Chief1C

About forty-five minutes to the nearest band-aid center, and ninety minutes to the nearest trauma center, by ground.

Make sure your external compartment door locks are lubed with something that doesn't, or can't cause oxidation. WD-40, contains water. We used to lock our compartment doors, however at a wreck during the winter, we found one of the doors couldn't be opened. Road salt had ruined the lock, I find every now and then that doors can't be locked, so I either dip the key in mineral oil or Vaseline, and lock/unlock it a few times. Mineral Oil is probably better, in a syringe with like a heavy duty needle, like old army surplus hypodermic needles. Or take the lock off and put a gob of Vaseline in there.

I had a buddy give me one that looks like that, about two years ago, when they were only available in gov't contract catalogs from North American Rescue. We did our own in house training, using an IV Dummy arm, a bad of red watery stage blood, and a BP cuff for pressure. It ruins the arm, so I suggest inventing something, like a rubber hose in a roll of foam-rubber. I found that when your hands get sticky-wet, or greasy-wet, like they are when you have copious amounts of human blood on them (on your gloves). That the little baton slips, the pressure doesn't slip much, but it was difficult to set with one hand. I still have one in my forestry coat (chain saws), but I switched to the Mechanical Advantage Tourniquet for my kits and the ambulance..as I'm the supply guy. We use what I feel is best economically, which doesn't necessarily mean what's cheap. The commonwealth supplied us with eight Combat Action Tourniquets, four for an ambulance, two for a squad unit.

When you approach the patient, and the first thing that comes to mind is: JESUS! HOLY S#!T! OH F##K! DO YOU HAVE ANY BLOOD LEFT I WISH I HAD TWO MORE HANDS WHERE'S THE REST OF IT ET AL, ETC... You should probably use a tourniquet. Our protocol allows for TK use, when direct pressure isn't working. They're pushing them for use now, no longer as a last resort. In fact, Pennsylvania has made commercially produced tourniquets a requirement. Several years ago, we'd probably have just stopped and got a stick somewhere and used a cravat. I've used TK's three times, all related to rural industry. The one that sticks out the most involved an arm caught in a grain bin drive belt. There was bone left, unfractured, but all the tissues, muscles, etc, were ripped away. The hand was degloved, and partially amputated, the radius and ulna were there, and they were feeling lonely. The blood loss was horrific, I don't know how the patient was still alive. Off the beaten path, very rough roads to get there, at least 25 miles out. I asked if there had been water in the room before, as to turn red and mock blood. No. So, wow... He survived, but with out an arm, which as a farmer... Is kind of throwing yourself into early retirement.

I have yet to suffer ill effect from just splashing some iodine on whatever is torn open. Our water isn't treated, it's ground water, it gets filtered - I assume, by that white tube ish thing on the pressure tank. I'm sure the mine acid kills anything living in the water, ha ha. But I do use a lot of iodine. We had terrible flooding a few months ago, they had laid a "loop" of water line for the sole purpose of increasing pressure while the fire pumps were on. This went under a creek, through an old lake bed. The lake bed consisted of several hundred thousand feet of silt. That now sat in the town, flood waters deeper than ever, silt knee deep. With stuff in it...like glass. Ouch. I washed a deep lac w/ what I'm pretty sure was muscle or fat showing, w/ town water, which was just dribbling out - w/ the fire pumps on. There was a fire threat, the pumps were turned on, and water shot out of the woods, not the fire hydrants. Doused it w/ iodine after I was told the water was contaminated, and shut off, never had any problems. But I've seen most first aid booklets tell laypersons to wash "cuts" with soap and water.

Well, it depends, does death count as a cure?

Call an HVAC Specialist, if it can't be glued or duct taped, I can't fix it.

I bet it was a rubber ball on a leather strap, eg mouth gag. Just sayin'

Regular EMS would avoid, or should avoid, the hell out of situations where you may just have to shoot back. But Tactical EMS, they should be armed. Aren't armed forces medics, et al., armed these days? Vs WWII era, where they weren't.

Well... It fits in with not doing something you wouldn't want to explain to a medical professional, et al. Ever see the film World's Greatest Dad? Horrible movie, but similar circumstances. Erotic cardiopulmonary arrest?

Neighbor is lying, they obviously knocked the patient out with something glass, robbed them; then called 911 to make it look like an accident. I'd assess and likely immobilize, since he can't say "X Hurts", and consider distance to the nearest hospital... and which is the quickest way to get there.

