nsmedic393

Yes, I probably drink more than the average bear. I stopped using alcohol as an anesthetic though......So its all good.

Basics making fun of medics in the wrong thread. read down the page, there is a primmadonna paramedic thread for exactly that reason.

Basics making fun of medics in the wrong thread. read down the page, there is a primmadonna paramedic thread for exactly that reason.

I come to work for my regular rotation, 24 on/72 off. Nobody is on call during their time off, we staff appropriatly to have enough units to respond at any time. We have a one minute out of chute time before 2200 and a two minute out of chute time after 2200, thank jebus nobody has to wait for medics to come from home before they get an ambulance on the road.

I want a better story. Interview the guy that opened the door. Ask his relationship to her, what happened, her pmhx, her medications and all that good stuff. As it sounds right now, Quick set of vitals, IV and possibly some valium depending on what the history reveals.

Once a complete physical assesment has beed completed, including BGL and ECG and there is sothing I am going to be able to do differently than my BLS partner than I'm gonna drive in and let my partner attend. As it stands now the only other thing the patient may need is a IV lock. I'm only a few feet away and my partner is perfectly capable of screaming at me if something goes wrong.

A question for all services that have 12 leads, do you place your leads while the patient still has their clothes on?

I don't gown patients just because the hospital will eventually do it. That being said, i do carry johnny shirts for the odd occaion that we have to cun the patients clothes off. I find they make life real handy when you have to do a 12 lead.

Horses butts, jedi masters.... This is why the thread needs to be closed. Not because people are speaking up, but because people are experiencing craniorectal inversion. Now the argument is "vet techs can do it, so we should too". Since you guys can't seem to see the difference...... THEY WORK ON ANIMALS!!!!!!!!!!!! I'm starting to believe if this goes on long enough that through denial and error :wink: (did you get that dust?) that someone might actually stumble upon a good reason. No, actually they won't.

What a dumb idea. Only carries two firefighters and the stretcher. So you are short staffed and the patient gets to enjoy the stink of a smokey cab while riding to the hospital. Not to mention all that gear piled onto the stretcher. Where is all that crap going to go once you have a patient?

Perhaps if companies are so quick to can medics, you should form a union. Here the province is responsible for QA/QI and if you screw up bad enough, they pull your license.

I agree completely. Good and bad medics alike make mistakes. Its the good ones that admit they made a mistake, learn from it and use that knowledge to benifit their patients in the future.

Thats good to hear. Between the vent and the lifepack those are going to be the only "partners" I have.

Thanks medik8. I wasn't even sure how to properly spell it for a search on google. Tons of info now.

Just wondering if anyone has had experience with the "parapack" ventilator. (i believe thats what it is called) made by 02 systems. Or better yet if somebody knows where I can download a manual.

Perhaps because they have gone through the entire precess and have first hand knowledge of how it sucks?

Wow, I though the whole point was to try to avoid having to run a code.

Hi Neesie, so nice of you to target me in particular. Most of my coleagues have already answered your questions but I will re-interate my specific point of view. IV initiation is a skill. A monkey can do a skill. All the reasons you suggested for doing this skill (fluid challenge, D50%) are resons for you average ALS provider. My posts adress the PCPs, here and EMTs elsewhere, that are not allowed to do anything with the IV. For them there is no need to start the IV unless starting it for their ALS partner. Now you can argue that you NEED to do IVs because you can do things with the Iv but I feel that you are practising outside of your education. My PCP course was bought from a college in alberta so I have a good idea of what education you have gone through. It is not enough to know all the ins and outs of giving fluid or IV drugs. Also, as everyone else has posted my opinions are listed on previous posts. Instead of arguing about this all over again just read the previous posts.

Brat, I'm an ACP in nova scotia. I can haul out pretty near any drug I want and use it at my own discretion. Yet, when it comes to treating an Opioid overdose I chose to manage the airway and ventilate and use narcan only as a last resort for the can't intubate, cant ventilate patient. So who is incorrect, me or you? While I'm at it, do you think a patient going through a withdrawl seizure would be better treated by your BLS load and go treatment, or by my benzodiazepine treatment?

So now the reason for intermediates to give narcan is because it will save 30 seconds for their medic partner. 30 seconds is nothing.

There is a big difference between coming across a patient with a arrhythmia and causing that said same arrhythmia. If the first instance you are either called by 911 or the patient develops it during a transfer and you have to play with the cards you are dealt regardless of your cirtification level. Now if you give a drug that causes an arrhythmia and you aren't properly equipped to deal with it than you have made everything much much worse havn't you?

Its pretty friggin rare that someone dies form a Benzo OD. Usual tx at the hospital is no monitor them until they wake up, its rare that the hospitals would use romazicon. Like VS said, for opoids and benzos the best possible pre-hospital care is airway management and supporting respirations if needed. People in general (not just you neb) need to get away form the mentality that there is a vial or a syringe or a shot or spray to fix everything. Probably annother thing to mention aside from skill level is the level and quality of evidence to support a protocol for romazicon. Around here if you want a new drug you better have some evidence in the form of studies to show that you need it. I don't know if you are familiar with levels of evidence but narcan is currently listed as a class 2B which means "There is fair evidence to support procedure or treatment " and the evidence has been obtained by Evidence obtained from a well designed cohort or case-control study, usually from more than one center or research group or evidence obtained from a well designed controlled trail but without randomization or Dramatic results from uncontrolled experiments. Romazicon is listed as a 3/D "There is evidence to support that the procedure or treatment should not be used" and the evidence was obtained by Opinions of respected authorities, based on clinical experience, descriptive studies or reports of expert committees. Soundl like there isn't enough evidence that anyone should be giving Romazicon prehospitally, let alone I's. Looks to me like there isn't enough evidence that anybody should be giving Romazicon pre-hospitally, let alone emt-Is.

I would like to add a side note to my previous post. In one word accountability. It is a great responsability to be an ALS provider. You take on a leadership role and you have to be willing to take responsability for your actions. I take responsability for what happens during the course of patient care and its not something to be taken lightly. You have to be heald accountable at all times for everything. if heaven forbid something goes wrong, they look at the education and experience differences between medics and can say "you should have known better". Literally you should know more than your BLS partner. I am accountable to my BLS partner if I screw up also. If I lead them down the wrong path its on my shoulders. One of my big sayings is "Always try to do right by your patients and keep their best interests at heart".This applies weather you are ALS or BLS. If I am doing something wrong and my BLS partner points it out to me than I will be gratefull that they were able to pick up on it. Anyways, its not like I go around thumping my chest and telling everyone "I'm the boss" all the time. I just want to try and give an understanding of the responsabilities placed on an ALS provider that some BLS providers may not understand. I myself didn't really understand it until I got my cert saying that I was now the highest level provider and the responsability was now on my shoulders.

Perhaps the laws are different in Canada. I'll sum it up, here as far as patient care is concerned, the highlest level of certification is in charge of the call and the highest level of certification will swing from a branch before anybody else does if something goes wrong. Like I said, maybe its different where you are from but here the BLS providers, unless functioning with annother BLS provider bear almost no responsability for what happens on a call. With that ebing said, since its my arse on the line I have nothing to prove to a BLS partner. Its not like I give each new partner a quiz before the shift, but if i suspect that they don't know whats going on I am going to probe deeper. How you go about completing a simple truck check can proove loads about what you know. ie, where the stock is, specific pieces of equipment, operation of the defib and so on... You say to let them do their job and we should take care of ours? Thats a load of crap. Our job is patient care. Its not two seperate deals. However, as stated above, when it comes to patient care I AM THE BOSS, peried end of conversation.