An MI: My Experience at 30,000 Ft.

[rescuemedic7306]

Originally posted by MMiz+May 7 2005, 04:28 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MMiz @ May 7 2005, 04:28 PM)</td></tr><tr><td id='QUOTE'><!--QuoteBegin-ffemt8978@May 7 2005, 10:48 AM
usafmedic45,

I have a question for you about your scope of practice. You stated you were an EMT-I, but you're obviously familiar with the ACLS protocols for cardioinversion and first line cardiac drugs. Aren't both of these things outside of your scope of practice?

I realize that you got the doc to sign off on it, but I was just wondering what made you ask in the first place.

Good job on the save, BTW.

That's exactly what I was thinking.

I was actually signed up to take a summer-long ACLS course for Basics, but had to cancel due to time constraints. After my experience, I wondered how having that knowledge would have impacted my experience at 30,000 feet.

Also, I didn't even think about placing the AED on the live patient, as it's not in our protocols. I still don't think I would have done it.

What made you think of putting the AED on the patient? Is that common practice? (That goes out to everyone)

I got a booklet thanking me for my service, some frequent flyer miles, and a coupon for a sandwich at the airport... and a round of applause [/b][/quote]
I always stick the AED on Cardiac patients concious or not (we use a Zoll which allows us to get a strip thru the pads) just in case they decide to do the 'fish' thing...then we're all ready to perform our magic! B)

And...ditto on the save!

 

[rescuecpt]

Originally posted by rescuemedic7306@May 9 2005, 02:15 AM
I always stick the AED on Cardiac patients concious or not (we use a Zoll which allows us to get a strip thru the pads) just in case they decide to do the 'fish' thing...then we're all ready to perform our magic! B)

When I was a basic we had an obese pt who was having an MI that we couldn't get any vitals on (no apparent breathing, no pulse, no BP). We put the AED on, turns out he was not shockable because he still had a pulse... I was reprimanded by the County for breaking AED protocols and had to meet with the County training officer to discuss why I did what I did (we forgot to write on the PCR that we suspected loss of pulse prior to hooking up the AED).

It's much nicer now to be able to throw on the 3 lead and know for sure. The hardest part was riding as a basic while in my CC class, when I didn't have a preceptor and wasn't allowed to do ALS I felt so naked.

 

[Strike3]

It makes me sick to see you guys talking about who got what save, and "another live saved" ********...

I hate that EMS wants a freakin' pat on the back everytime some doesn't die in our care. We do our jobs as a service to the community, not for the glory of saving a life. All the freakin' Ricky Rescues on here are ridiculous. \

Go to work. Do your job. Have some fun while you're there. Go home safe. Don't look for praise and publicity. Don't go around bragging about what you did. All you did is your JOB. It's kinda like a mailman doing a touchdown dance everytime he puts a letter in someones mailbox. It looks immature, self important and stupid.

We're supposed to do our jobs to help other people. NOT our ego's.

Congrats on doing your damn job.




As for the original post here....The plane PT...You should have given 4 baby asprin as soon as you asessed the PT. That's protocol in any system, for any active cardiac PT for any basic. I know it's easier to look back on things and see things different, but the asprin and O2 should be second nature. You shouldn't even have to think about it once you verify that the PT hasn't had any recently, and has no allergies to it.

I'm glad you weren't like half the EMS people I work with, that hide from anything if they're "off duty". Congrats on that.

 

[Jon]

Originally posted by Strike3+May 10 2005, 01:21 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Strike3 @ May 10 2005, 01:21 PM)</td></tr><tr><td id='QUOTE'> As for the original post here....The plane PT...You should have given 4 baby asprin as soon as you asessed the PT. That's protocol in any system, for any active cardiac PT for any basic. [/b]

first off, In PA, I'm not allowed to give ASA as a BLS provider.

<!--QuoteBegin-Strike3@May 10 2005, 01:21 PM
Go to work. Do your job. Have some fun while you're there. Go home safe. Don't look for praise and publicity. Don't go around bragging about what you did. All you did is your JOB. It's kinda like a mailman doing a touchdown dance everytime he puts a letter in someones mailbox. It looks immature, self important and stupid.[/quote]

To turn your anology on yourself, Football players do touchdown dances after good scores. They don't after every play. Saving a life is a "good play" while taking grandma to dialysis is a "routine play"

after a bad call, most folks I know second guess themselves, and feel bad about how they could have saved the patient. After a good call, we are happy that we saved a life.

