dahlio

This place sounds like a dream job in EMS. How big is your coverage area? Do you ride to paramedics in the helicopter, or one RN and one Paramedic? Sounds like a real nice place to work.

Why would you do such a thing without an assessment? You don't even know your vitals, or SAMPLE. Unless we're missing something, there's nothing more they can do for this patient, the're just not "feeling well". Wait later for a full assessment before calling ALS.

Everything. SAMPLE, Vitals, the weather (hot out, humid). Also, Sex of the patient would be nice to know as well. I'd hate to ask a guy if he was pregnant.

Why not void all the space to keep it inline.

I agree completely with what JPINFV said. There's no reason to put other people in harm (going through red lights) to save 30 seconds, because most of the time, it doesn't matter. Get extremely to the right. There's nothing in the law that says you can legally run a red light if theres an Emergency Vehicle behind you. You need to get as right as possible, and then you wouldn't obstruct the law to yield, since you did all that was possible to get out of the Emergency Vehicle's way. Just my thoughts.

Two Years ago, my school counselor asked me what I was going to do with the rest of my life. I told him I wanted to be an audio engineer. 6 months later, and I had totally changed that, deciding to go in to EMS.

When designing a uniform, you need to think of the most extreme cases that you're going to use it in, including crawling in to wrecked cars. Not to say that's the only thing to consider, as it was just an example in my previous post. How about something that can stand up in the rain, and something that's easy to clean, so when that guy who had 8 beers throws up on you, it isn't going to ruin it. If it costs twice as much, but lasts longer than a regular uniform, I believe it's well worth the money.

Before I took a look at the product, I figured you could just cut it off with shears, hold manual stabilization, and apply a c-collar. This product is too much plastic for shears. If I were to encounter it tomorrow, I'd keep it in place, while using a Sam splint to make a make-shift c-collar on top of it. That's the best I could come up with, and I don't think I'd want to remove it, at least not without proper education. Speaking of which, if it does get popular enough, I agree, the proper method of stabilization does need to be taught to ems professionals.

So that's what the I in EMT-I means...hmmm Anyway, doesn't matter what color this jump suit is, it needs to have reflective striping on it. I know mine does, and it works well when looking from far away. Orange might in fact be the best color for the daytime, since it's bright, and noticeable. That, or bright yellow suits, so you don't look like an inmate, and you can easily detect any stains from blood, or other bodily fluids.

I personally love the flight/jump suit. Others don't. I think it's a good, comfortable, easy on/easy off, which is great for night shifts, where you can sleep in your gym shorts/t-shirt, which are underneath your jump suit. Also, it provides the distinct look EMS is looking for, as not to be confused with LEO, or Firefighters. I think Dress Uniforms are still necessary for Public Relation events, such as parades, functions, and events, but for all EMS calls, the jump suit provides a good alternative. I know that I prefer wearing a jump suit, compared to my EMS pants/ shirt on a prolonged extrication call. It's just a lot more comfortable underneath that big turnout coat, then in my EMS pants.

Here where I live, we use a GE/Ericckson/M/A com/Whatever system using EDACS on the 800 mhz band. We've been transitioning to new radio consoles/portables, thanks to Nextel and the 800mhz rebanding deal. It's programed in to the new radios that when we do change frequencies (which you can read more about here http://www.800ta.org/ ), all we do is turn a knob, and we're good to go (at least we hope so). They are, in my experience, very clear, and never have received interference, except when my pager is right next to it, but that has to do with Electro-Magnetic Pulse, not interference with other radio systems. Anyway, our system consists of Fire/LEO/EMS/Public Works/other township entities. In all honesty, public works only ever uses it in snow storms and stuff, and I've never heard any other town agencies talk. We have 6 repeaters at two repeater sites. Meaning 5 conversations, and one left over for the control channel. We have 40 or so talkgroups. Talkgroups are not channels, more of place markers. In other words, every radio has 6 frequencies programmed in it, but can only hear traffic on those talkgroups that are programmed, hence where the control channel plays a sorting role. Also, a feature with EDACS, is individual call, which can allow two radios to communicate with each other directly, without anyone else hearing. Also is the option to put it through a telephone system. Overall, I think the system, at least for our township, works well, and very rarely does the system get maxed out. Only when it does, is when something big is going on, and that tends to involve almost every agency. If you have any other questions, post it, and I'll see if I can answer it. Good luck.

Very cool tool, however, not at 15 bucks a pop, especially the way I lose stuff. Maybe a stocking stuffer for Christmas, but don't think I'd buy it for myself.

All pulse rates were withing the 75-85 bpm range at all times. All the b/p's were take from the pt. in the semi fowlers position. The only history we were aware of, was of chronic migranes. I didn't think about taking it in the other arm...thanks for the sugg.

