--------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: E2D00001 Date: 02/06/97 From: CHRIS NOLD Time: 11:10pm \/To: MARK ELLIOTT (Read 0 times) Subj: New guy -> Region 16, I believe. Texas Panhandle. Took the test last Thursday -> (a week ago) and am expecting the results back the first part of next -> week. What do you know about the EMS program in Lubbock? I'm assuming it's at the university...I've heard alot of good about it. --- WILDMAIL!/WC v4.12 * Origin: Rowlett PD CrimeStoppers BBS (214)412-6262 (1:124/3152.0) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: E2D00002 Date: 02/06/97 From: CHRIS NOLD Time: 11:33pm \/To: GARY SAFFER (Read 0 times) Subj: PULSE-OXIMETERS -> NOW, the pt does not -> MG>have to be taken off of O2 upon arrival at the ER for a room-air -> SaO2 -> MG>reading, which we all know that us medics completely "ruin" by -> MG>putting NRB's on the Pt. My goodness! what were we thinking?! -> -> Mike, this is the 1990's successor to the ever popular "room air -> blood gas" that ERs used to insist were absolutely vital for patient -> care. Never mind that the patient is gasping for air even with an O2 -> mask on! -> Gary -> -> CMPQwk 1.42 129 Two most common elements: Hydrogen & Stupidity -> --- Silver Xpress Mail System 5.4P1a -> * Origin: 6-200 (1:101/460) I'm glad I'm not the only who got mad when they ripped off the O2 for that shtuff! Speaking of diagnostic evaluations, is there any services out there yet who are doing blood testing in the field? E.I.: blood gasses, routine lab tests, etc? I've been hearing that the capability is out there, but haven't heard of it in use... --- WILDMAIL!/WC v4.12 * Origin: Rowlett PD CrimeStoppers BBS (214)412-6262 (1:124/3152.0) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: E2D00003 Date: 02/09/97 From: MARK ELLIOTT Time: 12:24am \/To: CHRIS NOLD (Read 0 times) Subj: New guy On 6 Feb 97 11:10pm, CHRIS NOLD wrote to MARK ELLIOTT: CN> What do you know about the EMS program in Lubbock? I'm assuming it's at CN> the university...I've heard alot of good about it. Hi Chris, Absolutely nothing. Everyone that I've met that works for the Fritch Volunteer Service or for Rural Metro in Borger took their classes either from the local JC (Frank Phillip's) or Amarillo College. Later, Mark ... " " -- Marceau --- Via Silver Xpress V4.4P [Reg] * Origin: Deacon Blue's Space Station and Bait Shop (1:3825/21) --- InterEcho 1.19 * Origin: Node (1:3825/21) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: E2D00004 Date: 02/09/97 From: ANDREW BOTT Time: 02:04am \/To: LILLIAN ACKLEY (Read 0 times) Subj: my name is larry boughton i'm a papamedo02:04:1402/09/97 RE: my name is larry boughton i'm a papamedon. BY: Lillian Ackley to MHS:Mike Bouser on Mon Jan 20 1997 11:00 pm > my name is larry boughton. I'm a paramedic in new york state and i have > been in the e.m.s. since 1991. i would like to ask this question. why > do every state in the u.s.a. have different protocals for treating pts > for medical and trauma. there is no difference in the way our bodies > function from state to state. > That may be true but. Different locations and applications of EMS require veriations of the ems parameters. I work for Rural/Metro Medical Services, e have several different sets of parameters depending on what we are doing. In orange co. fl, It is a large system, and in most cases, the hospital is less that 10 miles away. So here, the parameters and medications are very limited. But in Santa Rosa Co. (Pan handle area) the response area is much larger, so the carry more medications and the medical director has expanded the scope of the ems unit there. Are gulf coast operation does a lot of very long istance transports (5-8hrs), so the they have more of an ICU type parameter. That would not be really practical here in Orlando, to carry all those extra meds because we would never get to that level of Treatment before arriving at the hospital. Andrew --- GEcho 1.11+ * Origin: Rural/Metro AMT * Orlando * Florida Operations (1:363/305) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: E2D00005 Date: 02/09/97 From: ANDREW BOTT Time: 02:09am \/To: GARY SAFFER (Read 0 times) Subj: PULSE-OXIMETERS RE: PULSE-OXIMETERS BY: Gary Saffer to Mike Bouser on Wed Jan 22 1997 01:35 pm > > MB> Besides carefully assessing the patient, using the oximeter > MB>as a tool to perhaps verify your initial conclusions would seem to be > MB>the route to stick > MB>to. > > The Pulse Ox is only one tool, and although accurate as far as what it > measures, what that measurement means can and does vary. If you have two > different patients each with a O2 sat of 90%, one can be okay, and the > other can be in dire straights. The best use of the Pulse Ox that I have > found is to put it on a patient and leave it in the constant monitor > mode. That CAN help tell you if the patient is getting better, but even > still is no substitute for good clinical skills. > > Gary > > CMPQwk 1.42 129 Two most common elements: Hydrogen & Stupidity Where we have found that Sa O2 readings to be most mistunderstood is with CHF patients in the early stages of failure. The medic would assess the patient with acute distress and reguard the Sa O2 level to be acceptable we in fact that is not the case. --- GEcho 1.11+ * Origin: Rural/Metro AMT * Orlando * Florida Operations (1:363/305) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: E2D00006 