daedalus

awesome dude! I remember seeing my status change from "EMT-Basic" to "Paramedic" on the nremt website, I was on cloud 9 the whole day. Now it will be PARAMEDICinPEA hahaha.

wow... I know of this incident. Would elaborate but I don't think it would be a good idea. Amazing they actually are going through and looking for an attorney.

While unfortunate, the OP's company seemed to be dispatching to emergency calls and was not equipped to do so. It is stupid and dangerous but for now it is a fact. (at least in 06 it was....) In my opinion, all BLS ambulances should have an AED so that a responding EMS crew can provide a higher level of care then a mall security guard...... I know most ambulance companies in the Los Angeles area are not equipped with AEDs, which is a tragedy. I gave charcoal 3 times the past 6 months. All were orders from the med control doc.

Ruff, sorry. I posted that from my phone after I had read your post calling my response "ridiculous". I didn't see that there were followup posts. I generally find you to be a knowledgeable forum poster and enjoy reading what you have to say. Indeed, if Mr. Greene had an ambulance outside I would have expected him to give O2.

Seriously?? Did you even bother to research the facts in the case before posting? He did not have an ambulance, he was not a field employee, and was on break.

The comments on Yahoo news are disgusting. Here we have a man that decided to dedicate his career to helping others (we all know how much EMTs and dispatchers get paid) and when he is shot and killed the public chalks it up to "karma" or "that monkey deserves it". The internet really brings out the inner racism and ignorance of the general public. My own views on the situation are that he did all he needed to do by calling it in. Now, I would have called it in and stayed with the person in distress, but what can an EMT-B without equipment do in a situation like that? Better, what could an EMT-B with equipment do? We better all behave ourselves lest we want to be tried and sentenced in the court of public opinion with the help of youtube and camera phones.

Paramedic school will not offer you what you are looking for. The EMT class will be sufficient for your needs if you are taking it to become proficient in handling injuries in your volunteer groups as a layman. You will never use the knowledge or procedural skills from paramedic school again without working in an ALS system, and these skills rapidly atrophy. You will not be forming field impressions (read: diagnosis) and treating with medication and invasive procedures as a layman, so you will have wasted a year of your life completing a paramedic program just to learn first aid when an EMT class will be more then enough for you. As a layman, some of the EMT scope will not even be available to you while working alone.

<br><br>While I agree that local acronyms should be avoided, and I do try to avoid them, Hs and Ts are really a nationwide (possibly worldwide in english speaking countries) acronym used in the American Heart Association materials for emergency cardiac care, and mean the same to everyone everywhere. These are taught in the standard ACLS course. Similarly, I have never heard of ROSC being used to describe anything other then return of spontaneous circulation. I do understand the advantage of spelling things out and will opt for that in the future. <br><br>Six Hs and five Ts are common etiologies of cardiac arrest:<br>Hypovolemia, hypoxia, hydrogen ions (acidosis), hypo/hyper kalemia, hypothermia<br>Toxins, tamponade, tension pneumo, thrombosis, trauma. <div><br></div><div>Now you can see why it is&nbsp;convenient&nbsp;to refer to the above group as just the Hs and Ts, as it would be an exercise in redundancy for the AHA to make students rehash this list during megacodes.&nbsp;</div>

I have always looked at it as addressing one of "the Hs and Ts". I run my bag wide open during codes, but it is purely an empirical intervention and I have no data to back it up. I would stop doing it if evidence to suggest it has a negative effect on outcomes becomes available. As a side note, I have protocols to infuse iced saline wide open if ROSC.

The problem with high altitude is the lower barometric pressure and lower pressure of inspired oxygen (PiO2). You have air at high altitudes, and the gasses present are in the same proportions as at sea level (O2 is still 21% of the air), however, there is less air in general. Think of the molecules making up the mixture we call "air" as being more spaced out and less abundant at high altitude. Without proper acclimatization, hypoxia is the primary offending agent behind AMS, HAPE, and HACE. Where as decompression issues from diving relate to how gasses dissolve into solution (blood) at different pressures. For example, HAPE is a form of pulmonary hypertension brought in by hypoxic pulmonary vasoconstriction. Hydrostatic pulmonary edema develops, and hence you get the name HAPE.