Your first point that you bring up, about the hospital calling a trauma alert on MOI, is rediculas. You have to talk to med control, and give them a report. The hospital should be determining whether or not they want to proceed with calling the trauma alert. As for number 2/3, I don't think it matters. All trauma centers should be equipped to handle just that, trauma. If they take the trip, however, you might as well, as trauma 1 centers handle these things a lot more. Just my opinion.

Not confused about the fact that her B/p would drop after taking NTG. It just sounded like that when it wore off, it actually made her hypertensive afterwards. The NTG would explain the low B/P the first time around, but what I'm really curious as to why she shot up in to the 150 range, and then lowered again by the time we got to the hospital, without more administration of NTG. Maybe she was just that anxious, but she was keeping it inside...no idea. Thanks again.

Yeah, hence why I put the amount of lpm. I kind of looked at the cop funny when transferring over to our bottle. Yeah it's a 2 and a half out of the ten scale. Sorry about the confusion, hopefully that clarified it up for you. I also stated in my original post that I continued her o2 therapy via NRM (should have been NRB, typo on my part), at 10 lpm.

Thanks, had no idea the nitro could make a patient hypertensive like that, good to know. Thank you for your continued responses.

I was dispatched to a woman not feeling good (I don't feel good a lot, however, dont call an ambulance for that :roll: ). Arrive to find a patient lying on the park bench, at a BBQ. Police on scene (trained first responders) have her on o2 via NRB at 6lpm.....anyway. I get a quick picture from him, and she says she's complaining of chest pain. Start my assessment, and find out she had taken Nitroglycerin, not prescribed to her. We ask for ALS, which arrives 5 minutes later. Prior to their arrival, B/P 98/72, pulse 88, diaphoretic, no trouble breathing, resps of about 16. Pain on a scale 1/10=5. Chest pain is not reproduceable upon palpation, and it's a tightning feeling, and does not radiate. Pain had been going on for 10 minutes prior to our arrival. Continue her on NRM at 10lpm. Load her in to the ambulance, as medics hop in ours. They hook up the monitor, and get a BP of 152/108. After a 12-lead, they say it's sinus rhythm. 5 minutes later, repeat B/P of 112/88. The medics give her baby aspirin, as a precaution. We get one more repeat BP before going in to the ER of 96/68. Pain is 1/10=2/3. I was so confuse after this call. Were the crazy BP's just a result of the Nitro? Curious as to what people think this could have been. Thanks again, and if you need more info, or if i left something out, just let me know. Thanks for your responses.

We have a couple of blue rotators on the front of our newest rig, I believe it really helps. When we were looking at a demo ambulance from PL, they had the 7 LED box lights in front, which a a couple halves were amber. I don't like the idea of amber in the front. Amber means caution, not emergency (in my mind). I believe they belong in the back of the ambulance, because if you're looking at the back, it's more of a "stay back", rather then when your looking at the front, it means more, "get the hell out of my way". Just my opinion.

So I recently took a class on... Incident Rehab. They say they recommend every two bottles (30 min.), you take them out and make them sit for 5-10 minutes, taking vitals, and what not. In fact, the fire departments in my area have started to make idea cards with what that particular Firefighters normal B/P is, so we have an idea of how it is after they go into the fire. Only problem that I was thinking about this, was how much their normal B/P can change over a three year period (the period our OEM cards are good for). Different medications, and job conditions, and what not can affect them a year and a half after their B/P was taken. It was pretty funny when a guy in my class said that their service likes to get vitals before the firefighters enter....like thats going to happen. Just thought I'd give a little report on the class. Learned a lot from it, and never realized how active you need to actually be at a fire scene. Thanks again for the comments.

Absolutly true. Everytime I take a CEU class, I realize how uneducated I am, which makes me want to advance even more in the field. Well Put, Spenac!

One thing that I have learned, is that you as an emt are the patient's advocate. Someone once told me that, and It's changed my mindset on giving reports. Also, there's nothing wrong in using your run sheet to remember anything, just don't read it word for word, but if you need it to give vitals, or for allergies/medications, by all means, use it.

Looks like he's trying that Salvia stuff... hmm.. http://www.emtcity.com/phpBB2/viewtopic.php?t=9097

Taken from the NJ State Board of Medical Examiners - Statues and Regulations (as taken from http://www.state.nj.us/lps/ca/bme/bmelaws.pdf ) N.J.A.C. 13:35-6.2 Pronouncement of death (a) The following words and terms, when used in this section, shall have the following meanings unless the context clearly indicates otherwise. (down a little ways) “Pronouncement of death” means the act of conducting an inquiry concerning the circumstances of a death, checking for vital signs, ascertaining pertinent history and, where appropriate, performing a complete external examination of the unclothed body and providing a medical opinion as to conclusion and cause(s) of the death. Hope this helps...

I'll take two :roll: