CBEMT

I know that in one of our hospitals, the first thing a patient gets after EMS Narcan is IM Narcan. So yet another option is Narcan bolus to wake him up, IM Narcan to keep him going.

You're right, I shouldn't have to. However, documenting that someone walked to the truck, for example, would be to admit a violation of company policy- "nobody walks." Of course, management could really care less whether the patient walks or not, they know the kinds of idiots we deal with. They just don't want us documenting it, because that costs them money. So they invent a punishable offense around it for use if somebody really insists on being a problem for them. If I don't play the game, I run the risk of being fired- and having to find employment at another private company with the same rules. Me personally, I'd rather keep my seniority than bounce from company to company until there aren't any left that I don't have a reputation at.

Only 499 what-ifs to go... :roll: I feel really sorry for your fellow providers that they have to work someone with thinks so little of them. Now that I say that, maybe I am expecting too much... I mean, I haven't met an EMT yet who couldn't tell the difference between a Nitro tab and Asprin. I never thought EMS education here was above-average, but after seeing some of the paranoia in this thread I can only assume that there's some truly horrible EMT schools out there. The secondary problem is, they clearly don't have partners willing to help educate them on what they need to know to work in the street.

I prefer to write my run forms once. If I document no-pay criteria, I'm going to be told to re-write it. It's the re-write that would be fraud.

What planet are you on? I said I'm an ALS provider, and if I decide the patient needs a nitro I'm going to give him one. Reading comprehension- it does a poster good! Actually I'm not, I'm more worried about the fact that you can't pull yourself out of the textbook long enough to work in the real world, where sometimes I can only do 5 things at once and need my partner to be an extension of my hands. I'm not even asking you to do something you don't know how to do! (IE push Morphine, which is what this topic was originally about.) I can't wait for your 500 what-ifs that would somehow lead to you losing your license.

Explain to me how we prevent criminals from lying on permit applications (which is what Cho in order to purchase these weapons), stealing guns, and buying them off the black market, and I might agree with you. Until then, people with ill will will always have guns. The difference will be that if American liberals have their way, said criminals will be the only ones to have them.

*headdesk*

Ok, different scenario. Not to be an @$$, I'm genuinely curious given the responses so far. Nitro. Allowed for our Basics, of the patient's own med and with medical control. ASA. Allowed for our Basics with the usual precautions, other than that it's completely theirs. Basic Bob is my partner. I'm an ALS provider. We get a chest pain call. I'm, say, setting up for a 12-lead, and I ask Bob to administer ASA. He does, and I think everybody would agree that this is no problem (unless you're the type threatened by Basics with asprin, in which case feel free to stop reading). Now I'm looking for an IV, and I want the patient to get a nitro. Patient does not have a script. Can I tell Bob to give the patient a Nitro without incurring the wrath of the board?

I'm surprised they really want you to be that specific, because walking to the stretcher (or walking to the ambulance) means you aren't getting paid by Medicare for that run. But hey, if they REALLY want you to, by all means. If they're like a local company here that hands back unpaid run forms to be re-written, tell them to kiss your ass. My favorite is when the college we go to walks two drunks to the truck and wants us to take both. Company "policy" is that nobody walks, ergo you have no reason to document that somebody walked to the truck- everybody gets the stretcher. Ok, so how am I supposed to document that I transported two different people to on the stretcher at the same time? Granted these kids don't have Medicare, but still.

Depends where you work. I work "transport" and have had more than my fair share of hypotensive, unresponsive patients. It all depends on the local laws and your company's contracts. That said, you're starting to scare me with your eagerness for the flashy things.

"My partner did this while I did that." "Assisted in getting her seated." Who cares? WAY more info in there than there needs to be. "Pt found seated in chair AO x 4/4. Pt c/o mechanical fall from standing --> floor [secondary to symbol] dizziness. 1" lac R anterior scalp. Wound flushed/dressed. Vitals as noted. Pt-->stretcher-->truck-->ED [without] incidents or [change]." Done. Six lines condensed down to two and a half, and much more professional-sounding to boot. Granted I typically document more than that for such a call (a few more assessments, plus pertinent negatives and such), but if I was going to write what you did, that's how its done.

Don't forget Hatzalah.... Every time I'm in NYC, I've seen their units on runs. They seem pretty busy.

So 23 people get an ulcer within 30 days of being backboarded, so let's ditch the backboard, because clearly pressure ulcers are worse than spinal injuries. I don't even know why I'm discussing the merits of a study with 39 patients in it.

I know what happens beyond me- the patient is taken off the board, in many cases before I'm even gone. A LOT of people get boarded in my area, and when the trauma center is backed up the minor ones could be sitting there for a while (granted they're not all strapped to the board, but that's another story for another day). Even still, I have yet to hear about anyone complaining of or suing over a pressure ulcer that they got from a backboard anywhere near here. Ever.

Our company doesn't do jack, either for us or anbody else. Some of the hospitals put out little goodies and thank you posters, one of them gives away a different freebie every day along with a huge banner outside the ambulance bay. Others put out a plate of cookies on Monday and that's it. All depends what days you work and where you transport to that week.

Hmm. So we aren't supposed to without O2 from COPD patients because it won't cause a problem in the short time that they're with us, but we're supposed to stop using backboards because they may cause a problem.... in the short time that they're with us?

Wow, paragod complex much? Don't you get kicked out of the Liberal Club for ignorant statements like that? Which pretty much proves that you are completely closed to any ideas on the subject outside of your own bleeding heart, tree-hugging hippy mindset. Besides, "A liberal is just a conservative that hasn't been muged yet." Sorry, no dice. Any idiot can make up a story that proves their own point. Let me guess, with people like you deciding who gets to "enjoy" their "privelage"? Sorry, the Constitution says otherwise, in spite of 200 years worth of attacks from gungrabbers like you. "I wonder how many times I can say 'I'm smarter than everybody' in one thread?" Nope. We see you for what you are, while your prejudiced mind sees us how the DNC tells you we are.

You know, the more I look at these two scenarios the more I think they could essesntially be the same thing- MI or CHF, with the added possibility of cardiogenic thrown in for #2. The BP is going to tell the tale on that guy; if your instructor isn't going to provide vitals she needs to stop giving you scenario-based questions. As for the first patient, she's definitely getting a Nitro, I'll make a decision on Lasix enroute when I have time to re-assess and think about it for a minute. Even still, under my protocol she'd only get 20mg, which is going to do.... jack @#$%. Our starting dose for patients with no script is 40 for cryin out loud.

I still want somebody to show me how we're supposed to examine the patient's back after we start scooping everybody to avoid the supposedly horrible logroll.

#2 sounds a lot more like CHF (which may or may not be secondary to an MI) than #1, at least to me. Respiratory distress, edema, higher daily dose of Lasix, skin signs, etc.

I'm not sure if I'm on your side or not, because I'm not 100% sure that any of that post was actually English.

One thing I've been told about the area they work in is that Austin itself is a big annoying splotch of blue in the otherwise red state of Texas...

Half right half wrong. The PURCHASE was perfectly legal. The act of purchaser handing the weapons to Harris and Kliebold was illegal. So what you have there are a list of illegal uses of legal weapons, which is what makes the perpetrators criminals in the first place- THEY DON'T OBEY THE LAW in either obtaining guns OR using them! But in A2L's world, gun laws aren't broken by people who break laws. All he wants to do is make more laws for criminals to break and be duly charged with- not one thing he's suggested will stop a crime or save someone's life. So cops have them.... why? To carry out executions in the street? I mean, you said it yourself- guns are for killing and nothing more.