Chief1C

I suppose, depending on how long they're on the board, if you totally over analyze it.. Immobilizing them could be fatal. Elderly patient, maybe a little diabetes. Gets a pressure sore, gets infected, sepsis sets in, they die. I used the Back Raft, I'm on the fence. It could lead to hypothermia, it doesn't stay inflated when it's cold, it stays cold for a good while, leaves an adhesive mess on the board, which is a b*tch to remove. Anyhoo.. Lortab. Tired, when I get very tired, I over think things.

It's a vinyl frame, full of round pellets. You suck the air out, and it fully conforms to the shape of the patient. A novel idea, we purchased a BoundTree "Vacuum Spine Board" w/ an extra scoop for Wilderness extrication. Used it in training, the only problem is it sticks to the patient if it's warm out. So placing a sheet over it is good practice. It's easier, we found, to scoop the patient onto the mattress, rather than trying to log roll them onto it.

Better safe than sorry, suppose the ambulance wrecks? What if it to death, but there will be a lot of moving around at the TC. She would benefit from being immobilized. Keep someone from having her move just right, so that some stray bone fragment tears into an important structure. Though, I'm guilty of this myself, as a patient. Struck downward, w/ LOC, walked into the ER w/ head, neck, and T-spine tenderness; and asked why immobilize me now, wouldn't I know if something was wrong? Response from a good friend and well respected TC physician. A loud, harsh... NO!

If you're in the US, and don't have a digital odometer; or an odometer with a decimal and tenth.. You'll need a GPS by 1/1/2011. Just got a letter on Wednesday stating that Medicare will be paying to the tenth of a mile, so a navigation system will be necessary in some instances. We're just going to use the "Trip" setting, but there has been a GPS in place for at least eight to ten years. Both mobile and portable versions, as we do A LOT of search/rescue incidents. Likewise, a lot less people/hunters/hikers are getting lost b/c GPS has caught on with them too. We use them when going to hospitals that we do not commonly transport to. As for local use, it's so rural that it makes maps unnecessary. Of course, due to a federally mandated address change (we had 'Star Routes', Rural Routes and Rural Free Delivery before) we don't have exact maps available for every unit. Just photo copies of our primary coverage...and the GPS units can't be updated till that company updates their system. Though we utilize a per-structure, and zoned emergency locator mapping system that has been in place for over fourteen years, and works great. Too bad there isn't money to keep it up to date with new builds.

Master Stream!

On the fence. I've had several calls involving swelling of the male anatomy. The parts that aren't supposed to get bigger. None of them wanted to be physically examined, prehospital. It was obviously difficult to walk, and sit, so they called 911. Ice was about all they wanted. What do you do when the patient does not want to be exposed. Not that I had any extreme interest in seeing it first hand, but I felt like I would only be doing half of my tasks, if I didn't at least attempt to help. As for me, you ain't seeing anything, and I'll fight anyone off who comes near me with shears. Exit only.

Welcome to the City. It can indeed be a resourceful tool for learning.

We were recently ordered to not take any photos with cell phones at wrecks or fires any more. Every ambo in the county carries a digital camera; and our rescue-engine carries one. That's okay, b/c we use it for training, but we're also forbidden from sending them to our email addresses. The benefit of keeping one on the ambo, is showing pics to the ER or chopper personnel for MOI. I guess the media attention spurred by the fatal wreck where the video was shown around a southern town prompted reaction of preventing similar, locally. Although I don't know anyone sinister enough to do that. Thought I'd share. But I'll look on my portable drives for something you may be able to use, pre-rule.

Yup, kind odd to see in NYC, unless it's a reserve ambulance. I used those the first two years I was an EMT. IMO, it's easier to lift, the closer you stand to your partner. It fit perfectly in all homes, esp. the big mansions, elevators, etc. The only downside, the ambulance was modular, with a CPR seat. The cot, mounted against the wall, so the seat was sort of useless. But it worked well for the patient monitor. We retired the last M30 in '08, actually not a bad thing to sleep on in the station, pretty comfy.

