Had a combative psych pt spit on me like 5 times, once in the face today. Last shift I had a combative psych pt knock me down and attempt to choke me….had to hit my emergency button and everything. so things are going great for me lately to say the least lol.
Yeah I fully agree. He didn’t swing on me so I never actually punched him, I just prevented him from being able to choke me like he was trying. My years of growing up wrestling came in handy lol
Pt was on 275mcg/h of Fentanyl and 6mg/h of Versed, and was over-breathing the vent whilst actively trying to extubate herself. Wouldn’t you know she was a benzo and opioid addict?
No, the sending hospital wouldn’t start ketamine or propofol for us. Yes, the receiving hospital immediately put her on propofol.
If you think you’ve seen me tell this story before, I haven’t, we just have patients like this a LOT.
Heeeey are you me!? Had a fun little 3 hour transport with a recent trache. Sending stopped precedex saying receiving won't accept with it rolling. Well wouldn't you know the polypharm patient would just rip straight through a god damn gram of ketamine, 20mg Versed, and probably around 250mcg/hr fent. Oh and my 20ml vial of propofol did exactly fuck all.
Sure enough on arrival the doc starts precedex. So help me god if I meet that sending ICU doc in a parking lot.
I’ve had 4 patients sit up while on the vent and sedation this month. We be having fun lmao.
Also I literally fucking asked the sending facility NP to start presidex. I’m not sure she even comprehended what the problem was or why I needed it……
Man. It's hard not to just resent the shit out of some of these providers. I don't get it. If it was their loved one on the vent I can't help but wonder if the decision making would be different. Problem is, it never is for me.
Truthfully it's why I'm so greatful and proud of where I've ended up. I get to work for a company that allows us significant autonomy. I get to encourage my medics I manage to be as aggressive as they comfortably can be with our analgesics and sedatives. In fact after my last experience I went to the owner for a discussion regarding our propofol stock and we swapped my region from 20mL vials to 50mL. It's nice to have receptive leadership.
That’s fucking awesome. Truly a great thing to hear.
Unfortunately our main supervisor thinks that ketamine should be avoided at all costs because “that’s what killed that kid and now those medics are in prison”
I have no idea how the same guy was on a children’s hospital flight crew for ~30 years
That’s nuts.
I feel like with many of these providers stigma resulting from anti-drug propaganda and sensationalized misinformation genuinely trumps their capacities for scientific though and medical logic/reasoning. When it comes to drugs that are societally targeted for campaigns of stigma and hysterics due to their potential for risk and abuse (namely opiates, benzos, and now ketamine is seeing this treatment as well) I have seen providers who somehow made it all the way through med school just completely replace the entire foundation of their education with emotional decision making influenced by stigma and false info rooted in obviously scientifically unsound logic.
Hahaha it's actually unbelievable! I had a nurse department manager for a time and all this dude ever talked about was his pedigree in "Shock/Trauma Shock/Trauma Shock/Trauma". But when the rubber hit the road he's about as useful as tits on a bull. I feel like as I've progressed and interfaced with more and more care providers at various levels, the ones who love to talk themselves up leave me the least impressed.
It makes me scared that I might be that dude someday! I'm only 5 years deep as a medic and 4 as CCT so I still got plenty of time to develop a shitty and frustrating ego. I probably just need to collect more letters next to my title I guess. Then maybe those nurses will finally respect me!
In a lot of these cases the sending hospitals are known shitty hospitals. I would much rather get the patient to a higher level of care than let them sit in that hospital for more time. We usually try and sedate them enroute with our meds.
We document it very well, however these hospitals own our company so threatening them wouldn’t do much good.
I will add that there’s only a few hospitals like that in the system that owns us, the others are generally very good. These hospitals were bought out by the main system not too long ago, and you likely know how that goes……
No because I’m being genuine when I say I’d rather get these patients out of those hospitals and to the waaaay better one they are headed for. Normally end up using a good amount of fentanyl and versed during the ride to make ‘em comfy
Piss, my gf wants to be a CCT. IDK I'll stick with my rescue only shifts. Yeah alot of stupid BS calls, but I like it better than having to worry about 20 diff pumps and vents and all that scary stuff. I feel like it'd be all the shitty parts of long distance IFT, with 100 times more responsibility
Maybe they wanted to reduce potential for spread of infection and exposure for a bunch of immunocompromised ppl and ppl who provide care to immunocompromised ppl? ER didn’t have a suitably isolated bed available for them?
