Latest Comments by sir.shocksalot

sir.shocksalot 1,653 Views

Joined: Nov 13, '10; Posts: 11 (27% Liked) ; Likes: 6
Paramedic; from US

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  • 0

    I read a study where it was documented that trendelenburg caused no improvement in perfusion in settings of shock. Right now PHTLS and ITLS are both recommending that trendelenburg not be done at all. It sounds like it has gone the way of the MAST pants.

    I will echo applewhitern and say that I still see it get done by those that really haven't kept up with the times.

  • 0

    We recently got told by our billing people that a patient must sign our Hippa and billing authorization forms even if they are blind or don't speak English. My understanding was that if the patient can't understand what they are signing their signature is invalid. At one place I worked we had the HIPPA form in different languages so the patient could read it and sign. And I also understood that you would have to read the entire document to a blind person before they could sign.

    Our billing people say that being blind or having a language barrier is not adequate for being "physically or mentally incapable of signing". I'm pretty sure they are breaking the rules. Anyone have any idea where I can find information that defines being blind or non-english speaking as NOT "physically or mentally incapable", anyone else have similar rules?

  • 0

    14g in the ACs are fairly common in traumas and cardiac arrests. Most AC veins in a relatively healthy person can accommodate a 16g, when you donate blood they use 16g needles.

    I would say my most common spot that I hit with a 14g is an external jugular vein, I have found smaller needles have a hard time puncturing the vessel wall.

    I know that in the local ERs the average IV size is an 18g or 20g, most adults in the ER don't get anything smaller than a 20g unless they are a tough stick and thats all you can get.

  • 1
    nightengalegoddess likes this.

    What a kick to the groin! I agree with the other posters, you are better off out of that job. It almost sounds like you were set up to fail, how is your preceptor supposed to know that you aren't progressing if they are never there to watch you? Also, is it just a coincidence that the second you ask for a different preceptor they let you go? hmm...

    I wouldn't let it get you down, you probably weren't the only one to receive a similar treatment. Look for another ICU job and keep at it.

  • 0

    It seems like Denver Health is starting to get strained from the decrease in nearby hospitals. The west side of Denver, near where the old SAC used to be is quite ghetto and sees a decent amount of trauma that would usually go to SAC, now most of it has to go to DH. SAC moved way out of the way to the point where they are now kind of a pain in the butt to get to, as a result DH is getting ridiculously busy.

    Lutheran is another hospital that is pretty much situated in the ghetto, so it makes sense to me that they are having budget problems, it doesn't help that SAC moved further away leaving Lutheran the only hospital on the west side of Denver.

    The only way this problem will start improving is when the economy picks up, people start getting jobs, and people start getting some semblance of insurance that pays more than medicare/medicaid.

  • 0

    Wow, I'm truly shocked at the EMS services in some areas. Paramedics absolutely can give Haldol prehospital, heck we even have Droperidol on the ambulance. We can also give Ativan or Versed to sedate combative patients. All without consultation with an MD.
    I will second another posters comment; if you have a patient who is combative from a head bleed, how are you supposed to know he has a head bleed if he keeps fighting you? Furthermore, benzos are potentiated by alcohol, so anti-psychotics are the drug of choice in combative drunks.

    Paramedics can give a wide variety of drugs and preform a wide variety of procedures depending on local protocol. Unfortunately most paramedics lack the appropriate education for said medications and procedures and in my experience most paramedics get vary nervous around chemical sedation so it might not be a common site in your ER.

  • 3

    Quote from GreyGull
    PhART - Pharmacology Advanced Training
    They really didn't think that acronym through did they?

  • 0

    You can also ask your local EMS agency. Since all Paramedics are required to have ACLS and PALS for employment, most agencies typically teach those courses.

  • 0

    I'll second student4life, get a Macbook. I have a Macbook Pro and I LOVE it, works fast, none of the usual PC issues. I would recommend the regular Macbook (999.99) over the air, only because the Air is kinda flimsy looking and not even close to the macbook in terms of power (just for running applications and videos).

  • 0

    OP, as a passenger abord the aircraft you don't have to pass any sort of "flight physical". Pilots have strict FAA requirements and color blindness is a no-go. However since you aren't flying the aircraft you won't have any such restriction. The only physicals that are done by flight teams are general health physicals (can you lift stuff without slipping discs, and will you have an MI if you walk up 3 steps?), and height and weight requirements (will depend on the aircraft, i think its under 200 generally speaking, and unless you are basketball player tall you won't have to worry about height).

    I'm not sure what Imthatguy was referring to with military flight surgeons and what not, the military has completely different requirements just to be let in regardless of what you will be doing, so their requirements are irrelevant in the civilian world.

  • 2
    TUhopeful and mariposabella like this.

    I would go for the BSN. The initial costs may be higher (you can offset them with loans as needed) but it will pay off faster. My understanding is that ASN graduates are having a tough time finding jobs right now, and hospitals are hiring mostly BSNs or RNs with a decent amount of acute care experience.

    Also if your long term goal is an MSN or DNP then a BSN is a prerequisite to that; there doesn't seem to be a lot of logic in going to get your ASN then your BSN if you can simply skip the first step. Good luck in your decision.