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View Full Version : What are you talking about? EMERGENCY Squad 51


Richard Vyse
02-06-2012, 11:50 AM
I watch this show and really have no idea what the heck they're talking about. Can our medical folks chime in and explain what the heck this stuff is.

1) D5W
2) TKO
3) Saline solution
4) Ringers Lactat
5) V-Tach

I'm sure they're are more but these come to mind.

http://www.youtube.com/watch?v=ib23j0SPkUY

Russell Street
02-06-2012, 12:01 PM
Here ya go Richard, as best I recall (it's been a few years since I've worked in the field).

D5W= Dextrose 5% in water, used as an IV medium
TKO= To keep open
Saline= Saline solution, can be used as an IV medium
Ringers Lactate= Lactated Ringers solution, also used as an IV medium
V-Tach= Ventricular tachycardia

Currently operating medical personnel please feel free to correct me.

Steve Lichtman
02-06-2012, 12:36 PM
Here ya go Richard, as best I recall (it's been a few years since I've worked in the field).

D5W= Dextrose 5% in water, used as an IV medium
TKO= To keep open
Saline= Saline solution, can be used as an IV medium
Ringers Lactate= Lactated Ringers solution, also used as an IV medium
V-Tach= Ventricular tachycardia

Currently operating medical personnel please feel free to correct me.

Not to correct, just to clarify:
TKO = "to keep open", a very slow IV drip rate that is just enough fluid, as the name implies, to keep the IV open and not clotted.
Normal Saline = 0.9% saline solution in water, an IV fluid
Ringers Lactate = similar to saline but with additional electrolytes, usually used in trauma
V-Tach = ventricular tachycardia, the heart is beating too fast to provide useful pumping action, usually precedes V-fib, ventricular fibrillation, where the heart muscle is beating erratically and not pumping at all.

My favorite saying as a kid was "IV D5W TKO!" I had no idea what it meant, but it was way cool for an 8 year old. It was years before I knew what it meant - and then they discontinued use of D5W!

Richard Vyse
02-06-2012, 04:00 PM
Now I'll know what Dr. Bracken and Dr. Early are talking about. Thanks. One more question. "Why is it they want to start an IV on EVERY patient they treat?"

A woman fainted and wanted to get up and go home but Johnnie insisted they start an IV and take her to the hospital. I think I would told him where to go.

On one other occasion they were treating a patient and the ambulance arrived and Johnnie asked Dr. Bracken if they could transport immediately. What do you think the answer was...

Dave Lisiecki
02-06-2012, 04:15 PM
[I can't view the video from where I am at the moment, but...]
I, too, remember those lines, although I have never (until now) learned precisely what they meant. I seem to remember them also administering epinephrine IV with the D5W. When do I want to do that?

Bill Leverett
02-06-2012, 04:36 PM
I'll jump in on this.

You must remember that this was all cutting edge pre-hospital care. Like all medics, Johnny and Roy liked to use the stuff they were taught.

Starting an IV on everyone was considered part of the standard of care. We now realize that starting an IV on EVERYONE is not needed and may actually harm the pt when you factor in the risks associated with an IV (infection, air/catheter embolism, phlebitis, interstitial IV).

Epinepherine is the same as adrenalin. It is used in the treatment of severe allergic reactions (anaphylaxis), cardiac arrest, severe asthmatics and a few other medical conditions. It is usually given through the IV (intravenous...that's why it's important that the IV is run TKVO). It can also be used in a nebulizing mask for some causes of shortness of breath such as croup.

Hope that helps.

Steve Lichtman
02-06-2012, 08:51 PM
FYI, sometimes we start an IV on a patient who may, even remotely, need medication (given through the IV). If a patient's condition deteriorates and their blood pressure drops, it's much harder to start an IV.

Back in the day, they often started an IV on a patient because they could. It would justify the paramedic program. And, also, it looked really good on TV!

... When do I want to do that?Not till after you have your paramedic certification. If you do it before, you can be charged with practicing medicine without a license!!!!! :eek:

Steve Tarbert
02-06-2012, 10:54 PM
Besides, the program would be boring if they just transported all of those patients without doing anything for them......

John ED Renstrom
02-06-2012, 10:57 PM
I got to call them on it. move the man to the floor. how they going to treat him all crumpled up in a ball on the end of the sofa. there is good old johnny and Roy cool as cucumber and the ambulance arrives with two scared kids.
I to was glued to the set.

Chris M. Kelley
02-07-2012, 04:45 AM
Yanno... I just got the DVD set with the final movies... Stopped watching on the first one. I didn't like Emergency at all. Hollywood Hope. People rarely died. I've had two saves from cardio-pulmonary arrest, in 13 years. Two. They both arrested in the ambulance. Sure, I've brought a dozen or more back, but they didn't survive. They used death to promote the show, and prove paramedics were needed. Then miraculously, everyone else survived. I think the Pilot, "Snake Bite" and "Welcome to Santa Rosa County" were the only episodes I enjoyed.

