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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.

I took my test today and it shut off at 76 after 45 min I think I did well, in the past few weeks I have done almost 300 questions a day from EMT-Naional-training .com, went over OB/GYN, Medical emergency's, and so on. The waiting for the results is killing me !!!!! All of my pre-test were in the 80's to low 90's so i have faith . On average how long did some of you that took the test wait for results?

Or self ambulate him to the captain's chair...wouldn't put it past him.

Which device did your patient have? There are a couple out on the market. The Heartmate II is the one I've encountered. Once an LVAD is in place, CPR is out. Start compressing with this thing and you'll dislodge the tubing leaving a gaping hole in the LV. Generally, should it fail there may be a hand crank (not joking) to keep the device operational. Checking vitals gets tricky. The patient may or may not have a palpable pulse. As with many specialized treatments/devices your patient and his/her family members should prove to be a wealth of knowledge regarding the condition/device s/he has. My experience has been that the patient usually loves to talk about it. All you gotta do is ask. I found this, too. It's 20 pages long but it looks to be a good information packet. Edit: Some device may have a hand crank. Not all of them will. Edit #2: Your patient should have an LVAD coordinator at the hospital that implanted the device. The coordinators LOVE when EMS calls to get information about a device. Seriously! They really do love it! Find out who the coordinator is and talk to him/her. You may even be able to arrange a training session. If this patient lives in your local it behooves everyone in your service to know what's what. Apologies for the scattered post.

Lvads have a manual over ride pump you can use in case of mechanical failure . I was taught that in EMT b believe it or not Usually your best bet if possible is asking the patient or family as they are best educated hoping they are available to answer.

Medicgirl-- I am so sorry you went through this. It must not have been a good call and for that I am so deeply sorry. Ignore Miscusi or whatever that jerkoff's name is... Showing emotion is what makes us all human, it makes you a better provider, and a better member of society. If we never let anything get to us, what's the point of anything. For reasons of my own, I have been feeling everything this past month, every emotion possible, I have felt it. It is lonely and awful. No one should feel this. And because I am going through this, that does not make me less of a provider, it does not make me less of an asset to medicine. I think those who lack the ability to empathize with a patient is not an asset but rather a disadvantage to medicine. Having the ability to provide compassionate care, means you have helped a patient in one of their worst times. Helping the mother who lost their daughter by holding her hand, getting her tissues, makes you a better provider. EMS is more than just transport. This isn't the days of the hurst providing transport, where you load and go. EMS is medicine, and with where EMS is going, you would do well Miscusi to change your view. EMS is moving towards being more of a primary provider in some communities, with diagnosing abilities, and having the ability to critically think through a patient's problems. Being a mindless, emotionless robot is not helping this profession. If death does not bother you, you need to leave EMS and do so very quickly. I do not know of a single provider I have ever encountered, save for trolls and you, that feels death is a non-issue. Yes death happens, it happens a lot. A 90 year old passing away in their sleep is not as sad as an infant passing away d/t SIDS, but it is sad. It is sad for those who loved them, it is sad for those who cared. Do you think you show more machismo or are more of a man for saying death is not upsetting? What are you trying to prove? I really hope this is just machismo and an act, because if not, that makes me sad for you.

Don't you remember reading a quote that says "The journey of a thousand miles, begins with but one step" or something along that line. Well welcome to your first step.

Baby steps first, the marathon a bit later.