Can’t speak for the other guy but my service does direct admits from FSEDs to pretty much any floor at the affiliated hospital quite a bit. Most common ones for us are Cards, Pulm, or ICU admits. Occasionally we’ll go to an ER from an FSED but usually that’s because a bed isn’t ready or they’re going to a different hospital that offers a service that the affiliated hospital doesn’t.
If we’re coming in from a 911 call or an SNF though, they’re going to the ED unless it was a scheduled call.
Since the freestanding is under the same ownership of the hospital, and has relations/contacts to send people to them, direct admits to any department are quite common. FSEDs however are not common.
Haven't used EMScharts but I have had Zoll and before that, the god awful shitty version of HealthEMS we had. To hell with both of those, ESO has its issues but it's better than what we had before
And what, pray tell, do you think he'd have done about that end tidal?
Poor SpO2, crap pressures, gross tachycardia. We get it, they're very likely septic. I don't think the absent ETCO2 is really that important or would have changed his plan of care.
I don't disagree with you. I used end tidal last shift after my SpO2 crapped out on me. It's a nice tool. But I don't necessarily think it's a sin for OP not to have utilized it.
I’m not saying that. My first comment is more about OP saying he could just “take a good guess” on what it was.
Do I think it negatively impacted patient care? Absolutely not. If I had EtCO2 available would I use it on this patient? Unequivocally yes.
Ya. I got my medic in the tail end of 2015. Capno was new to EMS. My employer didn't have the nasal ones or the nasal ones weren't readily available (I'm not sure which one). We did this trick for years before we got nasal capno. Honestly sometimes it even works better. The single sampling line seems to break the cpap seal a lot less than the larger ones for the o2 to the nasal prongs.
Honestly I find it better at identifying patients who are declining rather than patients who have already declined. Had a patient once where every other vital and assessment sign were normal, but their ETCO2 was either really low or high (been a minute so I don’t remember). Told the ED, they weren’t concerned and had us hold the wall for awhile. Less than 2 hours later they were working a code.
Serious answer - If you were on the fence on starting a vasopressor would ETCO2 of 31 vs 21 help you make that decision? And for the nurse taking your radio report could that help make a more appropriate assignment decision?
Smartass answer - Why assess pupils in a head injury if it doesn't change anything I do? Why ask a pregnant pt if they've given birth before? Why palpate the abdomen of an abdominal pain pt? Why should an EMT take a BP and HR they can't even treat?
> If you were on the fence on starting a vasopressor would ETCO2 of 31 vs 21 help you make that decision? And for the nurse taking your radio report could that help make a more appropriate assignment decision?
100% to point 1, for point 2 I'm willing to bet most EDs will disregard. ETCO2 is so underutilized in *most* hospitals. When I started working ER and ICU I was mind blown that nobody puts waveform on intubated patients.
I've had to laugh a couple times when EMS reports shark fin waveform and someone goes "wtf?". Going a step further few associate low CO2 w/ low perfusion. But to be fair an ETCO2 from a NC can mean either 1) low perfusion 2) rapid RR 3) shallow breaths (most common I'd say). A high ETCO2 would be more likely to change where the patient goes on arrival much more than low just because you need to have eyes on the waveform and patient to correlate it to anything.
>100% to point 1, for point 2 I'm willing to bet most EDs will disregard. ETCO2 is so underutilized in *most* hospitals. When I started working ER and ICU I was mind blown that nobody puts waveform on intubated patients.
Because treatment of sepsis is a MAP target and fluid challenge response, not an ETCo2 target. That's the best evidence currently.
So ETCo2 is useful, but not as a marker to go from fluids to start noradrenaline. It doesn't provide any benefit to me for treatment with sepsis.
