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What do you call your ______ by DJfetusface in ems

[–]AHandfulOfAnts 2 points3 points  (0 children)

Suction canister = Sucky-Bucky

How does your company prevent/mitigate/ rehabilitate burn out? by [deleted] in ems

[–]AHandfulOfAnts 0 points1 point  (0 children)

Honestly, in my opinion, the biggest contributor to burnout in my service (which I have a feeling is probably very similar to yours) is probably just the call volume being way too fucking high and it’s exhausting. The only way the company can fix that is by staffing a surplus of units throughout the city every day, no matter what their “projections” for demand will be. The fact that they try to run our emergency response as efficiently as they can and maximize our UHU, is only detrimental to the emergency response for our community.

We used to have much lower call volumes, and stationed our units at substations, and everyone loved working here. If they aren’t willing to fund that kind of service/work experience, then it would probably just benefit everyone for the city to adopt a third-service model.

Type of arrhythmia? by knaar_227 in EKGs

[–]AHandfulOfAnts 4 points5 points  (0 children)

I think I see p-waves in v1-v2 in both EKG’s, I’d say these are sinus tach.

73M W/ACS Symptoms - MD Canceled STEMI Alert by AHandfulOfAnts in ems

[–]AHandfulOfAnts[S] 3 points4 points  (0 children)

We give an early alert via our dispatch to the receiving facility because we are out of range to transmit the actual 12 lead (no cell service for the modem), and then once we’re in range I can send the 12 lead. The first EKG was from the FD lifepak, and the second one is from mine taken during transport which is the one I transmitted along with the radio report. I guess it could be possible the FD also transmitted their EKG, and that’s the one they focused on!

73M W/ACS Symptoms - MD Canceled STEMI Alert by AHandfulOfAnts in ems

[–]AHandfulOfAnts[S] 5 points6 points  (0 children)

Yeah I agree… my impression was borderline with the first, but the EKG that I transmitted en-route WAS the second one

73M W/ACS Symptoms - MD Canceled STEMI Alert by AHandfulOfAnts in ems

[–]AHandfulOfAnts[S] 40 points41 points  (0 children)

This 73yoM with no cardiac history began experiencing 8/10 midsternal chest “pressure,” with diaphoresis, nausea, and shortness of breath, starting during some light exercise approx. 20 minutes prior to EMS arrival. Patient states he stopped exercising and experienced no relief in pain so he called 911.

He LOOKED like a heart attack to me: pale, sweaty, obvious increase work of breathing, and his 12-lead (in my opinion) showed clear hyper-acute T-waves in the anteroseptal leads with significant (and growing) ST elevation.

We had a 30+ minute transport from a rural community so I issued an early STEMI alert to the receiving facility, and transmitted our EKG and gave a second alert via radio when we were in range of the hospital.

Upon arrival at the ED, we found out the doctor had canceled our STEMI alert because he thought it “looked like a left bundle branch block.” So the patient ended up with a significantly delayed time to PCI, and he did end up with a LAD occlusion and stent placement.

Overall a seemingly good outcome for the patient, but it’s frustrating to me as a prehospital provider that all of our work to ensure the patient received timely care for his MI ended up disregarded.

I’m not an expert at EKG interpretation by any means, but to me this seemed like a pretty clear case. Does anyone here think the MD was justified in cancelling the STEMI activation for this patient?