dahlio

Went once to the short of breath, and went in to a home in the suburbs. It appeared to be a lady in her mid 40's who was a bit short of breath. Oxygen was put on her, and my partner started getting information. I start taking vitals, and in the midst of a blood pressure, a man comes out from the kitchen, with a baseball bat, screaming at us, "What are you doing to my mom!" The man starts at us, and he tells us to get the hell out. Left the blood pressure cuff and oxygen inside, as both me and my partner bolt out the front, to our ambulance, and pull a block away. We request the police, and they eventually intervene, and get the son away (No idea whether he was arrested, but I would hope so). Finally go back in to the house, and the son ripped the blood pressure cuff off, and broke the dial. Not sure what we could have done to really prevent this, since the scene did not appear to be unsafe. Freaked me and my partner out for the rest of the day. Definitely learned to expect the unexpected though.

I understand what edema is, and what things cause it (Kidney Failure, Heart Disease, etc.). But what does it mean when there is edema plus three? Is that three different sites? What does that number mean? Just something I'd like clarified, thanks.

I don't know any "tricks", but all of my narratives typically start, "Upon arrival, m/f pt. found (laying, sitting, etc., who is (Level of Con.). Pt.'s c/c of ____. Then I'll do pertinent negatives, and go from there, including my assessment, and any treatment I did after assessing. Then I usually state how the patient got to the ambulance (Ambulated, Reeves, Stair Chair, etc.). If it's an RMA, I'll state that the patient was made aware of the risks of not going to the hospital. Otherwise, I then continue with my assessment in the back of the ambulance, once again any treatments, and any substantial changes in the pt's condition. I'll finish off talking about the transfer of care, and whether anything incidental happened. I tend to use the words "without incident and as charted". The "as charted" part I put in, so it refers the reader to the above chart of vitals signs and the like. The biggest thing to remember, is that if it's not written down, it didn't happen. Good luck, and just practice. Take scenarios and right a chart about what things you would have done.

Yeah, New Jersey does require them on an ambulance, and your service should be providing them. Both a helmet and jacket are required, but very rarely do they actually get used.

Gotta love the free goodies

Such a disgrace. There will always be turf wars, and that's fine, but when it affects patient care, thats complete negligence. Shame on that second paramedic. This is what makes us look less professional.

One reason: It's hard to believe that there's that much room between the door and the cot. Plus, in this spec, it's believed to have a captain's chair, for a healthcare provider to provide airway maintenance while seated. And you could probably argue Since it's neither to the left, or in the center. Obviously there would be modifications to the KKK specs if this were a feasible alternative. Like I said before, I don't like it. Specifically for the airway maintenance space (or lack-there of), and due to the loading restrictions. It's also weird it was brought out at a fire convention.... what do they need an ambulance for? :roll:

Signatures are just something I forget about. Going from volley to paid has really changed a lot when it comes to paperwork (and thats a good thing). My service has three boxes. The first, is the person's signature or mark, which also has an optional witness space. The second, is someone signing in lieu of the patient. I.E., AMS, or other medical restriction that doesn't allow them to sign for themselves. Those people include the pt's healthcare provider (only for NFT (not us, but the discharging nurse)), a relative, or a power of attorney. The third box is only for EMS, and can not be used for IFT, which is if the patient is unconscious, and there is no-one able to sign. Both my partner and I are to sign, with a report on why box 1 or 2 could be used. Seems to work well, but as I said before, I am forgetful. (Been pretty good lately though)

To add to all this discussion, I don't believe an ambulance like this would meet federal KKK standards. So it's out of the question for now.

I carry two of these bad boys.. I got tickets if you want...

Did you get the RMA?

Tell me about it, going from writing a volly pcr, to a professional service pcr, it's a huge difference. I've finally gotten the hang of it, but your pcr is much more complete then a volly pcr. The narrative is the biggest part of the pcr, and that's where your focus should be on a chart. One of my partners the other day, asked me why I wrote about my oxygen administration, along with the tick marks. I told him that tick marks don't explain why I chose to give oxygen, nor does it explain whether it had an effect on the patient. Tick Marks are guidelines, but nothing can replace a narrative.

