the 100% directionless thread

[RocketMedic]

Oh, I fully understand that I am woefully undertrained and underequipped for proper RSI, but this patient needed to have his airway protected. 20mg etomidate + 5mg versed did a great job of sedating him. In hindsight, I should have pushed fentanyl as well. I did have (and use) an alternative airway plan I had prepared when I realized that it was not a realistic ET intubation case given my skill level, airway conditions and patient condition. The King LT was a perfect answer.

 

[Handsome Robb]

Shattered tibial plateau? That's gotta hurt...dude tried to AMA so I told him if he could walk he could. Took half a step and asked for pain meds and a ride

Earned himself a plate and some pins soon after we got to the hospital.

I hate being an *** like that but he needed to go.

 

[Epi-do]

Shattered tibial plateau? That's gotta hurt...dude tried to AMA so I told him if he could walk he could. Took half a step and asked for pain meds and a ride

Earned himself a plate and some pins soon after we got to the hospital.

I hate being an *** like that but he needed to go.

Sometimes you just have to play that game. Been there, done that, but with a family member instead of a patient at work.

It was my husband's grandmother. She had a UTI, couldn't even get herself out of her chair to eat or use the bathroom, was well on her way to becoming septic, and fought me tooth and nail about going to the hospital.

The deal was, if she could get up and get from the bathroom to her chair (and I even allowed the bargain to include her getting assistance from my mother-in-law), she could stay home. If it couldn't be done without me stepping in to add additional assistance, she had to go. Several days later, she was discharged from the hospital, and had finally forgiven me for making her go.

 

[Jambi]

Oh, I fully understand that I am woefully undertrained and underequipped for proper RSI, but this patient needed to have his airway protected. 20mg etomidate + 5mg versed did a great job of sedating him. In hindsight, I should have pushed fentanyl as well. I did have (and use) an alternative airway plan I had prepared when I realized that it was not a realistic ET intubation case given my skill level, airway conditions and patient condition. The King LT was a perfect answer.

Sorry man, nothing I posted was in regards to you. I just found the links very informational. I also understand how our hands are tied by medical direction etc and protocol. I don't RSI in my area, and I couldn't do dosing without having to look up the sedation and paralytic meds, so I like to expose myself to the stuff.

 

[Jambi]

Shattered tibial plateau? That's gotta hurt...dude tried to AMA so I told him if he could walk he could. Took half a step and asked for pain meds and a ride

Earned himself a plate and some pins soon after we got to the hospital.

I hate being an *** like that but he needed to go.

Done the same thing. It works. :beerchug:

 

[VFlutter]

"Treat the patient not the monitor" Fail....

Had a patient come from recovery room totally awake and alert with no complaints. Hooked him up to the monitor and his spo2 was reading 78%. At first I thought it was a bad reading but it had a perfect pleth wave. So I bump up his oxygen incrementally until I max out his NC at 6lpm with an Sp02 of 84%. The patient is in no distress, not SOB, other vitals WNL, some faint crackles at the bases but otherwise bilateral clear lung sounds. The MD comes to explain the results of the procedure and says the patient looks great. I ask for an ABG but he tells me to hold off and give some IV lasix and see what happens. Give lasix and Sats continue to drop so I finally get an order for an ABG and chest X ray. Comes back with a p02 of 40 and severe pulmonary Edema. 120mg IV Lasix and a few hours of Bipap resolve the issue. I am glad I didn't brush off the readings just because the patient was asymptomatic. I am guessing he would have quickly went into respiratory failure.

 

[Handsome Robb]

"Treat the patient not the monitor" Fail....

Had a patient come from recovery room totally awake and alert with no complaints. Hooked him up to the monitor and his spo2 was reading 78%. At first I thought it was a bad reading but it had a perfect pleth wave. So I bump up his oxygen incrementally until I max out his NC at 6lpm with an Sp02 of 84%. The patient is in no distress, not SOB, other vitals WNL, some faint crackles at the bases but otherwise bilateral clear lung sounds. The MD comes to explain the results of the procedure and says the patient looks great. I ask for an ABG but he tells me to hold off and give some IV lasix and see what happens. Give lasix and Sats continue to drop so I finally get an order for an ABG and chest X ray. Comes back with a p02 of 40 and severe pulmonary Edema. 120mg IV Lasix and a few hours of Bipap resolve the issue. I am glad I didn't brush off the readings just because the patient was asymptomatic. I am guessing he would have quickly went into respiratory failure.

