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We do have a place, but it should only be under direct supervision. Let's face it, we (EMTs) do not know ANYTHING when it comes to the field of medicine. The education and training is a joke. It is nothing more than advanced first aid. So we do have a place, but only as first responders OR as part of an ALS unit in a supporting role.

Ah yes "national security" ..... the ubiquidos excuse to do anything that you as a power-at-be want and pretty much get away with. Hey I wonder if Osams is under my bed with his cellphone and kidney machine keeping company with the Communists?

Yea.... The whole firefighter wearing gear inside of a nursing home asking medical questions looked about as stupid as they portrayed the nurse. I know it is supposed to be a funny, but I just got the idea that the posted video and those similar to it found on youtube are to just make firefighters feel good about themselves. Oh well. Matty

I'll have to disagree with the assessing to things we do not fully understand (as even a paramedic doesn't fully understand every finding he has). In high volume hospitals with wait times up to several hours at time, the information we present to the triage nurse can greatly influence whether patient is sent to the primary ER, the secondary ER without monitored beds, or the outside waiting room or lobby. The nurses do not have the time to perform a full assessment on each patient. It's not uncommon to have 2 codes going on at a time, STEMI patients waiting for a few minutes in a hallway, SEVERE respiratory distress, and so on (you get the picture, sure you've seen it more than I have), so incoming patients get a quick report from us and frighteningly if we don't give any indications that there's something urgently wrong, then they don't necessarily ask.

Ugh, don't remind me. My state has several different laws giving specific immunity to firefighters (and specifically not naming other "brands" of providers) for medical care provided in the field. Fire owns EMS, the IAFF owns the state legislature, the legislature makes the laws, and the public suffers.

Our agency currently uses carries an Iron duck BLS bag which carries all trauma dressings, Basic Airway adjuncts, BVM, NC, NRB's, and Blood pressure cuffs. We also carry a ALS bag that contains our IV needles, syringes, Meds, and Intubation equipment. We are currently at a cross road in trying to decide whether or not to go to a ALS bag that also contains all of the basic airway equipment ie. adjuncts, NC,NRB, and BVM. and a truama bag, or to keep the same configuration we have but switch to back pack style bags. After saying all of that, the purpose of this is to find out what bag configurations the rest of you out there are using either to let me know what is or is not working in other areas of the country/world. Also we staff our ambulance with one EMT and one Paramedic, if you could include in your response how you staff your ambulance that would be helpful. Thank you in advance to all that respond.

Matty, does this mean that all women who wear Burka's are terrorists? Do all surfers smoke dope? Are all junkies street dwelling scum? Generalisations like this are more detrimental & show a lack of understanding. I know many muslims who deplore the reign terror has started, but attitudes such as this will never & can never help. for clarity, here is a quote as to why some women choose to wear a burka Is this so different from some fundamentalist organisations such as the Amish & their dress codes?

One should not be able to give nitro without the ability to first, initiate and monitor/maintain an IV line, and secondly they need to be able to obtain and interpret a 12 lead and 15 lead ECG. The risk is too great of harm to your patient without being able to do these things. In Alberta us EMT's can give nitro (whether or not the medical director allows this in protocols is individual to the service). My service is urban ALS, so EMT's have a great potential for learning and assisting with these things. When I was still in my rural days and had the chance to admin nitro, I withheld as I could not rule out RVI. This was good, as upon arrival at hospital and completion of 15 lead ECG's it was shown in (from what I can recall) 24/30'ish patients that there was right sided involvement. So I could have potentially harmed or killed a couple dozen people if I would have said "oh, chest pain, cardiac, let's give nitro". IV, O2, ASA (if no contraindications), maybe a little Entonox ... I did my thing and never hurt anyone. Hopefully most people aren't jumping the gun and giving something "just because they can".

Sounds like Edmonton! ... now I'm hungry for Kraft Dinner

One call I had this summer that made me feel like that. I was beating myself up about whether or not each decision I made was the right one; had I made a different choice at one of many points would things have turned out differently? I know now they wouldn't have, injuries were simply not compatible with life. I was offered a chat by one of our CISM people I trust, at the time I just wanted to go home. She gave me her cell and said to call if I needed. After I realized I couldn't normalize myself after work and was really reacting, I called and was able to arrange a meeting. That was probably the best thing I could have done; very informal, just a chance to vent and get all that stuff off my chest to someone who was able to make the time to listen (for two hours). So without minimalizing what you're feeling as I truly do understand, most or all of us have been or will be in that same position probably more than once during our careers. Definitely talk to someone, maybe take a debriefing. Get the specifics off your chest with someone trusted. Whatever happened, mistake or not, you're human. Take the initiative and talk to someone about what's bothering you, because if you don't it will quite likely eat you alive.

