ambodriver

I am gainfully employed. Thanks for you concern though! Also I have a tattoo on my deltoid, it's not visible in uniform. I personally don't like the sleeve look, but hey whatever floats your boat. I was informing you of how it works around here. People tatt'ed up here still get pay checks.

So my partner and I were talking about a call in our service where someone gave an amp of D50 b/c of a misread glucometer. They believed the pt. was hypoglcemic when in fact BGL was aprox. 150. (non-diabetic pt.) It was a CP pt. I didn't believe an amp of D50 would be too harmful, as I thought it would be absorbed pretty quickly. My partner stated if the pt. was having an MI the amp of D50 would worsen the MI by making the blood more viscous. Thoughts on this? I couldn't find anything to support his claim. I thought this mistake was pretty harmless.

Plenty of guys in chicago with full tat work ups. Also in the surrounding areas. Anyone who would not hire someone based on their tattoos is way behind the times.

that's a pretty sire subject around here ha ha

obviously someone doesn't comprehend sarcasm. I even posted 'sarcasm' after my reply.

HEY GUYS!!!1!! Screw your fancy medicine, 15 LITER NRB AND GO GO GO!! Practicing good medicine is for suckers. BLS > ALS!!! You guys suck!!!!11! sarcasm off. this whole thread makes me want to puke.

This is flawed logic. An EMT-P is an EMT-B. Most paramedic programs require you to be a basic for awhile before you become a medic. Basic skills.....are basic. That's why its a one semester class. How many times do you need to backboard and splint someone before you master it? Direct pressure and a trauma exam isn't rocket science. It's more common sense. I've seen way more clueless basics on calls then I have medics.

lol that joke of a test? I probably could have past it without even going to class. ha

Link is broken?

Man I work in an urban system, in a very ghetto area. Lots of violent trauma etc. I admire you rural guys with much longer transports. A lot more time to help (hurt) a patient! I'd love to work a rural area some time in my career for a short stint. I don't doubt there are guns and violent traumas in the sticks. -City Slicker!

I don't see why B's shouldn't be able to give narcan in an auto injector. But really, those B's pushing for that and wanting to give drugs should continue their education and become paramedics. I don't give 2 shits about this brochure. I can't believe they'll make a political mess out of it. Well I guess I can. If we can stop one call @ 3 AM when I'm sound asleep for an OD this brochure is OK in my book. I am so sick of pumping narcan in all these idiots.

In our region we are able to give 10 mg of Versed IM to the combative patient. This works great if you have enough guys to hold him down, I don't attempt to get close to the pt. with a needle unless he is being held down. I've done thid quite a few times in our lock up. Usually for this type of patient we will have the police and our FF's assist us with 4 point restraints. A pair of panty hose is great to put over a patient's face to stop spitting. This way you can still monitor the airway quite well. Safer than pillow cases. A NRB mask also works to block spit. Spit can be very dangerous...we are talking about hepatitis. Don't joke around with it. Stop it at any cost it is a BIG risk. Stay safe foks!! ??? really ???

Depends on the type of call. A call with a lot of work, an arrest, DAI etc. takes a bit longer for obvious reason. On calls where the driver can handle all the tech stuff, i.e IV and assessment without needing me to help I am able to write the PCR during the call and en route. If that happens I can usually clear the whole call in about 45 mins to an hour depending on different circumstances. Some crews can take 1.5 hours plus and it's a pain to have to cover them because their so slow! So many different factors though, hard to really determine this. Things such as patient removal, treatment etc. can all have an impact. Interesting topic though, and interesting replies!

O2 STATS and SUGAR PRESSURES?