****calling all EMT and medic students to read this and think twice when someone says "treat the patient, not the monitor****

It's an acoustic type of day...10 Years and Aaron Lewis killin' it in Medic 06!

 

[STXmedic]

It's an acoustic type of day...10 Years and Aaron Lewis killin' it in Medic 06!

You, good sir, need to join me on the box.

 

[Handsome Robb]

Sometimes you just have to play that game. Been there, done that, but with a family member instead of a patient at work.

It was my husband's grandmother. She had a UTI, couldn't even get herself out of her chair to eat or use the bathroom, was well on her way to becoming septic, and fought me tooth and nail about going to the hospital.

The deal was, if she could get up and get from the bathroom to her chair (and I even allowed the bargain to include her getting assistance from my mother-in-law), she could stay home. If it couldn't be done without me stepping in to add additional assistance, she had to go. Several days later, she was discharged from the hospital, and had finally forgiven me for making her go.

It was one of those injuries you looked at and at first thought "it's not that bad" then from a different angle it was a "I'm not sure what's wrong but it definitely isn't anatomically correct" type of injuries. Had an epic full thickness lac that was distracting some people from the seriousness of it, myself included in the beginning until I walked around him to talk to his wife and caught it at a better angle.

 

[Jim37F]

I guess the important take away is to pay attention to BOTH your patient and monitoring equipment

In other news, I got word from my USAR unit. Without going into detail, I am no longer planning on going on a little plane trip and the next several months of my calendar are cleared back to normal lol

So....I'm going to pounce on that part time EMT "Ambulance Operator" job at one of the local FDs (better pay than the private companies with 911 contracts, no more IFTs lol only downside is that it's part time not full, but that does also mean I don't have to quit my CCT shift!)

 

[DesertMedic66]

Good thing I decided to look at my schedule. Management decided to put me on a shift tomorrow and forgot to give me a call and let me know about it.

 

[rmabrey]

It's an acoustic type of day...10 Years and Aaron Lewis killin' it in Medic 06!

I drank beer with him several years ago, meaning I drank his beer since he doesnt drink anymore. He's super cool. Offered me tickets and a back stage pass for the show but I had to work.

 

[Handsome Robb]

I guess the important take away is to pay attention to BOTH your patient and monitoring equipment

Clinical. Correlation.

Credit to usalsfyre for teaching me about it.

I drank beer with him several years ago, meaning I drank his beer since he doesnt drink anymore. He's super cool. Offered me tickets and a back stage pass for the show but I had to work. View attachment 1575

They put on a helluva show that's a bummer you couldn't go!

I've heard he's a super nice guy too.

So this is a little younger but sounds like I may, possibly, just maybe, if I get really lucky be kickin' it with Rusko backstage and then at the after party at the end of September. It pays to have friends in the production business.

Sometimes I think I picked the wrong career when I hear about what my buddy actually does...

 

[rmabrey]

Id already seen them 3 times. He did come back recently to do an acoustic set as promised. Missed that one cause of buying a house and a baby on the way.

 

[DesertMedic66]

This is one of the coolest pictures I have seen in a long time:

 

[JPINFV]

This is one of the coolest pictures I have seen in a long time:
[picture]

Wait... a fire engine in an emergency zone that's parked, but the engineer managed to find the switch to turn off the disco lights?

 

[DesertMedic66]

Wait... a fire engine in an emergency zone that's parked, but the engineer managed to find the switch to turn off the disco lights?

Probably a new engineer

 

[CodeBru1984]

This is one of the coolest pictures I have seen in a long time:

We seriously need a "like" button for this picture!

 

[Handsome Robb]

Id already seen them 3 times. He did come back recently to do an acoustic set as promised. Missed that one cause of buying a house and a baby on the way.

Nice! An acoustic set would be awesome. I've seen Aaron Lewis do two acoustic sets, up there on the list of the best shows I've seen.

Desert that's an awesome picture.

 

[CALEMT]

This is one of the coolest pictures I have seen in a long time:

Which fire was that?