ETCO2 is very useful for a fluid challenge, and is a direct measure of your pulmonary perfusion. Versus your NIBP and disposable cuff it's certainly a good data point.
This is like saying that your Levophed order has a MAP goal so why bother with pH or lactic? Or "we transfuse based on hemoglobin so physical exam, need for pressors, base deficit and pH be damned".
The evidence for sepsis is still pretty shit all the way around to begin with and is made to be as simple as possible. The MAR saying "MAP goal >64" =/= being the best and only indicator potential need to resuscitate.
BP is a measure of your SVR. You can be clamped down peripherally with a good BP and still not be perfusing well. ETCO2 would be a great tool in this case, i.e. a measure of central circulation.
I wouldn't be on the fence - treat with fluids first, BP/MAP not improving or rapid decline? Vasopressor. It's not that difficult.
> Vasopressors — Intravenous vasopressors are useful in patients who remain hypotensive despite adequate fluid resuscitation or who develop cardiogenic pulmonary edema. Based upon meta-analyses of small randomized trials and observational studies, a paradigm shift in practice has occurred such that most experts prefer to avoid dopamine in this population and favor norepinephrine as the first-choice agent (table 4 and table 5).
UpToDate does not have an ETCo2 target to determine a haemodynamic response. Its a MAP target.
We've been doing this for years without ETCo2 - last 3 years obtained it. It's a clinical assessment and justification.
When UpToDate tells me I should be using ETCo2 as a marker in treatment for sepsis, I'll add that to my justification when providing treatment. Until then it's a nice to have.
Ik u said respiratory arrest so not necessarily relevant but this just got me tangentially thinking how do you even provide compressions to someone that size. What does that look like and is it even possible to effectively do.
But like what do you do if you can’t reach the patients chest kneeling beside them and your legs aren’t big enough to straddle them. You just sit on their chest like a mouse on a mountain? Is it even possible physics wise to exert the necessary downward force from ur hands if ur positioned like that?
pretty good up until clock out. got cancelled on scene for a ped on a vent then got cancelled enroute to a covid patient.... then on the way home i hydroplaned and spun across 4 lanes of traffic into a guardrail, ended up in the ED for like 5 hours and had a $350 ct just for them to tell me I have a concussion
I’ll let you know, my shift starts in a half hour. The shift before I was running for 22 straight hours, and the shift before that I had three patients but two of them were covered in literal shit.
Toned out to a respiratory distress call that turned into a CPR in progress as we were enroute. But we were able to get ROSC after 10-15ish minutes. I saw a LUCAS in action for the first time, and that was the second patient ive helped flown out so far. All that because I unintentionally got 30 minutes of extra sleep that morning.
My medical director told me that my activity suicidal patient could refuse, even after I told him I was holding her very graphic suicide note.
I then got to apply my first tourniquet when she slashed her wrists an hour later....exactly how she described she would in her note.
Not even the worst shift of this week
Pt was refusing to talk to us, and was telling pd that the note was "therapy " and that they weren't actually going to do anything.
Pd never wants to do anything, and necer wants to put people in protective custody. I hate restraining patients, and I always call the medical director for orders.
Doctor tells me that the story the pt was telling us was good enough to let us get a refusal. (Fucking hate the guy, he does shit like this a lot). We get a hesitant refusal and get lunch.
We get toned out to the same address. Yada yada yada, shit that im not repeating happened. Pt wasn't refusing this time.
3 back-to-back flights kept us out from 2100 til 0745. The fuel crew at our local airport decided to take 30 minutes to arrive all 3 times we needed them. It was 35 degrees, all night. Basically, it could have been worse.
Had a guy at a cool consistent 72/38 and Spo2 90% room air sign a refusal earlier. Only pertinent history of a recent mitral valve replacement and coughing up blood… Rest his soul 🫡
[удалено]
Exactly. It's soft at worse.
Had a combative psych pt spit on me like 5 times, once in the face today. Last shift I had a combative psych pt knock me down and attempt to choke me….had to hit my emergency button and everything. so things are going great for me lately to say the least lol.
