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Code Jockey posted:I just wanted to say EMTs are amazing and I really appreciate what you do, I had to deal with EMTs a bit in my dad's final years as he required more and more care / had more falls, and they were always really loving cool people. Thankfully my dad never lost his marbles, and remained pretty calm and rational and friendly with the EMTs, so calls to my house weren't so bad, I don't think. He could get grumpy, but the responders usually got him into a better mood pretty quick. I think to stay in EMS you need at least a kind of minor sociopathy, the ability to temporarily shut down emotions and remove yourself from a situation and go through the algorithms. I can't speak for anybody but myself, but I've always found it pretty easy to compartmentalize situations; I can make myself cry on command by recalling some of my experiences if I really want to, but day-to-day my mind is clear as can be. Obviously that's not to say that some calls don't get through to you (child abuse cases are my weakness, which admittedly isn't great when you're working on the critical care team at the premier DC pediatric hospital  ), but in general if you last any amount of time you're able to kind of tune out the emotional aspect of calls. The first two or three times I was on cardiac arrest calls were very surreal; it felt like I was watching myself on TV or something.Sorry for rambling; I've been up for too long and am having trouble organizing thoughts. 
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May 3, 2016 11:45
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| # ? Apr 26, 2024 19:16 |
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I literally no longer view patients as human beings, but instead as a problem that requires fixing. It sounds terrible at first read, but the more you think about it, the better you understand the mentality behind it, and you realize that this line of thinking is almost a necessity in order to survive EMS. Coming up on 6 years as a medic soon... Who am I kidding? We all drink a gently caress-ton. THAT'S how we last in this field
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May 3, 2016 14:19
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EMT the perfect job for aspies.
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May 3, 2016 14:52
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tater_salad posted:EMT the perfect job for aspies. What happens when they're called to the scene of a train wreck, though?
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May 3, 2016 16:33
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Regalingualius posted:What happens when they're called to the scene of a train wreck, though? http://m.youtube.com/watch?v=mjuVVlSgYLc
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May 3, 2016 16:38
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Took a 27 year old woman out of a nursing home last night for advanced cellulitis. She was in the nursing home because she was too obese to ambulate, which caused a host of other ailments, but the one that stuck out was corneal abrasion. Apparently, she was so fat that it puffed her face up in a way that made her eyelids curl in, so her eyelashes scratched her corneas every time she blinked. Some transplant board had approved a corneal transplant, which blew my mind, since it's just going to happen again. system protocol posted:For this exact reason on most calls these days, I just leave the stretcher in the ambulance and bring in the stair chair. A lot of the time around here, houses on the corner of two streets will have two driveways, and one tends to have way easier access to wherever the patient is. tater_salad posted:EMT the perfect job for aspies. Can you imagine being stuck in a building/ambulance for 24 hours with someone who has a touch of the 'spergers?
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May 3, 2016 19:07
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Holy poo poo. I'm sitting here at my desk crying, beat red, and can't contain myself.
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May 3, 2016 19:08
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Ugly In The Morning posted:Took a 27 year old woman out of a nursing home last night for advanced cellulitis. She was in the nursing home because she was too obese to ambulate, which caused a host of other ailments, but the one that stuck out was corneal abrasion. How do you stay that fat in a nursing home? Once you can't walk you have to rely on an enabler to bring you food, and a nursing home doesn't provide 5000 calories a day.
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May 3, 2016 19:20
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I guess if her metabolism slowed down enough that even a normal diet outstripped her maintenance...?
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May 3, 2016 19:26
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It sounded like her grandmother was bringing her food. Congrats, grandma, you're killing your granddaughter!
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May 3, 2016 19:30
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What's her Youtube channel?
