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Nobody wears a white coat any more...
...a tribute to becoming a doctor.
No stuff, just fluff.
<td bgcolor="#000000">lj name</td><td bgcolor="#DDDDAA"></td></tr><td bgcolor="#000000">sex</td><td bgcolor="#DDDDAA"></td></tr><td bgcolor="#000000">age</td><td bgcolor="#DDDDAA"></td></tr><td bgcolor="#000000">your best friend thinks</td><td bgcolor="#DDDDAA">you'd taste good with ketchup </td></tr><td bgcolor="#000000">your family think</td><td bgcolor="#DDDDAA">you're sweet </td></tr><td bgcolor="#000000">strangers think</td><td bgcolor="#DDDDAA">you're just a cuddly bear </td></tr>
what do they really think of you by purple
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Found myself referenced in somebodies, which was an obscurely pleasing event.

And now on to non-fluff stuff.
Today was ACLS training, day one. Today, I successfully completed my AED and CPR testing. From noticing a person down, to establishing responsiveness, to rescue breaths and chest compressions and using the AED within 90 seconds of receiving it. I got it all right. Although those mannequins have got to be easier to compress than real people. Because I've seen a code.
Morning was...well, tedious. And overall, well, overwhelming. Too many drugs and doses, no way to learn them well. So we sat and listened and stared at him. I highlighted all of the drugs he talked about, like agood medical student. But I slept through a lot of it, due to extreme inability to stay awake. And there was a point in time where one of the lecturers was standing there, talking about using the AED, and right there on her chest, perfectly centred, is ''No Signal" and a countdown timer. For some reason , I found this to be terribly funny.
Afternoon: First station was the CPR/AED station. Because everyone asked me, an AED is an Automatic External Defibrillator. It's a cute little box that's designed for absolutely anyone to be able to use. You take it out and turn it on, and a synthesized voice says "Attach pads to patient and connect to device." And you take the pads and peel them off their backing, and you stick them to the patient's bare chest where indicated (there's a little diagram on the back of the pads). And then you plug the other end into the machine. It only fits one way, and there's a little flashing light to direct you. And the voice says "Analyzing rhythm. Do not touch the patient." And everyone gets back, and the AED decides if a shock is required. And if it is, it charges to the right amount and tells you to make sure the patient is clear, then to press the "Shock" button. Bang. And so on, and so forth. The idea behind these little wonders, besides them being much lighter for paramedics to tote around, is that your Average Human Being can now become a lifesaver. Prior to the introduction of the AED, the survival rate for an out-of-hospital coronary event was around 5% or less. In areas where these are available to the public, the survival rate has increased to 50-80%, simply because the response time is so much faster. There are even some models that will walk you through performing CPR.
90 second limit, baybee. I had it out, on, and shocking in under a minute.
Station two was on how to use a Real Defibrillator. "Who wants to try?" And everyone stood around for a bit, and I finally said "I'll do it." So we practised learning the voltages (100, 200, 300 and synchronised for V-Tach, unless it's pulseless, when you start at 200, and you might as well do it synced; 200, 300, 360 for V-Fib) and applying the paddles and shocking. And they had real current (just 20 joules or whatever) running through the mannequin, so it was all dramatically realistic. "Everyone clear?"
Station three, just as much fun, was on intubation. We learned how to use the blades, both kinds, and why the straight blade (Miller) is good on a mannequin but the curved one (Mack?) is better on Real People (the curved one pulls the epiglottis back instead of going over it, something that works well in humans but not in rubber throats. And we learned something about the combi-tube, and intubating infants, and I only made my mannequin make funny noises (meaning that I would've broken teeth in a real patient) once or twice. And I only missed the trachea and intubated the stomach once. Not too bad, for a beginner.
Station four was the Respiratory Arrest Case. And we all stood around the mannequin and she said "Who's going to be the code leader?" And nobody volunteered. So I finally said "I will." And so I got to stand at the head and tell everyone what we were doing. None of us knew. But with a little prompting, we got through the respiratory arrest, and I successfully intubated him after bagging him, and his labs came back with a K of 2 and a magnesium of 1, so gosh I wonder why he was having trouble. And we got him into ICU and corrected his 'lytes, and then it occurred to me: We have a COPD patient here with a relatively unknown medical history, because the EMT's only got his COPD status and not even his med list before he quit breathing and thus quit being able to answer questions, because they were apparently playing cards on the way to the hospital since he only went into respiratory arrest when he entered the ED. We should've gotten a bloody finger stick. I've seen a patient who was mistakenly intubated for respiratory arrest when her glucose was....oh, about 8. It's okay, though, we didn't get yelled at for it. And I got my signature, which is all that matters.