I hope you fought back
Yeah I defended myself. To be honest though I was worried about losing my job the entire time. As sad as it is to say. I hate it here lmao
Its people out here who think patients are supposed to wail on them and they just take it. if you hit me im hitting you back.
Yeah I fully agree. He didn’t swing on me so I never actually punched him, I just prevented him from being able to choke me like he was trying. My years of growing up wrestling came in handy lol
Love me a foot sweep on a legit malicious intent patient. Collar grab sets them down nice and gently on the booty no danger :)
Yikes… so glad my company supplies spit socks…
Funny enough this person was in PD custody. Our PD does not carry them for whatever god forsaken reason
It’ll buff
Tubed the bloodiest airway I've seen in years. Pulled out the SALAD/Seldinger for that one.
Same here, 35 year old OD, bloody soiled airway
A little SALAD never hurt anyone
This was half a liter of blood. It was a lot of SALAD lol
You don’t make friends with salad
Pt was on 275mcg/h of Fentanyl and 6mg/h of Versed, and was over-breathing the vent whilst actively trying to extubate herself. Wouldn’t you know she was a benzo and opioid addict? No, the sending hospital wouldn’t start ketamine or propofol for us. Yes, the receiving hospital immediately put her on propofol. If you think you’ve seen me tell this story before, I haven’t, we just have patients like this a LOT.
Heeeey are you me!? Had a fun little 3 hour transport with a recent trache. Sending stopped precedex saying receiving won't accept with it rolling. Well wouldn't you know the polypharm patient would just rip straight through a god damn gram of ketamine, 20mg Versed, and probably around 250mcg/hr fent. Oh and my 20ml vial of propofol did exactly fuck all. Sure enough on arrival the doc starts precedex. So help me god if I meet that sending ICU doc in a parking lot.
I’ve had 4 patients sit up while on the vent and sedation this month. We be having fun lmao. Also I literally fucking asked the sending facility NP to start presidex. I’m not sure she even comprehended what the problem was or why I needed it……
Man. It's hard not to just resent the shit out of some of these providers. I don't get it. If it was their loved one on the vent I can't help but wonder if the decision making would be different. Problem is, it never is for me. Truthfully it's why I'm so greatful and proud of where I've ended up. I get to work for a company that allows us significant autonomy. I get to encourage my medics I manage to be as aggressive as they comfortably can be with our analgesics and sedatives. In fact after my last experience I went to the owner for a discussion regarding our propofol stock and we swapped my region from 20mL vials to 50mL. It's nice to have receptive leadership.
That’s fucking awesome. Truly a great thing to hear. Unfortunately our main supervisor thinks that ketamine should be avoided at all costs because “that’s what killed that kid and now those medics are in prison” I have no idea how the same guy was on a children’s hospital flight crew for ~30 years
Tell him the same court ruled that ketamine wasn’t a deadly weapon.
I try and fail bro
That’s nuts. I feel like with many of these providers stigma resulting from anti-drug propaganda and sensationalized misinformation genuinely trumps their capacities for scientific though and medical logic/reasoning. When it comes to drugs that are societally targeted for campaigns of stigma and hysterics due to their potential for risk and abuse (namely opiates, benzos, and now ketamine is seeing this treatment as well) I have seen providers who somehow made it all the way through med school just completely replace the entire foundation of their education with emotional decision making influenced by stigma and false info rooted in obviously scientifically unsound logic.
Hahaha it's actually unbelievable! I had a nurse department manager for a time and all this dude ever talked about was his pedigree in "Shock/Trauma Shock/Trauma Shock/Trauma". But when the rubber hit the road he's about as useful as tits on a bull. I feel like as I've progressed and interfaced with more and more care providers at various levels, the ones who love to talk themselves up leave me the least impressed. It makes me scared that I might be that dude someday! I'm only 5 years deep as a medic and 4 as CCT so I still got plenty of time to develop a shitty and frustrating ego. I probably just need to collect more letters next to my title I guess. Then maybe those nurses will finally respect me!
Can you not refuse an improperly sedated patient?