I won't dispute that a hundred thousand people became EMT's, Paramedics, Nurses, Doctors, et al; from watching the show. But I wonder how many quit, when they realized how ineffective EMS really was (everywhere except in major cities) in the early years?

Richard Vyse
02-07-2012, 09:57 AM
Yanno... I just got the DVD set with the final movies... Stopped watching on the first one. I didn't like Emergency at all. Hollywood Hope. People rarely died. I've had two saves from cardio-pulmonary arrest, in 13 years. Two. They both arrested in the ambulance. Sure, I've brought a dozen or more back, but they didn't survive. They used death to promote the show, and prove paramedics were needed. Then miraculously, everyone else survived. I think the Pilot, "Snake Bite" and "Welcome to Santa Rosa County" were the only episodes I enjoyed.

I won't dispute that a hundred thousand people became EMT's, Paramedics, Nurses, Doctors, et al; from watching the show. But I wonder how many quit, when they realized how ineffective EMS really was (everywhere except in major cities) in the early years?

I get a kick on how they begin treatment and the patient has not been removed from their accident situation. As I recall an episode where they got all the vitals and wanted to start an IV but the patient was in such a terrible position it made no sense. Seems to me it made more sense to remove and secure patient then begin treatment.

In another episode a kid was trapped in a tree head first. There was speculation about the tree splitting and doing this or doing that so they went through their rituals of freeing the kid only to come back to the original rescue. Cut off the limb and remove the kid. Heck, they were even pumping O2 into the tree therefore created the fear the tree might explored if they use a chainsaw to cut the tree.

Love that show and watch it everynight. I know what you're saying, "Richard, Get a Life".

Kent Martinson
02-07-2012, 11:17 AM
Yanno... I just got the DVD set with the final movies... Stopped watching on the first one. I didn't like Emergency at all. Hollywood Hope. People rarely died. I've had two saves from cardio-pulmonary arrest, in 13 years. Two. They both arrested in the ambulance. Sure, I've brought a dozen or more back, but they didn't survive. They used death to promote the show, and prove paramedics were needed. Then miraculously, everyone else survived. I think the Pilot, "Snake Bite" and "Welcome to Santa Rosa County" were the only episodes I enjoyed.

I won't dispute that a hundred thousand people became EMT's, Paramedics, Nurses, Doctors, et al; from watching the show. But I wonder how many quit, when they realized how ineffective EMS really was (everywhere except in major cities) in the early years?

Every tree starts with just one seed. Sure, it may have been "Hollywood hype", but just emagine how little things would have changed if the public had never been given a chance to see a more positive side. I'm sure many, that got into EMS because of that show, have left the profession, but we change the world one person at a time. I got my start in EMS just months before the show started and have been in it ever since. The show was never intended to get thousands of people into the profession, it was intended to be entertainment. If only a few entered EMS because of the show and stayed with it, then the show was a double success.

Steve Tarbert
02-07-2012, 11:21 AM
As a former paramedic, I felt more pride in taking care of patients and helping them get to the ER alive, instead of "saves". I had a few "saves" and my most memorable was a 44 year old truck driver who went into a full arrest at a local discount pharmacy. We worked him right there in the front of the store with full ALS measures. We were able to bring him back and by the time we got to the ER, he was talking to us. About 2 weeks later, I received a call from our company's owner that I was requested at the hospital for a meeting. When I walked into the conference room, I was "mobbed" by 4 kids of various ages. They're mom was sitting at the table crying. Then the truck driver walked in from another entrance and gave me a big hug. I had not thought much about the run since it happened but did occasionally wonder how the guy was. The best part to all of this is that this day was the Wednesday before Thanksgiving and the family got their Dad home for Thanksgiving. Now that was a great Thanksgiving for everyone.

Abe Bush
02-07-2012, 11:28 AM
My favorite episodes were the ones when the ambulance would crash! Which only happened one or two times. But you could always tell it was going to happen before hand, because instead of the ambulance being little more than background filler (along with the 'ambulance drivers' themselves, as non speaking cot jockeys or extras), the camera would show the ambulance leaving, driving to the hospital with siren wailing from various angles, and suddenly it would wreck. Any other time the ambulance was only shown arriving, and/or leaving the scene and occasionally backing up to the ER bay.

It seems like there was also an episode where they were called to some accident on a highway far away from their normal jurisdiction, and it was so far away the responding ambulance was a 1959 Superior Cadillac combination!

P.S. I also remember one of the early episodes had Dr. Brackett incorrectly calling for an I.V. of DW5 (instead of D5W).

Not only did they show medical procedures incorrectly much of the time, but they also downplayed the role of RN's. They basically showed RNs as little more than clipboard clutching secretaries, you never saw an RN perform any medical procedures, only the doctors and paramedics did that. The nurses just stood there clutching a clipboard, making up the bed, handing Dr. Brackett his instruments, handing out supplies to Johnny and Roy, helping out with the biophone on occasion, and walking around the halls of Rampart General.

