Linuss

Funny, kind of like how you have zero proof that it doesn't exist?

Yes, it's perfectly fine to take multiple patients, and don't know why anyone would state otherwise. Yes, at my last service, which was rural, I did it plenty of times. Usually trucks would transport 2, but sometimes there would be more. My most was 3. This was due to an MCI machete attack (Yes, you read that right... machete).

You say that as if they will lose their dog forever for going to the hospital. Realistically, a patient will not need their dog during the first part of their visit to the hospital. People will be taking them places and doing things for them, especially if the patient is critical. Like I said, if I don't feel safe and don't want to take them, I won't take them. Granted a lot has to happen for me to make that decision, but if I make it, I would LOVE for someone to throw a hissy fit.

And that's when I grab it back out of her hand, say "Finders keepers" and walk away.

We have Epi drips....

We have Fentanyl for analgesia. Good thing about Fentanyl is the quick onset AND you can do it IN if need be. I've used Morphine but I don't like the slow onset, even if it last longer. We use Zofran for antiemetic, though I have used Phenergan and liked it too. I think ODT Zofran, and an IV/ IM antiemetic, either Phenergan or Zofran, would be the best combo. We have Ativan AND Versed as our Benzos, with our choice at when to use which. Can do both IV and IM, and can do the Versed IN as well. We have Albuterol AND Atrovent, in separate vials for bronchospasm. Our nitroglycerin is in both tablet and IV infusion. Yes, we carry the glass bottles, and I've yet to have one break on me. We leave it on the truck in the drug cabinet, so no real chance of it dropping and breaking unless YOU drop it.

We do. We also don't use the crappy throwaway blue sheets, but actual hospital sheets. When we drop a patient off, we get new sheets and new pillow. Tit-for-tat.

Honestly it will depend on how I view the dog at that time. I'll take the lickings from my superiors later if I refuse to take the dog due to me not feeling safe. Think about it. If the owner is acutely ill or screaming in agony, the dog may think you're trying to hurt them, regardless of how nice the dog usually is. We were called to a house last night with 3 dogs running around. We waited for over 20 minutes for SO to show up for our protection from the dogs (a pit, a boxer and a husky) who were acting odd around our rig when we pulled up. Once we got inside, the patient said "My dogs don't bite" I asked what his bandaging and stitches were on his arm, and his reply? "My dogs bit me" I have no problems with dogs, I have 5 of them. However, if a dog doesn't make me feel safe, the AWD laws be damned, the dog stays behind, and I'll deal with the complaints later. Not like the patient is going to be walking around the hospital the very minute they get there. But, again, it's to be taken case by case, and with most service dogs I've met, they would go with the owner.

Copied from my post on the same thing a few weeks back: Pouch 1, IV pouch: Crap load of syringes, ranging from 1cc to 20cc. Assorted IV vaths 2x CAT tourniquets Few IV start kits Few IV extensions Few saline flushes 15gtts sets IV Pump tubing Pouch 2, Cardiac drug pouch: D50 5x Epi 3x Atropine 2x Lidocaine 1x Sodium Bicarb D5W 3x DuoDote Side pouch 1: Sharps container Side pouch 2: BP Cuff Stethoscope Back pouch, Airway: 5 sizes of LMAs 5 sizes of Kings Intubation roll, with all assocaited equipment such as each Mac and Miller blade, 2x handles, extra batteries, 1 of each tube size, BAAM, Adult and Pedi Magills, adult and pedi tube tamers, ETCO2 connector, assorted OPAs, assorted NPAs, meconium aspirator Main pouch: 2x C-collars Portable suction EZ-IO 1l NS 1l LR Dopamine premix Lidocaine premix Adult bougie Pedi bougie Abd pads CPAP with adult and pedi masks NRB for adult and pedi NC for adult and pedi Capno-cannulas Mini drug box with: Acetominiphen Oral glucose Narcan Lidocaine jelly ASA NTG Adenosine Albuterol Benadrul Calcium Gluconate Amiodarone Enalaprilat Epi 1:1 Etomidate Famotidine Glucagon Heparin Atrovent Labetalol Lopressor Mag Sulfate Solu-medrol Levophed Zofran Oxytocin Rocuronium Tetracaine Thiamine Vasopressin

