Arizonaffcep

Once...with my gf...whom I am married to now.

Seems to be a fairly common thought in Private EMS in AZ.

Yes...the minimum equipment is: IV Pump, Monitor (with at least 2 spare batteries), Transport Vent, Drug Box, Complete Airway Kit, at least 1 LSB, Soft Breakdown, KED Board, Hare Traction, PPE. This is my personal list of things that MUST be intact before I go in-service. In looking over the other supplies, as long a I have enough to run a trauma code, I'm ok (not saying I won't restock, because I get everything to a minimum level before I ideally go in-service, but as long as we have a little bit of everything else, I can work). I've run into this same thing. I'm in a unique position, because I'm in the field as part time only...in hospital FT. So...as I only pick up shifts in the field for fun, I have no problem telling them to shove it if I feel its an inappropriate situation. Luckily, the majority of what I've come across is, they ask if we'd be willing to take XYZ call, if not it's ok, and put's the ball in my court. If it's a critical call, or 911 and I have at least what I'm comfortable with on the truck, I usually don't refuse, with the understanding we will take care of the rest afterwards. And yes, I'll ask the details of the call if it's critical and make the call myself...(dispatchers forgive me) but at least with the services I've worked for (private EMS), the dispatchers are all AMS, possibly from hypoxia from no fresh air. See my answer to the first question(s). As far as backing me up...I've told them before, they are more than welcome to dispatch me on the call...but I will NOT respond or leave the property until my minimums are filled.

I was always under the impression that if you were on the clock, you weren't covered by Good Sam Laws.

Thats only erffective when your company will listen to you. Most where I work would say something like..."Too bad. You're on a call."

Ya...since when is there any $ in 911? Although this article does bring a good point of discussion. That being, the fiscal difference between what could be called a "Mom and Pop" EMS agency vs. a corporate EMS agency. Who is truly able to provide quality care at an affordable price? 1. I would imagine that the corporate EMS agency would have much better funding and track record for "fiscal responsibility." Now...please don't read into that as "Don't provide for basic employee needs, etc." What I mean is they would have greater purchase power (as an example) for supplies, equipment, trucks, etc. which would mean greater savings in the long run. The big problem with Corporate type EMS companies is the do shift the focus from the employee and making the most important item (typically from my experience, at least) $. This includes providing livable bennies for employee and family at a reasonable price. 2. "Mom and Pop" EMS companies would seem to me to be more apt to be willing to please their employees, sometimes at their loss (now...keep in mind that I have no experience working for a "Mom and Pop Shop" so if I'm wrong, let me know). How does this company stay in business long term? 3. Clearly, it is evident based upon an overly tired mind that if a company takes care of its employees, the employees will take care of the company. With this in mind, and with my own experiences with larger EMS "corporate EMS" companies, that this is far from the standard. Why is this? Have we become so expendable that "anyone with a pulse" is as desirable as the person with advanced knowledge/experience to a company? How has this affected the profession? Just some things I was thinking after reading the article. If I rambled on incoherently, please forgive me...I'm on almost 28 hours without sleep....

So...if you used mild salsa, would it, upon mixing, be medium?

He must be a big Dave Mathew's Band fan.

I would be less concerned about a swollen airway (as you said, not an allergic reaction, unless of course, the Pt is allergic...) as opposed to copious secretions-thus creating an airway issue. Actually, now that think of it, I would make the assumption that atropine, given as you would for a organophosphate poisoning, would work to tame the secretions-if they become too much of an issue.

So...would it be too out of line to ask for any of their numbers?

:angryfire: Ouch! Bread and milk...with lots of tums and VERY soft toilet paper! P.S. Remember to wash your hands before rubbing your eyes or going to the bathroom!

](*,)

So this mom and her son are in a horrible car crash, both are brought to the local trauma center. The Chaplain there calls the husband who comes rushing from work to be by their sides. When he gets there, the Doctor greets him and says, "Sir, I have some good news, and some bad news." The husband's eyes start to well up, and asks "What's the good news?" The Doctor says, "Well, you son has been hurt bad, we've had to remove his spleen, but he will be ok." The husband starts to cry and asks how his wife is. The Doctor says "Your wife, on the other hand has suffered a severe traumatic injury, which has left her paralyzed. She will never be able to walk again, you will have to bathe her, feed her, change her diapers for the rest of her life." The husband is totally inconsolable at this point. The Doctor now starts to laugh, and slaps the husband on the shoulder and says "I'm just f*ing with ya! She's dead!"

Wow! That must have been a hell of an impact! I've heard of people getting a car emblem tattooed on their chest from the steering collum...but that C with a circle on it on bone! Wow!

Didn't know that. But...I would imagine that the manometers that are used to calibrate the transducers are a lot more accurate than the +/- 3mmHg, which as was pointed out in an earlier post, is the tolerance of the metal coil-spring analog dials used on an ambulance. (sorry for the edit...forgot to spell check...)

Which is also known as a RIC team.

In the ED, FAST refers to "Focused Assesment with Sonography for Trauma."

Either way...well worth a grimace...

Big difference between analog dials and computer monitored...much greater precision is needed and desired for computer montitoring.

Why would you give anything PO with a compromised airway? :wink:

To go along with the "auto lunch" comment...what about the U/S done as a FAST?

Sure...the analog B/P (AKA by Auscultation) with a traditional dial, the hatch marks are even numbers...the needle is basically always on an even number (needle is wider than the space between hatch marks)...so in theory it can't read odd numbers. Not that it really matters...whats the difference between 1 point on either the systolic or diastolic. Nothing, either way.

There's such a thing? What kind of helicopter? Not trying to be an ass, but I've never seen any helicopter for civilian use that could handle "portable CT" stuff (never heard of portable CT scanner either). Have heard of portable U/S, about the size of a laptop computer...maybe that? Please help my curiosity!

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A very good point with the extended release pills. If it couldn't be confirmed, sure...does no real harm. And of course if it was confirmed (via pill bottle, etc), then go for it. However, if the patient said "I took these" and handed you bottles of pills that were not extended release (Xanax, etc.) then if it's over the 30 min mark, there is a higher chance that the charcoal and or stomach pumping (currently really going out of favor due to time frame involved) is a more punitive thing, rather than for medicinal purposes.