CBEMT

Actually spenac it seems like the firefighters are complaining that patients aren't getting the care that they deserve. I can hardly fault them for that.

Once I get it, I won't have a choice... maintaining NREMT-P is required for state licensure.

:shock: Sounds good, and I agree with the concept. Speaking for myself, I didn't have the ability to check a temp for the first 4 years of my career- no thermometer. So I had to rely on the patient's skin to decide if I was going with sepsis or not. IMHO I got pretty good at it, though. I also can't honestly say I've ever thought about exposing a patient's groin when I've got vitals and conditions like that...

That's my point- way we would hear the request for a reset on another portable, because the radio the alarm came from will be making more noise than Patton's army. Subtle it ain't.

Not a bad plan, except for the "idiot beep" that loudly announces itself when the transmit button is pressed to keep you from cutting yourself off in that 2 seconds that it takes the radio to start transmitting.

With a six-hundred pound SOB patient? Never, I would think. Even if she codes when the ambulance shows up, I'd rather run the code in an ambulance than the jump seat of an engine.

Full-time: We have had a history of non-licensed"help," for lack of a better word, usually they were preparing for our EMT school. Due to a large number of licensed personnel we've taken on this year, non-licensed people are no longer guaranteed a shift. POC: A small number of non-licensed drivers. All must have CPR, driver training, and department orientation. Usually they are members of the fire department looking for a little extra cash but don't want to go to EMT school just yet. Fine with me, I'm there for patient care, not driving. The only time I don't like it is when I ONLY have a driver and myself. By DOH rules, apparently that means I have to run the call as BLS until I can get clearance from med control to ALS it or an EMT shows up (I've found there's some wiggle room with that though). If I have a driver and another EMT of some level, I'm ok with that.

So how do you propose to plain-English explain to the dispatcher that you've got a gun to your head and need help without your assailant knowing? Simple English is the best- except when it will get you killed. As for us, we have the Motorola panic button that sets all kinds of alarms of in dispatch- as well as makes all kinds of noise on your portable. It also results in Dispatch calling you and saying "Hey, can you guys reset your panic button so my alarm will stop?"

I didn't know people spiked enroute. Are you storing the bags and drip sets in the cab? That just seems.... odd. :?

A good friend slipped two discs in his back picking up a drug-seeking mutt. Ended his career.

Two crossed over the shoulders, one across the hips (sometimes I go a smidge lower and cross the upper thighs), and a figure-8 at the feet. That plus the stretcher straps, and I've never observed enough motion by the patient to have to worry about "chocking" them between the siderails.

I've transported both neonate and pedi teams, both of whom consisted of a doctor and nurse, and an RT prn. The neo team seemed to have Respiratory most of the time though. Since we were a private, we had to do what the team told us, including l/s decisions. But, if they didn't say anything up front, I didn't ask and did it my way. After a little while, the nurses started working with me instead of dictating. Besides, by that time I had figured out what needed a quick trip and who didn't. Post cardiac arrest, 30-minute run during morning rush? Sure. Stable new onset IDDM at 9pm? Nah. The neonate teams in particular seemed to have an affinity for the flashy stuff; I mean they really did NOT want to spend any length of time on the road, which to me simply spoke of their discomfort with anything outside of their bright spacious NICU. But in general, both teams would commonly say, "We want the lights, but just to get through the red lights." :roll: Basically if the truck wasn't moving for any "extended" period of time they started asking questions.

Our own station for the first time in our history. Currently we exist in the basement of a larger building, and our ambulance is parked outside, exposed to the Northeast elements. The past week has NOT been kind to our unit, and shoveling it and the driveway out sucks hardcore. It would would be really great to include classroom space for our yearly EMT school, so we can stop paying for space and instead put that money back into the program. Not looking for anything fancy. Dayroom, kitchen, Manager's office, Supervisor's office/bunkroom, crew bunkroom, classroom, separate training and supply closets like we have now, and a laundry room. Two-bay garage if we can afford it (might be able to get the administration to kick in some money if we can hand them a million to start with...) to allow for future expansion to a possible second vehicle. Please.

