FireMedicChick164

I am a NY EMT Critical Care. What are you looking to find out?

Patients lie to us and the police all the time! They like to change their stories when they get to the ER and tell the triage nurse something totally different to make us look like dummies too. Here in my district in NY the police are dispatched to the call AND we are dispatched to the call. Most of the time they get their first so they can advise of any issues prior to our arrival.

The term "bus" when referring to an ambulance is really a slang term here in NY. We us it when talking amongst ourselves but not over the air. Over the air we use the unit numbers but in conversation it's not uncommon to use.

We have great tap water here. It's the only thing I will drink...no bottled water for me.

The only thing I believe will restore blood is letting to body make more (or a transfusion). They took LR out of protocol years ago and now we only use NS here and for fluid replacement and to increase volume (to try to raise BP). They do have "artificial blood" out there but I don't know enough about it to have an opinion. Info on artificial blood: http://science.howstuffworks.com/innovation/everyday-innovations/artificial-blood.htm http://www.rsc.org/chemistryworld/Issues/2010/October/ArtificialBlood.asp Info on Lactated Ringers: http://en.wikipedia.org/wiki/Lactated_Ringer%27s_solution

R.I.P Brother...

Hey Brother...I feel your pain. Glad you are back in the green as far as your bank account goes! I have been a NY EMT B for 9 years and for the last 2 have been an EMT CC (our EMT I) I joined my local volunteer FD when I was 19 and they have paid for all of my EMT school thus far). I just recently landed a good job and began to see my bank account go up. I have been going to college on and off for the last 10 years to train to be a teacher (in between life getting in the way). Lo and behold I have 2 more semester left to go and there are no teaching jobs around here! My fiance was laid off from his teaching job in February and can't seem to find anything. I was working teaching pre school for the last year trying to pay the bills and it wasn't working. We have to pay for our wedding and get my debt all paid off and my nerves were starting to fray. My life is beginning to look up. So is yours. I just wanted to let you know that you are not alone in the frustration of the job search. That conviction you have may hinder your getting a job but some employers still may hire you if you can speak to them and let them know that was in the past and you have every intention of going forward honestly. You never know. Private companies (at least here) pay just above minimum wage. If you can get in to a big city EMS as a career that's probably the route you want to go. Some of the hospitals here hire EMT's as ER Technicians....have you looked into that route. Do any of the hospitals have their own EMS? Good luck with your job search and keep me posted. Meri

When I took my EMT -B class (11 years ago) the academy I was attending gave a practice exam to the students who wanted to take it a few weeks before the actual exam took place. They had a pool of questions from previous tests and quizzes and gave us a 50 question practice exam. It was great because we were able to focus on what areas we were weak in and either get remediation or just study extra on those topics. If your school is considering it I'd say it's a great idea. They even gave a practice exam when I took my EMT-CC 2 years ago and it helped me quite a bit. It can only help you! Good luck!!

Just a random thought: If you are sitting in the waiting room...have you been triaged yet? Sometimes there is a wait to even be triaged and if you are just waiting for them to triage you no chart has been initiated so technically you'd just be in the hospital not registered yet in the ER. Also I have heard of ambulances being dispatched for calls outside of hospitals but never to an ER.

I agree with everyone else here, This guy needs to be reported! If enough people complain about him maybe they will be forced to do something. Unfortunately there are providers like that everywhere....We have one in my agency that I'd like to punch in the mouth sometimes. He is arrogant, childish, and although his skills are fine his patient interaction and judgment calls leave a lot to be desired. I have mentioned it to my supervisors and had discussions with my Lieutenant (I'm a Captain) about it and he is being watched now. Good luck and let me know if anything positive happens. Keep us your skills and be the best EMT you can be!

thanks for sharing. unfortunately I couldn't open the video

I agree with the statement that addicts need to admit that they have a problem before they can accept treatment. How many agencies are really equipped to offer some form of referral service or help in the event that one of their members does have a problem? What type of things could be do to PREVENT providers from stealing medications? It's not just the EMS field that this is a problem, I have also heard of docs and nurses stealing meds or diverting them from patients who need them to fuel their own addiction. As of last year my vollie FD began carrying narcs on our ambulance. They are kept on the ambulance in a locked box with a numbered zip tab and that box is in a safe that requires the ALS providers key tag AND code to gain access. It records when the safe is opened and we have to have a witness if/when we even open the safe and we must fill out the log book. The restock safe is located in the dispatch office (same set up) and the only people who have keys to that are the 2 narcs officers. Witnesses are needed for that to be opened also. Hopefully we have put into place enough safeguards so if we did have someone involved in our agency with a drug problem they couldn't get access to anything. I'm wondering what other agencies have put in to place to discourage providers from trying to steal narcs. I'd be interested to hear if anyone has any input. Thanks!