If I feel we need something that we don't have, I buy it, I'm the supply officer. If it's something we can't afford, I apply for a grant. If it's a luxury item, I go to liquidation sales at clinics, storage facilities, etc; and see if I can personally buy it, and donate it. For instance. NIBP was approved for BLS units. I thought it would be the cats ass, since we have hella long transport times. Instituted a policy on how to use it, first BP is manual, last BP is manual. Road conditions, they suck, don't allow for auscultation all the time. I wanted an electronic stethoscope, but I could see that walking away. Our pulse ox was getting on to about ten years old, so I recommended for purchase a multiple function device. It's not something we needed necessarily, but it has the potential to make our job easier b/c it prints. Well, it's supposed to, the printer has been on back order.

Saving money is always good. One example, collars. We would use the single size collars, pay $9.99 each, and they would occasionally reuse them. Whether or not that's bad, is neither here nor there, but they're disposable. Eventually, switched to select a size, again, $14.99 each. I suggested we switch brands, pointed it out in a catalog, bam. Selectable size collars, same fit, good quality, $4.99 each. That's a lot of money at the end of the year. Little changes go a long way.

I understand what you're saying. That may be more difficult to incorporate into your daily schedule, at a paid agency. However, you could start with a more thorough daily routine? Maybe check everything under the hood, clean the actual compartments and cabinets, be very thorough with cleaning the patient area, etc.. maybe wash and wax the rigs. Typically, while we have a check list, actual maintenance is done by a mechanic for liability reasons; QA is done automatically by the ePCR software. A log book of vehicle checks is a good plan. Perhaps you could look into an education based EMS management or leadership course; or an officer training program? Maybe even look into becoming an EMS instructor, and taking on a training role with in your service? That may help you climb the ladder, per se.

Welcome to the City! Don't forget to click on chat, when there's some folks on board. We have quite a number of cool, well educated, folks from CehNehDeh! Always wanted to visit BC, myself. Enjoy the site, it can be a helpful tool for quick advice from different backgrounds and minds; or if you're just having a bad day.

In August, we actually had a high speed crash, in a 25mph zone.. A guy hit a well casing, a dumpster, a pile of railroad ties, went through a garden, hit two signs and flattened an apple tree, while setting his GPS. Which he had mounted directly in front of him, on the dash. At his stature, I don't see how he could see around it. Lucky he wasn't killed. I was ticketed for having a dash light attached to my windshield, so you would figure a GPS would create a blindspot too? Today, I used that industrial Velcro, and attached the GPS to the underside of my dash. dimmed the screen so I can't see it, and used a double male audio cord to plug it into the iPod jack. That way it can tell me where to go, but I don't have to look at it. Velcro, duck tape, hot glue... You can fix anything. If only they had duck tape on the Titanic.

I'm offended by people who are selfish enough to drive intoxicated, then expect me to help put their lifeless corpse in a plastic bag and go home and sleep through the night. Living in such a rural area, I've put a hell of a lot of folks I've known all my life, in body bags; and seen a lot of sickening sights. We all have, I'm sure. Scares me, to think what's coming at me on the next curve. Gives me something to say to people when they bitch and moan about getting a DUI. "Hey, remember so and so. Even with $150K in top of the line rescue tools, we were using tin snip and pliers, took four hours to remove the body. Couldn't sleep for a week, I wish he'd gotten a DUI instead of a grave." I remember some calls, and some of them haunt me just b/c of how well I knew the victim. It's hard to see a face you've seen almost daily, for 10, 20, 25 years, "freshly lifeless". Hollywood can't even reproduce that stuff. It's not the same as seeing someone in a casket, it's shocking, and stains the mind. I think if more people seen what we in EMS or emergency medicine see, there might be a lot less tragic scenes.

I'd think that if she called PD when she found them. But I think she risked a catastrophe by bring them into public. Fortunately for her, stupidity isn't illegal.

That's nice.. I used to pop three or four Darvocet at a time for my back. It's such a weak drug, even at 300mg. Comforting.

The title was Right Side MI, What would you do... Well, if it's me, I'd call 9-1-1. However, out here in the sticks. I'd likely fly them to a hospital that could treat them, rather than have them wait it out at the nearest band-aid ER so they can be transferred later on.

Call 9-1-1

Yeah, how bout it, thank (whom ever you worship to) they don't have any..

If you do a lot of 'away from the vehicle' care, or rural applications. It's a great ALS bag. It's huge. When you have all of the components together, it's fricken huge. But it is a nice bag.

Seriously, a negative strike?

I used the company directory to vote. 37 times.