While I commend your restraint (who really wants to be found dead in an ambulance when the other party is found with his junk out), I sincerely hope you kicked him in it at your next opportunity.

Do what you have to do. Nobody can prepare you for that kind of situation. Just be careful. They won, but I'm sure it was no picnic getting there: http://www.hpso.com/case/cases_prof_index....EMT%2FParamedic

And here we went and bought all kinds of straps for that. Dammit!

A local private got something like that, except they got the SP02 instead of pacing. And yet their weekly newspaper job ad invites providers to join up and use "the latest technology" as they journey towards "the future of EMS." :roll:

So, what, they can't handle patients without the doctor handy? Seems to me the doctor should be considered a resource, not a crutch. Kristo, I have nothing but faith in you and your colleagues. I'm sure you can still handle a heart attack after January 15, 2008.

When were we talking about that?

See, now you're inserting things into the scenario that weren't there. We're talking about a paramedic making a dialysis transport versus two EMTs. I'll even allow the 30-minute hospital trip (not applicable to my area) addition. It's my contention that I'm dead regardless of who's there. How long are your medics going to work the code on the side of the road? Are you going to call it right there and THEN take me in? Here's where you prove that we're really comparing apples and oranges here. I'm not contesting that the chest pain call should be getting ALS, and any assertion to the contrary is an out and out lie. (In terms of risk to benefit, the most effective intervention you can do for an MI is ASA and transport to a cath lab, but I still won't use that to justify BLSing chest pain. I've seen in person how much time can be saved by transmitting 12-leads from the field. That said, if the first response is a BLS transport and ALS response is going to take longer than a trip to the hospital, I would hope that BLS would pack it up and run.) But notice- you were, more or less, PREPARED for your patient to code- you knew you were on a serious medical call with the potential to go downhill quickly, you had your IV already established, she was already on the monitor, you had your drug box open and ready.... etc etc. I'm sorry. Comparing that to a stable patient dialysis patient who mysteriously craps out enroute to treatment, and then using it to justify ALS dialysis transfers, is simply ridiculous.

So you find a house full of AK-47s and RPGs, with maps on the walls and military paraphernalia everywhere. You consider this confidential information? People seriously need to find their HIPAA trainer and get their money back, and use it to buy some common sense. :roll:

Political correctness offends me.

How about a 9-foot backboard strap? Just crossed my mind.

The only people who need to back off the kool-aide are the ones who think anybody on an ambulance can fix everything. FBAO arrest? Sure, if you're not monitoring your patient I suppose they could pull out a ham sandwich and start going to town. Here they can, yeah. I never had the extra cert when I was a Basic, but lots of people do. Hyperkalemic? Absolutely, run that 12-lead with no pulse, let me know how it turns out. Or are we not just drawing labs now, but running the tests too? One epi and a shock? Sure, I'll buy that, but let me guess- you already had an IV? I'd love to see you back that one up, because surely you've read the LA study where the gangbangers brought in by private auto (Homeboy Ambulance Service) had better outcomes than those brought in by an ALS system? I'm not sure how many hospitals there are in LA, but I'm sure there's not many areas more than 15 minutes from one of them. All of you have lovely anecdotes and what-if scenarios. All I'm doing is asking you to prove an outcome-based benefit for two medics over two basics in a cardiac arrest during a non-emergency transfer. As I thought, the "Paramedics Fix Everything" attitude wasn't far behind.

People- it's A CARDIAC @#$%ING ARREST- what do you THINK the outcome's going to be? Throw a doctor who happens by in there too while we're making up stories about two medics switching off compressions in the back of the truck..... while they go nowhere. Doesn't matter. When you're already moving at the moment of code it is! Not one of you can prove anymore successful outcome to two medics coding a patient by themselves when it occurs during a routine or any other transport any more than I can prove two Basics could successfully complete an IABP transport. How bout we leave it at that.