Thanks for the response. Sometimes scenarios are hard to decipher. As I stated in my original posting, I would go with the croup/epiglot. route barring a an object in the airway. I guess the best thing would be to attempt back blows and thrusts to see if anything popped out and/or improved the condition. This is what I meant when I said "barring". If this were not to work, then it would be a "pucker" situation. So barring out the foreign object in the airway, I would treat this as croup. My tx. for this would be listed off my SMO's, nebulized EPI, if no improvement, then attempt intubation X 1. We don't have RSI in my SMO's. We used versed and etomidate. Etomidate is for adults only, so we are to used versed for sedation and intubation. You can't really rag on me for it, since I am not the medical director. Sorry. During intubation I'd be on the look out for a foreign object and swelling of the epiglottis. If I could not get the tube, I would cric. I'm not sure why you are disappointed with my treatment plan, or why exactly you take personal offense to my posting. People are strange around here. I see there is a little negative by my posting name, a -1 reputation. I find that quite amusing. Thank you! I still stand by my response to the SPO2. Based on the appearance of this child I would not waste time with it. And I guess when I say waste time, I mean go digging for it, it is deep in our bag. So that situation is unique to us I guess. My priority would be on getting a line and some sort of airway intervention done immediately. Especially with the child who I quote the OP of thread has more cyanosis "than able to shake a stick at". This kid looks like shit and needs agressive, fast treatment. By looking at this kid I know SPO2 is less then ideal. The cyanosis tells me that. I think SPO2 is a great tool, however in this situation I would not worry about it. One thing I do love about SPO2 is trending. So I guess we could use it to see if the neb has helped the kid. However, I think a visual/auditory assessment with be a more reliable/quicker indicator of improvement. By no means did I mean to rile you up. This is a scenario on a forum which I glance at every so often, and I wished to respond. I know the die hards here like to treat this like a firehouse and bust balls etc. I want no part in that. cheers sir. hope you had a merrrrry xmas! Here is a good write up that summarizes my position on Pulse Ox magic! http://tooldtowork.blogspot.com/2008/06/one-where-he-rants-about-pulse-oximetry.html whoa what kind of conclusions are you jumping to? Why are you taking this to a silly level? Let's be real here. I don't NEED the pulse ox in this situation AT ALL. Does cyanosis, stridor and DIB not ENOUGH EVIDENCE to determine whether this kid is in respiratory distress?? Do you need a baseline pulse ox to justify intubating the cyanotic kid with stridor to the doctors in your ER? If you do, it really sucks to work where you are. Pulse ox is NOT going to change my treatment of this patient. Will it change yours? Hell if I never did a serious peds call ever again I'd be very very OK with that. But we know that isn't going to happen. So your thread is well appreciated by me. Thanks.

I have a partner who relies so heavily on SPO2 and it drives me crazy. He's a piss poor medic. Do you really have to waste time throwing the SPO2 on when the kid is in obvious severe resp. distress? He's cyanotic w/stridor. Barring a foreign object in the airway, I'm going down the epiglot./croup route. (we have no evidence of a allergic rx) Lets have my partner start some racemic epi while I ready the intubation and cric equipment. If the epi does nothing, I will intubate (utilizing versed per my systems SMO), while intubating I'll be looking for a foreign body and/or swelling of the epiglottis. If I see any evidence of this and cannot get the tube, I will be cric'ing. Not slamming you BTW with the comment about the pulse ox. I just feel a good visual assessment is more reliable. We don't need a pusle ox. to tell us whats going on, and in this scenario out on the street with 2 people, I think it is a waste of time to be worried about that. I would probably bust out our SPO2 when we intubate since it has digital capn. on it as well. merry xmas guys

I'm around 11 or 12 and one surgical cric. 100%. Another guy at my station has like 20 or so, right place right time I guess

I work on a 24/48 schedule, and I have 2 whole days off. One os just my and my infant, and the other is wife and infant. That's a lot of time off imo. Can you goto a shift schedule? It's great.

Yes. We have guys that come and work out early too. If I'm on the treadmill and the ambo goes out when im there early ill jump on.

43k is a good salary? Seems like FDNY guys are getting screwed (Hey its ok lots of hard workin' EMS folks are) especially with the cost of living in NY etc. I wish you guys the best.. Here Academy was 3 months for medics, 6 months for FF's. PT was brutal....attention to detail was the most important thing. It helps establish a feeling of pride in the job.

Had quite a few beat dowms

It's safer from a distance! Actually if I was Wabbit, I could shoot it while flying in a helicopter in a large metropolis at all the addicts.

omg. what a shame. best show ever lolz

Without a chem anda mental status this could not be a refusal. Their parents are not the ones making the decision in this case. I hope it doesn't come back to bite your ass. The doc on scene is not your medical director and his input about transport is meaningless.