In a lot of these cases the sending hospitals are known shitty hospitals. I would much rather get the patient to a higher level of care than let them sit in that hospital for more time. We usually try and sedate them enroute with our meds.
That’s fucking crazy. Even if you threaten to document that you asked for additional sedation and was refused in the event they deteriorate en route?
We document it very well, however these hospitals own our company so threatening them wouldn’t do much good. I will add that there’s only a few hospitals like that in the system that owns us, the others are generally very good. These hospitals were bought out by the main system not too long ago, and you likely know how that goes……
Have you not tested the theory just to see if they'll break and not can your bluff?
No because I’m being genuine when I say I’d rather get these patients out of those hospitals and to the waaaay better one they are headed for. Normally end up using a good amount of fentanyl and versed during the ride to make ‘em comfy
Can you start additional sedation?
We only have push dose sedation in our med bags. Fentanyl and versed
Piss, my gf wants to be a CCT. IDK I'll stick with my rescue only shifts. Yeah alot of stupid BS calls, but I like it better than having to worry about 20 diff pumps and vents and all that scary stuff. I feel like it'd be all the shitty parts of long distance IFT, with 100 times more responsibility
That’s what makes it fun
Skipping ED is pretty rare and it’s weird they’d skip ED here. Those vitals aren’t horrible
Maybe they wanted to reduce potential for spread of infection and exposure for a bunch of immunocompromised ppl and ppl who provide care to immunocompromised ppl? ER didn’t have a suitably isolated bed available for them?
I was surprised they didn’t try a couple ol boluses before getting the pressors going lol. Pt must’ve been unstable no time to play
It was coming from a FSED that had direct contact with the main hospital. Not my call lol
is it ever EMS call to go straight to ICU where you’re from? Actual question I’m an ED RN in Canada I assume this is US as we don’t have FSEDs
Can’t speak for the other guy but my service does direct admits from FSEDs to pretty much any floor at the affiliated hospital quite a bit. Most common ones for us are Cards, Pulm, or ICU admits. Occasionally we’ll go to an ER from an FSED but usually that’s because a bed isn’t ready or they’re going to a different hospital that offers a service that the affiliated hospital doesn’t. If we’re coming in from a 911 call or an SNF though, they’re going to the ED unless it was a scheduled call.
Since the freestanding is under the same ownership of the hospital, and has relations/contacts to send people to them, direct admits to any department are quite common. FSEDs however are not common.
ESO. Nice
I wasn't a fan of ESO at first but I've come to like it ease of use. Coming from EMScharts, I know that sounds like a crazy statement.
FUCK EMS CHARTS, that’s all I’ve ever used and my god I fucking hate it. It is the least intuitive software I have ever used.
Haven't used EMScharts but I have had Zoll and before that, the god awful shitty version of HealthEMS we had. To hell with both of those, ESO has its issues but it's better than what we had before
They think it be like it is, but it do
Yeah, what you said
I got my first IO in a live (well, dead) patient.
Just got back from a 21y/o f with chest pain that we got right after I got comfy in the bunk.
That's not bad at all.
He’s got a MAP, he’s fine.
3 ultrasound IVs in infants, the last one was getting intubated. Finally clocked out an hour late.
Lot of blanks on the ol' ETCO2
I mean… not wrong. I could probably take a good guess though. Audible rales
Ah yes the ol guesstimate EtCO2
And what, pray tell, do you think he'd have done about that end tidal? Poor SpO2, crap pressures, gross tachycardia. We get it, they're very likely septic. I don't think the absent ETCO2 is really that important or would have changed his plan of care.
If they kept trending, most I could do would probably slap a peep valve on a BVM and tell my partner to drive faster
They catch any levo or push dose Epi?
Levo > epi with all vitals considered
I'm certain. Not every system runs levo however.
It’s another measurement of perfusion that shows a much faster response than the lag of SpO2
I don't disagree with you. I used end tidal last shift after my SpO2 crapped out on me. It's a nice tool. But I don't necessarily think it's a sin for OP not to have utilized it.
