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ShreddedMedic29 2 points submitted 10 days ago

I know what you mean. It not that bugs me. Every call affects people different. Usually, when a pt is alive and has a chance to stay that way and then dies is when I start running the canada goose clearance sale call through my head 20 more times instead of the usual 2 or 3.

canada goose black friday sale There a difference between patient care and outcomes than being a fucking sensitive ass little bitch, that my company has hired so much of lately. If a call fucks with you, so be it, find out what you did right and wrong and feel bad, don let it eat you up. So fuck you, OP is a green horn getting broke Canada Goose online in, don forget where you came from. canada goose black friday sale

On the other hand, if one snowflake gets upset buy canada goose jacket cheap because their FTO yelled at them to stop while driving hot because there is an old lady in the way or thinks everyone is being rude to them because 14 cusswords were mixed up in their sentence or someone told them they were doing canada goose store something wrong I GONNA LOSE MY SHIT!! That the people we need to worry about, those that are more worried about being offended than cycling a call events in their head

canada goose uk outlet There are case reports of TXA being used successfully in nontraditional ways; topically for minor wounds, nebulized for airway bleeds, or in liquid mouthwashes for dental procedures. Your medic probably knew some of this. To spray a major traumatic wound with the stuff is a stretch, and I don know if it has been demonstrated clinically. canada goose uk outlet

Canada Goose Online I have a couple concerns with his clinical judgement though. Canada Goose Online

Was there a good anatomic/pathologic reason for Canada Goose Jackets the failed IO attempts?

You said there was a concern for internal bleeding. Clearly topical TXA isn a solution for that.

Obviously I not seeing the wound, but depending on the location, I can imagine topical TXA is a better way to use time and hands than direct pressure or a TQ.

buy canada goose jacket cheap Med control probably should have been contacted before breaching protocols like that. buy canada goose jacket cheap

canada goose uk black friday Did he harm the patient by spraying TXA around? Probably not. Did he help the patient? Also doubtful canada goose uk black friday

Canada Goose Jackets ShreddedMedic29 4 points submitted 11 days ago Canada Goose Jackets

Canada Goose Canada Goose sale Coats On Sale The location of the wound and it length prevented us from full control of the bleed. I hated to do it but we put tourniquets Canada Goose Coats On Sale

Canada Goose online directly over the part of the wound site that was less damaged although I feel it was useless. I put that motherfucker on as tight and high as I could go keeping in mind the rest of pt problems as J detail below. Canada Goose online

Canada Goose sale Lac ran from illiac crest down to the knee, (general area) Minor crepitus on left side hip. We don use PASG. Abdomen distended with dark, blue blackish coloring. Canada Goose sale

uk canada goose Our protocols only allow for tib IO. Left ankle was at 90 angle, no pedal pulse, crepitus noted in tibia canada goose coats left side. It was minor but when he drilled he pulled out stating it wouldn work. uk canada goose

cheap canada goose uk Right side deep lac with major bleed, major avulsion with likely tib/fib fracture. Bleeding but controlled by tourniquet. Not sure if the crush/avulsion was not bleeding bad because if the lac or what but yeah, we seemed to be fucked all away around cheap canada goose uk

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Do you guys have extenuating circumstances protocols? There’s very few calls I’ve ever had to call for canada goose deals orders but this sounds like a situation where I would either try an Canada Goose Outlet ej or be on the phone asking to drill a shoulder based on the injuries you described.

As for keeping blood in, when the tq doesn’t stop the left leg I would take a whole roll of kerlix, and scoop/sponge blood away from the top of the lac to see if I could tell where the blood was coming from and either go in with compressed gauze/combat gauze/or hemostats based on what you are allowed to do and try to stop it right at the source with a new dressing. If you cut his pants leave the belt on and tie off the ends of the pressure dressing to the belt. Blankets and heat on in the back will help with clotting too. 604 points submitted 12 days ago

Canada Goose Outlet I use 5 main tactics on the anxious/demanding folks (as we go into viral URI season) I work in one of the richest counties in the country so a loooot of know it all’s: Canada Goose Outlet

1) set the rules BEFORE the exam I tell people “gosh, canada goose black friday sale sounds like you’ve been feeling horrible! canadian goose jacket You either have a viral or bacterial cold, and my job is to look for any evidence of a bacterial infection instead of just a viral one I’m going to look in your ears, nose, throat, lungs to see if you have any ear infection, strep throat, pneumonia etc”. Then as I do a really looooong exam with some “hm!” Sounds, narrating the exam: “your ears look good no bacteria here. Throat looks totally clear no strep throat. Lungs sound crystal clear no crackles or wheezing at all! Great!”. Then the patient really has no argument since I’ve already set these expectations that they don’t get antibiotics if there is no bacteria.

2) do some “I can read your mind and know what I’m talking about” tactics I have a sign on the wall saying VIRAL COLDS on top with a graph of the typical symptoms. Basically day 1 3 fever and aches, day 2 4 congestion, then 3+ cough. I go through and say “unfortunately we are seeing a ton of people coming in with these symptoms that are typical for a viral cold”. I read them off. and usually they buy canada goose jacket will say “oh my gosh that’s exactly what I’ve been having.” And I say “yes, this VIRAL COLD is definitely going around!”

3) let’s focus on fixing your SYMPTOMS (with placebos) “right now we are seeing a ton of viral colds and they are making people really feel miserable. cheap Canada Goose What’s your worst symptom? Here are some PRESCRIPTION ONLY meds that are really going to help!” I think asking them to describe their worst symptom and giving https://www.canadagoose-jackets-online.com them a chance to complain about canada goose outlet how hoooorrible their nighttime coughing fits is and how they can’t function during the day because they haven’t slept in days and then empathetically, directly addressing their concern makes most people feel adequately cared for.

4) give them a choice this is a bit of a salesman/human psychology/parenting tactic “there are a few things we can do here. One is to wait it out if you don’t like taking medication, and as you can see on my chart, symptoms go away within 14 days. Another is to decrease the canada goose inflammation which honestly is 90% of the battle ibuprofen/naproxen. Or we can give you strong cough medications. What are your thoughts?” if they’re still not sold, I will occasionally give out hycodan/cheritussin and sell it as if it is so strong you can’t drive with it, and say it is a controlled substance/addictive/blah canada goose coats on sale blah. “Stronger” to many of these people canada goose clearance means “better”. and they can leave feeling good about themselves that they got the doctor to give them the “strong stuff”.

5) giving them an out for antibiotics I point to my chart and tell them “see how a viral cough can last a full 2 weeks while the inflammation is dying down? This is normal BUT If at any point you start having way more phlegm, a new fever come back, new wheezing or worsening shortness of breath this is NOT normal and I want you to please call or email me right away and I’ll write you antibiotics I won’t make you come back and see me just for that since I’ve already seen you I will send them to the pharmacy and you can just pick them up.” I’ve only ever had one person take me up on this in the 3 years I’ve been at my current office and that person probably did develop a superimposed pneumonia.

cheap Canada Goose I think at the end of the day, patients are like every other human being (including you and me) just want to feel like there is an end game/contingency plan and they won’t die at home without the right treatment cheap Canada Goose.

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