flight-lp

I spent some time "over there" this afternoon and I found it to be quite humerous. A lot of whiny people and a lot of bitching back and forth on who is better than who and that EMT's should be able to start IV's because "it just needs to be done", etc., etc. I may go back for a laugh every now and then. HEY DUST, go check it out, you would have a field day!!!!!!!!!!!!

To bad they closed the thread, I was going to have some fun! She is an inmature twit that has no business on an ambulance. Anyone wanna take bets on how long she lasts before she a)kills someone, b)gets killed by not watching her scene safety, or c) gets run off???????

Damn VS, you beat me to it!!!!!! Guys and Gals, working in an ED as a EMT or Medic does not a nurse make!!!!!! All of this crap about "we can do this, we can do that" is exactly that, CRAP!!! I have already called BS on one of these threads today and here pops up another. It is not as simple as a physician in the ER saying you can do something. There are other considerations i.e. State Board of Nursing, JCAHO, etc. I worked in an ED at one time, made almost $20/hr as a Paramedic. My job function........... A well paid transporter, phlebotomist, and nurse bitch!!!! I enjoyed it thoroughly and it did provide a well rounded educational experience, but I knew my limits. No meds (violation of the Nurse Practice Act) were involved. No interpretations of 12 leads (I'd run 'em then give them to the doc). If you are an EMT and working in an ER you do not "fall" under the physician. Nor can you perform any skill outside of your scope of practice as outlined by your state EMS board. And you certainly cannot administer medications. If you are, you are wrong as is your facility! (Only known exception is a hospital based EMS that clearly outlines your duties). Next thing you know someone will post that they can do thoracotomies in "their" ER! O.k. I'm off my soap box, thanks for allowing the vent....................

I'm not a pro on OK, but in Houston $9.50/hr. is a few pennies below average. Benefits are standard with most companies. Ask Rid, he should know.................................

If you do not want to be on an ambulance, then why on earth did you choose this career???

And on a more personal note................. As a proud EMS provider in Texas who spent a great deal of time and effort assisting those in need, I would like to extend a personal THANK YOU to AK! To travel thousands of miles to help people for no other reason than to do what was needed is an exemplary example of an individual who makes us all proud. Your selfless act of dedication and compassion might go unappreciated by some, but I raise my glass to you. Thank you for the assistance and god bless you!

While I was not directly involved with the aftermath of Katrina, I do have some insight to this whole fiasco and it began with gung-ho medcs from Oregon who thought they were going to do something cool and exciting. What they didn't realize is they were to be working in a contingency environment, i.e. GP large tents, MRE's, and minimal supplies. This wasn't a per diem job with accomadations at the Hilton! They should have realized this. They were so miserable and thus they intended to make everyone else miserable too. My involvement with them lies in the Rita aftermath. Yes, they were told to go to Beaumont, yes they were chosen by the "higher ups" from Henderson (Probably just to get rid of their sorry asses!). However, they were not told to take the ambulances, not were they authorized. Despite what the idiot in Baton Rouge thinks, they may work for him, but he did not own those ambulances and therefore Mr. Henderson had every right to be pissed beyond belief. Now, back to the morons...............They quit, got fired, what ever people want to say. But what they didn't do was evacuate Beaumont and Port Arthur like they were told, they decided to freelance! Thanks to them (among other things including a last minute shift of the storm), the largest hospital in Beaumont was not evacuated until AFTER Rita hit. Over 50 ambulances from Houston had to come clean up their cluster, heavily due to people wanting to do their own thing. The reality is that these types of operations are not "how you want it done". They are to be done the way you are told to do it. you can agree or disagree, but the second people start doing their own thing their own way is when a royal cluster f^#$ soon follows. True, the 1099 thing is screwy. Needs to be looked at. I do want to clarify one thing though. Henderson consulting does not have a vested interest in Goldstar EMS, they never did. They simply subcontracted for the ambulances. It was a win-win situation. It helped Goldstar's financial situation. 48 Ambulances at $800 / day. And it provided an immediate response to FEMA's need. It also afforded many of the former Goldstar employees a paycheck. Yeah they did give some of the units that have been in the "graveyard" for a while, but they were still ambulances, still capable of providing transport, and still capable of their designed use. This is similar to a military operation. You improvise, adapt, and overcome. If you can't, you don't need to be there. Just my personal .02 worth. Sorry, but this lets cry to the media crap is yet another reasons why EMS respect and professionalism is way behind the times. Tried to spell check, but I got a "critical error"!!!!!!!! :shock:

I had the opportunity to meet a couple of King Paramedics last year and they had to be without a doubt the most arrogant medics I have ever met. The only words of substantiation that came out of their mouth was "we don't have to run BS basic calls". Wouldn't their momma's be proud! Honestly I am really not too impressed. Yes they have somewhat liberal protocols and their education standards are set higher than the bar (but I do not agree with the "military medic experience does not count", most military medics or corpsmen could run circles around their civilian counterparts). My problem lies with their response time. Average is over 9 minutes, with only 70% in under 10 minutes and over 10% are OVER 15 MINUTES. Sorry, thats not that great. I also do not agree with a non-certified call taker or even an EMD/EMT deciding over the phone who should go and how stable or critical the patient is. If a Paramedic is available, then the Paramedic should be dispatched. They boast an all "P" staffing, how about putting some of those medics with AMR or the Fire Department's basics to provide better coverage? The way the stats are now, it is grossly insufficient.

Could you elaborate on the reasoning behind these allowances? Can they intubate? Can they treat the lethal dysrhythmias that they are "allowed" to interpret?

Tracheal deviation is a late ominous sign. In my experience most spontaneous pneumo's will not develop enough to cause a shift or are treated prior to that point. The only time I have seen deviation is in a patient that is dead or one that soon dies. All patients that I have ever placed a chest tube into that have exhibited a tracheal shift have died, despite the correctable treatment being in place. (And yes the tube was placed properly!)

Whats wrong with Bretylium Dust? Isn't it still first line along with Procainamide, Isuprel, and Propanolol? o.k. maybe the AHA refrerence wasn't the best reference example, but it is still correct..............................

O.k. then both of you were trained incorrectly or the material was misinterpreted. AHA - ACLS Providers Manual states that V1 and 2 are SEPTAL Leads, 3 and 4 are your anterior leads. Plus I wouldn't put a whole lot of faith in info given to me by a for profit drug company, they tend to "stretch" the truth.

He has pneumonia again, probably courtesy of the SNF unit. I do not agree that BLS should handle this, I think the SNF unit needs to learn how to activate an ALS response. This patient needs IV access, needs to be monitored, probably needs rehydration, and could possibly benefit from pharmacological interventions which a BLS unit cannot offer. I would have the ALS respond...................

Dissecting aortic aneurysm........Get him on the table quick!!!!!

Yet another reason why I am glad to not be in New York state............. Robbie, Thanks for the clarification, however I have never heard of this being an issue in my neck of the woods..........

A couple of recent threads about pain management..... http://www.emtcity.com/phpBB2/viewtopic.php?t=2229 http://www.emtcity.com/phpBB2/viewtopic.php?t=2817

Deleted, sorry wrong thread......

Yes patients are being denied pain managment Pre-Hospital. There were several threads extensively discussing this very issue (I'll try to track them down for you). There are very few agencies that allow medic autonomy to titrate analgesics to a patients pain response. In addition there are medics outs there who just flat out refuse to give it, stating such excuses like "he/she really wasn't hurting that much". Fentanyl is a wonderful drug and IMHO less hemodynamically altering. It is my analgesic of choice for the majority of my pain patients and as you stated is a wonderful alternative in cases where Morphine is contraindicated. Now I have not had my coffee yet this morning, could you explain the "diversion" issue? I'm not following you........................

Out of curiosity, what is the purpose of your research? Give us a little more info and we may be able to help you track down more info................

Interesting study, but the 33%who did not report improvement only got 1 dose fo MS. I'd be interested to see what the % is for subsequent doses. I am fortunate to have very liberal pain mangement protocols. PRN is a pain patients best friend! Plus with the increase in Fentanyl usage, hopefully this statistic will improve in the future.......

Great read Rid!!!!!

Just released........... http://abclocal.go.com/ktrk/story?section=...&id=3895076

It is with great sadness that I pass on the news that prominent Houston surgeon and cardiothoracic pioneer Dr. Michael DeBakey has been hospitalized in Houston for an aneurysm. Details are just now being released, his condition and prognosis unknown. I'll post more when I know. Please keep Dr. DeBakey and his family in your thoughts and prayers.................

Lds V1, V2 = Ant / Post MI Lds V3, V4 = Ant / Septal MI Uh, NO! V1 and 2 are your septal leads, V3 and 4 are your anterior leads. V7 through 9 will give you your posterior view.......

What kind of info specifically are you looking for? Fentanyl is used quite a bit in the Pre-hospital world. Has been for years.