Date: 02/09/97 From: ANDREW BOTT Time: 02:20am \/To: ALL (Read 0 times) Subj: Early Preperation for Flood Disasters I was watching CNN and find a report about all the snow that the North end of the country has received this year. The report was also expressing a concern over the fact that all this snow would cause major flooding in the valley regions of the country. My question is to those operations in these areas, what preperations have you taken for this possible disaster. I live in Florida (Orlando), so I am not really aware of this type of problem. If you could discribe what area of the country you are from and what are some of the major problems you face. I would like to use this information to educate my co-workers in our disaster management team. Andrew coolnet@cul.com --- GEcho 1.11+ * Origin: Rural/Metro AMT * Orlando * Florida Operations (1:363/305) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: E2E00000 Date: 02/08/97 From: ROBERT WILKIN Time: 01:28am \/To: GARY SAFFER (Read 0 times) Subj: NEW GUY .-=Mark Elliott said to Gary Saffer on 02-03-97=-. > ME>It was kinda strange, I'd go in to ride with the service and they'd > ME>say "Man, you shoulda been here yesterday! We had 14 runs in 12 > ME>hours and 4 of them were MVA aand two others were codes." Then we'd > ME>do paper work and clean the station and wash the ambulance and watch > ME>TV for the next 18 hours. Then I'd go home and on the way home the > ME>tones would start dropping and I'd sit there listening to them work > ME>the calls. > > This is known as the curse of the observer. > .-=End of Quote=-. Or more plainly......"Third Rider Syndrome" Robert Wilkin EMT-P --- GEcho 1.20/Pro * Origin: Rosie's Place! 2400-28800bps; 24hrs; (313) 941-0865! (1:2410/520) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: E2F00000 Date: 02/10/97 From: GARY SAFFER Time: 07:52pm \/To: CHRIS NOLD (Read 0 times) Subj: PULSE-OXIMETERS CN>-> Mike, this is the 1990's successor to the ever popular "room air CN>-> blood gas" that ERs used to insist were absolutely vital for CN>-> patient care. Never mind that the patient is gasping for air even CN>-> with an O2 mask on! CN>-> Gary CN>I'm glad I'm not the only who got mad when they ripped off the O2 for CN>that shtuff! I always thought it was stupid, and I guess I was right. These are the same people that would yell when we brought COPD patients in on high flow O2, because it would make them stop breathing. Another myth with amazing resilience. CN>Speaking of diagnostic evaluations, is there any services out there CN>yet who are doing blood testing in the field? E.I.: blood gasses, CN>routine lab tests, etc? I've been hearing that the capability is out CN>there, but haven't heard of it in use... I haven't heard of it, but that's not to say that it doesn't happen. Gary CMPQwk 1.42 129 We are the most intelligent planet on earth. - D. Quayle --- Silver Xpress Mail System 5.4P1a * Origin: 6-200 (1:101/460) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: E2F00001 Date: 02/10/97 From: GARY SAFFER Time: 07:52pm \/To: ANDREW BOTT (Read 0 times) Subj: PULSE-OXIMETERS AB>Where we have found that Sa O2 readings to be most mistunderstood is AB>with CHF patients in the early stages of failure. The medic would AB>assess the patient with acute distress and reguard the Sa O2 level to AB>be acceptable we in fact that is not the case. Just another case of looking at a device, and not the patient. Especially in failure, the patient can and often does just "look" a lot worse than the equipment tells you they are. Gary CMPQwk 1.42 129 Read the docs. Wow, what a radical concept! --- Silver Xpress Mail System 5.4P1a * Origin: 6-200 (1:101/460) --------------- FIDO MESSAGE AREA==> TOPIC: 197 EMERGENCY Ref: E2F00002 Date: 02/08/97 From: STAN SMITH Time: 01:59pm \/To: MARK ELLIOTT (Read 0 times) Subj: New guy -> -> So have you started to work on the ambulance..and what kind of runs -> -> have you been able to go on ?? -> Just the student runs. Nothing too exiting so far. I got to help `em -> patch up a guy on one of my ER rotations that had cut his forearm pretty -> badly. Most of my ambulance runs were falls and OD's and transports -> between hospitals. No codes or MVAs. -> It was kinda strange, I'd go in to ride with the service and they'd say -> "Man, you shoulda been here yesterday! We had 14 runs in 12 hours and 4 -> of them were MVA aand two others were codes." Then we'd do paper work -> and clean the station and wash the ambulance and watch TV for the next -> 18 hours. Then I'd go home and on the way home the tones would start -> dropping and I'd sit there listening to them work the calls. -> I finally did manage to get all my required runs in, though. -> Later, -> Mark -> --- InterEcho 1.19 -> * Origin: Node (1:3825/21) Well Welcome to the world of E.M.S. !! that's the way it is sometimes.. we have not been very busy ourselves.. had an OB call the other day at one of the malls, no major thing, she was having pain every 10 mins or more.. Then had a stroke pt. that had her stroke while she was walking the block near her home.. she coded on the way in to the hospital and I was able to tube her.. she is doing find but is still in the hospital.. Keep writing and let me know what your doing.. Talk to you later !! Stan Smith , EMT-B Greenville, SC --- Platinum Xpress/Win/Wildcat5! v2.0GY * Origin: Greenville Sheriff's Office BBS 864/467-5864 (1:3639/30)