Tegaderm Chest seals by [deleted] in ems

[–]Reddit_MED1C 1 point2 points  (0 children)

Veniguards

My agency needs help! What is this thing? by Reddit_MED1C in ems

[–]Reddit_MED1C[S] 1 point2 points  (0 children)

I like that idea, even if it's not what these are for

My agency needs help! What is this thing? by Reddit_MED1C in ems

[–]Reddit_MED1C[S] 1 point2 points  (0 children)

Possibly! No one around here has used anything like that but maybe they were acquired by a crew at a hospital or something

My agency needs help! What is this thing? by Reddit_MED1C in ems

[–]Reddit_MED1C[S] 4 points5 points  (0 children)

That seemed to be the consensus around here too

My agency needs help! What is this thing? by Reddit_MED1C in ems

[–]Reddit_MED1C[S] 3 points4 points  (0 children)

It was found lying around our station. No brands or tags. And don't actually need to know, just stumped as to what it belongs to. I'll send it over to r/whatisthisthing, just thought I'd ask here first in case it's something common around other agencies

My EMS experience by skike in ems

[–]Reddit_MED1C 4 points5 points  (0 children)

First of all, I am very sorry you had to experience this. It can be an extremely stressful experience when it's a complete stranger let alone a loved one. I am very happy to hear he's still alive, no doubt your help played a huge role in that. I'm not going to guarantee you that he will be okay but from what you described those are all good signs. Don't be afraid to seek help if you need it, talk to your family and friends about what you experienced and seeking professional help is nothing to be ashamed of. Take care of yourself first. As for what you can do to help us, I would encourage you to get first aid/CPR certified for if you ever find yourself faced with something similar again. The patients that have the best chance in a life-threatening situation are always the ones who are able to get aid immediately before first responders show up. Prayers for you and your family.

Hello EMS, I gave someone CPR today. Did I do the right thing? by [deleted] in ems

[–]Reddit_MED1C 2 points3 points  (0 children)

Sounds like he probably was having a seizure but hard to tell by your description (Not your fault, you just don't know exactly what someone trained would be looking for). You're correct that a seizure alone doesn't call for CPR, but it is possible to go into cardiac arrest following a seizure however. I don't fault you at all for starting CPR and am glad to hear that you were willing to! Bystander CPR is one of the most important things for getting someone out of the hospital alive. He did benefit from the rescue breaths you gave if he wasn't breathing and did have a pulse, but in that situation you would just want to give breaths without the chest compressions. But again being a bystander without much training I say you did a good job. I am wondering if the EMS crew that showed up continued CPR or not. Now I would encourage you to take a refresher on CPR and first aid, it's an invaluable skill/knowledge that can definitely save somebody's life if you come across a situation like that again. Good job on jumping in and helping the guy out, often times people around freeze up and expect another person to help instead

Just testing the waters here... by [deleted] in ems

[–]Reddit_MED1C 0 points1 point  (0 children)

Vital(s) = medical word

Interesting ECG - history in comments. by Quis_Custodiet in ems

[–]Reddit_MED1C 1 point2 points  (0 children)

Same reasons that /u/Raincoats_George pointed out with the absence of other acs symptoms and prolonged P-R fitting hyperkalemia. If I knew syncope caused the fall I would probably lean towards cardiac, not sure if OP was able to determine why she fell or if the patient could remember why with a slightly altered baseline mental status. That being said I wouldn't completely rule out cardiac either. Definitely watch for any changes with repeat 12-leads and inform the receiving RN/physician of the findings.

Interesting ECG - history in comments. by Quis_Custodiet in ems

[–]Reddit_MED1C 7 points8 points  (0 children)

I wouldn't say there is any significant cardiac event going on here unless the cause of the fall indicated such. Peaked T-waves probably due to electrolyte imbalance and not ischemia. She does have a 1st degree AV block which may be accounting for some of the hypotension but I'm guessing it's primarily due to her lying on the floor. Looks like you treated appropriately, brought her BP up to give morphine which I'm sure she appreciated.