Nothing wrong with having a cheat sheet, especially for things such as a commonly prescribed medication list, a drip calculation list, lab values, and stuff of that nature. Really, the only stuff that needs not be in your pocket guide that you NEED to know back and front are the "OH SHOOT, I NEED TO DO THIS NOW" medications, stuff that the situation does not lends itself to peaking inside a book.. You need to know the dosages of the emergent medications we carry. without thinking about it. You need to know Epi 1:1 for an allergic reaction. You need to know the dosage ranges of your ACLS drugs. You need to know your RSI ranges. Pediatric Epi dosages. Other things, such as Solu-medrol, the drip rate for Tridil, the rate for Mag Sulfate, stuff that is a bit further down the line, and not as often used, can wait till you can look it up. Pediatric dosages can wait until you double check them, especially with a Broslow tape. You are not less of a medic for not memorizing every damn word in your guidelines / protocols. There's a reason a copy is in the back of every ambulance.

Get your Paramedic, all but forget about fire, do a few years with an agency such as MedStar in Ft Worth to get high-volume 911 ALS experience for a few years (or even one of CareFlites ground units in Johnson County), get your critical care paramedic, get your flight paramedic, and then you'll stand a shot. Having another license like Respiratory Therapist or RN doesn't hurt either.

Yes, all the time. Contact said EMS service or hospital, and they will have the information.

Bag is actually only a bit heavier than an LP12... I'd say 35ish pounds, and considering an LP12 is about 25ish, it's not bad. I say it's only slightly more than the average ALS bag. But hey, I can guarantee it's less than our Stryker power cots Ah, forgot to add our cric kit is in the main pouch as well., Oh yeah, very progressive, which is what I love about Texas: The agency decides what they want, not some bureaucrat. RSI, DAI, surgical and needle crics, foley caths, OG/NG tubes, Code STEMI / Stroke / Trauma activations, heck even the EMTs can do Kings and 1:1 Epi for allergic reactions (no epi pens).

The big red bag that goes on every call, next to every patient, kind of like this, Pouch 1, IV pouch: Crap load of syringes, ranging from 1cc to 20cc. Assorted IV vaths 2x CAT tourniquets Few IV start kits Few IV extensions Few saline flushes 15gtts sets IV Pump tubing Pouch 2, Cardiac drug pouch: D50 5x Epi 3x Atropine 2x Lidocaine 1x Sodium Bicarb D5W 3x DuoDote Side pouch 1: Sharps container Side pouch 2: BP Cuff Stethoscope Back pouch, Airway: 5 sizes of LMAs 5 sizes of Kings Intubation roll, with all assocaited equipment such as each Mac and Miller blade, 2x handles, extra batteries, 1 of each tube size, BAAM, Adult and Pedi Magills, adult and pedi tube tamers, ETCO2 connector, assorted OPAs, assorted NPAs, meconium aspirator Main pouch: 2x C-collars Portable suction EZ-IO 1l NS 1l LR Dopamine premix Lidocaine premix Adult bougie Pedi bougie Abd pads CPAP with adult and pedi masks NRB for adult and pedi NC for adult and pedi Capno-cannulas Mini drug box with: Acetominiphen Oral glucose Narcan Lidocaine jelly ASA NTG Adenosine Albuterol Benadrul Calcium Gluconate Amiodarone Enalaprilat Epi 1:1 Etomidate Famotidine Glucagon Heparin Atrovent Labetalol Lopressor Mag Sulfate Solu-medrol Levophed Zofran Oxytocin Rocuronium Tetracaine Thiamine Vasopressin We also have Fent, Versed, Ativan and Tridil in the truck, which the first 3 are in a lock box, and the tridil is in a cabinet since it's a glass container. The glucometer is in a pouch on our LP12, so it's with us at all times too. We also have our "trauma bag" which holds a bunch of IV stuff and bandagaing... It's a small backpack which I guess we can bring with us in to a car with entrapment, or some other small space which we don't need the entire red bag, just trauma stuff.

