the 100% directionless thread

[fast65]

Only if you want to be a one and done guy.

Could you actually see me as that kind of guy?

 

[Handsome Robb]

Could you actually see me as that kind of guy?

Ever heard the term "setting yourself up for failure"? h34r:


I had a call today that totally stumped me. Most of my calls in my internship thus far have been very cut and dry, this one I got to the point of making the ALS vs. ILS/BLS decision and decided ALS after a bit of prompting from my preceptor. Pulled the trigger on monitor and 12-lead and found nothing, and the guy denied the IV and pain and nausea management. Could he have been ILS? Absolutely but I don't think I would have been comfortable dropping that on my Intermediate. Straight from my preceptor: "If you have no idea what's going on he probably has even less of an idea, play it safe and take the call." My new excuse is "I have no idea what the hell is going on so I'm going to just rule out everything I possibly can."

 

[DrankTheKoolaid]

I've drilled a few live people. Only time they complained (read: yell at the top of their lungs) is when I flushed it.

And for the to lido work, it has to be pushed before the flush, and sit in the trebecular space for a bit. In most cases, only a patient in extremis is going to get drilled and I don't have time to mess about with lido at that point.

Obviously a patient in extremis wont need it. But her case is exactly why lido is in most protocols. Went from extremis to compensated and now has to endure the pain of it. When a simple 0.5mg/kg left to sit for 30 seconds and it would be a non issue.

 

[fast65]

Ever heard the term "setting yourself up for failure"? h34r:

It's tends to be a constant action of mine bud.

 

[abckidsmom]

Obviously a patient in extremis wont need it. But her case is exactly why lido is in most protocols. Went from extremis to compensated and now has to endure the pain of it. When a simple 0.5mg/kg left to sit for 30 seconds and it would be a non issue.

Can you use or dilute lido in bristoject for this purpose?

 

[Anjel]

Today I worked from 0900 to 2100.

Tomorrow through Tuesday I work

0900 to 0700. Then school 0900 to 1600, then a clinical from 1630 to 2200.

I always called my friends, who did this crap, nuts.

 

[DrankTheKoolaid]

Can you use or dilute lido in bristoject for this purpose?

Yeah use just regular old code lidocaine. This makes it very easy and an insanely cheap treatment and 100mg of lido is like $2

 

[BandageBrigade]

(abckidsmom) Please dont take any of the following comments as criticism. I'm still 'new' as a paramedic (by my standards at least), so just curious of a few things. You pushed D-50 through the IO? Im assuming at this point she was not conscious? Was there a need to push further meds after she became coherent? I have not had a patient complain about an IO unless I am infusing/pushing something. If not then what was the pain from? If there was still in need to increase cbg then why not give oral glucose? BTW - I'm had a patient still complain of quite a bit of pain after having lido sit for a minute, I'm not convinced it makes much of a matter.

 

[adamjh3]

Today I worked from 0900 to 2100.

Tomorrow through Tuesday I work

0900 to 0700. Then school 0900 to 1600, then a clinical from 1630 to 2200.

I always called my friends, who did this crap, nuts.

Ugh, tell me about it. 1/4 way through a 48 right now, get off 0700 tuesday, go to school from 0830 to 1830, back to work from 0700-0700, school again at the same time thursday, then I'm driving a couple counties north Friday night to work a two day soccer tourney over the weekend.

Why do we do this to ourselves?

 

[abckidsmom]

(abckidsmom) Please dont take any of the following comments as criticism. I'm still 'new' as a paramedic (by my standards at least), so just curious of a few things. You pushed D-50 through the IO? Im assuming at this point she was not conscious? Was there a need to push further meds after she became coherent? I have not had a patient complain about an IO unless I am infusing/pushing something. If not then what was the pain from? If there was still in need to increase cbg then why not give oral glucose? BTW - I'm had a patient still complain of quite a bit of pain after having lido sit for a minute, I'm not convinced it makes much of a matter.

No worries, I wanted to think this through thoroughly because I was not happy with the choices in the situation.

She was really sick, 2 recent CVAs, unknown downtime since she was alone with a child. Very cold, we couldn't get the temp to register, breathing 4-6/min.

We attempted 2 IVs but her veins were super fragile and after watching the first one blow with a gentle flush I don't think I would have trusted any of them to D50.

In my experience, people with hypoglycemia and extended down times are slow to wake up even after the CBG is normal. Those neurons are looking around at each other trying to figure out who's still kicking and not really doing a whole lot of work.

She never woke up enough that I would have given oral glucose, mostly she got up to a GCS of 13-14, mumbling a lot about her leg and reaching out a little but not making a lot of sense.

I was hesitant, and might have waited till we got to the hospital, but I am comfortable with the decision. I tend to be pretty conservative overall, so the drill in my hand surprised me.

