I didn't realize how sucky burns truly are

[Seshat]

In Australia, pharmacists will accept excess or expired medicines, and forward them to the appropriate place for proper disposal. I'm not sure where/how, I just know that there's signs in the pharmacy asking people to bring unused/expired meds back for safe disposal.

Some aspects of the job are physically intensive, like placing a patient on a backboard or lifting them onto a stretcher. And the gear is heavy to carry. So, you would probably have a hard time functioning as an actual EMT.

I'd pain-crash about halfway through day one, then. Bah.

But you would know how and why to stablize an airway, apply a pressure dressing, and stabilize a bone until an ambulance arrived, and that's useful knowledge to have.

Absolutely. And to save a life, I would gladly tolerate a pain crash. A pain crash won't kill me. It just hurts a lot and leaves me unable to do anything much. (Except sit around and keep myself from being too bored. Skyrim right now.)

On a value-for-value basis? Life > pain crash.

I keep an EMT kit in my car for emergencies. That way, I have some useful medical supplies on hand in case I pass by an accident and there are no first responders on scene (has happened a few times).

I keep a simple first aid kit. When I still drove, I used it multiple times. I've re-set someone's sling for her, fitting it correctly and showing her how. I've helped a kid who fell off his bike in front of me. He (rightly) was not willing for me to take him to school, but I asked him to go to the school office and get proper treatment. (Minor injuries - a strain that an elastic bandage supported, and some grazes and scrapes that I wanted the school's adults to check.)

[Sapphire Silk]

Oxygen isn't something we'd carry either, no need and it would just get in the way. Plus, with the off roading we do I wouldn't want to break the regulator.

Just for my own curiosity Panacea, but when in the ER is it a standing order, or do you need a Dr order for each pt? I know in the ambulance it was a standing order, and I think on the ER rotations I did it seemed to be too. I know each state/hospital is different, just curious.

In the ER I have standing orders for oxygen, and quite a number of other things as well. For a heart patient, I can: start an IV, put on oxygen, order an EKG, order cardiac workup labs, put the patient on a heart monitor, order a chest x ray, and administer aspirin and nitroglycerin before even speaking to the doc.

I cannot do those things for a suspected stroke. We have written protocols that govern what I do in the ER.

On the regular floors it's different. Most hospitals have policies that let me put on a nasal cannula and then call for an order. But I need an individual order for each patient.

In the community, I am not working for the hospital, am not covered by their insurance, and do not have a supervising physician or any protocols or standing orders. Therefore I cannot do any nursing task that requires a physicians order outside of the hospital where I work (or hospice, in my current situation). Even though I know it is the right thing to do, I cannot do it. I would wait for the paramedics.

First aid I'm covered on; I don't need an order for that, and it falls within the scope of my nursing practice.

[crazylegs]

Even though I know it is the right thing to do, I cannot do it. I would wait for the paramedics.

First aid I'm covered on; I don't need an order for that, and it falls within the scope of my nursing practice.

Does that vary from state to state, or is it nationwide?

[Geek King]

Does that vary from state to state, or is it nationwide?

It does vary a bit, but all states in the U.S. has limits to what Good Samaritan Laws cover. The best place to check with is probably your local Red Cross. They're usually on the ball with current laws in the state they cover. To my knowledge, basic first aid and first responder care is always covered, but "heroic" efforts (tracheotomy, minor surgery, ect.) is likely not protected.

[Sapphire Silk]

Does that vary from state to state, or is it nationwide?

It does vary a bit, but all states in the U.S. has limits to what Good Samaritan Laws cover. The best place to check with is probably your local Red Cross. They're usually on the ball with current laws in the state they cover. To my knowledge, basic first aid and first responder care is always covered, but "heroic" efforts (tracheotomy, minor surgery, ect.) is likely not protected.

Each State has its own Good Samaritan Law, as well as its own Nurse Practice Act, and other laws regulating health care providers. However, they are all modeled the same and say pretty much the same thing.

If I as a nurse am going to give nursing care in the field at the scene of an emergency, I am still held to the same standard of care as if I were in a hospital. So if I were do to something outside my scope of practice, then I'd get in trouble with the board. For example, if I tried to trach someone with a mandible injury who had an airway problem. I'm not a surgeon, I don't have the training for that and it's not in my scope, so even if the job went well I'd still be in trouble.

There is, btw, NO law requiring a doctor or nurse to stop and render aid at the scene of an accident.

[kpzra]

On the same token, I WAS trained in doing a trach (not allowed in the county I lived in though) but if I did one in the field as a Good Samaritan, I could only turn that pt over to someone with the same or higher training than me. I also could get in A LOT of trouble because I was not working on an ambulance at the time even if KEMS allowed it. In Michigan, those in the medical field are held to different rules when it comes to Good Samaritan laws, and we are taught them on one of the first days of class. Alaska has a law that if you see someone in distress/accident you have to stop and offer aid.

Best bet? If not working in a marked medical vehicle, stick to basic first aid...direct words from my teacher.

[Sapphire Silk]

On the same token, I WAS trained in doing a trach (not allowed in the county I lived in though) but if I did one in the field as a Good Samaritan, I could only turn that pt over to someone with the same or higher training than me. I also could get in A LOT of trouble because I was not working on an ambulance at the time even if KEMS allowed it. In Michigan, those in the medical field are held to different rules when it comes to Good Samaritan laws, and we are taught them on one of the first days of class. Alaska has a law that if you see someone in distress/accident you have to stop and offer aid.

