CAdamsPAC Posted August 23, 2013 Share Posted August 23, 2013 along those same lines: " I'm out of birth control pills and I have a date tonight". seriously. Not my problem............have a good day on your way to the store for condoms. Link to comment Share on other sites More sharing options...
CAdamsPAC Posted August 23, 2013 Share Posted August 23, 2013 "I'm allergic to vicodin, but Norco works for me;" "vomiting x 1 hour;" "Fever x 30 min (seriously)." God, if teenagers and twenty-somethings knew ottowa rules and nexus criteria... AND if young parents knew how to treat a fever and what constituted an ACTUAL sick kid... Dr. Spock, where are you? Dependence equals control........paternalism, perpetuates dependence.........so control is assured....responsibility is abrogated..........self inflicted ignorance rewarded!!!!Welcome to the Brave New World!!!!!!!!!!! Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 23, 2013 Moderator Share Posted August 23, 2013 TRUE STORY: "I'm allergic to 2 mg of dilaudid IM but not 4 mg of dilaudid IV". Link to comment Share on other sites More sharing options...
paprospect24 Posted August 23, 2013 Share Posted August 23, 2013 "I'm allergic to vicodin, but Norco works for me;" "vomiting x 1 hour;" "Fever x 30 min (seriously)." God, if teenagers and twenty-somethings knew ottowa rules and nexus criteria... AND if young parents knew how to treat a fever and what constituted an ACTUAL sick kid... Dr. Spock, where are you? Its not that we don't know them. It's that out protocols are outdated and disregard evidence based medicine. Link to comment Share on other sites More sharing options...
jwells78 Posted August 23, 2013 Share Posted August 23, 2013 Its not that we don't know them. It's that out protocols are outdated and disregard evidence based medicine. ? Care to elaborate? I think I read you wrong Link to comment Share on other sites More sharing options...
ajnelson Posted August 23, 2013 Share Posted August 23, 2013 My cystic acne is painful... Link to comment Share on other sites More sharing options...
paprospect24 Posted August 23, 2013 Share Posted August 23, 2013 ? Care to elaborate? I think I read you wrong I think I'm the one who read you wrong. I thought you were referring to the EMTs who bring everyone into the ED strapped to that torture device we call a backboard. Link to comment Share on other sites More sharing options...
PM2PA Posted August 23, 2013 Share Posted August 23, 2013 On scene at a baseball game standby. "I ran out of tampons and I'm having my period right now." Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted August 23, 2013 Moderator Share Posted August 23, 2013 I think I'm the one who read you wrong. I thought you were referring to the EMTs who bring everyone into the ED strapped to that torture device we call a backboard. Believe me, no one faults you for this- we all know it's protocols that need serious overhaul. NAEMSP recently came out with recommendations that said that anyone who more or less meets NEXUS criteria doesn't need a full backboard. Whether that trickles down to EMS services or not remains to be seen. What jwells was referring to was if the 20-something in general knew these rules... Link to comment Share on other sites More sharing options...
PM2PA Posted August 23, 2013 Share Posted August 23, 2013 Believe me, no one faults you for this- we all know it's protocols that need serious overhaul. NAEMSP recently came out with recommendations that said that anyone who more or less meets NEXUS criteria doesn't need a full backboard. Whether that trickles down to EMS services or not remains to be seen. I highly doubt this will ever happen. Ask anyone in EMS what NEXUS criteria is and they will look at you like you have two heads (me included) as it's not taught in medic school. EMS is more concerned with lawsuit avoidance than actual patient care most of the time. And to boot, medical directors who write the protocols would probably opt for the easy way out and not even include it. Most of them are nothing more than a paycheck collector and could care less about teaching what they want their medics to know. Hence, neck/back pain post MVA? LOLFDGB unable to lie flat? CC and BB always. Link to comment Share on other sites More sharing options...
medic25 Posted August 23, 2013 Share Posted August 23, 2013 I highly doubt this will ever happen. Ask anyone in EMS what NEXUS criteria is and they will look at you like you have two heads (me included) as it's not taught in medic school. EMS is more concerned with lawsuit avoidance than actual patient care most of the time. And to boot, medical directors who write the protocols would probably opt for the easy way out and not even include it. Most of them are nothing more than a paycheck collector and could care less about teaching what they want their medics to know. Hence, neck/back pain post MVA? LOLFDGB unable to lie flat? CC and BB always. This may be your personal experience, but realize that there is a lot of variability between EMS systems nationwide. The paramedics in our system have been using NEXUS criteria for 5+ years for their selective spinal immobilization protocol, leading to significantly fewer patients being collared for minor trauma. We also implemented the NAEMSP guidelines for backboards last year, and are fairly close to pushing it out as a statewide policy. If you are ambulatory at any point in our system, you do not get a backboard, period. There is no literature to show that it reduces spinal injury, but there is literature to show that it causes patient discomfort, pressure ulcers, and respiratory compromise. Link to comment Share on other sites More sharing options...