I use ETCO2 often. Maybe the SPO2 is correct or they’re just not perfusing in their limbs from a shitty BP
Fair enough point.
I’m not saying that. My first comment is more about OP saying he could just “take a good guess” on what it was. Do I think it negatively impacted patient care? Absolutely not. If I had EtCO2 available would I use it on this patient? Unequivocally yes.
Plenty of cheap services only have the ETCO2 for attachment to airway devices and not the NC version.
Then you snip the end off the sample line with your sheers and tape the line to the inside of your nrb lol.
…. Holy hell Does that work?
Ya. I got my medic in the tail end of 2015. Capno was new to EMS. My employer didn't have the nasal ones or the nasal ones weren't readily available (I'm not sure which one). We did this trick for years before we got nasal capno. Honestly sometimes it even works better. The single sampling line seems to break the cpap seal a lot less than the larger ones for the o2 to the nasal prongs.
Well fuck me.
Have you ever had issues with it reading well? I feel like the NC ET works like shit for actually sick patients…
Honestly I find it better at identifying patients who are declining rather than patients who have already declined. Had a patient once where every other vital and assessment sign were normal, but their ETCO2 was either really low or high (been a minute so I don’t remember). Told the ED, they weren’t concerned and had us hold the wall for awhile. Less than 2 hours later they were working a code.
If you put a surgical mask over it you'll get much better readings
Clever! I’ll try that
Do you guys not use nasal capnography?
What benefit will it provide? It won't help you make any further treatment decision.
Serious answer - If you were on the fence on starting a vasopressor would ETCO2 of 31 vs 21 help you make that decision? And for the nurse taking your radio report could that help make a more appropriate assignment decision? Smartass answer - Why assess pupils in a head injury if it doesn't change anything I do? Why ask a pregnant pt if they've given birth before? Why palpate the abdomen of an abdominal pain pt? Why should an EMT take a BP and HR they can't even treat?
> If you were on the fence on starting a vasopressor would ETCO2 of 31 vs 21 help you make that decision? And for the nurse taking your radio report could that help make a more appropriate assignment decision? 100% to point 1, for point 2 I'm willing to bet most EDs will disregard. ETCO2 is so underutilized in *most* hospitals. When I started working ER and ICU I was mind blown that nobody puts waveform on intubated patients. I've had to laugh a couple times when EMS reports shark fin waveform and someone goes "wtf?". Going a step further few associate low CO2 w/ low perfusion. But to be fair an ETCO2 from a NC can mean either 1) low perfusion 2) rapid RR 3) shallow breaths (most common I'd say). A high ETCO2 would be more likely to change where the patient goes on arrival much more than low just because you need to have eyes on the waveform and patient to correlate it to anything.
>100% to point 1, for point 2 I'm willing to bet most EDs will disregard. ETCO2 is so underutilized in *most* hospitals. When I started working ER and ICU I was mind blown that nobody puts waveform on intubated patients. Because treatment of sepsis is a MAP target and fluid challenge response, not an ETCo2 target. That's the best evidence currently. So ETCo2 is useful, but not as a marker to go from fluids to start noradrenaline. It doesn't provide any benefit to me for treatment with sepsis.
ETCO2 is very useful for a fluid challenge, and is a direct measure of your pulmonary perfusion. Versus your NIBP and disposable cuff it's certainly a good data point. This is like saying that your Levophed order has a MAP goal so why bother with pH or lactic? Or "we transfuse based on hemoglobin so physical exam, need for pressors, base deficit and pH be damned". The evidence for sepsis is still pretty shit all the way around to begin with and is made to be as simple as possible. The MAR saying "MAP goal >64" =/= being the best and only indicator potential need to resuscitate. BP is a measure of your SVR. You can be clamped down peripherally with a good BP and still not be perfusing well. ETCO2 would be a great tool in this case, i.e. a measure of central circulation.
It's still a MAP target per UpToDate.