Best bet? If not working in a marked medical vehicle, stick to basic first aid...direct words from my teacher.

Given the distances in Alaska, I can understand such a law. Your teacher was a wise man.

I had a roommate who was a paramedic. He was required to keep a fully stocked kit in his private vehicle and to stop at all traffic accidents unless EMS was already on scene. He was a state employee.

[wheeitsme]

BTW, the reason that the doctor said no pain meds? I wasn't crying, or screaming, or whatever. I have a fairly high pain tolerance, but I told her that it was extreme pain and she said since I wasn't crying it couldn't be that bad, and that I was "Overstating" the pain. No, I wasn't. I didn't know that crying was an option...I was pounding the table though.
the dressing.

Oh, I HATE that attitude.

My husband hurt his elbow. He couldn't move his hand in certain directions. He actually said -out loud- "it hurts". That means any one else would be crying in pain. We go to the doctor. The Doc tries to brush it off, but since I'm there with the husband the Doc has us get an x-ray (just to reassure the little woman, you know).

As he is placing the x-ray up on that lighted thing he says "I'm pretty sure your elbow isn't broken, because if it were you would be in excruciating pain...(turns to look at the x-ray. Pauses.) Your elbow appears to be broken in 2 places."

No shit.

[Seshat]

There is, btw, NO law requiring a doctor or nurse to stop and render aid at the scene of an accident.

And rightly so. A transplant surgeon en route to a lifesaving transplant should not be required to render aid for a sprained ankle: and such a law, unless worded extremely carefully, would do that.

Let the community be full of trained first-responders. We can handle the sprained ankles, and triage the need for full paramedics.

I'm sure that if I responded to an accident, checked the situation, and shouted a serious symptom, folks like you (Panacea) or TPM would respond. That's all that's needed, IMO. (Actually, I'd probably shout 'You! Get your cell, call triple-0. Tell them the patient has a massive arterial bleed.')

[Sapphire Silk]

And rightly so. A transplant surgeon en route to a lifesaving transplant should not be required to render aid for a sprained ankle: and such a law, unless worded extremely carefully, would do that.

Let the community be full of trained first-responders. We can handle the sprained ankles, and triage the need for full paramedics.

I'm sure that if I responded to an accident, checked the situation, and shouted a serious symptom, folks like you (Panacea) or TPM would respond. That's all that's needed, IMO. (Actually, I'd probably shout 'You! Get your cell, call triple-0. Tell them the patient has a massive arterial bleed.')

Glad to know what the emergency number is if I ever get to visit Australia

Even if not on the way to life saving surgery, a doctor should not be forced to put his license at risk to help a stranger who might try and sue him later. Even though the Good Samaritan laws are designed to prevent that, it doesn't stop a sucky patient from trying.

But yeah, I've stopped at the scene of many accidents. Sometimes I rendered first aid. Other times I saw that other first responders had everything under control, and just stood back until police or EMS got there.

I once stopped at a bad traffic accident (no fatalities, thank god), where a woman was partially ejected from her vehicle. All I did was stabilize her head and neck until EMS arrived. She had no deficits on scene and was probably fine.

But I was amazed at how many nurses stopped at the scene, still in uniform (as was I). It was payday . . . we were all headed to the bank to cash our checks (this was before DD).

[Geek King]

But I was amazed at how many nurses stopped at the scene, still in uniform (as was I). It was payday . . . we were all headed to the bank to cash our checks (this was before DD).

Heh, lucky lady. Much like the lady that compound fractured her femur (how she didn't open the big arteries down there, I'll never know) fourteen miles into a wilderness hike in the creek right below where my scout troop was setting up camp for the evening. Suddenly this horde of scouts and leaders come pouring over the hill and start first aid/going for help/planning for possible travel.

Fortunately, we knew about the fire road a few hundered feet over that ran near some houses back in the woods, and a couple happened to be vacationing there that weekend, so we got an all-terrain rescue squad out there in about 45 minutes. She contacted us later to let us know she pulled through fine.

[Seshat]

I once stopped at a bad traffic accident (no fatalities, thank god), where a woman was partially ejected from her vehicle. All I did was stabilize her head and neck until EMS arrived. She had no deficits on scene and was probably fine.

My wife taught me to do something. When we see an accident, she gets me (the passenger) to assess whether we need to stop and render assistance. SHE (the driver) focusses on handling the road conditions and dealing with rubbernecking drivers who aren't paying attention to the road.

If I deem that assistance may be necessary, she'll stop as soon as safely possible and we can walk back and render assistance.

And yes, the first thing I look for is the presence of police, ambulance or fire vehicles; of any of those approaching. If they're there, there's nothing WE can do that's helpful!

[Sapphire Silk]

Heh, lucky lady. Much like the lady that compound fractured her femur (how she didn't open the big arteries down there, I'll never know) fourteen miles into a wilderness hike in the creek right below where my scout troop was setting up camp for the evening. Suddenly this horde of scouts and leaders come pouring over the hill and start first aid/going for help/planning for possible travel.

Fortunately, we knew about the fire road a few hundered feet over that ran near some houses back in the woods, and a couple happened to be vacationing there that weekend, so we got an all-terrain rescue squad out there in about 45 minutes. She contacted us later to let us know she pulled through fine.

Wow! Sure was a lucky lady!

Glad she updated you on her progress, that was thoughtful of her.

Just one more argument on why everyone should know first aid.