Can you say Paramedic School? Not quite as hard core as you state, but none the less, far more education then an EMT. (And none of those 4 week Paramedic classes either)

If I'm not mistaken, there is no official language in the United States. Specific states have passed laws making english an official language, but there are still many without official languages. New Jersey being one without an official language, as well as Oregon being without an official language. Proof, or what convinced me

Definitely have to agree with most on this thread. The ankle patient is yours, whether he is a prick or not. Get him to the hospital, and if they still need you for that bus accident, then I'm sure you'll know.

I understand the personal protection thing, and you're right, I havn't had my arse handing to myself on an ambulance. Tazors look like you're out to hurt someone since they aren't typically on an ambulance. The difference with your radio or your boot, is that it's typically on an ems worker, and tazors are not. Tazors serve one purpose, and radios and boots don't. They have a place in ems.

Fire breaks out at a Nursing Home. The nursing home has 150 residents, and 30 staff members. There are two wings of the home, east and west, with the fire being at the west. It's a two floor facility, on the side of a major highway. It's an urban area, and the only open space is at the high school 2 blocks away. (Not sure how in depth you want, but we ran something like this in my area last year) There's always the Plane crashes into a train underneath a bridge which is full of cars....but that's too much fun .

We have enough weapons on us if needed as it is. Your radio, your oxygen, your trauma shears only to name a few. Adding something that is a weapon isn't in my job description. Sounds like one more thing to put on my batman belt :roll:. Wouldn't a tazer be a little more than self defense? Sounds like a lawsuit in the making. To really answer the question, neither service that I work for have tazors, nor have I heard one that does.

At my volley squad: Stethoscope/Adult BP Cuff, a couple 4x4's, 2 rolls of tape, seat belt cutter, cpr mask, Adult BVM, 3 Ice Packs, Pen Light, Trauma Shears, 2 tubes of Oral Glucose, Oral/Nasal Adjuncts, Extra Large BP Cuff. We end up bringing the oxygen in to most calls as well, which is in a separate bag, which lays on the stretcher if needed. We also have a Pedi Kit, as well as a Trauma Kit, brought in accordingly. Paid Service: One huge bag, with O2 and all that was mentioned above, with the addition of more 4x4's, multi trauma dressings and the like. O2 is mounted on the cot if we need for transport. Kinda seems backwards to me that we carry two O2 bottles around.

Really Nice job, and a great reference for those here in the city. I'm looking forward to more EMS related wikipedia cleanups. Keep it up! (And good suggestion dust)

Not a bad idea if you don't want to get up close and personal. Definitely better than those face masks you see on keychains as well. And a BVM will deliver ~21% oxygen rather then the ~18% you exhale from your lungs. You know that 3% is crucial :wink:

Sorry I didn't specify that earlier. It would be going off the ambulance wall port, since we have a two H cylinder setup. A direct O2 H Tank hookup would definitely be a good idea to invest in, so I guess both. I don't think these would last on a D or E, and have no plans on hooking them up to those small tanks. Thanks again,

So the county OEM department gave us these pretty looking multi-liters, but no instructions on how to hook it up. I've been looking around, and I'm pretty sure I've found what to get in order to attach this device to an oxygen tank. Here are some pictures: And this is what I think I need: http://www1.mooremedical.com/index.cfm?PG=...il&PID=1822 Thanks in advance

http://en.wikipedia.org/wiki/Oxygen_bar (wikipedia is good for something like this) You pretty much pay to get O2 via NC at around a dollar a minute.

Isn't that the Third Watch equivalent for fire? You wouldn't believe how realistic Third Watch really is Prayers to the family of the 2 EMTs and Medic for a full recovery.