CBEMT

Because the union was in FAVOR of higher education as a means to higher pay for their members and better care for their patients. The union we're talking about doesn't give a @#$%. They've already got the pay, and patients are simply run numbers that justify trucks.

If I have lancets, I'll do it capillary. If I'm out, I may take it from the IV. Or if the last shift left me without any and the manager who's office the strips are locked up in isn't in (nights/weekends/holidays/early in the morning), I get to explain to the triage nurse that I have no freaking idea what the patient's BGL is.

I've come to believe that this is what it's going to take- legistlation at the state level to enforce change. In strong union states, however, it's never going to happen.

I'm not at all unaware of your distaste for the BLS level of care, but this is one I haven't seen from you before Dust. If BLS is not medical care, then what is CPR, ventilation, 02, bleeding control......? Even knocking Basics down in terms of scope, I fail to see how what's left isn't still medical in nature.

My point was to remind people that similar studies- regarding ALS providers- have shown the exct same thing.

Syncope? Nausea? By themselves, probably not although I have done it in the past based on the whole picture. The 74 year-old I had recently with weakness, dizziness, SOB, and "a little pressure up near my chest here," and a recent CABG history? You bet your ass I did!

Hmm.... so you're saying a small number of well-trained providers who only see critical cases provide better patient outcomes than a plethora of less experienced counterparts? Now WHERE have I seen that kind of thinking before.........?

It's called free enterprise, my friend. Its what happens in capitalist societies. We like it that way, even if it does result in some weird sh!t sometimes.

Since stretchers aren't sold without 3 straps plus the shoulders, I find this interesting. Also, since all stretcher manufacturers operating guidelines require all straps to be used, I don't see what your defense is going to be. Don't believe me? Alert Ambulance in Bristol, RI lost themselves a whole heapload of money because the crew failed to "secure the patient against both lateral and longitudinal movement," if I remember the ruling correctly. The court found that the patient was owed a certain level of protection (3 straps plus the harness), and anyone failing to do so was liable for whatever happens to the patient in an accident. Whether we leave the stretcher at the door depends on how many stairs and the weight of the patient. I use my seatbelt at all times in the back unless I absolutely have to do something enroute that can't be done from my seat.

I put people on low-flow all the time who aren't really having much difficulity at all, but their sats are down enough that I need to give them a little boost, and a NRB would clearly be overkill.

That's what I've been trying to tell YOU, Mr. "6 or 15." Oy vey... :roll:

Tell them a coffin is much more confining.

My point was also that 2, 3, or 4 liters are also perfectly acceptable depending on the patient's condition. Six or fifteen without thinking about it strikes me as the New Jersey/Los Angeles brand of BLS.

Still cookbook treatment, just a different book.

Yeah, believe or not the only places doing it right are a couple of the privates and a couple of the volunteer services. Even one of the all-paramedic municipal 3rd services does it the lazy way. Every once in a while you find one individual paid FD crew here or there that secures correctly but its very few and very far between

Thankfully, one article does not a standard of care make.

What, you mean we're supposed to use MORE than the one waist strap that many of the fire departments around here transport their patients with??? :roll: :roll: :roll: Gotta give them credit though, they do use two stretcher straps if the patient is backboarded- the stretcher straps are the only thing keeping the patient on the board, after all. :evil:

I think the point is that if all you can think to give a patient in regards to oxygen is either 6 liters per minute or fifteen, you may want to pack a lunch while waiting for other providers to have confidence in you.

Because a whacker bag in the trunk prepares you for 9/11?

LOL. Thanks dude, I needed that.

That part hasn't been changed. My understanding was that the UNconscious FBAO abdominal thrusts (the ones on the floor rather than standing) were eliminated, which is whhat I hope AZ meant. Typo, I figured.

I wouldn't be surprised if, over time, our brains adapt to sudden rushes of epi/norepi and physical activity after the pager goes off- realize also that an electronic signal has to activate that pager. Who's to say our brain, like an antenna, doesn't pick up the signal just before it reaches the pager, recognized it as an "Action Signal," and start dumping the chemicals thus waking us up?

I smell a cookbook..... :roll:

Every time we transport a stabbing, shooting, etc victim we disturb the crime scene. A big one that comes to mind is extrications where there is a fatality- the scene is literally cut apart. But I digress. My main concern was reading an autopsy report after the fact that said "cause of death: asphyxiation" or words to that effect. I mean, talk about "d'oh!"

Even moreso, if the patient HAS a valid DNR, and you aren't allowed to honor your patient's wishes because you're a Basic and not a medic, your system sucks even more. I once heard a working code described as the most violent thing you can do to a person legally. There's simply no excuse for the government (via protocol) forcing it on someone who clearly doesn't want it, and went so far as to sign a document to that effect. We have a similiar system here, but they ARE out there. The only people I've ever seen with the bracelet are those on home Hospice care- and frequently the family has the form but the bracelet's on the nightstand. Picked up a patient like that once to go to the hospice inpatient unit, and I just asked the family to put the bracelet on for me so as to prevent a problem during transport. The saving grace to the protocol is that it ALSO stipulates that "a Do Not Resuscitate order signed by the patient's physician and recorded in the patient's medical record" is also valid. So for all those thousands of nursing home patients who are DNRs but don't have the bracelet (because they aren't actually dying) but DO have the nursing home's own DNR form signed, we aren't forced to go full-court press on them. You may want to look into getting such language added to your protocol.