CBEMT

Depends how much BSA is involved. Over 10%, you shouldn't even be thinking about irrigation.

"ENGLISH mother$#%^er, do you speak it?!" ~Jules Winfield I can believe that in some areas, people still talk like this. What blows my mind is that people actually TYPE like this.

Negotiation isn't really the issue. It's that unions influence this state in ways I can't begin to describe here. You really have to live and work in the system to understand it. The last time, years ago, that our main receiving hospital made an issue of patient care, the department in question ran around town picking up every single drunk they could find and hauling them in. They'd get released, and brought right back. It wasn't just drunks either. I don't think any other hospital in town took in a patient while this was going on. This went on for several hours until the hospital cried uncle and promised not to make an issue of whatever it was that they had a problem with. Assuming anybody else reports a member of these fire departments, it would have to be either a volunteer or an employee of a private service. Since 75-80% of both of these groups are at any given time attempting to get hired by a paid fire department, none of them are going to be the ones to blow the whistle. Even if they did, it's their word against a run report that documents "board and collar." The ER staff aren't going to remember who does it right and who doesn't. And the beat goes on. Like I said, you'd have to work here to really get it. I'm not saying its right, it just is.

I'm seriously expecting his next step will be to stencil his name and nickname into the driver's side door like a freakin fighter pilot.

I can't believe we're still talking about this as a serious option.

After they pulled in, the crew went into the ER, brought out a stretcher, put a backboard on it from the EMS equipment area, and had the first patient hop on, then wheeled him in. Repeated 5 times. That way all patients arrived in the ER "on a board," and was documented as such. :roll: Classic Urban Union Fire Department in a state where nobody's paying attention. DOH doesn't have the cajones to take them on anyway. The Advisory Board also has I believe 3 union-appointed members, required by law (unions own the state legistlature, don'tcha know).

For a dispatch position, my company requires a perfusing pulse. You'll probably spend some time calltaking first, but other than that you're already "qualified."

Oh please that's not even that bad. I know a kid who has "volunteer FF/EMT" on his driver's side window and "Emergency Medical Technician" on the passenger side window. Just in case you missed the ones on the rear window.

Ah yes, CYA medicine... we're really advancing now!!!

Well, clearly, these people are morons. You really haven't lived till you've seen an ambulance back into the ER with 5 patients sitting in the back of the truck, all wearing collars.

Nobody "clears" c-spine in the field. They may have a Selective Spinal Immobilization protocol, but walking around claiming you "cleared" the patient's cspine is asking for trouble.

Redundancy? How do you figure?

This is like the #1 EMT-B graduate question now, right up there with "Which private ambulance companies are hiring?" (answer- all of them). Just take the freaking test and stop agonizing over how many questions you get.

Then you need to tell your bosses that your patients are not properly restrained, and then document the date and time you told the, and who was present. In writing would be great. Umm...... You may want to check on that. I can secure a patient to a board with 4 nine-foot straps such that the patient may be stood up, inverted, or rolled over and they will not move. I haven't seen any arrangement of a similar number of cravats that will do that, and not as quickly either. I've also never seen a backboard strap cut by an ER. Are they really that dumb? Not sure if it's OSHA (doubt it), but it is definitely part of the KKK standard and the subject of at least one court case resulting from a fatality in my state (which the ambulance company lost).

:shock: :shock: :shock: :shock: The demand valve has been completley removed from my states protocols effective this month. Unfortuntely, we still have to teach it in class because apparently it's still in the NREMT-B test.

When transporting, my first priority is to deliver the patient SAFELY to definitive care. If during a crash the patient splatters against the inside wall of the ambulance because I chose not to secure him/her to the stretcher properly, I have failed in my most basic purpose. And broken the law. If your service is unable to afford it, perhaps a multi-jurisdictional approach could be used for the purchase or availability of a bariatric unit. Many private services have them now, sometimes more than one. With bariatric stretchers. That have all necessary restraints. Here too we see that most EMS providers often fail to secure ANYTHING, much less the patient. There should be NO unsecured equipment in the patient compartment. Monitors, O2 bottles, anything. I'm telling you people, get yourself to a lecture by Dr. Nadine Levick if you don't believe me. What you don't know about ambulance crash safety WILL kill you. The Pediatric Intensive Care Transport team I work with has a Pedimate, and I LOVE the freakin thing. Patient is secured conveniently to the stretcher where providers can perform care and still remain belted in most cases. Most departments around here use the childseats that are built into the airway seat. I absolutely HATE these, because NO care can be performed while the provider is belted. The private service I work for buys regular, full-sized childseats for all units. Personally, I think the Pedimate should be the only acceptable method of pediatric restraint. Quick, easy, safe, nothing gets in the way, fits any standard EMS stretcher, rolls up for storage in a compartment.

Only takes one to lose everything you own or ever will own.

I can see the image, it's just small as you said. And AZ, the look we get from the limb leads is all some of us are going to get. That said, looks like VT to me. Rate seems too low though, I'll give you that.

Life would certainly be easier if we did use the generated tests. But we've had to throw out so many questions that its just easier to make them from scratch. Which kind of goes back to my pictures comment. Two pictures of two backboarded patients, done completely differently. One with three straps, the top strap being over the arms. The second, straps crossed over the shoulders, 5 or 6 straps total I think, voids padded all over the place, etc. With two options in a textbook that ostensibly appear "correct" to the student (after all, it can't be wrong if it's in the book, right?), what's the student's motivation to perform the procedure that appears more complicated and time-consuming, rather than the half-assed version? I won't even get into the pictures of patients "secured" to the stretcher. My point was we talk a good game about evidence-based medicine and "doing it the right way," and then we turn around and teach our students bad habits while they're still receiving their initial education.

So the fact that she outright told the producer ON CAMERA that she took the entire bottle of pills doesn't bother you? If some patient you're called to never told anyone he wanted to hurt himself, but he's standing on a bridge looking down, is he just looking for something he dropped?

I always figured Shock-Trauma protocols consist mainly of "2 large-bore IVs wide open call for a helicopter."

Brady's a decent book, but if there's going to be pictures I'd suggest something other than 1980's vintage. Wooden backboards and Lifepak 10's in 2007 EMT and Paramedic textbooks? Come on. Also, whoever programmed the test generator needs to be put up against a wall.

$12 and hour for our basics up here in the lower Northeast. I believe that our pay is on the low side for services in our area. On the other hand, you can keep the extra two bucks if it means I'm going to do 6-7 dialysis runs in an 8-hour shift like some of our competitors. At least our Basics have the chance of doing something interesting.

Two critical care teams here use them. The newer team has the newest, smallest version. They mainly use it so they don't have to lug the Zoll CCT inside. They hook up the propaq for the walk out to the truck mainly. Nice and small and does the job.

You sure? I saw many pictures of their employees, especially the ones who went down to the Hurricane Rita response. The rest of it yes, not a lot of redeeming value.