fyrfitrmedic and mama0807: We watched a video on acute stroke, and we all wondered something. The setup of the video was a bit cheesy: mother and daughter walking through the mall, mom says "Oh, oh my...my arm is weak...and my leg..." They sit down, girl says "Are you all right, do you want some water?" and mom says "No, call 911, I'm having a stroke, my doctor warned me..." and so on, and so forth. They call medics, medics arrive, and there in the middle of the mall, in front of Lazarus, the medics sit down with the woman and get her BP and do a Cincinnati Stroke Scale and chat up her daughter a bit. And then they load her on the cart, and put her in the ambulance. Is this the normal sequence of things? Or would you do the vitals and stroke scale in the truck? We thought they should've put her in the truck first.

Came home, took a nap, had a shake for dinner (good Nykkit). Got a call from ecchikun, his car was dead and could I come perform some kind of rescue? Be glad to. Especially since he'd been on his way up to FW. Which meant that I got to see Angel in Gas City where we split the hundred-mile drive. Even that little bit...as small as it was...helped. Plus, I took a half an hour of it to study for the exam tomorrow (we had a 33-question pretest. We'll have a 33 question posttest that is "very similar" to the pretest. Three guesses as to what the posttest is going to be like). The cards have all the answers I need, for drug dosing and such. I'm going to be fine.
And then down to the aeroport to pick up Seron, and then home to the Gathering. And hopefully tomorrow Angel will work things out with Keith, so when we call Saturday afternoon it will be a simple matter of telling Quinby's parents what will happen.

Today, O Best Beloved, I feel better than I did yesterday. And tomorrow I will feel better yet, because I will have my Angel by my side again. Plus, I get out of class at 12-ish. And I love being able to do anything but sit in class. I think I will take Shain with me, and sit in the student lounge, and kill some time before the aeroport.

I forgot to bring a stuffed aminal. Is lonely. I don't even have my plushie stomach. Maybe that's why I had such bizarre dreams last night. It was a time-travelling romance novel plot, where the main characters were always in the wrong century to wind up with their correct partner. A strange dance.

now feeling:: optimistic optimistic

6 whispers echo . o O ( ... ) O o . whisper a word
lakos From: lakos Date: August 28th, 2003 10:10 pm (UTC) (etched in stone)
Lazarus? They had to go and make obscure references in a *training video*? Gyah...
ayradyss From: ayradyss Date: August 28th, 2003 10:26 pm (UTC) (etched in stone)
Think you're digging too hard, lover. Sometimes a trendy department store is just a trendy department store.
attickah From: attickah Date: August 29th, 2003 07:34 am (UTC) (etched in stone)
Actually, that's the first thing I thought of, too...mainly because we don't have an lazarus department stores up here. I hadn't heard of them until I lived in Evansville.
mama0807 From: mama0807 Date: August 29th, 2003 08:49 am (UTC) (etched in stone)
'Swoop and scoop' would have been my choice as well...get vitals in the back of the rig. If the patient is presenting wih full CVA symptoms the biggest priority should be to get them to definitive care asap.

I saw this happen once, before I became an EMT. I was in EMT-school at the time though. I was working at a dept. store and a woman started stroking out. Medics came, and all they did in the store was put her on the stretcher and load her up.
fyrfitrmedic From: fyrfitrmedic Date: August 29th, 2003 04:27 pm (UTC) (etched in stone)
[nodding in agreement]

Much can be done in the back of the bus, why waste time and brain tissue on location?
mama0807 From: mama0807 Date: August 29th, 2003 05:17 pm (UTC) (etched in stone)
And that is the reason I think there should be at least 2 people in the back of the rig, to divide up duties. Granted, it's hard to do that at times in a volly service, but I don't think it's fair for the medics to have to do everything.
I have a rule. If you're in the back of the rig with me, you are going to work. If you're not EMT-certed and can't do vitals you can sure as hell get patient info.
6 whispers echo . o O ( ... ) O o . whisper a word