PRPGfirerescuetech

Job #1: 3 bachelors, working on a masters... Job #2: Masters.... Job #3: Bachelors.... Job# 4: Masters Job #5: Nothing beyond EMS cert...he yelled the loudest when they fired the last guy...

As the resident Philly / Montco / Bucks / Chester / Northhampton basic...allow me to make a few suggestions. 1. Dont plan on a 911 gig off the bat. Give that a year or so, roughly. 2. Try city transport companies, ill send you a few links with good contact info. 3. If your interested in heading into the counties, try a few squads in Buckswho do both transport and 911. It will be the resume notch you need to get into the bigger systems and better paying jobs. PM me with questions

yes, there were spelling errors in my last post im noticing. Im tired, and dont care enough to fix it. See yall tomorrow... PRPG

AMEN Dwayne! Disagreement does NOT equal disrespect. This discussion is a simple debate of beliefs, and to suggest disagreeing with your beliefs is a disrespect is a sign of a lack of solidarity in the foundation of the bliefs your faith is built on. Side note. Im on a 24 at a slow squad tomorrow, so i will have the time to present the non anectdotal fact in LONG...TEDIOUS....format for you all to enjoy, to back the basis of my opinion, wghich i stated in the page 1 of this thread. Look forward to that tomorrow...call permitting. Ah' sallam malakim PRPG

She is the supervisor.

doesnt matter. theres a big difference between a video and actually performing the skills. if they can think out the simple treatments, their abilities when called upon will be more concise and clean. we require the critical thinking from basics, and thats about the same as the first aid program. amping up education across the board is the only appropriate solution to improve emergent care across the board, be it the layperson level or not

Your a mess fella. I mean really...optimus prime? Who thinks of these things? Count me in for a mark in the "god doesnt exist" column.

Ruff. email me with numbers. If the proposal works ill bankroll it. prpg@prpg.org -PRPG

:bs: :bs::bs::bs:

Motorcycles. All im sayin.

Alot of good posts everyone. This call did go BLS, my partners reasoning being a "normotensive" pressure (regardless of the change from baseline. He was wrong, and I knew it, but i've never made it a practice to kick calls back to the ALS provider. Simply stated, if you boot it to me, its your mistake. Thats why we do QA. He'll learn. I did the oxygen thing, treated for shock and got the bleeding stopped with a pressure dressing. My point was simple. Theres alot of ways this could have gone, and sometimes we can disagree. Did this call go ok BLS? sure. Could she have crashed out? Certainly. Theres always a varied opinion, because ALs is an ART, not a science. If it was a defined science, would we really be here? As long as we are doing the best we can with the clinical indicators we have, in the best interest of the patient, we've done our job, and we've done it well.

Simple, yet a great posting. Ace, well done. This piece of material is the cornerstone to every facet of Prehospital medicine. WELL DONE. PRPG

Great question. Central line removed the day before.

For all those who responded ALS, please, without cutting each others modalities up, outline what your treatment regiment is going to be for the ten minute transport to the hospital. Ive got a point for this, bear with me....

4 hour treatment. Suprisingly, different organization, although I did chuckle at the likelyhood that she would be the one. It was a new medic, we were on our 12th? call, he saw blood and a "normal" blood pressure, regardless of change from their baseline, and kicked it BLS. To everyone, great responses. This is a baseline call that could go either way for several reasons.

limited MICU ALS unit, EMT / Paramedic. Either the medic drives and the basic techs the call, or the medics techs the call and the basic drives. Anticipate a ten minute transport time. Keep in mind, im not bartering an opinion, just curious of yours (collectively)

