Down the corridor Jason straddles the gurney, thumbs on her sternum.
If we can use digital cameras to capture pictures of crashed cars to show the trauma team, can we use video cameras to record our patients’ “seizures” for later rebroadcast — not on You Tube, but for the patient’s ED doctor and consulting neurologist?
We have reached the Essential Eight — eights drugs that I am not going on the road without.
Now Aspirin use has become so prominent that many of my patients have already taken Aspirin before I get there — either they took it themselves, were given it by a friend or coworker or a medical professional on the scene gave it to them. When I do bring them to the hospital, the first question I am asked is “Did they get Aspirin?”
The best bradycardia calls are for the patient passed out in the bathroom. You find them on the floor, cold and clammy, no pressure, pulse in the 20’s. We used to give a full amp of Atropine, now we give 0.5, and if that doesn’t work another 0.5 mg, etc. A couple times I have given the full 1 mg by mistake. Old dogs. Still the drug works well, the pulse picks up, the patient wakes up, the skin colors up and drys out and all is well in paramedic land. “You fixed them,” the doctor says to me in the ED. Music to my ears.
We don’t carry med pumps so the drip is pretty much of an eyeball, and then titrate to blood pressure. When the pressure bottoms, you bump it up. You get a pressure above 90, you ease it down.
My secret EMS pride has always been my IV skills. I like to think of myself as a Zen master of IVs. And so I know I am hexing myself when I write this — I know somewhere out there right now a diabetic with no veins is slipping into unconciousness, and I will be summoned to perform, and then empty catheter wrappers all around me, I will despair to the heavens that I have lost my IV karma and at last reach into my kit for the Glucagon.
Now as we move up the list toward what I call The Essential Eight, the choices are going to become harder.
“So, the Metoprolol finally worked,” I said to the nurse.
“No,” she said, “We gave him Cardizem.”
When Fentanyl arrives in my kit, it will likely be ranked quite high on my list and push Toradol down even further, possibly to the point where we will have no need to carry it.
I must confess that in my 21 years riding ambulances, 18 as a paramedic, I have never given Activated Charcoal to a patient.
“In summary, the use of vasopressin alone or in combination with epinephrine as the first line vasopressors during resuscitation from cardiac arrest offers no benefit related to short- and long-term survival compared to the use of epinephrine alone.”
It’s a great feeling to wake slowly and wonder where I am and slowly open my eyes and realize my surroundings. “Hey, I’m already at work. How great is this!”
A hundred yards ahead, we can see the officer standing by the snow-covered car, but then he turns and waves his arms to get our attention. “Stay there!” he shouts.
Somewhere Around Here I have to confess in my twenty-one years in EMS, I have only gotten the bed pan out less than a dozen times. I also admit there were occasions when the bed pan was not always in the first place in the ambulance I looked (this was at a time when I…
I did an interview with Greg Friese of Everyday EMS Tips as part of his EMS Author Chat series.
In emergency medicine, field and hospital come together when the EMT/paramedic hands over patient care to the nurse. This transfer is almost always professional and courteous. The good feelings demonstrated on the job between paramedic and nurse are not limited to working hours. After we punch out for the shift, we often meet in restaurants,…
Flu season is rapidly upon us. I woke up this morning with a slight case of the sniffles that as the day has gone on has proved to be (hopefully) somewhat of a false alarm. I am hoping to get through the week unaffected as next Saturday I hope to run* in my first half-marathon….
Tonight is the premiere of another new EMS oriented TV series — Trauma — which is on at 9:00 PM EST on NBC. At that hour I will likely be reading “Brown Bear, Brown Bear What do you See?” and “Good Night, Moon” to my twenty-month-old daughter in hopes that she will finally close her…
I’ve written recently above the new advances that have made our care and lives easier: Stretchers going from two man to one man to now power-operated. Airway adjuncts like bougies, LMAs, and of course capnography. Life Pack 5s to Life Pack 10s to LifePack 12 with 12-leads. EZ-IOs. I discovered another one just the other…