Hey guys, maybe instead of attacking JLO1965 someone could do some research on the protocols from the early 90's. Also take into consideration that the MAST was originally a military invention to treat those in the field who were gravely wounded so they may have time to get to a field hospital. More info here: http://en.wikipedia.org/wiki/Military_anti-shock_trousers I'm all for sharing info about what we do and our equipment. Nothing that I said in my first post is anything but facts and I cited my source in my post. If we can't educate the public and/or share info with each other how are we ever going to learn from others mistakes and improve our patient care. Protocols change all the time for a variety of reasons which is why research is being done on a consistent basis. It also sounds to me from the reply by JLO1965 that the record keeping was sloppy on this case. Just trying to see things from both perspectives. Meri

First I need you to clear up a few things for me: 1. You said the BLS crew arrived and put the MAST on the patient. Did they inflate them right away? 2. Then you said the EMT arrived and started yelling for them to remove MAST from the patient. Was the "EMT" an ALS provider? What about the EMT that arrived with the BLS crew? If the BLS crew inflated the pants then they should have NOT been removed in the field. 3. What state are you from? Here in NY our protocols are for the MAST are for hypotension secondary to suspected pelvic fx and severe traumatic hypotension. They are NEVER removed in the field. (Compartment Syndrome comes into play here as well if they are left on long enough also) In the 9 years I had been an EMT Basic and the 2 years I have been an AEMT I have never had to use the MAST. Our main hospital is pretty close to our district and even the trauma center is only 15-20 minutes away (5 minutes by chopper). **The NY State Dept Of Health placed in their protocols recently the results of a study done on MAST. I have copied the recommendations below: MAST (PASG) are "usually indicated, useful, and effective" (Class I evidence) for: · None. MAST (PASG) are "acceptable, of uncertain efficacy, [although the] weight of evidence favors usefulness and efficacy" (Class IIa evidence) for: · "Hypotension due to suspected pelvic fracture; · Severe traumatic hypotension (palpable pulse, blood pressure not obtainable). *" MAST (PASG) are "acceptable, of uncertain efficacy, may be helpful, probably not harmful" (Class IIb evidence) for: · "Penetrating abdominal injury; · Lower extremity hemorrhage (otherwise uncontrolled); * · Pelvic fracture without hypotension; * · Spinal shock. *" MAST (PASG) are "inappropriate, not indicated, may be harmful" (Class III evidence) for: · "Adjunct to CPR; · Diaphragmatic rupture; · Penetrating thoracic injury; · Pulmonary edema; · To splint fractures of the lower extremities; · Extremity trauma; · Abdominal evisceration; · Acute myocardial infarction; · Cardiac tamponade; · Cardiogenic shock; · Gravid uterus*** It basically states above that for a penetrating thoracic injury (such as a stab wound to the chest) that the MAST is inappropriate, not indicated, may be harmful. The website that the information from the above study is on: http://www.health.state.ny.us/nysdoh/ems/pdf/2008-11-19_bls_protocols In the PDF file the info is on page 123. Hope I was helpful. Meri

NY EMT-CC here! RSI is not in protocol here..although my agency does carry valium, versed, and morphine in an electronic safe on the ambulance. They are in protocol for severe pain and seizures. Although we have only been carrying narcs for about a year now and are one of the very few services in the county to do so.

This same question popped up on the JEMS website too. I have posted the link below so you can look at that too. http://connect.jems.com/forum/topics/albuterolchf-1?xg_source=activity In NY where I practice albuterol is indicated for asthma and COPD. I do remember our instructors telling us that we shouldn't use it for CHF patients. It can make their condition much worse. I always try to get a thorough history before I give any meds and the few CHF patients I have seen we have just given O2 and put on a cardic monitor. Our closest hospital is less than 10 minutes away.

we don't carry them, don't use them, they aren't in protocol. The way I figure it, if a patient is faking being unconscious and is good enough at it to pass our "tests" (ie: the hand drop, scratching to bottom of their feet, etc.) then the hospital can deal with them because they are doing it for a reason (whether good or bad). We actually had a female patient who was "unconscious" and had us fooled until we got to the hospital and the sat right up and talked to the nurses as soon as we were out of the room. Apparently there was an issue with her husband (unknown what it was) and she figured that was then only way for her to get out from under his watch and get some help. We even went as far as to cut off her dress in the rig looking for any reason she wasn't responsive! She didn't flinch at all.....even passed the hand drop test!!

don't go in to EMS to get rich....do it because you want to help people and you will be fine. Depends on where in the country you work and what type of entity you work for. I am a vollie so I work for free....love every second of it!!

doesn't bother me...I actually think it's kind of amusing. Don't take yourself so seriously!!

practice, practice, practice....i suck at math but when i took my EMT-CC i had to learn it. My friends all drilled me using different numbers it until i got it.

CONGRATS! I have been an EMT for 11 years you are going to love it! Are you currently with a service or will you be looking for a job? I do my EMT as a vollie and work full time as a teacher. Nothing wrong with being a professional volunteer!! congrats again!!