TRAUMA - Episode 5

[Richard B the EMT]

Firemedic65, I don't consider your comments as "hits", rather, I consider them to be furthering along my own comments.

Perhaps the discussion here is for, if only a short one, stopping to think, and perhaps improve our own treatment of patients.

By the way, and this is to all, as long as you have a good reason to do so, feel free to disagree with me. Your disagreement might be with information that might swing me to your point of view, or I might swing you to mine. This is as it should be, an idea exchange, without name calling (non here, but some have gone foolish and did some name calling on other strings).

[Arctickat]

It was on while I was doing other things. Rabbit ran a chest pain and it was pretty accurate. Slightly exaggerated vis-a-vis the yapping spouse, but lord knows we've had ones pretty close to that. The only nit pick I had was administration of NTG before establishing a line. That was the only scene I saw and it was mildly entertaining.

I did notice Rabbit squirt three sprays one after the other...at least when Carter did that on ER the patient had the decency to faint.

8 more episodes left....yayyy!!!

Edited October 28, 2009 by Arctickat

[FireMedic65]

Firemedic65, I don't consider your comments as "hits", rather, I consider them to be furthering along my own comments.

Perhaps the discussion here is for, if only a short one, stopping to think, and perhaps improve our own treatment of patients.

By the way, and this is to all, as long as you have a good reason to do so, feel free to disagree with me. Your disagreement might be with information that might swing me to your point of view, or I might swing you to mine. This is as it should be, an idea exchange, without name calling (non here, but some have gone foolish and did some name calling on other strings).

I figured you wouldn't take my post like that. I just wanted to be sure, so you didn't get the wrong idea.

Well said though. We can actually learn a few things from this show.

[RomeViking09]

20) OK, referring to MY protocols: The pilot, acting as an EMT in the ground ambulance, starts an IV, an ALS protocol? I yield that some jurisdictions, perhaps a BLS person CAN start an IV, legally.

State I am in (Georgia) Entry Level to work on an Ambulance in most regions is EMT-I and we do start IVs (I/85). Also after some quick research California's EMS laws allow for EMT-I (Basic) to start IVs with additional Training and EMT-II (EMT-Intermediate) can start IVs in their scope of practice. I don't know if SF FD Uses EMT-II or Authorizes EMT-I to do IVs. But just because where you live someone can or can't do something does not mean it is the same everywhere

[Richard B the EMT]

Just mentioning, on the topic of EMTs and IV lines, if the IV is flowing, an EMT is not allowed to transport, the patient needs higher medical authority, at least here in New York State.

From New York State Department of Health...

New York State

Department of Health

Bureau of Emergency Medical Services

POLICY STATEMENT

Supercedes/Updates: NEW

No. 04-02

Date: 02/26/04

Re: Maintenance of IVs by EMTs

MAINTENANCE OF IVs BY EMERGENCY MEDICAL TECHINICIANS - BASICS

This policy is intended to clarify that an Emergency Medical TechnicianBasic

(EMT- may not transport a patient with an intravenous line (IV) in place. The

Department of Health, Bureau of Emergency Medical Services (BEMS) at the

request of the State Emergency Medical Advisory Council (SEMAC) was asked

to clarify the role of an EMT-B in providing care to patients who require IV

therapy.

This issue has been addressed previously by the Department of Health and the

SEMAC. A former opinion provided by the Bureau of Emergency Medical

Services (EMS) in September 1991, indicated that a non-medicated IV could be

maintained and discontinued by a basic EMT if special training were provided to

the EMT, and the training was documented by the ambulance service. This

opinion is now rescinded in part due to the changing composition of prehospital

care providers. In the mid-1980s, there were a minimal number of

advanced EMS providers who were able to respond to the demands of facilities

requiring the transportation of patients requiring IV maintenance. Currently, there

are significantly more ALS providers who can appropriately care for patients that

require advanced EMS care and IV therapy.

Policy

The SEMAC has determined that it is no longer permissible for a BLS

ambulance service, staffed by EMT-Bs to transport a patient with an IV line

in place.

This applies to the following situations:

1. Intravenous lines with fluid.

2. Intravenous lines with medication.

3. Central and peripheral vascular access devices with medication.

It is allowable for an EMT-B to transport a patient with a secured saline lock

device in place as long as no fluids or medication are attached to the port.

However, the EMT-B must insure that the venous access site is secured and

dressed prior to leaving the health care facility.

Summary

Hospitals and long term care facilities are responsible under state and federal

regulations to assure a patient is transported with the appropriate level of medical

care necessary to the patients medical condition. The transport of a patient with

an IV, medicated or non-medicated, requires the presence of an advanced

emergency medical technician or a licensed health care provider with the

appropriate skills. A basic level ambulance may transport a patient with an IV

only if the hospital or nursing home provides appropriate medical staff to

accompany the patient to maintain the IV. If the hospital or nursing home cannot

provide medical staff during the transport of the patient, then an advanced life

support ambulance service must provide the service. In order for an EMT-B to

care for the patient, the IV must be discontinued or secured with a nonmedicated

saline lock device during transport

Issued By:

Edward G. Wronski, Bureau Director

In conjunction with the SEMAC

Edited October 28, 2009 by Richard B the EMT

[VentMedic]

I've been trying to figure out if the flight op is even part of the SFFD EMS system, or if it is a separate entity, as they are around here. I thought it was separate, so was surprised to see them take to the streets.

No medical helicopters in SF. No helipads at any of the SF hospitals.

I would say they landed on a set somewhere outside of the city but since I don't watch the show, I can't say. I was inconvenienced enough by their filming downtown when I was there. BTW, makeup is a marvelous thing for some of these actors.

[FireMedic65]

No medical helicopters in SF. No helipads at any of the SF hospitals.

I would say they landed on a set somewhere outside of the city but since I don't watch the show, I can't say. I was inconvenienced enough by their filming downtown when I was there. BTW, makeup is a marvelous thing for some of these actors.

Right, SF has no HEMS or even helipads at any hospital. Helicopters have to land at an airport or something and have an ambulance go the rest of the way. Sounds really silly to me.

As for what Dust was asking, Rabbit was lurking around the EMS station and was put on street duty from the ambulance peoples boss. It seems to me, like they are one in the same on the show.

[mrsbull]

As far as EMT-Bs starting Iv's I have a class I am "supposed" to take for Iv cert here in Colorado. I however will have to wait til the next one because I am not state certified yet. NREMT- yes but not state.

When a basic here in Co can do IVs they can also do D-50,narcan and something else I forget. Epi or something mabe. This is what I was told by the ems office at the college here. I have not looked up the state protocols for this nor do I know about ems companies here locally.

[VentMedic]

Right, SF has no HEMS or even helipads at any hospital. Helicopters have to land at an airport or something and have an ambulance go the rest of the way. Sounds really silly to me.

SF is not that big to where they need HEMS.

However a helipad would be nice at a couple of the hospitals. SFGH, the trauma center, has been trying to get a helipad approved for many years. The arguments used against it are now featured on the TV screen.

The medical helicopters in the surrounding areas are generally staffed by RNs since CA's protocols for Paramedics are very limiting.

[Dustdevil]

I wonder how long til the show becomes a platform for pushing the gay agenda.