Why is said person "missing"? Was the person found?

Ever go swimming? I assume any store that sells swimming accessories, sells these little white clips with foam ends. I can buy them here in town at the GENERAL STORE, an actual general mercantile store, like you'd see straight out of the Walton's.. So, I assume Wally World, etc., sells them. Clip them on the patients nose. No air flow.

I have about three or four dozen NuMasks, from samples and from various EMS Expositions. I use them when I get the chance to arrive on scene of a cardiopulmonary arrest, alone, and long before an ambulance. If it doesn't seal perfectly by itself, all you need is one hand. The BVM fits right in the tube, if the BVM has a handle, you're in business. They're so soft, you can yank it out, trauma free if they puke. But watch out, that thing is like a vomit nozzle. As for the little blue airway that comes with it? Throw it away. Use a standard OPA, I use Hudson Lifesaver Tubes - but replace them, not reuse them - and haven't have too many problems since I got the knack of using the NuMask. The founder/inventor and I developed a pretty good email thing. B/c I seen it in JEMS, called for a sample, used it.. Then he took a survey from me on it's use for EMS. It was developed as a hands free CPR Mask. My first gripe was that they had a great product, a few set backs, but nothing major; but the real test, would be to market it w/ a BVM w/ a handle.. Like an Ambu Spur; or the blue LSP Bag masks. So he kept sending me replacements whenever I sent an email that I used one, w/ the outcome stats, etc.. and I see now they sell them w/ BVM's. I'd just buy my own BVM and get the sample, IMO. I'd say, from a rural BLS point of view, however.. The time from the person being found, to access to the 911 system, to EMS arrival.. You're pretty much plant food. However, when I have been able to arrive quickly, with witnessed arrests, the patients color has always greatly improved with the NuMask, vs a standard mask. You get better tidal volume. I've used them about six or eight times now, one patient, a smidge under a century old-totally f**king serious. Resuscitated, BLS. That's pretty good, IMO, seeing as how about 9 out of 10 rural cardiac arrest victims are beyond help before the dispatcher even pushes the buttons. These things are also the shit for single rescuer CPR in the ambulance. You get one in, hook up one of THESE and snap it to like a scissor strap on your leg, and you can stand in one place the whole time w/o moving around to C cup the mask, and bag. Just get out the CPR board that prolly nobody uses anymore, to keep the airway open.

Funeral Director... In case you REALLY fail in EMS?

You're right. Kick yourself out of EMS immediately. Sarcasm. Don't over analyze it.

There's that term again, niacin flush. Had a patient that called for N&V w/ watery stools using a "Niacin Flush Kit". Wouldn't, or couldn't explain what it was, or where it came from; only that it was to remove evidence of marijuana use from ones system. The patient was adgiatated, uncooperative when alert, mostly lethargic and confused. This, after several hours of projectile vomiting and dry heaves which resulted in mostly blood and sputum coming out. Which answered the question, yes, you can carry someone on a Reeves, in the fetal position.

We bought software on eBay to program our Kenwood portables; and from (locally for you - kinda) Keystone Communications to program Motorola HT1250's and our Minitor 5 pagers.

How far 'upstate'? Fort Drum is hiring civilian EMT's.

I'd say your neighbor is probably lying. I tell patients we don't report to the police. I also tell them, if they're too drunk to be cooperative, they're too drunk to refuse. It's highly unlikely that any LEO would be able to tell what you drank, unless you told them. It's possible to end up in a such a manner from drinking just about anything. It's also very dangerous, can lead to tragic death, but that's on the person holding the bottle. I'd say if you're worried, be glad you woke up, and don't get that drunk again. Just remember, the higher the proof, the less it takes to knock you out (or kill you). Best to never let someone that drunk, be left alone. I deal with this stuff all the time, usually it's ppl I know very well, being in such a small town. I'd rather have someone pissed off at me, than die, and have their blood be on my hands, figuratively speaking. You can never win, with a drunk person. Either they're a sweetheart in person, and an @$$hole drunk; vice-versa, or no matter what, they're always in a grouchy mood. But you can have the satisfaction of knowing, that in the morning, they'll be back to their old self, alive. Unless they drank themselves into brain damage. Then, once again, it's their own fault... However, I'm sure they'll try to blame and sue you for their own stupidity.

Lay the cot flat, have them lay on one side, and turn the lights down. Maybe open a window.

Thank You! I needed a laugh.