Abe

John ED Renstrom
02-07-2012, 11:43 AM
good story. glad you got your thank yous. all in all it reminds me of Talking with Jim S. we touched on the CSI type shows and the impossible thing they do in a hr with a unlimited budget. it's Hollywood, you buy the bit or you can't watch the show. it this case it's more fun to pick out what did Roy and Johnny do wrong this time (there were both trained paramedics). went threw the training to make the show more real. that and laugh at the mother may I days of EMS. Dr and emergency room Nurses with nothing better to do then recite the obvious to a man on the scene. then we get to see how far EMS has come along and were we need to be going. EMS and medicine in general is still a profession were each and every branch is on a separate tree. instead of flowing up from candy stripier to surgeon. you got to jump from one department to another not getting any credit for what you learned over at the other one. with each niche guarding there trade like kids with candy. it kind of funny you get to step back and look at it. wonder any of us live as long as we do.

Abe Bush
02-07-2012, 11:56 AM
As a former paramedic, I felt more pride in taking care of patients and helping them get to the ER alive, instead of "saves". I had a few "saves" and my most memorable was a 44 year old truck driver who went into a full arrest at a local discount pharmacy. We worked him right there in the front of the store with full ALS measures. We were able to bring him back and by the time we got to the ER, he was talking to us. About 2 weeks later, I received a call from our company's owner that I was requested at the hospital for a meeting. When I walked into the conference room, I was "mobbed" by 4 kids of various ages. They're mom was sitting at the table crying. Then the truck driver walked in from another entrance and gave me a big hug. I had not thought much about the run since it happened but did occasionally wonder how the guy was. The best part to all of this is that this day was the Wednesday before Thanksgiving and the family got their Dad home for Thanksgiving. Now that was a great Thanksgiving for everyone.

What a great story Steve, and what a great Thanksgiving for your patient and his family!

Abe

Richard Vyse
02-07-2012, 11:56 AM
We know TV shows hype it up to make it sell, why not! Do we honestly think HBO's "Six-Feet Under" would have ever made it 5 years if it were to depict how a real funeral home operates? Not at all.

Chris M. Kelley
02-07-2012, 04:24 PM
I've seen every single episode, before the DVD was popular, I had them all on Columbia House VHS tapes. The kicker, they weren't in order as they aired on television. I have no doubt the show did amazing things for EMS, and like I said, I won't dispute that. We used to watch it on Monday nights at the fire hall, it was on WGN Chicago. The old guys would critique their skills, and the young kids would shush them and hone in because we'd never seen nor heard of it before.

Steve Tarbert
02-07-2012, 07:42 PM
I know of some EMS systems that still operate on the "mother may I" method to treat patients. The care is excellent but it does make you wonder

Scott Crittenden
02-07-2012, 08:44 PM
Normal Saline: Water with just enough salt to preserve it.
Ringers Lactate: Gatorade
D5W: Kool-aide.


Even Richard can understand it now!:thumb:

Steve Lichtman
02-07-2012, 08:45 PM
Yanno... I just got the DVD set with the final movies... Stopped watching on the first one. I didn't like Emergency at all. Hollywood Hope. People rarely died. I've had two saves from cardio-pulmonary arrest, in 13 years. Two. They both arrested in the ambulance. Sure, I've brought a dozen or more back, but they didn't survive. They used death to promote the show, and prove paramedics were needed. Then miraculously, everyone else survived. I think the Pilot, "Snake Bite" and "Welcome to Santa Rosa County" were the only episodes I enjoyed.

I won't dispute that a hundred thousand people became EMT's, Paramedics, Nurses, Doctors, et al; from watching the show. But I wonder how many quit, when they realized how ineffective EMS really was (everywhere except in major cities) in the early years?OK, I won't disagree that "Emergency!" was much more dramatic than real-life. No, I don't have a "big rescue" every shift. And no, I don't have a cardiac arrest "save" every other shift, though I've had 10 I know of over the years. And yes, I know only a couple of their patients died (besides some who came into the ER and died and didn't contact the medics), and I've had a lot more than that.

But "Emergency!" got me into EMS, and I know I've helped a lot of people over the years. Saved? No. Helped? Yes. That's what is effective. I got into "real" EMS in 1977, and I've been here ever since, and I never felt bad because real life wasn't exactly like TV. It's still good.

Funny, though, those same episodes are my favorites, too. And "Indirect Method", about the first woman paramedic trainee (I actually was partnered with the real-life first woman paramedic on whom the episode was based).

Kevin Lynch
02-07-2012, 09:17 PM
It's funny how the show that spun-off the super hits gets forgotten....Like EMERGENCY spun from Adam 12. The Simpsons used to be a short cartoon on the Tracey Ulman Show.