the 100% directionless thread

[DragonClaw]

Someone knocked over my BFs bike. It's all scratched it and paint peeled off from the gasoline spill and it hemorrhaged all the oil. We weren't sure where it was leaking from, but we put more oil in it and it continued to bleed.

This is the first time he's had the bike over since that dude was yelling at him about the noise.

https://imgur.com/a/Wkw8DPq

 

[ffemt8978]

I just found out my new job will be mostly remote work for the foreseeable future. I was given a complete home office. Just gets better and better.

Definitely taking the under on the desk upgrades.

 

[Seirende]

I'll try the magnets and maybe the esketamine but after that I think I have only one option left. So here's hoping one of those options work

 

[Seirende]

Am I going crazy (can't be, I'm already there) or does an inebriated diabetic (poorly managed to the point of amputation) suicidally depressed patient who is vomiting and in and out of it call for a little more assessment than a BGL and "do you want to go to the hospital?"

Frickin hose monkeys IMO

 

[CCCSD]

Suicidal ideation and alcoholism are their issues, not the responsibility of society l

 

[DragonClaw]

Suicidal ideation and alcoholism are their issues, not the responsibility of society l

Don't you wear a uniform that means you volunteered otherwise?

Aren't you a cop or something?

 

[Seirende]

Suicidal ideation and alcoholism are their issues, not the responsibility of society l

Chronic issues are of course not in the realm of emergency services. When they turn into acute events, such as described above, then they should be given proper evaluation every time.

 

[Seirende]

I notice you left out the diabetes

 

[Seirende]

Could that be because you have prejudice against people struggling with mental illness and addiction, but reserve judgement for those struggling with less stigmatized conditions?

 

[NomadicMedic]

Am I going crazy (can't be, I'm already there) or does an inebriated diabetic (poorly managed to the point of amputation) suicidally depressed patient who is vomiting and in and out of it call for a little more assessment than a BGL and "do you want to go to the hospital?"

Frickin hose monkeys IMO

Sometimes the best question is "do you want to go to the hospital?" Being drunk and puking don't automatically mean that they need a hospital.
Not to say I don't agree that they're in need of more assessment, but... You're not practicing as an EMS provider any longer. You should probably step back and if you really have an issue, call the agency and make a complaint. QI will sort it out.

 

[Seirende]

Sometimes the best question is "do you want to go to the hospital?" Being drunk and puking don't automatically mean that they need a hospital.
Not to say I don't agree that they're in need of more assessment, but... You're not practicing as an EMS provider any longer. You should probably step back and if you really have an issue, call the agency and make a complaint. QI will sort it out.

I would have liked to have seen a set of vitals taken, at the least

 

[DragonClaw]

I would have liked to have seen a set of vitals taken, at the least

What if the pt denied?

 

[NomadicMedic]

I would have liked to have seen a set of vitals taken, at the least

Yeah, like I said, call the agency and speak to QI. I recently got a complaint about a crew that, upon review, turned out to be the impetus for a deeper audit of the crew's charts and basically ended a paramedic's employment.

 

[Seirende]

You should probably step back

Step back from what?

 

[Tigger]

Let us remember that the rules state that no medical advice is to be provided on this forum.

I am speaking for myself here only, but I don't think I can provide any sort of peer support in this environment. Maybe someone else can, but I cannot imagine being successful in such an endeavor.

What I do know is that you can reach out to the Code Green Campaign or the Uniformed Services Peer Council to get help from folks who are really talented at helping EMS providers in specific.

 

[Seirende]

You're not practicing as an EMS provider any longer. You should probably step back

Just to make sure I'm following, I should step back from... actually you had better just explain it to me, but be gentle.

 

[DragonClaw]

Just to make sure I'm following, I should step back from... actually you had better just explain it to me, but be gentle.

It's not your scene, I think he means.

 

[Seirende]

It's not your scene, I think he means.

Which would be true whether I were currently practicing or not

 

[Akulahawk]

Some posts were moved to the more appropriate forum. Carry on!!

 

[Akulahawk]

Am I going crazy (can't be, I'm already there) or does an inebriated diabetic (poorly managed to the point of amputation) suicidally depressed patient who is vomiting and in and out of it call for a little more assessment than a BGL and "do you want to go to the hospital?"

Frickin hose monkeys IMO

Those "hose monkeys" may have mucho experience dealing with that particular individual. Being drunk, being a poorly managed diabetic, being chronically suicidal usually isn't an emergency medical problem. A trip to the local ED isn't going to fix those chronic problems. Also being drunk, unless it is causing other more acute problems, doesn't really need to go to the ED. All the ED is going to do is "Metabolize to Freedom" and once they've sobered up enough, off they go. Where things get interesting is that if the person is altered, the "do you want to go" question isn't a question. Someone that's vomiting, in and out of consciousness, and has a high BGL might just be in DKA. However if the person is lucid / Alert and Oriented when awake, that gets to be really a tough spot.

That being said, I used to take care of a patient who was pretty much in DKA whenever he was NOT in the hospital. He'd go out and drink soft drinks, bump his BGL well above 700, would end up going in to DKA, pass out, and someone would usually see him as a person down and call 911. We'd fix him up and then we'd see him again within a few days. Eventually he passed out where nobody could see him... Significant investment of time, resources, social work attention, and so on didn't fix his problem and (unfortunately) he likely inadvertently ended the problem. I don't think he was suicidal, I just think he didn't care if he lived or died, and probably figured he'd live a long time because he always kept getting rescued.

All that being said, if you think the crew handled the situation you're referring to inappropriately, contact the QA/QI people and let them know of your concerns. It very well could be "unfounded" as the crew may have an articulable reason for what they did in the overall case or it may evolve into a much more significant investigation that results in serious discipline for those involved in that particular case.