FireMedic65

Stable does not necessarily mean they aren't in need of ALS care. Most of the time they are having difficulty breathing, but they are still "alright". Put them on the monitor, put in an IV or heplock, breathing treatment. That's ALS care being provided, but the patient is still "stable". Now, if you were to be dispatched for a "fall victim" and it turns out to just be a twisted ankle, heck even a broken ankle, this patient is most likely stable and does not require ALS care. Yes, there are circumstances that would make them ALS, like if they fell down stairs and smashed their head and are altered or the reason they fell was hypoglycemia or had a syncopal episode, etc etc. I am just referring to normal situations without other contributing factors. You make a good point though

I agree Ben. These sort of situations happen all the time when you run an EMT/Medic ambulance. A lot of the time, the patient will not require ALS care, and the EMT will attend to them. At that point, the EMT is in charge. The Medic is just there to help at that point, and drive to the hospital. Usually you are dispatched, and given a type of incident, and severity. Most 911 are ALS just by the nature of the call, but some are dispatched 911, but turn out they are not. When you get on scene, the assessment it made and it's determined what care is needed. We do this because EMT's are not just ambulance drivers, and they need to keep their skills of taking blood pressures up to snuff or something. This happens a lot also, in volunteer services. Medics do volunteer at ambulance squads, but when they do, they are only allowed to give care up to the level that the ambulance is licensed for, BLS. Even though they are a paramedic responding to a 911 with an EMT, their level of care is still only that of an EMT. So, technically, no one is of a higher "license" regardless of their training and education.

What is the ER going to do for them? Recheck their BGL? Say "yea, your sugar must have been low". Now wait here until we find you a ride home and wait for another bill in the mail. Their sugar was low, we fixed it. Do you put a bandaid on someones papercut, then haul them into the ER for blood work and a full round of antibiotics?

Indeed, that's a good one. Not the best though, but close!

Very good points. If I don't get a flash when starting an IV, I consider it a failed attempt. D50 is very hard to push through any IV. I wouldn't attempt to try pushing it through anything smaller than at least a 20g and that's pushing it. I like 18s, they flow a little better, but we don't need to get into Poiseuille's law. Even if you have a patent line, with a good flash, good flow of a saline flush, the D50 will still take some effort to push. Glucagon is usually a second choice because it takes longer.

Where are they located? At home, at a bar, walking down the street? Surely if I am drunk, I can answer questions properly, I can tell you where I am, my bday and who the president is. But can I walk straight? Am I falling over? If I am home, and I am falling over, big deal and put me in my bed on my stomach. If I am at a bar, or walking down the street, unable to walk straight and falling over. I sign AMA because I told you my name and Lincolns bday, then I stumbled into traffic later and get waffled by a truck. I can sue you, and win.

We were not there to see this patient. Maybe they were in the proper position to place an EJ. Maybe they weren't. Every patient situation is different. If a patient is in an MVC, and their head is lateral, and I see a nice vein, I will do the EJ, and I have. To protect c-spine, and the patient's head is facing laterally, do we not try to gently move it back to the proper position? EVERY patient I have ever seen, that was fully mobilized, was in anatomical position regarding their head. Now, you can't sell me that every patient fell and landed like this, or crashed their car and their body stopped in that position.

Attending EMT is in charge of the patient. Driver is in charge of the vehicle. If the EMT says no lights and sirens, they are making judgment saying the patient is not in critical condition and can go to the hospital in a timely fashion. If the drive still insists on using the lights and sirens, I suppose, technically he is endangering that patient by putting the patient at risk by having them on and doing a more speedy transport. This argument never really came up. It was always up to me if I wanted lights/sirens or not when transporting. If I were to be driving, I would ask the EMT/Medic what priority they would like to transport. Ultimately, the senior emt/attending EMT that is GIVING CARE is in charge.

pumping water out of the street to prevent flooding into homes?

Thought I read she was older than that. Oh well

wait a minute, that's not the picture I was thinking of... the one I was thinking of was an Australian fire engine.

I guess it can depend on the situation. Just about everything we do can lead to liability if you think about it. If someone calls 911 for help and they don't need it. Like they tripped over and broke a finger or something. Do they need to see a DR? No, probably not. But maybe they hit their head or did some sort of other damage. More likely we see this all the time in MVCs. Patient states they are fine, but 3hrs later you see them walk into the ER with complaints they didn't have before.

I giggle every time I see that picture.

what bothers me if you doing exactly what you warned people not to do. only what the other people were doing was readable. maybe you should set your ego and "mod" aside for once.

It was fun and appropriate. Everyone was doing it at the time and having fun doing it. YOU didn't like it and made it stop.

I bet it would make a wicked cool sound.

NOT REALLY FUNNY STUFF. MORE JUST FOR FUN. I'M CURIOUS, THOUGH, HOW MANY OF YOU WILL BE TOO LAZY TO ACTUALLY FIND A TRANSLATOR.-BE SAFE and you gave everyone a hassle for typing upside down. practice what you preach dude.

I don't let any intoxicated person go away on their own.. If they later walk out into traffic, get smashed by a car... it could come back to me.

This is what you get... Gentleman, we have the technology... I just don't want to spend a lot of money..

Cranial IO!

If they alert and oriented, they can make their own judgment. If they are not, they cannot make that call for themselves. If they refuse transport, I'd have at least medical command back me up, and most likely call the police in since this person shouldn't be out walking around and driving.

It's a lot harder to "miss" doing an IO. Properly trained people using the EZ-IO will be able to gain quick and easy access to give fluids and medications. An EJ leaves a lot more for error IMHO. The patient will be moving probably, adding difficulty for starters. Not to mention you are sticking a needle into their neck! If by chance you miss the vein, blow it or whatever else, you are stuck holding your finger over the site. Just my thoughts...

if you want a movie is "awesome" music, watch Juno! Hard to believe that girl is almost 30yrs old... and a lesbian but still a good movie.

do you get a recruiting bonus?

Ever see "Broken Vessels? It's about burnt out medics doing drugs and stealing from patients to buy said drugs... Good movie actually.