HellsBells

I agree with the above, in my experience these type of wounds are usually easily controlled. However, if you simply can't control the bleeding with any other method, then obviously a tourinquet is in order. This reminds me of a pt we had a couple years back. While working at a gravel quarry, a production worker got his arm pulled into a conveyer belt used to seperate rocks. They managed to stop the machine and get his arm out before our arrival. His arm had been bandaged by first aid before our arrival, it was actually quite skillfully done. He was not bleeding through the banage and had good distal CMS. The first aid attendent mentioned that there was a lac over his tricep, but he didn't seem overly excited about it. On further examination in the ambulance, we noticed that his humerus was obviously fractured, so we put him in a sling/swathe, but elected not to remove the bandage, since as mentioned the circulation was present and the environment was dirty/dusty. During transport his pain level becomes very severe, alomst screaming in pain, we maxed out our pain meds, and he is still in considerable discomfort, seemingly out of line with a simple fracture. Anyway, arrival at the hospital, the resident removes his bandage, only to reveal that his entire tricep has been severed from his arm, and the bone from his humerus visable and actually broken in at least three different places. From that point on I've typically removed bangages put on by first aiders prior to my arrival.

Why were you even on this call to begin with? By all accounts to seems like you responded to this call in your own vehicle with equipment you purchased yourself. I think it would be in your best interest to put the scanner away, and wait till you are actually licenced as an EMT before responding to calls. As for what you did wrong treatment wise... Did you perhaps consider the fact that his chest pain and SOB may have been related in some way to the bent steering wheel? Did he have chest pain before the MVC? Did the pills reduce his pain? Did you give both pills at once, and do you know what the dose was for each? It is very risky to give a pt medication (even if its their own Rx) without any medical training or oversight. Furthermore, when you do finish your EMT-B do you plan on working with the local Fire Dept.? If so its probably not a good idea to get a reputation as a scanner cowboy, who shows up without invitation and then slinks away after the fact.

Im sorry to hear of his passing, he was a great proponent for change and professionalism in EMS. Personally, I hope to bring even a fraction of his dedication and pride to my own EMS career. His contribution to this webforum will be missed.

WTF?

Link is dead

Yeah its protocol in alberta to give dex via IM only.

Yeah, it seems the journalist is a bit of a wiseacre.

"At least one mailbox was also destroyed during the altercation." My favorite part of the story.

Typically I intubate with compressions. I dont find it difficult on the typical pt and i was taught that compressions are paramount in a cardiac arrest.

Your instructor is old school. IM is the standard for epi these days. Your instructor is old school. IM is the standard for epi these days.

No ERDoc, I don't think we are on the same footing as garbagemen. It is astonishing to me that I have to explain the context of that remark to you. I was simply stating that if all "public service" employees require ID, as another poster stated, then I would like to see nameplate on the trashman and the guy repaving my street. Whats good for the goose is good for the gander.

Personally, I don't know what being a public servant has to do with wearing a nameplate. I don't see many garbagemen with nametags on. As for wearing one, I have no problem with it. We were given 2 pin-on nameplates when I was hired, I wear them when I think of it, but often misplace them. I typically introduce myself to the pt by name, and if they demanded my last name, I'd give them my employee number, and give them the number for my depts pt advocate. I don't consider it the "right" of the pt to know my last name. If they have a compliant they can follow the official channels. That way I can aviod any potential for harrasment at home.

If your nameplate is velcro then dont wear it. I took mine off as soon as I received my new coat.

Dont be so hasty yee nonbelievers. The day has not yet ended... Repent Repent.

Seems a little reckless to give benzos for possible vertigo.

So I can understand that race is important for certain disease processes, but I'm assuming that when the doctor actually assesses the pt he too would also be able to recognize the race of the pt. Or is race recognition a protected skill for paramedics only?

So I see there is a posting for emt/paramedic skills instructors currently posted. Im wondering if anyone can speak on the quality of this school, as I'm not familiar with their program.

So, as far as I can see this story just includes compliants from the family. Personally, I would wait to crucify this ambulance crew until the entire story becomes known.

There is a service in Alberta called Beaver EMS

Agreed. As we have just seen in the federal election, sweeeping change is possible. Down with provinicial Conservatives, power to Wildrose Alliance!

The good (or bad) news about a 61% voter turnout is that its up 3% from last election.

The Conservatives win a majority. Layton's NDP somehow steps up to become the new official opposition. For the first time in Canadian history Liberals fall to a third place finish. The seperatist Bloc Quebecois lose the lions share of their seats, being reduced to only 4 in the house of commons. Even the fledgling Green party manages a win for their party leader Elizabeth May. For an election that, at the outset seemed predictable, dull, and unessasary, it proved to be anything but. It, in fact turned out to be quite a historic outing for federal politic in our country. Not only that, with a stable majority government we shouldn't be subjected to another election for the next four years. Woot.

Entonox- Not particularly effective in my experience, has some limited use in peds with minor M/S injury and females in labor. Otherwise, seems like more of a placebo than anything.

Now that the province of Alberta is under the purview of the provincial government, all EMS has been forced into one union. Prior to that change I have worked for both union and non-union services here. I didn't find any particularly huge difference between wages, benefits, and work place satisfaction between the two. However, its seems that Canadian EMS, on average, enjoys better wages and benefits than our US counterparts. I'm not sure if that has to do with increased educational standards, a public health care system, or both. But, I don't think it is a result of strong unionization of practioners, as there has been no consistant organization of EMS across the country. British Columbia, under CUPE organization has not faired well. At least not for members without significant seniority. New hires in that province are subject to inconsistant work schedules, poor benefits, and postings in various regions that may lead to long drive times to work locations. That said, having no personal experience with USA's EMS system I can any speculate on the conditions found within that system.

This seems like a silly argument, no one can completely predict when a pt may go into cardiac arrest, particularly facilities where the majority of pts are elderly people with multiple medical problems, no matter how benign the reason for the original transport is.