PM2PA Posted August 23, 2013 Share Posted August 23, 2013 This may be your personal experience, but realize that there is a lot of variability between EMS systems nationwide. The paramedics in our system have been using NEXUS criteria for 5+ years for their selective spinal immobilization protocol, leading to significantly fewer patients being collared for minor trauma. We also implemented the NAEMSP guidelines for backboards last year, and are fairly close to pushing it out as a statewide policy. If you are ambulatory at any point in our system, you do not get a backboard, period. There is no literature to show that it reduces spinal injury, but there is literature to show that it causes patient discomfort, pressure ulcers, and respiratory compromise. Interesting. Where is this system? King/Wake/Austin-Travis county? Link to comment Share on other sites More sharing options...
cbrsmurf Posted August 23, 2013 Share Posted August 23, 2013 If things are slow, try putting a backboard on the ground and strap yourself to it for 15 mins. Those things are painful. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 23, 2013 Moderator Share Posted August 23, 2013 If things are slow, try putting a backboard on the ground and strap yourself to it for 15 mins. Those things are painful. we did an "improvised equipment" practical in my emt-basic course. the "backboard" was a door off an ampm minimart that the fire chief in my class commandeered. I was strapped to it with duck tape for an extended period of time. Link to comment Share on other sites More sharing options...
medic25 Posted August 24, 2013 Share Posted August 24, 2013 Interesting. Where is this system? King/Wake/Austin-Travis county? Putting us in esteemed company with those systems :) New Haven, CT actually. Link to comment Share on other sites More sharing options...
Just Steve Posted August 24, 2013 Share Posted August 24, 2013 I highly doubt this will ever happen. Ask anyone in EMS what NEXUS criteria is and they will look at you like you have two heads (me included) as it's not taught in medic school. EMS is more concerned with lawsuit avoidance than actual patient care most of the time. And to boot, medical directors who write the protocols would probably opt for the easy way out and not even include it. Most of them are nothing more than a paycheck collector and could care less about teaching what they want their medics to know. Hence, neck/back pain post MVA? LOLFDGB unable to lie flat? CC and BB always. And it will probably remain this way for non aggressive systems where EMS providers do not advocate effectively for themselves, their profession, or their patients. As long as the feet on the street are unwilling, or don't perform the diligence in researching and advocating for modern care standards, nothing will change. Along the same lines, if providers fail to meet existing protocols with any sort of efficiency, the EMS medical director will be rightfully hesitent to go out on a limb and be progressive with crews that fail to even match conservative standards. Your EMS providers should be calling for a protocol review annually and show up with the latest studies, proposals to run your own studies, proof of compliance with existing standards, and a mouthpiece who can speak intelligently with the EMS director. This will require additional effort and education, without pay increase, for your EMS providers. As long as y'all are willing to accept the status quo, that is what you will get. Yes, I have worked EMS in both conservative and progressive systems. The latter being oh so much better. Link to comment Share on other sites More sharing options...
Just Steve Posted August 24, 2013 Share Posted August 24, 2013 For the OP.. "well I wasn't sure if I should come in about this pain in my knee but I called my mom, who is a retired nurse..." Link to comment Share on other sites More sharing options...
jwells78 Posted August 24, 2013 Share Posted August 24, 2013 I couldn't resist, had this one come in yesterday: CHEST PAIN. 26 y/o male, well appearing- no risk factors. "Pull up your shirt" I say, (this was at the rapid eval area). He has an abrasion to his Lt nipple from working in the heat 2 days prior. Those things hurt, yes, but ... seriously? Really glad nobody ordered a CXR and EKG on this guy... Link to comment Share on other sites More sharing options...
bgdog Posted August 24, 2013 Share Posted August 24, 2013 Had this happen: At MVA scene the officers want to talk to everyone "involved" in the accident after they are checked out by EMS. EMS transports them all to the ER first. In the ER I am doing the medical screening asking the pt what brings him in. Answer- the ambulance crew said I needed to be checked out. Me- what are your injuries? He says injuries? I say yes were you not involved in the accident. He pauses and says Oh, oh you mean "involved- like involved. Oh no I just witnessed the wreck." True story... ^^^^fricken hilarious.^^^^ Had a guy come in once for a scratch. Literally a scratch on his arm. I said "that's a scratch, you've never had a scratch before?" He said "yeah I have, I just wanted to get it checked out" Scientist say that hydrogen is the most plentiful matter in the universe. Frank Zappa disagrees. "It's not hydrogen that's the most plentiful substance, it's stupidity" Sometimes I wonder. Link to comment Share on other sites More sharing options...
dstpierre Posted August 24, 2013 Share Posted August 24, 2013 when their first requests upon arriving to the ED are for warm blankets and a sandwich...you sir, are not having an emergency Link to comment Share on other sites More sharing options...
emorley Posted August 24, 2013 Share Posted August 24, 2013 1. Patient, while waiting for the doctor, yelling out "when can I get a room where I can be fed.'" Link to comment Share on other sites More sharing options...
emorley Posted August 24, 2013 Share Posted August 24, 2013 "Allergic" to every pain medicine except "D-D-Dilaudid" Link to comment Share on other sites More sharing options...
Kelbie Posted August 29, 2013 Share Posted August 29, 2013 I was at walmart 2 weeks ago and I slipped in a puddle and fell and my attorney told me to come here to get checked out and get everything xrayed. By the way, can you fax this to my attorney before I go? Link to comment Share on other sites More sharing options...
Kelbie Posted August 29, 2013 Share Posted August 29, 2013 or "what do I have to do to get admitted here? I need a sandwhich" Link to comment Share on other sites More sharing options...
tariesen Posted August 29, 2013 Share Posted August 29, 2013 "No complaints; covered in feces." Link to comment Share on other sites More sharing options...
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