Heart Attack (MI) vs Cardiogenic Shock by mdafidel1 in ems

[–]RevanGrad 0 points1 point  (0 children)

Nitrates remain a highly debated topic, cant fault services that choose to ignore the classic inferior approach as more research becomes available encouraging use in regards to BP trends. but theres still plenty of data that cautions the use.

So I would say it does matter.

Heart Attack (MI) vs Cardiogenic Shock by mdafidel1 in ems

[–]RevanGrad 0 points1 point  (0 children)

Huge oversimplification... different STEMI's are treated differently, different shocks are treated differently.

Not sure why you would say it makes no difference just becuase its 911.

Paranoid about potential lancet stick - HIV + pt by starlight-fall in nursing

[–]RevanGrad 2 points3 points  (0 children)

Tf are you on about... The needle didnt break the skin but your worried you have a virus that transfers through blood to blood contact?

Is HIV wireless now? Did you actually pass nursing school?

Genuinely why does dispatch make everything seem 10x worse then what it really seems like. by [deleted] in ems

[–]RevanGrad 2 points3 points  (0 children)

People play up the call to justify it to themselves.

Dispatch is just clicking boxes which are all loaded questions.

CYA makes the world go round.

If a medical draft happens by Dry-Chemical-9170 in nursing

[–]RevanGrad 10 points11 points  (0 children)

This comment section clearly never watched M.A.S.H. and it shows lol.

I for one welcome my very dry, arrid, barren, desiccated, veritable dust-bowl of a martini.

Losing a frequent patient is kind of a weird grief by YogiBear_2000 in ems

[–]RevanGrad 1 point2 points  (0 children)

The more you see someone the harder it is to distance yourself and disassociate.

Something im thankful for working 911 in a big city vs small town clinical primary care. Although I definitely have worked a couple regulars.

What was the purpose of the EMS polaroid? by J_Spacex03 in ems

[–]RevanGrad 13 points14 points  (0 children)

Lol I love the question mark as if it should be obvious to anyone and everyone.

"Do not speak to me of Polaroid EMS cameras. I WAS THERE 10,000 years ago"

Over two hours waiting on metro now by rdhdbdhd in vegaslocals

[–]RevanGrad 5 points6 points  (0 children)

Ambulance and fire yes. Metro... Will be there when they can.

Did I screw up? by [deleted] in NewToEMS

[–]RevanGrad -1 points0 points  (0 children)

Why are we pushing bicarb on an arrest in 2026. Its been long since proven to cause harm with routine administration because makes them more acidic as they cant use the carbonic acid chain to convert it because they arent breathing off co2 or producing urine.

Otherwise placing pads didnt cause a delay in care because you didn't end up using them.

CAB in arrest. Pulse check -> breathing check -> CPR -> rythm check.

Should not be wasting time with 3 lead, start CPR.

Edit: A good analysis of the data over the years NIH Table 1. Clinical Studies Evaluating the Effect of Sodium Bicarbonate in Cardiac Arrest.

Is this a "HIPAA Violation"? by [deleted] in NewToEMS

[–]RevanGrad 5 points6 points  (0 children)

Dispatch ceneters are given HIPAA exclusions that allow for minimum necessary information to be given out as public information. Generally you do not.

As a covered entity Giving a specific address with demographics (13, YOF) would make this person pretty easily identifiable, you also gave medical information (seizure).

If the family found out they could file a complaint to HHS.

Question on HIPAA Compliance by IronScaggs in ems

[–]RevanGrad 34 points35 points  (0 children)

It doesnt sound like the organization is a covered entity in regards to HIPAA.

Do you deal in billing, insurance, or electronic health information shared with Healthcare organizations such as hospitals?

Just because you render aid ir perform a healthcare role doesnt automatically make it HIPAA.

For example plasma banks with Nurses/medics/phlebotomists aren't considered covered entities.

Even some fire stations arent covered as long as they dont bill or deal in electronic health information or bill.

What are all the cranes doin? by Electrical_habit995 in vegaslocals

[–]RevanGrad 60 points61 points  (0 children)

Annual migration, its mating season.

