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There are no absolutes in special cases such as these. They do not happen every day, and even if there is a policy for such things. I'm thinking there is no way every possible scenario could be addressed. If a special needs kid needs a certain piece of equipment, a favorite toy, a favorite book, their favorite cup or plate, a blanket, etc, I will do everything in my power to make it happen. If an abled bodied kid needed something similar, I will do the same for them if at all possible. Here is a position paper by the DOH and NY EMS. It clearly states that based on ADA standards you cannot ban a service animal for any reason unless the dog is a threat- aggressive, etc. I have never seen something like this happen. They must be allowed anywhere normal business is being conducted. http://www.health.state.ny.us/nysdoh/ems/policy/07-01.htm and from the ADA directly: http://www.ada.gov/qasrvc.htm

As respectfully as I can say this, I haven't heard an idea that made me cringe as much as that in a long, long time. That's equivalent to saying that we shouldn't change ANY part of our practice if it could affect people's jobs. Science says transporting dead people is bad? Too bad, keep doing it, 'cause the hospitals might have to lay people off if they're not making enough money from continuing field codes. EMS isn't about saving people's jobs, least of all firefighters', and I for one am not going to advocate the maintaining of a system, no matter how long it's been around, if it's no longer the kind of system that's going to move EMS forward or benefit our patients. I'm not out to help maintain anyone's livelihood but my own, and this attitude of neutrality with respect to fire-based EMS has to stop--because I guarantee you that, from what the IAFF promotes, they're not out to protect the livelihood of anyone but firefighters. I've said it before and I'll say it again, the biggest reason why EMS is run by everyone else BUT EMS is because we are too damn neutral. We're all a bunch of cowards too scared to stand up to the IAFF and our national organizations are too scared to take a stance AGAINST fire based EMS. But you know what? We are the only ones who don't think there's a war going on for control of EMS. The IAFF has made itself clear: they are out to take EMS, and they'll use whatever tactics they have to to get a hold of it. If you want to see EMS grow and prosper and progress as a profession, then YOU have to be willing to say NO to any person or any organization that would seek to lower EMS educational standards.

On our car, we have one pillow on the cot at all times, which gets switched out after every call or at least a new pillow case, as well as we have one extra pillow or two in our cabinets. Also we have a pillow with a trauma strap wrapped around it with a ice pack in it to be used as a pillow splint. In many cases I have used two pillows for my patient, so they are comfortable, especially on those long transfers.

I wrote a tutorial on axis determination here: http://ems12lead.com/2008/10/04/axis-determination-part-i/ Good luck! Tom