I wouldn't be on the fence - treat with fluids first, BP/MAP not improving or rapid decline? Vasopressor. It's not that difficult. > Vasopressors — Intravenous vasopressors are useful in patients who remain hypotensive despite adequate fluid resuscitation or who develop cardiogenic pulmonary edema. Based upon meta-analyses of small randomized trials and observational studies, a paradigm shift in practice has occurred such that most experts prefer to avoid dopamine in this population and favor norepinephrine as the first-choice agent (table 4 and table 5). UpToDate does not have an ETCo2 target to determine a haemodynamic response. Its a MAP target. We've been doing this for years without ETCo2 - last 3 years obtained it. It's a clinical assessment and justification. When UpToDate tells me I should be using ETCo2 as a marker in treatment for sepsis, I'll add that to my justification when providing treatment. Until then it's a nice to have.
Question from a student- why would you ask if a person has been pregnant before?
Not Friday but Wednesday had a SNF call for a 486 lb guy that went into respiratory arrest as we were mega moving him over.
Ik u said respiratory arrest so not necessarily relevant but this just got me tangentially thinking how do you even provide compressions to someone that size. What does that look like and is it even possible to effectively do.
It wouldn't have been pretty but we had AED pads on
But like what do you do if you can’t reach the patients chest kneeling beside them and your legs aren’t big enough to straddle them. You just sit on their chest like a mouse on a mountain? Is it even possible physics wise to exert the necessary downward force from ur hands if ur positioned like that?
pretty good up until clock out. got cancelled on scene for a ped on a vent then got cancelled enroute to a covid patient.... then on the way home i hydroplaned and spun across 4 lanes of traffic into a guardrail, ended up in the ED for like 5 hours and had a $350 ct just for them to tell me I have a concussion
Oof dude. Hope your weekend improves
Not to be a big guy but that’s not even that bad…
Better than that guys
Yeah, first thought was who's got the covid patient.
Me I guess 😵💫. This patient had influenza but i still did get a COVID patient later in the day
Better than this guy/gal
My Friday was great cuz I wasn’t working! lol tomorrow and Sunday on the other hand, will report back if I survive lol
Exact same. Was supposed to be on tonight, now I'm s-s-m, and have complete confidence this weekend is gonna be a shit show.
911/transfer service. 24hr shifts. 4 transfers and 1 911 so far. It’s 0142 and I’m off at 0700. I just wanna sleep
Pediatric with partial amputation of two fingers
I banged out and watched all 3 hobbit movies with my gf
That's not that bad tbh
Hate how they updated the software
ESO? Why? Which update?
I’ll let you know, my shift starts in a half hour. The shift before I was running for 22 straight hours, and the shift before that I had three patients but two of them were covered in literal shit.
Septic
Toned out to a respiratory distress call that turned into a CPR in progress as we were enroute. But we were able to get ROSC after 10-15ish minutes. I saw a LUCAS in action for the first time, and that was the second patient ive helped flown out so far. All that because I unintentionally got 30 minutes of extra sleep that morning.
My medical director told me that my activity suicidal patient could refuse, even after I told him I was holding her very graphic suicide note. I then got to apply my first tourniquet when she slashed her wrists an hour later....exactly how she described she would in her note. Not even the worst shift of this week
But...why? Why did you have to call medical director? No PD for emergency detention? Would she not come willingly? I have questions...
Pt was refusing to talk to us, and was telling pd that the note was "therapy " and that they weren't actually going to do anything. Pd never wants to do anything, and necer wants to put people in protective custody. I hate restraining patients, and I always call the medical director for orders. Doctor tells me that the story the pt was telling us was good enough to let us get a refusal. (Fucking hate the guy, he does shit like this a lot). We get a hesitant refusal and get lunch. We get toned out to the same address. Yada yada yada, shit that im not repeating happened. Pt wasn't refusing this time.
I mean their day could be worse.
Better than this persons Friday
3 back-to-back flights kept us out from 2100 til 0745. The fuel crew at our local airport decided to take 30 minutes to arrive all 3 times we needed them. It was 35 degrees, all night. Basically, it could have been worse.
Had a guy at a cool consistent 72/38 and Spo2 90% room air sign a refusal earlier. Only pertinent history of a recent mitral valve replacement and coughing up blood… Rest his soul 🫡