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May 4, 2016 23:05
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Frequent fliers are fun. One of our frequent fliers called 3 times this weekend. On Friday, I took him in. He said it was an "allergic reaction". Claimed he was red and itchy. Not red. Probably itchy. Almost certainly not an allergic reaction. Stated it had "been a while" since he bathed. The crew that took him in saturday (same complaint) saw him get discharged before they cleared the hospital. Sunday he called at 5:45 in the morning (right before crew change). Straight up said he was going to the hospital to get a bath. Yelled at a paramedic. I decided that if he called when I was working yesterday, I would look into renting a UHaul to forcibly move him out of district.
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May 10, 2016 21:06
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Ugly In The Morning posted:Frequent fliers are fun. As I'm walking up to the house, I see her brother is sitting on the ground next to the front step, visibly nauseous, with a pool of vomit in front of him and he's got one of those 75 oz gas station cups full of milk. I mutter "I don't even wanna know," to myself before walking inside. The sister was fine and FOR ONCE she actually didn't want to go to the hospital. I started back outside to tell my partner the good news when I overhear the cops talking to the brother. Cop 1: "Blah blah blah gasoline." Cop 2: "Blah blah blah siphon." Me: "You gotta be loving kidding me." Come to find out the brother had bought a new fuel pump for this lovely van they had, and he had to empty out the fuel tank to install it (may have been something else, I know jack poo poo about cars). So he decided to do it the old fashioned way, and siphon it out with a garden hose. He accidentally swallowed a mouthful of gasoline, so now he's throwing up. There were a few other family members at the house and apparently one of them told him that drinking milk would neutralize the gasoline or something. We get him to the hospital and the doc is pissed that he's come into the ER in for the umpteenth time that month. I specifically recall me telling him our boy swallowed a mouthful of gasoline, and doc saying "So WHAT?" He turned out fine; the nurse told me that poison control said that amount shouldn't be fatal, that he'd be nauseous and burping for the rest of the night, and that he should drink plenty of water or juice, but absolutely not milk.
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May 10, 2016 22:06
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Doppelganger posted:section 8 house, Man, Section 8 housing is the worst for the most irritating frequent fliers. My service's building is smack dab between the section 8 block and a giant nursing home, so at least we don't usually have to drive far. In that housing block, there's -the guy I mentioned who calls for everything. He has frequent anxiety attacks from trading his klonopin for cigarettes. His girlfriend (who looks like Marty Feldman in a wheelchair) will tell him he absolutely has to go to the ER for everything, so even just RMAing him for a skinned knee is drat near impossible. -A woman who calls 911 for absolutely anything she thinks is wrong with her kid, then gets agitated when we can't write prescriptions. We're there every week, you'd think she'd learn by now how EMS works. -A diabetic who drinks three quarts of full-sugar coke a DAY and somehow ends up having all kinds of issues. Also tries to use us as a taxi to get to the city with the hospital in it. Among many, many more.
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May 10, 2016 22:16
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Ugly In The Morning posted:Man, Section 8 housing is the worst for the most irritating frequent fliers. -The family I just mentioned, though most of them are now dead. -Woman with a GI problem I can't remember the name of. She would sell her pain meds and then scream bloody murder all the way to the hospital. Although sometimes she chilled out once we got her in the back of the truck, but start back up as soon as we rolled her into the ER. -Old drug addict who was also addicted to Coke. No, not coke, Coke. Literally every time I've picked him up, he was carrying a plastic bag full of Coca Cola cans. He went to the local ER so much that one time they no-poo poo offered to write him a prescription for Vicodin if he promised not to come back for a month. He was back the very next night.