Why can't crews give swiney shots to other EMS, fire, police? Last year for what I think was a few weeks in a row, we had paramedics taken off the road (voluntarily) to do a flu clinic in our central station for us. Way better than standing in line for 3 hours (or 8). They're obviously competant at giving IM shots and obviously have permission from the medical director. What's the big deal? Saves time.

It sounds to me as if the OP is trying to paint the picture of a dissecting AAA. And if so, there is little to be gained and much to be lost by palping by an inexperienced, likely heavy handed, new EMTB. It also sounded, (playing devils' advocate) the the OP may be asking why we continue to teach abd palpation to students that, most often, won't have the educational background to do anything educated/intelligent with that information. I can agree to a certain extent on both points actually. Though without giving it some significant thought, which often involves waiting to see what Dust thinks, I can't really argue either way at this point. I do agree that if you're 'yanking the hands' of anyone off of a patient, most especially those of an already insecure, terrified 3rd ride EMTB then you need to take a chill pill. These folks have gotten into the back of the ambulance, again, most often, without the knowledge/education/training necessary to feel confident and productive, which often causes them to do some pretty dorky things. Making them feel even dumber by reacting to those dorky things in a foolish manner simply sets them back, when our job is to attempt to elevate them to a new level while in our care. I look at 3rd riders almost exactly the way I do my patients. They are in a place that they've been convinced by books and teachers that they belong, only to find that nothing actually works the way that they were taught. They are insecure, scared, have no control over the events occurring, and will be gone before they have even a tiny chance to remedy that. Chastising them for unprofessional behaviors that are predictable, in fact unavoidable does no good to anyone. In fact the new EMTB that steps up and gets in my way by being overly aggressive immediately gets kudos in my book. EMS is a contact, not spectator sport. It takes balls to put yourself 'out there' when on early rides, timidity should be discouraged even if initial brazenness is at first unproductive. Why teach it? Because a small percentage of them will stay in the ambulance long enough to learn it's value. Because it's a standard of care regardless of their ability to use that information. Because it forces them to actually put their hands on patients, one of the skills that many have a terribly hard time learning. Because for every DAAA 'near miss' there will be 5000 abds that have exactly nothing wrong with them reinforcing the more important skills stated above. Though you've taken a bit of a beating here, I think this is a great thread! At least it caused someone with my limited brain power to sit and think for a few hours. Thanks for the post brother. Dwayne

Well, it sure beats wasting your life away infront of the computer and or T.V. I doubt, (but I do not honestly know) that they are alone on these calls. If they are basic BLS, then, why not? Having kids, I can see how today, alot of these kids are not 'involved in anything' anymore. Not many are doing sports, and the clubs at the HS's are lacking.

over ride her pump and allow her to pass peacefully and pain free.

What is a RCMP officer? Was that someone he was working with? How sad, just sad. Last February I had a tonsilectomy that put me in the ER about a week later with massive hemorrhaging. The blood was puring out my nose, and my mouth, but I still did the best I could to thank the medics who rushed me to the ER...

nvrmind

Holy crap, Batman! What happened to this thread?! First of all, I see no issue with Lisa O's comment. It does indeed seem like an attempt to empathize, and nothing more. Secondly, Siffalis, you really seem to be screwing the pooch on this one. You're implying all sorts of things that aren't present, and your tone is just atrociously antagonistic. Arctikat is right: If you wanted the thread to go a certain way, you should have given it some guidance and set-up first! You even seem to take issue with people discussing the actual content of the article... not sure what's up with that. Short on sleep lately? Thirdly: You said it yourself. This is an open forum. Nobody needs your permission to post what they like in this thread, whether it's the direction you wanted it to go or not... How'zabout everyone takes a step back for a little bit? Let's cool things off a touch and figure out what the real issue is here once the red fog clears... Wendy CO EMT-B

http://www.canada.com/news/national/Dying+officer+thanked+paramedic+rescuers/2426743/story.html