CBEMT

What's next- bubble wrap suits? I played on steel and aluminum playgrounds sunk into dirt, and sometimes concrete. So did everybody I grew up with. And somehow, we're all still alive and relatively well-adjusted. Now you have half the kids in the US on meds before they're even teenagers, and when they grow up they're effing useless whiny crybabies. But they were safe on the playground!

$12-13/hour for Basics in my area of the Northeast for all schedules and shifts in non-911 transport companies (nursing homes do call for emergencies though- I had some real doozies), with benefits and PTO. The one I used to work for even has a 401k but not many take advantage of it, because most people aren't there more than a couple of years before even going to another company, leaving the field, or getting on a fire department or other municipal service. Raises depend what company you work for. Some have regular raises every 6 months or a year, other don't give raises for long periods of time and then suddenly give an across-the-board raise of up to $1- generally more as a recruiting tool ("Oh crap, we're not getting any new hires because the other guys are paying more") than a retention issue. I've even seen part-time employees paid less per hour than full-time.

I think the point of those expressing outrage is that if the girls hadn't been Gypsies, there would have been a much different reaction on the part of the beachgoers. But Gypsies seem to be considered a lower form of life in Italy.

No Parking sign. But to be fair, the roots of a tree had pushed the top of it out into a street.

I'm trying to figure out why a volunteer department is the one trying to make the takeover. Do they think that suddenly they'll have paid firefighter jobs?

Go somewhere where you can do what you want, not be forced to do what you want AND something else you don't really want to do.

You're changing the scenario. That's someone with no medical complaint. I have denied transport to someone who, while having a minor illness, wanted a ride over the state line for prescriptions because his daughter was too sick to take him (slightly worse cold than his). "Rescue's available, needless call. Any more calls from this address, send the police first." Now, had he said he wanted transport to the ER for said illness, I'd be obligated to either arrange for a private ambulance if he had insurance, or take him myself. Would he have needed actual care? No, and he wouldn't have gotten any. But I don't have the right to tell him that he doesn't need to go. I've taken someone to the hospital whom I was absolutely convinced was using us to move apartments- she gave us a different mailing address than the one we responded to, and she wanted us to take 5 suitcases and 8 cardboard boxes worth of her crap with us! But, she had back pain from a previous slip and fall, so we had to take her (plus I worked for a private at the time, we'd get fired if we didn't). We let her take one bag in case she was admitted. I got the last laugh though, even if I didn't try to- she couldn't remember the name of the hospital, so I took my best guess based on her description. And I was wrong!

I'm willing to admit if I'm wrong, but does it seem to anyone else that Florida's use of HEMS in general is a classic case of treating protocols instead of patients?

I don't see myself as some sort of gatekeeper for the ED. That's what Triage nurses get paid to do. Not only is it beyond my current education to tell a patient that they don't need to be seen by a doctor, it's just not my place. People call (either for themselves or someone else). I respond, I evaluate, treat if necessary, transport if necessary- OR REQUESTED- or document a refusal if the patient is capable, so desires, and understands all risks, etc. I don't make the patient's decisions for them. Depending on the circumstances, at my POC gig I have the option of calling a private ambulance for transport in non-emergency cases (with the patient's permission) so as to keep my 911 unit available. But the patient still goes. Triage can decide if they get a bed, or a chair out in Public Waiting. I don't get paid enough to do their job for them. I will admit that was DOES get my goat is when Ambulance Triage is full of skells, and the nurses in Public Triage call a Medical Team to a Critical Care room for someone who walked in through the front door. There's someone who SHOULD have called 911, might have even benefited from pre-hospital intervention (rare, but it happens) but chose not to for whatever reason.

Come on, you can't leave us hanging like that, dude!

Dude, if you're getting this worked up over a moron Primary Care Physician (there's a few million of them), you're not going to last very long in this field. Relax, treat your patient, go to the next call.

