jmp6753

Working as a Medic in my county, with our protocols there is hardly anything I cant do.

When I worked for a fire district, we had a 3400 gallon water tender. It was a converted over the road truck that came standard with dual 70 gallon fuel tanks. One was used for diesel and the other was converted to carry gasoline. (the diesel side was tapped so the tank would not leave the vehicle with less than 1/4 tank) We had installed electric fuel pumps with a detachable fill hose. It was actually highly effective. This tender would spend up to 24 hours out on wildland fires and could top off your fuel tank as you refilled with water.

TMB-Too many birthdays TMCB-Too many cheeseburgers

That would be awesome if there was a bomb tech standing next to it....

Where I work we have all ALS ambulances. Two of the the major fire departments have ALS crews. It really is crazy. The fire departments scare the public into voting for their EMS levys because they believe that the ambulance company may have no ambulances available (which happens very rarely). By contract the ambulance has to be on-scene within 7 mins and 59 seconds of the call being received. Yes there are way too many cooks in the kitchen. By MPD protocol, the transport paramedic is in charge upon their arrival. I ran a call recently where it was a non-emergent response for a fall. Grandma rolled out of bed and has back pain. The fire department sent a $1,000,000 tillered ladder truck, with 4 paramedics and I arrived with a paramedic partner and a paramedic intern. 7 medics for a bls back pain call. Just a little over kill.

Always call for PD! Bail Agents have a very limited scope of ability. They are not covered by state or federal law to detain a person especially one in an ambulance and may require a Police hold. As far as HIPPA is concered, they are not law enforcment and are not entitled to that information for investigation. I will not ever let them in the back of my rig and I only trust Police that I know...

I switched to a rural system after being an "urban" paramedic for 7 years when I was promoted last year. There are quite a few differences. Response times are much longer, I have areas of my district that are 70 minutes away running code. That in mind, you get to see the meds actually work. In the city its one thing to give Lasix. In the country you give the Lasix but in a half hour you now have to deal with the pee. We give a lot more pain meds just due to re-dosing. I have really come to realize that dirt and gravel roads are pure evil. The one thing that I really despise though is in a rural system you have a rural "hospital". Anything that is remotely serious gets transferred out. Either to a facility 75 or 120 miles away. Even the types of ambulances are different. In the city I had a nice mod. Out here we are running in a 4 wheel drive type 1. All things considered, I think it has been a good experience doing rural EMS. But I cant wait to transfer back to the city!!

My very first call as a paramedic was an mva. One vehicle into a tree at 100+ mph. The car actually hit the tree roof first, since it was in the process of rolling. Both the hood and the trunk were touching. It took 20 mins of extrication along with two wreckers to get the 14 y/o driver out of the car. She was a full trauma system entry. Fractured ribs, pulmonary contusions, fractured liver, ruptured spleen, shattered pelvis and the standard extremity fractures. Definately had me wondering if I was ready for this job!!

Im all about being progressive and forward thinking. That being said, at what point do we draw the line? Another piece of equipment for the ambulance (where space is already at premium). I am sure it will require some sort of certification and on-going training. I am sure that at some point during my career US will show up on my ambulance. Im just not ready to embrace the idea yet.

Whoops!! The best thing you can do is admit to your mistake. Make sure that your patients MIR shows that the pt received Valium. Absolutely make sure that the person you turned over patient care to know also. What ever you do, do NOT falsify your report! Let your work supervisor know. Where I work, we have a really cool medical program director. If we go to him first and admit our mistake we are much better off. Probably a slap on the wrist. If he finds out later or has to investigate it, well, hell have no fury than a mad MPD. The long and short is it was an honest mistake (I hope) and no harm came to the patient. Dont ever try and hide anything. That is playing with fire and will eventually cost you your job and eventually your cert or license.

If this was your first situation like this, it certainly wont be your last in your tenure. Rarely have I been called to a clinic or Dr's office and found the Dr in the room with the patient. Even a critical one. One thing I have done a time or two was make the Dr ride in with me to the ER. Let them explain to the ER Doc why the patient declined so much. Best of luck!

I like the idea!!! I think we need to give more meds by blow dart!! HMMM, tranquilizer guns on ambulances. I hope it catches on

I have never heard of giving less than the entire dose of D50. As I have mentioned in a thread about D50 before, in our area we also commonly have people drink the dose (as long as they are conscious enough to protect their own airway and swallow) rather then multiple attempts at an IV on a person with poor vascular access. In our large "urban outdoorsman" population, we do also do the 100mg of Thiamine before the D50. If your pateint has a BGL of less than 60, at what point would you consider a smaller dose?

For my agency, they are required for use on any incident with a speed limit greater than 25 mph.

We currently give Narcan IN using an atomizer. Works as well and as fast as IV. I love not having a needle out when dealing with potentially violent patients.