--------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DEJ00007 Date: 10/14/96 From: ROBERT CONNER Time: 01:20pm \/To: FRANK ARNOLD (Read 1 times) Subj: Looking For Help Frank, it seems to me that the best possible place to find information on HHNK would be either the American Diabetes Association, or possibly the nearest emergency dept. I admit the HHNK is a new one to me,too. How about posting something here when you find out? Good luck. --- WILDMAIL!/WC v4.12 * Origin: The Hammer BBS (405) 376-0210 Mustang, OK (1:147/1039.0) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DEL00000 Date: 10/14/96 From: ED MCCARTHY Time: 11:49pm \/To: STEPHEN KIRKPATRICK (Read 1 times) Subj: Seizures Hello Stephen. I read your comments about how seizure patients are handled by emergency people. You sounded sort of upset about an apparent lack of interest on the part of EMTs and cops. There are many, many reasons for having seizures. trauma, Diabetes, Strokes, Drug abuse including alcoholism, and withdrawl, Epilepsy, High fevers, neurological disorders but to name a few. Seizures have "phases" The pre-seizure, called an 'aura'. The actual seizure, and then a "cooling off period" called the post ictal state. SDuring this time, the patient is often confused, and lethargic. Assuming no worrisome findings are discovered after evaluating the patient, and the history is basically benign, if thr patient is fully awake, and refuses care, is is within his/her right. It should be explained to the patient that there is no telling if another seizure is iminent, but it is a significant risk. We try to encourage every patient to come to the ER for an eval after a seizure. If they are awake, oriented, understand the risks, and still refuse, they have that right in Massachusetts. As far as litigation, That is not the reason ambulances take people to hospitals. they take people to hospitals 'cause they need, or want to be seen for an illness or injury. If by doing so, the EMT "covers his/her ass", well, that's fine. You seem to have a skewed idea of emergency services. The vast majority of us do not haul people around like cordwood, or dirty laundry to "get them off our hands" They're the whole reason we're out there. Any More questions, I'd be glad to help with. :) --- WILDMAIL!/WC v4.12 * Origin: Big City BBS (1:101/590.0) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DEL00001 Date: 10/14/96 From: ED MCCARTHY Time: 11:51pm \/To: JAMES NOLD (Read 1 times) Subj: patches I work for Boston EMS in Massachusetts. I'd love to score some patches from you! We have a large patch board up in our satellite station, and new additions are always welcome. I have the two Boston EMS department patches, and a couple of the local private carriers' patches. --- WILDMAIL!/WC v4.12 * Origin: Big City BBS (1:101/590.0) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DEL00002 Date: 10/15/96 From: ED MCCARTHY Time: 12:01am \/To: DAVID RODGERS (Read 1 times) Subj: EMT -> Ok, Im 17 and in and going to be certified as a Emt, Then EMT Paramed -> was wondering if anyone out there is one, If so then I was wondering -> What kind of thigs do you see, 2, how much does it pay. -> -> -> ... Welcome to Hell. Here's your copy of Windows. -> -> --- PPoint 1.96 -> * Origin: Microsoft Haters Anonymous (1:124/6308.4) Dear david..... You might want to work as an EMT basic for a while before going on to Paramedic for a couple of reasons. One, most states require you to work as an EMT for a while so you'll have some experience before going on to Paramedic school. What good is a paramedic who hasn't worked in an ambulance before? Two, you mighht find that you may not like EMS work, and Paramedic School is a large investment in money, time, and effort. (where I come from anyway.) I'd hate to sink all that into a medic ticket if I hated the work. Three The pay isn't the greatest, and much of the rual EMS is volunteer in many parts of the country. Alot of people I know have a running joke that the six rectangles that make up the 'star of life' represent how many dollars an hour most EMTs get paid! Municipal services are better, especially one with Union representation As for what we see, there is some trauma, and some good medicals. But the majority of calls we do in the urban setting are routine BS. Kids with fevers, drunks with seizures, and minor illnesses, and injuries. I've been called for dandruff! good luck..... ....s rr so --- WILDMAIL!