I bought my own personal PulseOx for about $30 off Amazon, as while my company had a couple, I somehow always got screwed out of them because a BLS truck would grab it before me. As a Paramedic, I didn't feel comfortable running the respiratory calls I did without a pulse ox to augment it, and felt like an idiot walking in to the ER, being asked what my SOBs sats were, and me going "No clue"

Here we go, per the Texas DSHS FAQ on DNRs DNR ONLY applies to CPR, Pacing, Defibrillation, Advanced Airways and Artificial ventilation...no mention on cardiac drugs, just electricity. Also, healthcare professionals do NOT have to honor a DNR if "There are unnatural or suspicious circumstances surrounding the death." which you can argue giving adenosine and causing arrest is unnatural. Granted, this is just my state for OOH-DNRs (which the OP lives in the same state) and I'd still call MC while CPR is being done.

I could have SWORN I remember being told a cardiac arrest caused by something we did still gets worked, because it's not a "natural" cause of death, which a DNR is supposed to be for. Just like "suspicious" circumstances surrounding a code with a DNR... you still work it. Though I can't find it in protocols, be it from my company or others....

Texas is what is known as a delegated practice state, which will be a shock for you coming from Cali. There are no state-wide protocols, each med control can determine what they want their personnel to do and not do. Plenty of good agencies down here... now getting on with one you like, as a brand new medic, is another problem completely

Having tattoos (that are in good/decent taste) won't instantly disqualify you from being hired. I've worked with Medics / EMTs that have full sleeves as well, so long as it's nothing offensive. Some places might have you cover up / wear a long sleeve shirt while working. It just depends on the agency. What has you fixed on Miami? Why not some other place, maybe even a 3rd service agency?

Have any proof AT ALL to back up your claims? Or is it as anecdotal as it seems? Honestly, for people who claims they like evidenced based medicine, some of you totally fail at proving things beyond "It just makes sense". I haven't seen any meaningful research into survival rates in different countries different EMS systems. Don't get me wrong (because I know someone will) I'm a proponent of education. But don't bash something and then not back up your accusations.

Wait wait wait. Your advanced first responders are "more equipped and trained", yet have almost the exact same drugs, and only, on average, 80 more hours of education in 4 times the time frame? Hell, I had 210 hours in my EMT in 4 months. So I had 10 more hours in a quarter of the time of your advanced responders who are apparently better at emergencies than I was as an EMT?

Devils advocate: What's the difference between a medic drawing up the meds and giving them, and the medic drawing up the meds and having his basic push the plunger? If the meds screw up the patient, it doesn't matter which provider actually administers the drug, does it? (not legally speaking, of course...) And now my personal view: At my system, EMTs can only give patient prescribed Nitro, Albuterol, ASA, EpiPen. Hell, if I'm going to give one of those 4 drugs anyhow, what's the difference between me giving mine from the ambulance, and an EMT giving it? Same med, same indication, just different doctor prescribing.

That's the point often thrown out by the other side... "What would you want if you were in their position" That doesn't mean what they do is ok, doesn't make it any less wrong, and in fact it is a detriment to the people that actually WORK to become citizens, instead of sneaking across the border. That is why I am against any and all amnesty plans. You're rewarding criminals, plain and simple. What kind of message does that send to the family in Croatia who's been doing it the legit way trying for 5 years? Is the path to becoming a citizen really hard? Sure. Can it be streamlined a bit? Yea. But so what? Why do some view it as a right to become a citizen in whatever country you want? Why should we extend citizen benefits to any and everyone that asks? Kind of defeats the whole purpose of being a sovereign nation, does it not? And thankfully we have house bill 1868... now just to get those lazy politicians off their butts to close the 14th amendment's loophole about 'birthright' citizenship. Sure, I had it "easy" and won the lottery by getting born to a upper-middle class white American family. So? Does that mean I have to feel bad? Sure as hell doesn't! Does that give me an obligation to help the less fortunate, within my power? Hell yeah, and I do. Paramedic, remember? But I do not, and will not, feel sorry for people who undermine the very principal of this nation, viewing it as their entitled right to live here if they so desire, my country's laws be damned. If you can't respect a country's laws, and can't respect a country, why are you there? You know, the vast majority of the reason why there is so much violence in the middle east is because we aren't a hardcore Islamic nation like some people want. We just can't do anything right, can we?

8 months is new? Since when? Just because I don't post doesn't mean I'm new. But you were still wrong, either in your original wording, or your thought process. Your news story is still irrelevant--- they were still illegals, were they not? And as such, broke a law, and as such, were caught and punished. I fail to see how that makes a law, that isn't even in effect yet, a bad law, like you so boldly claimed.