CBEMT

I don't have RSI but I do have 10 Mark I kits onboard. He's getting as many as necessary to see improvement. Transport will be to my trauma center with a notification to get any homeless people out of the shower room and break open the decon trailer (NOBODY who's been contaminated enters our hospitals until the hospital decons them themselves, regardless what they got at the scene). Take Fire's EMT and ask if they can spare another member to drive. Another IV enroute, and maybe the combo pads too.

To clarify, this is not an EMS safety concern. This is to establish a consistency among personnel for transport/no transport decisions. Some of the factors being considered are patient surroundings and safety if allowed to refuse, medications, availability of friends to help the patient home if necessary, etc. Like I said a lot of factors here given our setting that I can't really get into publicly that complicate the situation.

You're not alone, he certainly doesn't meet any of my state's criteria for Incompatible With Life- we'd be working him even without a rhythm.

Anyone have something like a Mental Status Exam form, or protocols you might have that specifically spell out who could be allowed to refuse transport after, say, a hypoglycemic episode or suspicion of ETOH intoxication? I know its something that should be in every run report, and it will be, but this will be more to establish a guideline for transport/no transport in the absence of established protocol rather than the subjective judgment of the provider in charge. It sound silly and I wish I could explain further without compromising what anonymity I have, but unfortunately that's what I can give you. What it comes down to is a that transporting nearly all of these patients to the ER (as desired by regulatory body) is conflicting with the possibility that departure from established precedent would lead to a fear of calling EMS in the first place, and thereby increasing risk of serious injury or death to our population. We're trying to strike a balance that would satisfy everyone involved. Thanks!

Isn't that poverty level in SF??

Know someone in EMS who's had it, and did very well. He's naturally a large person (very tall with a large frame) so its tough for him to lose weight and he might still be a little bigger than he wants. But man- the difference is still like night and day compared to what he was.

Most of the career fire departments in my area do that. It creates a career path for their EMS personnel that would not be otherwise available to them outside of Suppression. Lieutenant (3 per unit on different shifts), Captain (1 per unit on his/her own shift), and (currently) one Deputy Chief-level EMS officer (office job). It also prevents a Suppression officer from pulling rank on a scene, because s/he doesn't have the only bars there. The largest department in my area is looking into an EMS Battalion Chief who would function as a roving field supervisor for the EMS crews, who currently answer to the Suppression BC in whatever area they're assigned to. It would create ANOTHER level of career opportunity with more openings, since there would need to be shift coverage. The other reason for having the EMS BC is that EMS officers (Lt/Cpt) are tough to hang onto in this department due to call volume and burnout. As a result, there are many "Acting" officers, who are experienced EMS provides but may not have taken the promotional test to be a sworn officer (most departments here require 5 years on the ambulance before being allowed to test). So I think the feeling is that these Acting officers are experienced providers, but inexperienced officers, and may need some oversight in the field that comes from an EMS officer rather than from a Suppression officer.

It was at the top of my head (the pointy part :roll: ) because I recently attended a meeting of area EMS leadership and our trauma center, and it was brought to our attention that the ED nurse manager is willing to receive emails from services or individual providers requesting info. This was extremely well received. Occasionally it has been possible for individual providers to get patient outcomes based on personal relationships with hospital personnel built over time, or in some cases just happening to run into the same doctor who took the patient from you, etc, but never an official, approved method. One of the ED attendings, who is also the state EMS Medical Consultant even traveled over the state line to make a personalized feedback presentation of selected cases to a department there who recently started transporting directly to the trauma center instead of to their local ER for later transfer (long story). He had the complete support of hospital management.

Don't know how far that would get an agency if a worker was struck- "Industry Standard" may override that technical exemption, but that would have to be ruled on in court. The ANSI rules for what constitutes Class II and III are EXTREMELY specific. There isn't a set of bunker gear on the market that qualifies. So far the departments in my area that have the vests are wearing them over the bunkers on incidents. I hear that some of the guys have the vests over their coats hanging up, and if the call they're going out for isn't on a roadway they just yank the vest off after they gear up (they got the breakaway version) and put it back on later. They do this because apparently it's a serious pain in the ass to put the vests on while wearing a bunker coat.

Yeah, I want to know if he slept through CPR class.

If your agency had all of its funding sources removed, would it continue to exist? Obviously I would've liked to see the law left alone, but I don't understand what's complicated about how it happened.

And since states use federal highway funds for all kinds of projects like local main roads etc, you'll be hard-pressed to find any strip of pavement that is not, technically, a federal highway.

It already WAS repealed, when funding for the federal AIDS law it was attached to was discontinued. So, technically, the Ryan White law doesn't exist at the present time.

If it doesn't already exist, establish a procedure for EMS to request feedback/outcome information on select patients brought to your facility. Obviously this shouldn't be every sniffle and stubbed toe, but that should be fairly self-explanatory.

I need an EMT, with only a First Responder on the truck I can't use any ALS skills per DOH. (FR in my state is not a recognized level of care. It is my department's designation for a CPR-trained member who is utilized as a driver.)

FT: As we are under the University Health Services umbrella, we are funded by the Student Health Services Fee assessed with tuition. We do not bill. PT: Tax dollars, $400,000 a year for the whole department including us. We bill, but revenue goes to the General Fund. We probably average close to $2,000 in donations per year, most often from patients or families of patients.

I think I'm in love with that main lightbar. :shock: :shock: [/whacker] FT job: 2005 Ford/Horton E450 PT job: 2005 Ford/Horton E450 2001 Ford/E-One E450 1998 Ford/E-One E450

I wouldn't but it past very many people in that city to bring their kids down to the playground for the sole purpose of suing the city.

Well there's your problem. Crocs are stupid.

Is it your assertion that a three year-old's parents being in some other area of the playground is acceptable? There's a difference between a bike helmet and padded canopied playgrounds. When I was in school I could count the number of kids I knew on meds on on one hand. Now that one hand counts the kids NOT on meds. Are you trying to tell me that's progress? Ultimate issue: the parents of a child still in diapers should not be so far from the child that they can't prevent him or her from removing articles of clothing. Parenting 101, you'd think.

If I could cuddle with my Stryker stairchair comfortably, I would. Carrying the Stryker power stretcher SUCKS.

Not enough details.

Ok, so when the t-bone impact damages the retracting mechanism, how do you extricate? You can't use the Jaws for a door pop because spreading from the point where the door meets the body won't open the door.

I love the smell of capitalism in the morning! :cheers: =D> :salute: :headbang: :occasion5:

If you're working with me I'd prefer you clamp the IV first, but other than that if the arm has to be used than so be it.