/WC v4.12 * Origin: Big City BBS (1:101/590.0) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DEL00003 Date: 10/14/96 From: GARY SAFFER Time: 08:47pm \/To: BLAKE BOWERS (Read 1 times) Subj: COMPLAINTS BB> CN> I just recently taped most of the episodes of Emergency off the BB> CN> satellite, to watch it for the first time. It's cool, BB> CN> considering how BB>Snicker.... BB>Of course, those of us who were alive then..... Those of us who watched it in first run, and were still older than some of the others on this echo! :> Gary CMPQwk 1.42 129 Software Independent: Won't work w/ any software --- Silver Xpress Mail System 5.4P1a * Origin: 6-200 (1:101/460) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DEL00004 Date: 10/14/96 From: LOU OLIVEIRA Time: 04:58am \/To: FRANK ARNOLD (Read 1 times) Subj: Looking For Help Frank Arnold asked : -> To any how may help, -> I'm taking an E.M.T. Intermediate class and the new state guide lines -> are out and they include something that the instructor has not seen -> before it is worth extra credit for me if I can find out something -> about Hyperosmolar Hyperglycemia Non-Ketotic Coma (HHNK) I really -> need to find out the Pathophysiology of this. I also need -> Preciptating factors, Sighs and symptoms, and management. But any -> help on this topic would be greatly appreciated. Thank you in -> advance. Frank Arnlold EMT-B HHNK is a medical emergency occurring in patients with Type II diabetes, where there is enough insulin produced to avoid diabetic ketoacidosis, but not enough to prevent severe hyperglycemia, diruesis and severe fluid depletion. S/S : somnolence, coma, seizures and aphasia. The immediate therapy is to administer fluids intravenously, 6-20 L maybe needed within first 24-48 hours. 0.9% or 0.45% normal saline is used, depending on the degree of dehydration. Regular insulin is given IV to reduced hyperglycemia and blood sugar levels are monitored. Not being an EMT, I don't know what the guidelines for field management are, but I hope this helps. Lou, RN --- Platinum Xpress/Wildcat! v1.2f * Origin: Purrrrring Platinum Xpress! and Wildcat! (1:2630/133) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DEL00005 Date: 10/16/96 From: CHAD MOSER Time: 12:28am \/To: JAMES TARPLEY (Read 1 times) Subj: Re: complaints Haven't worked for the long, (1 month). I did however do my Paramedic 3rd rides at EMSA. There are a lot of things going on right now. In fact too many to list here. Chad Moser --- TriToss (tm) Professional 10.0 - (Unregistered) * Origin: Another World - Just a world away.. (918) 224-4279 (1:170/205.0) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DEL00006 Date: 10/16/96 From: CHAD MOSER Time: 12:30am \/To: JAMES NOLD (Read 1 times) Subj: EMSA\Tulsa EMSA seems like a good service to work for. Lots going on right now. I'll have to fill you in on it at a later date. Not enough time left online to go into it. Chad Moser --- TriToss (tm) Professional 10.0 - (Unregistered) * Origin: Another World - Just a world away.. (918) 224-4279 (1:170/205.0) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DEL00007 Date: 10/16/96 From: CHAD MOSER Time: 12:31am \/To: JAMES NOLD (Read 1 times) Subj: patches Let me know what kind of patch are you/your sister interested in? Chad Moser --- TriToss (tm) Professional 10.0 - (Unregistered) * Origin: Another World - Just a world away.. (918) 224-4279 (1:170/205.0) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: DEL00008 Date: 10/13/96 From: GEORGE JACKSON Time: 10:13pm \/To: GARY SAFFER (Read 1 times) Subj: COMPLAINTS -> Personally, I think it is because it is so easy to become an EMT, that the -> labor pool is so much bigger than the demand that it is a buyers -> (employer's) market. If it took longer, and the requirements were more -> stringent, and maybe cost more, there would be fewer EMTs and salaries could -> be higher. In Canada it takes about 1500+ hours to get your basic certification. The pay's a lot better than in the States (at least for the municipal services, I don't know about the transfer services), but we still have a glut of people. We lso have the problem that EMS isn't represented as well politically compared to the other emergency services. Nothing can change the minds of the people who own the private services in he States, after all it's a free market system. The general public would never get upset over the conditions faced by EMS workers since they've got more important things to worry about. Your best bet is to work on improving EMS' relations with their employers in cities where it's a municipal service. Without competition they can afford to pay decent salaries, and you might actually be able to convince them to do it (as a public body the politicians are influenced a little less by the bottom line and a little more by altruism, though not by much). I don't know what kind of hiring practices are used where you work, but here it's based on a rigourous testing program that's done every time there's a ob open. Only the best get hired, so it makes up for the fact that there's so many people applying for each spot. They could take advantage of the number of applicants and use that to bid down the expected wages, but they know that they'd be getting the most desperate people, not the best. Nothing's going to change in the system until EMS gains the same kind of respect enjoyed by fire and police, and that will only come through improved awareness and relations with the politicians who control the system. --- QScan/PCB v1.19b / 01-0150 * Origin: Ability OnLine - Toronto Canada - 416 650-5411 (1:250/518)