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May 10, 2016 23:06
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I knew exactly what this would be before clicking the link. Gets me everytime. peanut posted:What's her Youtube channel? https://www.youtube.com/watch?v=user?junklovers?featured Going back to the bit where people were talking about DNR's and advance directives and so on, I had to deal with this about a year ago with my grandfather. Basically he lived a lovely life, ate terribly, and had numerous health problems. 1. Heart attack aged mid 50's 2. Heart attack in early-mid 60's 3. Heart attack in early 70's 4. Stroke, mid 60's 5. Aneurysm on aorta, 30cm long early 70's Basically he had all sorts of health problems and complications from this, and was on some heavy medication that all but killed his appetite. He would maybe eat 100g of food a day. He was at a point probably just after Christmas 2014 where he started to rapidly decline, basically one day he stood up, said he didn't feel too well, and got about halfway to the bathroom before projectile vomiting and making GBS threads himself. Turns out he was essentially in renal failure due to his body receiving literally no nutrition for months, one kidney had shut down completely and the second was running at 6% capacity. Had him hospitalised, he was in for about 5 weeks and they managed to get him back to 16% function on the one kidney. However, the doctor said it wasn't worthwhile having him on dialysis. Why? Basically everything else had started to shut down or fail. We put him into a high-care home for a while, he decided one day he didn't like his catheter? (piss tube one) and pulled it out completely. Low and behold, he got infected and ended up back in hospital. This lead to him going through numerous micro-strokes, and rapid-advanced senility. I remember seeing him mid-February, and he was a shadow of the man I remember - all skin and bones, hair had all but fallen out (he had a fair head of hair even through his 70's), he was cold despite being in a heated room with 4 hospital blankets on, even nurses touching him hurt, giving IV medication via the inlet thing on the IV was painful. We saw the critical care doctor on the Friday who basically just said his body has all but shut down, he didn't recognise anyone but myself and my sister (don't know how considering his children and wife were there as well), and that if he was alive on the Monday he would be incredibly surprised. Funnily enough, it was a secondary aortic aneurysm that killed him. Obviously something had caused it to rupture again, as he died of massive internal bleeding. Moral of the story, if you tell the medical staff to keep them alive despite all of that, gently caress you and your family because you're cruel. If assisted suicide was legal in Australia we would have put him out of his misery long before he died. Slight derail but I guess I'm just trying to make my point that you shouldn't hold on for anything. If they're dying, let them fuckin die.
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May 14, 2016 07:34
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*Tones Drop* Dispatch: Rescue 3, respond, possible injury, [address]. Us: Message received show us en route. Dispatch: Rescue 3, be advised, you're responding to a conscious and alert 18 year old male, chief complaint - patient states he has a condom stuck on his penis and he feels like it's cutting off circulation. Us: 
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May 15, 2016 10:47
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The Scientist posted:
Hospitals can definitely do this. It's called terminal/palliative sedation. It's more difficult to maintain outside of a hospital setting. I have it written into my advance directive because even though its use is becoming more common, it's often not used until after people have suffered unnecessarily for a considerable period of time, and gently caress that. A friend of mine had a non-survivable heart attack a few years ago and was given palliative sedation in the emergency room - there was no point in transferring him to the ICU. It's also common for people in induced comas to be kept chemically unconscious until death after it becomes apparent that recovery isn't possible (and sometimes even when some recovery is possible but treatment would condemn the patient to a life of suffering). So yes it's possible, and yes it's done, but if it's something you emphatically want then make sure your wishes are recorded and make sure your family members are aware of them as it's a bit of a crap shoot whether a given doctor or a given hospital will even raise it as an option. Otherwise, be aware that different institutions define "comfort care" differently, and the extent to which comfort care relieves suffering can depend on the setting. Nursing homes here cannot give the same level of comfort care which hospitals can, which means people are left with the lovely choice of dying with some level of distress in familiar surroundings or leaving familiar surroundings and people to have their symptoms relieved. Likewise, some symptoms are difficult to impossible to manage in a home care setting. Unfortunately, end of life care often happens on the fly, with both patients and their families being outpaced by events because they believed there was "plenty of time" to think about those things. I'm watching it happen to a friend's mother at the moment. 