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Sorry to go off topic since medicgirl is looking for help, but I'm sensing a troll. Check out these girls:

If you are not affected by the crap we see in this field then you are either burnt out and need help or you have no conscience and should not be in the field. We all have those pts that affect us. With experience we learn to shut it off in a part of our mind while we care for the pt and continue with the shift. Once you are safely away from pt care, you MUST open that box and deal with it. If you don't, you will fall apart. We all have different ways of dealing with it. Find a healthy way and do it (drinking doesn't count unless it is a single, therapeutic drink with a caring friend). Talk to someone who can understand what you are going through, talk to someone who can't understand what you are going through but will listen and support you anyway. Take up kick boxing or weight lifting, go for a run. Do something but don't keep it boxed off in your head.

I remember a similar topic on another forum and I thought it would be interesting to discuss it here. So: If you had to pick only 5 meds to stock a drug bag for use in an austere environment what would they be and WHY? Be specific. For example, don't say antibiotic, say what specific drug you would take and your rationale. I will give you a freebie: since i live in Canada where it is not considered a drug, 0.9% Nacl will not be considered a drug for the purposes of this topic (but other fluids will be). Multiple dosage forms of the same drug also count as that one drug. Also feel free to mention what administration equipment you would like to have along with you (no restrictions here). So what would be YOUR top 5 medications to take with you? I'll start it off: 1. Epi 1:1000 - can use to tx anaphylaxis or asthma exacerbation refractory to salbutamol. 2. Either naproxen or ibuprofen. Not sure which one i'd take. For minor injuries. 3. Gravol (dimenhydrinate) injection - it is an antihistamine (salt of diphenhydramine). In theory you might be able to use it for allergies as well as n/v if there was no other option. 4. Ketamine - can be used for analgesia, sedation or general anesthesia depending on dose. Pts keep their airway reflexes intact. 5. A broad spectrum ABx for PO and IV/IM use, likely a fluroquinilone such as levofloxacin or ciprofloxacin. A cephalosporin such as cephalexin would be useful for Abx. prophylaxis for wounds. I'm not sure what would be more critical - the cipro will provide coverage for most types of commmon RTI, UTI and bacterial gastroenteritis issues. I would also add a few litres of saline and iv start gear. Again, in canada, crystalloid iv solutions are otc and not legally considered drugs.

I'm well aware of the levels in NYC and have worked with many EMTs and Medics on LI who also worked in NYC. Again, you failed to answer the question. Do you work for FDNY, a hospital based service or one of the privates? You know exactly what I mean when I say cowboy. Should I use the term buff? I know you understand that. I also know full well that EMTs and medics are not doctors. I did EMS in NY, not NYC, for 10 years and know the systems from Staten Island to Montauk pretty well. When we say scared, you know we do not mean it literally. However, the fact that you cannot do anything more and cannot properly provide the care the pt needs because of the standards in NYS and the fact that you are an EMT should literally scare you. People are dying because of the dismal state of EMS in NY but that is for another thread. So what are you going to do when this guy goes unconscious because his SBP is 70 and you can't bag him and your ALS backup is tied up on another call and you have to take care of the pt. You are right, there is nothing you can do but watch him die. The fact that that doesn't bother you makes you a piss poor provider in any system.

Never getting sick when this dude is on duty... If he even works for NYEMS

Welcome.

Hello!

Same words, different meanings. You say "Mobile Emergency Response Unit", and I thought "Major Incident Response Vehicle", MIRV for short, of which the FDNY EMS Command has one for each of the five counties comprising New York City. They're kind of Emergency Rooms on wheels, able to take active care of up to 6 patients at a time, with no discrimination between responders and civilians for that care. On reading further, I then determined you're director of what I know as a "Third Alarm Response" unit, doing true scene rehabilitation of and for responders. We just have coffee, tea and lemonade from the Red Cross or Salvation Army vans, or FDNY "RAC" units (I don't know what the initials stand for). One of these days, FDNY will, hopefully, activate a field rehab unit, operating much as you've described. A final thought: WELCOME to the City!

Yeah, I can't remember the last compassion code that I did was actually a true code. More of a long look, a check the pulse, a put the monitor on and really look at the baby. Did I start cpr, not that I can remember but cpr was usually already started. My job isn't to save the baby at that time. The baby is already dead. My job is to work with the parents and help them through this immediate time. Work with them to prepare them for what is going to happen in the next hour to two. That's my new job, parental support and familial support. And I have to say I'm pretty damn good at that. I do have a perspective that many medics do not.

This. +1000

There's also a big difference between what one plans on doing and what one ends up doing.

I agree with this. Giving the parents false hope is not good. Just be open and honest. Let them grieve, don't get them worked up thinking they grey, quiet, dead baby has a chance, it does no good.

If you had actually read the replies made by seasoned EMS providers, many of which are instructors or have been instructors, you would have known NREMT is required by states to get certification.

well how nice ! If the day comes I wander in to Austin, I'll look you guys up. ( I go to friendswood a lot )

Ahhh... careful dissing on floor nurses. So you would just ditch them and not continue to offer help? Neat. Yeah, but if we don't do anything about the BP, seeing as he's missed his morning anti-hypertensive AND B-blocker, it's just going to keep going up and make the situation worse. I know hydralazine can cause tachycardia, but it also is very effective at lowering BP.