 

[Handsome Robb]

My partner talked me into trying this new Sleep Cycle app for my phone. I guess it uses the accelerometer to judge your sleep cycle and "gently wakes you up at the lightest point of your cycle starting 30 minutes prior to your set alarm time" or something of the sort.

He thinks it will hopefully help me be more awake in the morning rather than the zombie I am before I get a cup of coffee or an energy drink...we will see but hey, I'm open to anything.

I feel like I should set a backup alarm for the first few weeks. I don't think my supervisor would accept an experimental app as an excuse for why I'm late. :lol:

 

[fast65]

My partner talked me into trying this new Sleep Cycle app for my phone. I guess it uses the accelerometer to judge your sleep cycle and "gently wakes you up at the lightest point of your cycle starting 30 minutes prior to your set alarm time" or something of the sort.

He thinks it will hopefully help me be more awake in the morning rather than the zombie I am before I get a cup of coffee or an energy drink...we will see but hey, I'm open to anything.

I feel like I should set a backup alarm for the first few weeks. I don't think my supervisor would accept an experimental app as an excuse for why I'm late. :lol:

What's the name of the app?

 

[DesertMedic66]

Got sand in my eye and borrowed a preloaded syringe of saline (sharpless) from the hospital to rinse it out. Of course I had to do the mature thing and tell the nurses I was going to be shooting up some heroin and wanted to clean my injection kit. The looks on their faces were priceless.

 

[Handsome Robb]

What's the name of the app?

It's called "Sleep Cycle". It's the first thing that pops up in the app store. It was 99 cents I think. Not free but I'll try it for a dollar, especially if it helps my mornings out, I am not a morning person.

My partner swears by it. We will see how it works, I was reading about it and it seems like the logic behind it makes sense but I also don't know a whole lot about sleep cycles outside of the basics.

 

[fast65]

It's called "Sleep Cycle". It's the first thing that pops up in the app store. It was 99 cents I think. Not free but I'll try it for a dollar, especially if it helps my mornings out, I am not a morning person.

My partner swears by it. We will see how it works, I was reading about it and it seems like the logic behind it makes sense but I also don't know a whole lot about sleep cycles outside of the basics.

I think I'll try it, thank you sir.

Ugh...last night my partner kept waking me up because I didn't hear the dispatcher moving us up for coverage, apparently I would wake up when another unit got a call and turn down my radio, I really don't like that.

 

[abckidsmom]

It's called "Sleep Cycle". It's the first thing that pops up in the app store. It was 99 cents I think. Not free but I'll try it for a dollar, especially if it helps my mornings out, I am not a morning person.

My partner swears by it. We will see how it works, I was reading about it and it seems like the logic behind it makes sense but I also don't know a whole lot about sleep cycles outside of the basics.

How does it know how you're sleeping?

 

[Handsome Robb]

I think I'll try it, thank you sir.

Ugh...last night my partner kept waking me up because I didn't hear the dispatcher moving us up for coverage, apparently I would wake up when another unit got a call and turn down my radio, I really don't like that.

They don't have selective toning for the stations when you are in quarters? I understand backfilling stations but why drop tones on every station for one unit? We even get to sleep in peace in our hard posts and only hear traffic when they drop tones on our specific hard post.

 

[abckidsmom]

I think I'll try it, thank you sir.

Ugh...last night my partner kept waking me up because I didn't hear the dispatcher moving us up for coverage, apparently I would wake up when another unit got a call and turn down my radio, I really don't like that.

Tones went off one night and I turned the radio off. My partner slept through his radio too. It was not fun waking up to the other medics' air horns on the apron. They were les than pleased.

 

[Handsome Robb]

How does it know how you're sleeping?

So apparently you turn the app on (it can't run in the background), place it face down on the corner of your bed by your head and it uses the accelerometer in the iPhone to judge your sleep cycle by your movements. I don't know if that makes any sense haha.

It actually generates a graph and starts statistics and averages of your sleep cycle, time sleeping and all that jazz as you use it.

This is all from reviews and my partner, I'll keep you updated how it works. It seems like it might not work with two different people in the bed.

 

[fast65]

They don't have selective toning for the stations when you are in quarters? I understand backfilling stations but why drop tones on every station for one unit? We even get to sleep in peace in our hard posts and only hear traffic when they drop tones on our specific hard post.

Well, I am paranoid about turning my radio to "tones only" for my unit, so I keep it on our company channel and I hear all the traffic on my end of the county. So, sometimes I hear the other units get a call and sometimes I don't; it depends on the dispatcher, but some send tones for a move up and some don't. They're supposed to, and quite honestly, it drives me crazy when they don't send tones for a move up in the middle of the night.

Ugh, I can imagine that wasn't a great experience abckidsmom :/