3 months after diagnosis, she's reliant on a PEG tube, can no longer walk, is in intractable pain, and no end of life care arrangements have been discussed - she doesn't even have a DNR and I just want to punch people. Her carers are at the "she probably won't make Christmas" stage when the reality is that she probably won't see the middle of the year and the time which she does have left will be miserable because there are no plans in place to deal with what comes next. Lolie fucked around with this message at 12:04 on May 15, 2016 |
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May 15, 2016 11:30
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On Friday, I spent 45 minutes with my crew, the other crew, and a cop trying to get a 400 pound man-blob out of a bathtub following a strictly mechanical fall. His house smelled so bad I was leaning over him, trying to talk him through it, while trying not to throw up directly into his mouth. We ended up using some sheets as a sling, got his arms, and rolled him slowly out while the smallest guy was on "watch his head" duty. Patient went, walked to his bedroom with a walker, got dressed, and I was able to talk him into going to the hospital. He had a decently hardcore medical history, gave me his med list, and so on. Patient is alert and oriented, normal movement of extremities, only injuries are two small scrapes. He bumped his head on the way down, though, which is why I wanted him to go. Anyway, he waddles over to the stretcher, we get him on there, transport is initiated. I'm talking to him, trying to keep him calm, telling him that he should talk to the hospital social worker to see what resources are available for him with regards to getting him to the doctor and a life alert necklace, when all the sudden, we're about ten minutes from the hospital, I've given the facility my report (and asked for a lift assist at the door, natch) and... "Hey, I can't feel my foot". Oh. Well, this could be bad. I did a stroke scale, and he's got deficits all up and down his right side, and his speech, which was fine thirty seconds ago is slurring. I yell up to my medic, who's driving this one since it was just about as BLS as it can get, to step up to code three. I call county on the radio and tell them to update the hospital that we have a possible stroke and will be there in five. I'm trying to monitor the patient's BP but he's so drat fat and has so much edema from his CHF I have no idea if I'm even close. Got to the hospital, and the neurologist shows up to try to rule out stroke, since they have 4 other code strokes going on at once, and within two minutes they were wheeling him to the CT scan room. I'm not superstitious, but maybe there is something to that whole friday the 13th thing.
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May 15, 2016 17:20
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I'm superstitious because any time I do anything that requires 3 uninterrupted minutes to complete, that's when the tones come in.
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May 15, 2016 18:48
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That story reminds me that I have no idea how to tell if someone is having a stroke, other than making them raise their arms and smile. What do you look for?
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May 16, 2016 00:02
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Ischemic regions on CT or MR
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May 16, 2016 00:32
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Faerunner posted:That story reminds me that I have no idea how to tell if someone is having a stroke, other than making them raise their arms and smile. What do you look for? Really the only outgoing evidence of stroke are a drooping/unresponsive face, asymmetry(one side is different from the other), and slurring of speech. Everything else requires mechanical testing or patient responses, like the "I can't feel my foot" line.
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May 16, 2016 03:07
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Faerunner posted:That story reminds me that I have no idea how to tell if someone is having a stroke, other than making them raise their arms and smile. What do you look for? http://www.stroke.org/understand-stroke/recognizing-stroke/act-fast This is the best acronym to remember.
