Sunday, March 28, 2010

I think my IQ just dropped a few points...

Look, I am all for making mistakes. It's how we learn best. I am all for asking questions so you DON'T make mistakes. But seriously people...use your brain. It's that organ located in the lump 3 feet above your ass. If you occasionally engage that organ, you can save yourself from a lot of mistakes, and make yourself look less like a fool, and more like someone I'd want treating my family.

For my hospital time clinical, I go to a large, well-known university hospital. They also have a peds ER upstairs from the adult ER, but the critical care rooms (trauma rooms) are down in the adult ER. So whenever there is a consult for the peds ER, the adult ER listens in, just in case they end up coming to the adult ER.

As an aside, any paramedic student doing time in a hospital should listen in when a medic unit does a consult. Not only does it let you know if there are any traumas or serious medical cases coming in that you could look in on, but it also shows you the difference between a good consult and a bad one.

Any way, yesterday I heard the box go off, and listened in with the charge nurse. It was a consult for peds, but we listened in. The information was as follows:
12 year old male picked up from school with chest pains and trouble breathing. Unknown medical history per patient and school nurse. All vitals unremarkable (BP something like 120/80, P 80 something, R 18, O2 sat 100% ra). EKG shows NSR, IV with lock.

All sounds ok right? Then the medic consulting dropped the bomb. "Given that the patient is past the age of puberty, we would like to know if we should give NTG and ASA."

WTF?????? Are you serious? With vitals like that, and a kid who's 12, you want to give NTG and ASA? First of all, per MD protocols, a child is considered pediatric until age 15. Secondly, per MD protocols, NTG is no indicated in children. Thirdly, haven't you ever heard of Reye's Syndrome? You know, what possibly happens in children who are given aspirin? (Granted, I don't know the time frame and dosages required to give a child Reye's Syndrome, but still).

But the biggest problem here is this. Regardless of the age and so on, look at the vital signs. There is ZERO sign of any kind of heart problem, and, absent any concrete history, I'd be hesitant to give ANYTHING.

So yeah, I think my IQ dropped a few points listening to that consult.

At any rate, the rest of the clinical on Friday went well. The clinical Sunday went well too. Not as many skill check-offs as I would like, but several good medical patients that were serious head-scratchers and a good experience to sit in on.

Wednesday, March 10, 2010

You CANNOT be serious...

Heard on the county radio tonight at the station: Haz Mat call for the 'smell of chemicals outside' someone's house. Chief gets on scene, sets up command. Engines are on scene, detect chemical. "Yeah, we can smell it, it's a slight smell of skunk."

Command cancels all incoming units, EMS units call in asking if they are canceled too.

Command: "No, keep EMS coming. The woman is on the balcony, complaining of respiratory distress from the smell."

Seriously? You smelled 'chemicals', and called 911. I can actually understand that, having been around a skunk when it initially let go, and it does smell like chemicals at first. But, the skunk is outside. YOU are outside. You are having respiratory distress. From a skunk? How's about you just GO INSIDE?????

Sometimes you just can't make this stuff up, you know?

Monday, March 8, 2010

4 more days

Till spring break. I have managed to get almost all of the projects due this week done; just the take home test and group presentation to finish. Spring break will be spent most likely trying to get ahead of the work load for the last half of the semester. And trying to find a job.

EMS Today was interesting, though it was hard for me to really get into a lot of things when I was there mainly with my fellow students. They all mainly wanted to get the stuff for the assignment done and then get the hell out. I would have liked to stay longer, check out some of the things I missed the first time around (due to long lines at the booths) and see the Chronicles of EMS at the Zoll booth. Maybe next year.

I did end up staying in B-more longer than I planned, since the plans for getting the group project done fell through. Classmate N and I walked down to Inner Harbor and hung out watching the last cannon shot on the Connie. Then we went up to Uno's for another drink and a snack. A friend drove up from home to pick me up, got lost several times, and we finally got home and dinner around 2030. Long day.

I looked for the bloggers I read, TOTWTYTR, AD, and Epi, but never actually recognized anyone. Perhaps next year I'll actually meet people.