Feel good about your job, so you don't end up sounding cynical and burnt-out.

Jon

 

[rescuejew]

Honestly, dude, EMS is our JOB and glory-hounding is inappropriate in my opinion, but you cant Monday-morning quarterback this guys care decisions either. You werent there. He's an EMT-Basic and regardless of training variances, he still hasnt had as much training as a Paramedic. I dont think he posted what he posted to say "Look at me, I saved a life.." I think it was more: "This was a weird experience and my pucker-factor was acting in hyperdrive.." Knocking this kid down, or anyone else for that matter doesnt make them better EMTs or you a better teacher...forums like this are how people learn about other systems, other protocols and pt care tips, along with humor. Sure there's a fair bit of paragod syndrome here, but if your skin is so thin and you cant handle it, what the hell are you doing here????

 

[MedicPrincess]

Originally posted by Strike3+May 10 2005, 01:21 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Strike3 @ May 10 2005, 01:21 PM)</td></tr><tr><td id='QUOTE'> You should have given 4 baby asprin as soon as you asessed the PT. That's protocol in any system, for any active cardiac PT for any basic. I know it's easier to look back on things and see things different, but the asprin and O2 should be second nature. [/b]

WOW...so you have worked in every EMS system there is. I am impressed!!

Asprin is not part of the protocols for a Basic here either.




<!--QuoteBegin-Strike3@May 10 2005, 01:21 PM
All the freakin' Ricky Rescues on here are ridiculous. \[/quote]

Welcome to EMTLife man. However, if this is your usual take on a bunch of people who share a common intrest getting together and talking about it, hoping to learn from one another, I cant say I hope you stick around to long.....

And what made you join a forum like this if you have such a problem with what we are doing here?

I know these guys have helped me figure things out more than once.

 

[rescuecpt]

EMS is not my job. I take it very seriously, but it's not my job.

People on this forum are here to share experiences, good and bad, so that we can learn from each other and have people to talk to who understand what we go through. If you don't like it, don't post. If you want to be a part of a supportive community, stick around.

 

[TTLWHKR]

Isn't Ricky Rescue an extrication doll?

Ya know, Rescue Randy's Cousin...

 

[TTLWHKR]

Originally posted by Strike3@May 10 2005, 01:21 PM
NOT our ego's.

Hello Kettle?

This is the pot.

 

[CodeSurfer]

Originally posted by EMTPrincess+May 7 2005, 06:26 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (EMTPrincess @ May 7 2005, 06:26 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-MMiz@May 7 2005, 04:28 PM
Also, I didn't even think about placing the AED on the live patient, as it's not in our protocols. I still don't think I would have done it.

What made you think of putting the AED on the patient? Is that common practice? (That goes out to everyone)

On my test for AED check off I was asked contraindications for the AED:

1. Use on a Trauma Patient
2. Use on a child under 8, or if you have adapters under 1
and
3. A conscious patient. [/b][/quote]
AED is contraindicated in SD if the patient has a pulse. There is you can have v-tach with a pulse... and some of the AED's (the really moron proof ones) would shock that rhythm even if the patient was still alive is what i'm told. I dont know if anyone has ever tried it.

 

[ffemt8978]

First of all, everyone needs to settle down a bit.

Strike3, your statement about giving 4 baby aspirin to an active cardiac patient being protocols in any system for any basic is incorrect.

When I was certified in Iowa, EMT-B's were not allowed to give any ASA to a patient. Samething for when I was certified in South Dakota.

Here in Washington, we give 2 baby aspirin (162mg) as a basic only if our medical control has written it into our standing orders. However, our protocols change if we have an EMT-IV on scene. We have to get an IV line first, then patient assist NTG, then the aspirin.

I do agree that O2 and aspirin should be given immediately to any patient displaying cardiac chest pain, AS LONG AS IT IS WITHIN YOUR PROTOCOLS.