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May 16, 2016 03:25
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Faerunner posted:That story reminds me that I have no idea how to tell if someone is having a stroke, other than making them raise their arms and smile. What do you look for? Here's a quick run down that we teach lay people. Helps identify a stroke and get people to the hospital. F Face: look for a drooping mouth or eye. Almost always one side or the other. A Arm: have them hold one arm up, then the other. Then have them squeeze your hand with each side. This step/letter is really a reminder to be aware of one sided weakness. It can be in the arm, leg or both arm and leg. If the person has facial droop it should be on the same side as the weakness. S Speech: abnormal speech, forgetting words, slurred speech, unable to say the right word, repetitive speech, or lack of speech. T Time: make sure you are aware of the onset of symptoms. Time is absurdly vital. Time = brain. The faster you get to the hospital, the faster the patient can receive treatment, and ideally this leads to better outcomes. We use the acronym FAST Why time matters: Strokes are caused by a lack of oxygen to the brain. Typically they can be caused by a clot/blockage (ischemic strokes) or by a broken vessel/bleeding stroke (hemorrhagic stroke). For clotting strokes (called ischemic) we have medications and procedures that can fix the stroke and Restart blood/ oxygen flow. They are time depend. The first treatment is a clot busting medication. It must be given within 3-4.5 hours after the onset of symptoms. There are other procedures such as thrombectomy (basically a drain snake for a clogged brain vessel) and they are also time dependent. They can usually be done within 12 hours of onset of symptoms, but are more effective the earlier we administer them. For bleeding strokes (hemorrhagic) we also have many different therapies. However, the earlier they are implemented the better the patient does. Remember, the longer you are having the stroke, the longer your brain is not getting oxygen and the more damage that is being done. The F.A.S.T acronym does not include all stroke symptoms. It only captures the most common ones. ANY sudden change in a person's mental status or behavior should raise alarm. Any change in mental behavior, level of consciousness, new weaknesses, or confusion should out you on alert. The afflicted person should be evaluated by a medical professional. It may not be a stroke, but it could absolutely be one of billions of different neurological, metabolic, or medical issues.
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May 16, 2016 07:28
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Faerunner posted:That story reminds me that I have no idea how to tell if someone is having a stroke, other than making them raise their arms and smile. What do you look for? (Facial droop) Now gimme a big smile. No, show me those choppers, really grin. Good. (Arm drift) Close your eyes and hold your arms out in front of you. Now hold them both straight forward until I tell you to stop.... stop. (Slurred speech) Now repeat after me: "You can't teach an old dog new tricks." If they gently caress up any of these steps, it's not ideal. Doppelganger fucked around with this message at 04:00 on May 22, 2016 |
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May 22, 2016 03:58
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Thank you, everybody! I figure this information is good to know, but hopefully I won't have to use it.
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May 22, 2016 06:39
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Help I'm having a stroke. I cannot grip my cock as hard as I used to
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May 22, 2016 17:08
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Then it sounds more like you're not stroking.
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May 22, 2016 18:25
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Phrases you never want to hear in your update from county 911 en route to your psych call: "Covered in feces".
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May 22, 2016 21:04
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online friend posted:oh, i misread He shouldn't. He's really rather an idiot without Queen Etheria.
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May 22, 2016 21:45
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Taking the nremt next week any advice?
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May 23, 2016 10:37
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Grody posted:Taking the nremt next week any advice? Know your vocabulary, your vocabulary, annnnd uhhhh, your vocabulary. Seriously, know your loving vocabulary; that's like, 90% of the test The thing is, the questions tend to actually be pretty easy if you're up on your terminology and can decipher what they're actually asking you. Also, visit this thread and I'm sure there are more helpful tips in there where we all hang out and discuss our crippling alcoholism and how frustrated we are with our respective services.
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May 23, 2016 10:49
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25 year old Vietnamese male, complaining of a severe migraine, which he says he's had problems with since he was a teenager. This seems to be one of those Gran Torino kind of Asian households where the older folks are more traditional, but the younger people are more equally familiar with American culture. As we're assessing him, I notice a bruise on his forehead. Me: What's this mark from? Did you hit your head? Girlfriend: No, that's from the healer. Me: .......Go on. Girlfriend: We took him to a healer last night, here, look. She pulls out a cracked iphone and shows us a video of the patient at some kind of Vietnamese shaman/faith healer. In the video, the healer is saying something I can't understand before jabbing my guy hard in the forehead a few times with his fingers. Me: Ok, that explains the bruise. Well, I don't think that way worked for him, what do you say we head to the hospital? Sister: But he made a crippled person in a wheelchair walk! Me: Well that's just terrific! 
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Jun 3, 2016 06:56
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