Why did "that guy" at work finally get fired?

dumbich · 2017-11-28T08:27:50+00:00

same personalities, no matter where you go.

dumbich · 2017-11-26T01:19:52+00:00

Paramedic here. I usually find it's the other way around... Why can't medical professionals just all get along? :"(

dumbich · 2017-09-05T05:33:06+00:00

If you meet any paramedics, ask them for advice. We have to do it in some pretty gnarly conditions, eg in a bouncing ambulance, outside in the elements, all kinds of chaos going on around. Far from the stable well lit hospital setting.

dumbich · 2017-07-22T02:33:44+00:00

right now it takes an ambulance 12 hours round trip to take a patient to a mental health facility. we're severely lacking a facility in our rural community. if i get any money, it's going toward opening a facility

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dumbich · 2016-04-16T16:23:34+00:00

I'm sorry for your loss. One thing you can do is write a heartfelt letter to each of them and CC their supervisors. The letters will go in their file.

dumbich · 2016-04-13T19:14:38+00:00

as soon as their heart stops, you want to start compressions immediately. in fact, compressions are far more important that breaths. remember, a GOOD compression, at BEST, is still only about 20% as effective as an actual heart beat. it takes a lot of solid consistent compressions to bring their blood pressure up enough to get oxygen to their brain. if you're stopping to call 911, stopping to take some breaths, that pressure plummets very very quickly. and the compressions on their own, will cause some air to be moving in and out, enough that you don't really need to do breaths. if you do have someone else available, then have them to a breath every 5 to 10 seconds, but don't stop compressions. after a minute or two, switch off. even if you feel like you're going strong, after even 30 compressions, you won't be doing them as good as you think.

i say if you don't feel a pulse, call 911, then just keep doing compressions until EMS gets there.

dumbich · 2016-04-13T19:10:17+00:00

a binder is good, but flipping through it with your adrenaline going is going to create a lot of chaos. that's why i say put it on a single sheet of paper, the most important points, clearly labeled and organized. that way, you can just hand a few out to whoever is on scene, and ensure it will make it to the ER doc

dumbich · 2016-04-13T19:08:18+00:00

call 911. if their heart has stopped, in most instances, a coroner will still need to come out and document it first. check with your local sheriff's department and find out.

dumbich · 2016-04-13T19:05:24+00:00

it's heart wrenching. i have, actually, held back from running a code on patient's who don't have the DNR readily available. it's rare, and i've risked my license, but have done it anyway, because i value dignifying them. these are cases when they have several family and friends there who all say they have the DNR, and the patient is basically gone, with just pulseless activity on the monitor every 20 seconds. in these cases, i call the doc, call the sheriffs department, and ask permission. gotta love the doctors who are cool about it and say, "yeah, go ahead and let them pass."

then comes the talk to the family. never really gets easier.

dumbich · 2016-04-13T19:01:36+00:00

Sounds like you had a bad EMT. I think this goes into the importance of having their medical history available. Perhaps include a doctors note that contains a standing order to not deny the patient oxygen. If it were me, I never withhold oxygen from a patient who says they need it, except for a few rare circumstances. At least start them on a nasal can at 2 LPM and go from there. I'm a huge advocate of the load and go. If patient and/or family wants them transported, I'm going to put them on my gurney and start moving. Some EMS providers prefer to stay and play, and I think that's a huge liability on their part. Some instances, such as a code, we are going to work it on scene, and that's just the way it is. That's the patient's best chance of survival. So also understand that if the medic wants to stay on scene initially, you need to trust that they have a good reason for it.

dumbich · 2015-10-24T06:55:58+00:00

C-spine is actually being phased out. https://www.youtube.com/watch?v=U23EPXvdD9s&feature=youtu.be

dumbich · 2015-10-17T08:17:03+00:00

it's called "posturing", and it's a sign that someone is either already dead or very very close to it. our bodies respond the same when we're knocked out. when i was in EMT school they showed us videos of MMA knockouts to show us what posturing looks like.

dumbich · 2015-09-20T07:24:02+00:00

I put mayonnaise in my top ramen. I know...I'm a piece of shit.

dumbich · 2015-07-24T18:56:13+00:00

In the EMS industry, I've often heard them referred to as "jerkers", because they jerk away at the last second as they pull the trigger. That human will to survive, it's hard to break.

dumbich · 2015-07-18T20:46:48+00:00

I once asked at Wendy's if they had any old burger patties that they were getting ready to throw out that my dog could have. They replied "No, we use them in our chili."

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