As far as the rest of your post goes, if you don't want to be recognized for saving somebody's life, so be it. It is not for you to rain on another person's parade if that's what they want.

This forum was created as a place for people in EMS to come and chat about experiences or feelings they've had working in EMS. We don't come here looking for praise, but rather seeking information and companionship with people who understand what we do.

 

[rescuemedic7306]

Originally posted by CodeSurfer+May 10 2005, 05:47 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (CodeSurfer @ May 10 2005, 05:47 PM)</td></tr><tr><td id='QUOTE'>

Originally posted by EMTPrincess@May 7 2005, 06:26 PM
<!--QuoteBegin-MMiz

@May 7 2005, 04:28 PM
Also, I didn't even think about placing the AED on the live patient, as it's not in our protocols.  I still don't think I would have done it.

What made you think of putting the AED on the patient?  Is that common practice?  (That goes out to everyone)

On my test for AED check off I was asked contraindications for the AED:

1. Use on a Trauma Patient
2. Use on a child under 8, or if you have adapters under 1
and
3. A conscious patient.

AED is contraindicated in SD if the patient has a pulse. There is you can have v-tach with a pulse... and some of the AED's (the really moron proof ones) would shock that rhythm even if the patient was still alive is what i'm told. I dont know if anyone has ever tried it.[/b][/quote]
Fortunately the AED we use has a 'monitoring' mode, even when pads are connected, so we don't have a problem sticking it on people to get a strip and to be ready. As for ASA, we have a local protocol to give it to CP pts unless (and this is an exact quote) 'They are actually putting an aspirin in their mouth as you walk through the door or they can produce a letter from their MD saying they are allergic to it'.

 

[Jon]

thats nice...but what does a set of pads cost??? $20? $30? They are expensive.

Jon

 

[rescuemedic7306]

25 smackers I believe...but we get them discounted through the hospital, so it's not such a problem......

Oh, and it goes on their bill h34r:

 

[Strike3]

Football players celebrate everything! Seen the NFL lately? That was my point.

I was in no way saying that what he did was wrong...not at all. I just was frustrated hearing the "look at me" comments. I think that's my biggest pet peever about EMS. The paragod thing is such a downfall.

I apologize for the ASA comment. I was taught that all basics could do it, which is why there were questions on it for the NREMT test. I'm not burnt out by any means, if anything, I'm still fairly new. I just think that I see too much glory and not enough humility.


I applaude you for stepping foreward, and I wish I saw more of that from others.

 

[Chimpie]

Originally posted by Strike3@May 10 2005, 06:50 PM
I applaude you for stepping foreward, and I wish I saw more of that from others.

Just as long as you don't comment about it afterwards right?

 

[Jon]

Originally posted by Strike3@May 10 2005, 08:50 PM
I applaude you for stepping foreward, and I wish I saw more of that from others.

Amen.


I don't stop at EVERY accident, but if it either looks bad, I get flagged down, or I actually wittnessed it happen, I will at least stop and make sure everyone is ok, and call 911 with my cell phone if requested, but only after confirming injuries / no injuries.

And if football players celebrate everything, why can't we?

Jon

 

[rescuecpt]

Originally posted by Strike3@May 10 2005, 08:50 PM
The paragod thing is such a downfall.

I'm not burnt out by any means, if anything, I'm still fairly new. I just think that I see too much glory and not enough humility.

You sound burnt out, maybe you've had some bad experiences with paragods, but it's not fair to come on here and within your first 4 posts insult almost everyone here. I hope you will stay and contribute and boast about some of the good things you do. Any save is a good save and in my "real job" I don't make a huge impact on people's lives, only their wallets - what does it hurt for me to come here and share my happiness about the thing that I love doing and that I do purely for the good of others? Nothing.

 

[TTLWHKR]

Originally posted by MedicStudentJon@May 10 2005, 08:35 PM
thats nice...but what does a set of pads cost??? $20? $30? They are expensive.

Jon

Our peds pads cost 85 bucks a pop!

 

[rescuemedic7306]

yup, Ped pads are $100 dollaroonies...so we don't use them too often I can tell you!