I don't even know what leads I am looking at, and saw what looked like one PVC in the entire set of strips. I will tell you that I get fluttering in my chest all the time, the cause of which is the occasional PVC as seen on holters (I have congenital heart disease so I am monitored carefully for any chest complaints) I have had done. Worse with stress, lack of sleep, caffeine, and chocolate. Bothersome but quite benign in my case. Probably yours as well. You may want to look at the provoking factors I listed above and see if those apply to you, and what you can do to cut down on coffee/energy drinks/soda, try and get a good nights sleep, and use stress reduction techniques (I exercise and meditate). Normal hearts are sensitive to these things, however yours might be more so because of your coronary artery disease.

I knew you were not having a go at me, I am sorry if my earlier post had that sort of a tone. I know, it sounds crazy, but I do not see medical assistants as any sort of a problem in our health care system. The role they fill is very specific and they do in fact go through classroom training. They are the doctor office receptionists and assistants, not licensed providers. They are not allowed to do anything (including taking vital signs) with out a physician requesting so, and everything they do must be from express delegation from the physician. Did I mention that MAs CANNOT work in an acute care environment. No hospitals. They can only give meds in an outpatient doctors office in non emergency situations. They exist to make life easier for the physician. They cannot work independently, cannot preform assessments. In this type of situation, you can guarantee that the physician has spent time in the room with the patient due to environment and workings of outpatient medicine. EMT-Bs on the other hand, and paramedics who go through mill programs, are huge embarrassment for our country.

NSTEMI (a heart attack, that did not produce ST segment elevation on EKG) Non Q Wave (see above) Peak Cardiac Triponin .86 (an elevated cardiac enzyme marker, signaling damage to the heart) Marked Hyperlipodemia (high blood fats, can be cholesterol or triglycerides, which is a risk factor for heart disease) Marked Hypertension A-symptomatic (high blood pressure, another risk factor for heart disease) Severe Cardiomiopothy (cardiomyopathy is dysfunction of the heart muscle) Ejection Fraction 25% (your father has a low ejection fraction, normal for an adult male is around 50%) Akanisis of posterial wall (the posterior wall of his heart does not contract normally due to damage, as see probably on ultrasound) Severe Hypokenisis of anterior lateral wall (same as above) Mitroregurgitation 1+ (mitral valve regurg is abnormal movement of blood back through the mitral valve during systole. This can be physiologic (normal) when it is mild.) Your father's heart was damaged due to a heart attack, and possibly was damaged before hand by previous cardiac events and/or chronic hypertension.The diagnosis of mitral regurgitation and of wall hypo/akinesis is made after echocardiography of the heart. This would be a routine test to preform after a patient has sustained a heart attack. From the results, it would be extremely beneficial for your father to followup with his cardiologist at all recommended appointments and to follow all treatments prescribed. I merely defined the terms you are working with, which is not medical advice and therefore does not violate forum TOS

Even if I wanted to delete my post, I can't. It would take administrator/moderator privileges. Besides, I do not entirely agree with the OP so my comments will stand. The gate to bring this thread back up for debate was opened by you when it was resuscitated from the murky depths of time.

A more practical reply: What do you intend to use it for? For a paramedic student or paramedic, I would recommend a Littman Classic II. It is lightweight and of excellent quality, and it will let you hear everything you will need to hear as a paramedic. The old adage is true to some extent, in that the ears of the provider are more important then the actual stethoscope. However, you need quality equipment along along with a quality education. The crap rip off sprauge stethoscopes they keep on most rigs just won't do in the discrimination of borderline lung sounds. Remember that the cardiology stethoscopes are designed to pick up on subtle sounds that take years of practice to recognize, and the meaning of which is not even taught in the standard paramedic program. The character of opening snaps and murmurs, the midsystolic click, etc are sounds that have no immediate relevance in the prehospital emergency environment (notable exceptions include ventricular gallops and the murmur of a mitral valve prolapse). Remember that when you buy a stethoscope.