I improvise frequently- within the bounds of medical science and established legal precedent! Experience is wonderful- but not bad habits!

During an MCI drill I verbalized an entire trauma assessment with an open mike in the back of the truck, with a few choice words thrown in during swerves and bumps during transport to the simulated hospital. Thankfully the drill was just our town and the frequency isn't repeated. Chief called our truck cellphone to ask us for his channel back. :oops: :oops: :oops:

Here we go, another attempt by socialists to legislate thought.

I'm not interested in how closely you monitor the patient!!! Your having a nice chat with them for the whole ride won't change the physiological process that is shutting down their respiratory drive!!! Yes, I know "But I'll see it happening!" Of course you will. Right before they go asystole, permanently. Wouldn't it be nice if we could transport patients without having to worry about that? Oh wait, we can- BY FOLLOWING THE STANDARD OF CARE, not winging it because "Nothing bad has ever happened on MY shifts." NO, IT IS TIME TO SEDATE AND TRANSPORT SUPINE IN ADEQUATE RESTRAINTS. These patients will be the first ones to go! MORE THAN ENOUGH TIME TO DIE. You got lucky. Your patient, even luckier. Be sure to tell the judge that. I'm sure s/he'll understand. Those would be called "contributing factors" to a cause of death called POSITIONAL ASPHYXIA. Do you still give sodium bicarb as your first-line cardiac arrest drug? That's old school. Why not? Because it is no longer the standard of care. Do you still pace asystole? That's old school. Why not? Because it is no longer the standard of care. Do you still infuse as much NS as you possibly can into hypotensive trauma patients? That's old school. Why not? Because it is no longer the standard of care. Do you still use rotating tourniquets for CHF? That's old school. Why not? Because it is no longer the standard of care. I can't believe I actually have to have this discussion with intelligent people. What part of "Your argument has no basis in medicine or case law" don't you all understand??? Every time I read a thread like this, it makes me want to be an expert witness when I grow up.

In our protocols 100mg Thiamine actually precedes an amp of D50 for BGL under 60 if BGL is known. If patient is altered and no meter is available (possible, because they aren't required equipment), push them anyway, followed by 2mg Narcan.

How'd the carry go?

I work with two of the Northeastern students on rotations, but they're in the group that went to FDNY. Luckily for them their clinical experience wasn't interrupted by these three idiots. On a larger note: what IS it with people taking pictures and video of stuff they know they shouldn't be doing in the first place? Every one of them has turned out to be their own worst evidence. It's like the advent of the digital camera has made people stupider.

The only reason I can think of for transporting a patient prone is an impaled object in the back that is positioned in such a way as to make transport on their SIDE impossible (hint- there aren't many ways for that to happen). As far as combative, no- combative patients should NEVER be transported prone. Why are you so hell-bent on justifying a procedure that's been shown to kill people?

Myspace is for 16 year old girls, and the pedophiles who love them. :twisted:

My old boss is gonna be PISSED. He went out a year or so ago and bought two Class I vests for every truck. Company logo and everything. ROFLMAO. Unfortunately, neither of my current jobs has issued vests.

:roll: By the time they're quiet, it's usually too late. Positional asphyxia isn't about the airway. Their airway is probably fine, it's their breathing that stops.

Since it didn't happen to you, it's never going to, is that it? You think we're making this shit up? Here, I'll even give you the first few Google hits: http://en.wikipedia.org/wiki/Positional_asphyxia http://www.charlydmiller.com/ranewz.html http://www.zarc.com/english/other_sprays/r...l_asphyxia.html http://www.ncbi.nlm.nih.gov/pubmed/12960668 http://www.chicagoreporter.com/index.php/c...tional_Asphyxia http://www.aele.org/law/Digests/civil169f.html

http://www.hpso.com/case-studies/article/166.jsp

Turn to MD and say, "This is why you should've called the transport team at Children's in the first goddamn place. Which, by the way, you're going to do as soon as we get a @#$%ing pulse back."