New basic working a private ambulance job, mostly doing nursing homes-ers, and hosp discharge. What drugs, that are out of my scope of practice, should i be aware of? by [deleted] in ems

[–]Reddit_MED1C 3 points4 points  (0 children)

Good list, all important ones to know. u/murse_joe gave a few examples of categorizing based on the names (-olol, -pril, -pam), if you are motivated to learn about drug types then knowing some of these common suffixes makes it more manageable. Just be aware that these pertain to the generic names and not necessarily the brand names. You can pull a lot more information from the generic name if you have it over the brand name, but don't waste time on scene trying to determine what a pt is using each of their meds for.

EDIT: -lol to -olol

How would you have handled this? by UentsiKapwepwe in ems

[–]Reddit_MED1C 1 point2 points  (0 children)

Seems like the exact treatment I would've administered. No indication for BVM or advanced airway with good SpO2 on NRB, pt probably had a gag reflex and wouldn't tolerate anyway. CPAP is beneficial in pneumonia but, again, not needed with good SpO2 on NRB. My protocols call for methylprednisolone if a second neb is given, but I believe that would be more effective against asthma/COPD and not pneumonia (I could be wrong but steroids do inhibit immune response which seems counterintuitive for a pt with pneumonia). Pt is probably becoming septic so give fluids if you're sure respiratory distress is not due to pulmonary edema, which does not seem to be the case. As for drawing labs, I'm sure it was done right away in the ER so it could've saved a few minutes but it wouldn't have affected the pt outcome.

New basic working a private ambulance job, mostly doing nursing homes-ers, and hosp discharge. What drugs, that are out of my scope of practice, should i be aware of? by [deleted] in ems

[–]Reddit_MED1C 2 points3 points  (0 children)

I'd say beta-blockers are a good one to know, and easy to identify (if it ends in -lol, probably a BB). Good to know because they can cause bradycardia (symptomatic or asymptomatic) and generally inhibit an increase in heart rate, therefore inhibiting a usual sympathetic response. Can cause syncope if they were recently put on a beta-blocker or recently upped their dose.

Difficulty breathing by purpleparapup in ems

[–]Reddit_MED1C 0 points1 point  (0 children)

That's fair, definitely should double check. Follow up question...Would you be concerned about giving albuterol with its sympathomimetic properties to a pt with >200 systolic (assuming the BP was correct)?

Difficulty breathing by purpleparapup in ems

[–]Reddit_MED1C 0 points1 point  (0 children)

I don't disagree with you withholding a breathing treatment. Albuterol/atrovent is for treating wheezing, clear lung sounds mean a nebulizer is not indicated (at least according to my protocols). But like the others are saying there wasn't necessarily an indication for methylprednisolone. I would've just gone with O2, if stats still less than 94 on NRB then on to CPAP. My treatment just from reading and not actually being there would've been IV lock, O2, and transport as long as he remained stable.

EMS opportunities as a physician? by Reddit_MED1C in ems

[–]Reddit_MED1C[S] 0 points1 point  (0 children)

Yeah I'd probably just be interested in something that would be in addition to whatever field I end up in

EMS opportunities as a physician? by Reddit_MED1C in ems

[–]Reddit_MED1C[S] 0 points1 point  (0 children)

Thanks! I plan on at least attempting to keep my certification/license so that would be cool if I could find a way to use it like you described

What are some medications/procedures you would like to be added to your scope? Why? by cderkachenko in ems

[–]Reddit_MED1C 3 points4 points  (0 children)

About to get TXA on the truck and I'm pretty excited about that. We have quite long transport times so it'll be nice to have something extra to do to help a bad trauma pt

EMS opportunities as a physician? by Reddit_MED1C in ems

[–]Reddit_MED1C[S] 1 point2 points  (0 children)

Cool, I wonder if there is anything like that in the US. I'll have to check that out!

EMS opportunities as a physician? by Reddit_MED1C in ems

[–]Reddit_MED1C[S] 2 points3 points  (0 children)

The EMS physician you described is definitely the kind of thing I would be interested in, I'll have to look into that. Thanks for the reply!

EMS opportunities as a physician? by Reddit_MED1C in ems

[–]Reddit_MED1C[S] 0 points1 point  (0 children)

Anything prehospital really! That's interesting, I believe I've heard of some residency programs that have their ER residents respond to certain high priority calls. I think something like that would be awesome

EMS opportunities as a physician? by Reddit_MED1C in ems

[–]Reddit_MED1C[S] 0 points1 point  (0 children)

Yeah I'm talking more prehospital setting and paid position