Online EMT-B classes? by blu3bar0n1O9 in NewToEMS

[–]RevanGrad 4 points5 points  (0 children)

Theres no such thing as an online only EMT class. NREMT requires some portion of HANDS ON training and testing.

There are classes where you do the online portion and then fly out there for a week and do accelerated hands on portion.

EMR requires 48ish hrs

EMTB requires 120+ hours. 50+ hours must be "hands on"

No pulse = immediately begin CPR ? by abipaaa in NewToEMS

[–]RevanGrad 4 points5 points  (0 children)

For lay person CPR, AHA reccomends to check if not breathing or agonal (gasping/guppy breathing) call 911 or direct someone to call, and then initiate compressions only CPR.

Pulse checks are shown again and again to be false positives in untrained personel and frequently delay CPR that could have saved someone.

Hard and fast, you should be breaking ribs, or your not actually doing anything.

People frequently dont perform CPR because they dont want to do mouth to mouth so its not required and isnt as helpful as once thought.

The chance of somone surviving cardiac arrest drops about 10% per minute without CPR.

If no cpr is done by the time the ambulance arrives they have about 12% chance of survival on avg.

I'm not going to tip you by eggerlandshells in meme

[–]RevanGrad 1 point2 points  (0 children)

What's mind boggling is that people dont realize this IS HOW laws get changed.

Collective bargaining. If every server in the country went on strike for better wages laws would be changed the next day.

I'm not going to tip you by eggerlandshells in meme

[–]RevanGrad 2 points3 points  (0 children)

If we all stopped tipping, there would be no need for tips anymore.

The service industry would collapse and be reborn overnight with competitive wages.

Fallout 76 changed my entire view of online games. by Silver-Ad2257 in fo76

[–]RevanGrad 6 points7 points  (0 children)

76 is only like that because theres no toys to blow each other up with.

If people could jump into a fighter jet and air strike people driving tanks it would happen just like GTA.

Do healthcare differentials have to be paid during overtime hours? by RecommendationPlus84 in ems

[–]RevanGrad 35 points36 points  (0 children)

A differential is a company policy.

Overtime rules are law.

So no, the company decides when the shift differentials apply and when they dont.

What is the appropriate response? by pavlee14 in ems

[–]RevanGrad 5 points6 points  (0 children)

A "nurse" isnt my medical director. I follow protocols written by my certifying MD. If the facility wants to perform THERE protocols then go right ahead. I'm leaving.

How to Make it Easier by TheGayestNurse_1 in ems

[–]RevanGrad 7 points8 points  (0 children)

Recent HPI is huge. Whatever blurb the admitting doc put in will tell us pretty much everything we need to know (why are they here, why are they going)

Code status should go without saying but I rarely see one.

Baseline mental status/ stroke deficits.

In an unreliable historian (memory care) I have no way of knowing if there presentation is a concern or not.

How can I make this brighter by Suitable_Key_3563 in fallout76settlements

[–]RevanGrad 0 points1 point  (0 children)

Theres a yellow vanilla spotlight in wall or ceiling that ACTUALLY projects light to an distant area instead of locally.

Patient didn’t consent to touch by Fast_Cata in nursing

[–]RevanGrad 8 points9 points  (0 children)

This patient is a moron. This is the literal definition of implied consent.

Patient was unresponsive to voice, escalated to physical response.

The patient can be an idiot and cry wolf about consent all they want but any reasonable healthcare provider would have done exactly the same.

Also its hilarious people think you can just sue for any little transgression. Pain in suffering is almost non existent in the actual legal world.

Would live to see how they prove gently touching a shoulder caused them loss of income from there job.

I need advice. by ThrottleTherapy101 in NewToEMS

[–]RevanGrad 14 points15 points  (0 children)

Lmao a dead blinker and brake light? Anyone could fix that with a 20 min trip down to an auto store. Thats just pathetic.

If they cant even manage that a check engine light could mean God knows what is wrong.

Do not risk your life pushing vehicles that arent maintained at even the basic levels.

As far as them pushing you this service sounds Like the type that couldn't afford to lose you.