough on everyone...
 
I've run on LOTS of flu this past week. Unfortunately, it gets upgraded to ALS if the patient says "my chest hurts".
 
This flu season was rough on everyone...
It certainly has been sounding like it. Most every shift when I stop by our ER for whatever reason the tracker board is completely full of flu-like symptoms.
 
It certainly has been sounding like it. Most every shift when I stop by our ER for whatever reason the tracker board is completely full of flu-like symptoms.

Word. We had multiple ERs down to sat, for over 2 months, on a regular basis.
 
I'm just a student but my worst nightmare has become something my instructor told us during our first lab. He was orienting a guy on his first shift and they get a call for a patient with hx of CHF who took a fall in her bedroom. They arrive on scene and she's diaphoretic and SOB...and also 500 pounds. The bariatric ambulance was out of service and in another county, so they made the fatal error of trying to jerk her onto a hydraulic cot using an orca blanket. New guy lifted with his back too much and threw out his lumbar. :confused: His first day was also his last.

Pretty sure I'm permanently traumatized into thinking this will be my first call too, haha. But since that story I've religiously practiced proper deadlift and squat form.
 
Asthma. Could hear hear her from the door, definitely working to breathe. Loud wheeze, tripoding, rate of about 25-30. Duo neb from the house, CPAP with neb in the truck, and 2g of mag hung en route. Only got more lethargic as we went, respiratory effort went down, and still was hearing wheezes as we got there. Switched to BVM once she started slumping over. Not quite the magic I was hoping to work, but she was properly prepped for intubation for the ED staff and at least still responsive upon arrival so I'll take it.
 
Asthma. Could hear hear her from the door, definitely working to breathe. Loud wheeze, tripoding, rate of about 25-30. Duo neb from the house, CPAP with neb in the truck, and 2g of mag hung en route. Only got more lethargic as we went, respiratory effort went down, and still was hearing wheezes as we got there. Switched to BVM once she started slumping over. Not quite the magic I was hoping to work, but she was properly prepped for intubation for the ED staff and at least still responsive upon arrival so I'll take it.

No Epi in your protocols?
 
Old people brain phart question. What is passing on the NREMT? 70% or is it higher.
 
I'm just a student but my worst nightmare has become something my instructor told us during our first lab. He was orienting a guy on his first shift and they get a call for a patient with hx of CHF who took a fall in her bedroom. They arrive on scene and she's diaphoretic and SOB...and also 500 pounds. The bariatric ambulance was out of service and in another county, so they made the fatal error of trying to jerk her onto a hydraulic cot using an orca blanket. New guy lifted with his back too much and threw out his lumbar. :confused: His first day was also his last.

Pretty sure I'm permanently traumatized into thinking this will be my first call too, haha. But since that story I've religiously practiced proper deadlift and squat form.

That's why firefighters exist lol. On a serious note, "jerking" people up is a terrible idea for exactly this reason.
 
No Epi in your protocols?
Technically IM epi protocol is only for peds, although situations like this I highly doubt I would be faulted for going that route. Just self report it, a little blurb on why, and that would likely be the last of it.

Realistically though, we were less than a mile when I DC'd the CPAP, time was a bit short then.
 
Technically IM epi protocol is only for peds, although situations like this I highly doubt I would be faulted for going that route. Just self report it, a little blurb on why, and that would likely be the last of it.

Realistically though, we were less than a mile when I DC'd the CPAP, time was a bit short then.
No epi in your protocols for status asthmaticus in extremis? That is utterly insane. Far, far more reason to use epi in that scenario than mag.
 
No epi in your protocols for status asthmaticus in extremis? That is utterly insane. Far, far more reason to use epi in that scenario than mag.
Not in the adult section. Could I have done it then afterwords written a "this is what I did and this is why" and been fine? Yes. However, I double checked my book to make sure, it's not written for adults.

Now that I am thinking about it, I am gonna pitch this at the clinical meeting next month. There are a few other things I want to toss in the mix and this one would be relevant and simple.
 
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Run down the street, get into the apartment, which looks like it just wrapped on shooting an episode of hoarders, and the "patient" goes "Can you plug my space heater in?"

"Ma'am do you have anything medically wrong with you today?"

....
 
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