43 year old B/F, on the 2nd floor of her residence in a rather affluent neighborhood, alert and oriented, complaining of moderate hemmoraging. Patient began her at home dialysis treatment in her brand spanking new R arm skin graft, finished her treatment, and hemmoraged significantly (1200-1500 cc's) of a rather thin looking blood (lotsa heparin). c/o "lightheadedness" which seems to change orthostatically. Supine in chair 134/88, 84, 99% ; Seated 126/84, 78, 98%; Standing 118/78, 76, 99% Hx: RF, HTN Meds: unsure Allergies: PCN Skin: clammy PN: all but chief complaint. Reports normotensive pressure 140's/90's This go ALS or BLS? Explain your position. XOXO, PRPG

HEAPING PILE OF UNNECESSARY CRAP. As Azcep stated, its a pretty bow on the same old ratty shirt. Same stuff all, just another line of burecratic BS sent forth from the idiots above.

attack. Welcome to the boards. If you dont like it, wear a cup and toughen up a bit. This is simple. You work to live. Regardless of situation. Im sure Medic Mike was there because of the wonderful staff, good municipal benefits, and attractive civil service compensation for retirement? Just a THOUGHT, NOT THAT I WOULD KNOW FOR SURE OR ANYTHING.

What color is the sky in your world pumpkin? Guess what, survival ahead of all else, welcome to adulthood.

canigeta amen? But seriously, interesting attempt at motivating EMS....good luck with that. World peace and a competent president would likely be easier to accomplish...

Ok, your not as dumb as i thought. However, you are insane. Anyone ever tell you that? Anyhoo, today, I redesigned one departments website, rewrote another departments infection control policy, and watched a 1/2 hour of Barneys "empathy education video" (i love you, you love me, blah blah...) Ok im done

1. Get a better scope 2. Toss a pen on their chest. You can see the changes in its movement at that pointe. PRPG

Selective immobilization is exactly what this criteria were discussing is about. One could extrapolate that by using the NEXUS spinal protocol, your selectively immobilizing patients. Regarding some of your other posts from this thread. 1. EMS absolutely should NOT be determining patient transport destination by a trauma centers class designation. This is simple kids. Trauma centers get trauma patients. It is not within any of our scopes to determine if a patient is "OK for a level two" or is "FUBAR'd for a level one". I encourage everyone to do some reading on what is required of each level of facility, and note the differences. BUT, keep in mind, delaying care for a patient by bypassing a appropriately level 2 facility for a level one will only serve to...how did asys put it... give a greasy haired lawyer another 1000 dollar bag of coke to snort off a hookers ass. Yeah...thats it. That was soooo classic line of the year...but anyway... 2. Call it what you want, but calling a "trauma alert" to any hospital is a good idea. Til your patient is complete BS, and your service gets the 1k bill for activating the team jammed directly in a place where it hurts...just a thought. Think it doesnt happen? PM me, ill give you the cell of the chief of the department who just went through it. 3. Your statements thus far are bordering practicing medicine without a license. Heres the thing. Performing the NEXUS protocol is great. If you do it right, its an awesome tool. Bottom line is, WE CANT DO IT. Period. First doc who hears you did it and get a bug up his behind is going to hang you for it. Lets also remember, PA BLS protocols stipulate all patients involved in MVA's and are transported are to be immobilized. This, of course, was a avoidance of liability move by the DOH, but as soon as they find out your toying with NEXUS, this is the protocol they are going to DE-cert you with...and send you off to Micky D'z patented burger flipper school. 4. Mike speaks of selective immobilization. Great idea. Err on the side of caution, and hope for the best. Not everyone needs a LSB. Everyone just keep in mind it only takes one time for a mistake in judgement to put us in the burger flipper class with commodore here. Ok...thats all i got. Thanks for listening. PRPG

Ok. To my PA people. There have been update Con ed research programs in Pennsylvania allowing for BLS spinal clearing protocols, developed to mimic the NEXUS protocol. Some were sucessful, others werent. I was a part of a study at one time, and know they still run a continuing education program that teaches the principals of NEXUS, but doesnt allow for it in the field. I can only assume pumpkin is confused possibly? Or im tired and feeling generous, im not sure. Just the same, it certainly isnt in the BLS protocols.