paramedicmike

Don't assume. My comments to which you are referring were directed at you. Kat, The link I embedded is to report it to the US Department of Health and Human Services. They would be the governmental investigating and enforcement agency that would look into situations like what you're reporting. If they deem it a violation they'll pursue it with some pretty hefty fines and legal consequences for the offending agency (agencies) or individuals involved. Facebook's explanation is one of the many reasons I gave up on them.

There's an enormous difference between transmitting patient related information over the airwaves in the normal course of completing a dispatched 911 call and an after the fact provision of detailed patient information in a Facebook post open for public discussion. If you are unable to distinguish between the two, normal course of completing a call vs social media ridicule, then perhaps EMS, health care in general and any profession requiring discretion and accommodating the confidentiality of your patients/clients may not be for you.

I quit facebook a few years ago so I can't see the page. However, here's the link for reporting if you think this is a violation. For all the years we've been posting to some of the same sites I've not known you to over-react.

Please be careful out there. Link.

Cue Julia Edward in 3...2... Punctuation, please. Your post is difficult to read. Do you still get a break down by section or is it simply "Pass/Fail" these days? It's been a while since I've taken it. How close are you to passing? Are you missing it by a wide margin? Or are you just barely missing it? I like the idea of practice questions. Practice questions that offer justifications for the correct answers (as opposed to just giving you the correct answer) are even better. Lots and lots of practice questions.

That's a loaded question. Despite what some, or even many, would argue fire and EMS are two different topics. Yes, many EMS agencies operated as part of a larger fire department. Whether they should or not is part of a larger discussion. A better question to ask, and ask yourself, is do *you* want to be a FF?

Does this have to be a first responder course? Would an EMT course meet your requirements? I'm thinking local community college or something similar. Otherwise you're probably looking at taking a week long course somewhere to which you would need to travel in order to attend. As I'm not in Georgia I won't be much help in that regard. Would a wilderness first responder course meet your requirements? It would likely be more time involved but may be an option for you.

Welcome. There are a lot of seasoned providers who contribute to these forums. This should be made clear up front so as to avoid any misunderstanding: Just because you don't like what you're reading/hearing doesn't make that information wrong or incorrect. Please seriously consider the posts above and the questions posed. While there is certainly excitement to be had working in EMS there is also a lot of physical and emotional stress involved in the job. The job is physically demanding. It is emotionally draining. Some self reflection and having a good idea of your motivation for becoming involved is going to be a good idea. That being said please consider this in addition to the above: It's ok to not know what your motivations are at the moment. It's ok to not be sure if this is really something you want to do. It's ok to get excited about the prospect of everything in which you're thinking of becoming involved. That excitement, however, should not be your sole or even your primary motivation. It should be an added benefit. It's ok to get involved in your local rescue squad to see if this is something you'd like to further pursue. It's ok to decide you like it and want to continue. It's also ok to decide you don't like it and walk away from it. This is a professional endeavor. Your patients, their families and other medical staff with whom you'll interact will expect a level of professionalism that you may not have yet experienced. This won't be high school (although station antics may have you questioning that from time to time). Be ready to be an adult. Be ready to see and experience things that will shake you more deeply than you could have ever considered. Education is important. The biggest problem facing EMS in the US today is education or inadequate education. Learn as much as you can. Never stop learning. No matter what people will tell you taking college level coursework (anatomy, math, history, writing, bio, chem and more) will help you become a better provider and a better person. There is nothing wrong with being educated. So where do you start? Find an EMT course. Register. Getting into an EMT class and successfully completing the course is your first step. Start your college coursework. In the meantime if you can become involved in your local rescue squad start the process. Keep an open mind. Learn when to ask questions then ask them. Or ask us. Someone here will have an answer for you. Lastly, don't stress about this. You're young. You're excited. You're motivated. You'll get there. Just take a deep breath and take that first step.

Welcome.

There was video floating around a few years back of a crew in Massachusetts if I recall correctly using one as a sled towed behind the ambulance during a snow storm. I just did a quick search and couldn't find it. I don't think it ended well for anyone involved. One of the early lessons of "not everything needs to wind up on the internet".

Local services still use them. There are guidelines that are designed to reduce their use. However, it seems old habits die hard in some people. We try to clear them as quickly as possible upon arrival.

Congrats on getting it done.

You're looking for discussion but you're not discussing. So what is it you want to know? What kind of good discussion did it bring about? What is it you're looking for from us? Despite the immensely vague nature of your posts there are some excellent points of discussion to be made. For example: 1) What's the goal of treating AF? 2) How do you reach that goal? 3) Do the interventions you stated were undertaken with this patient have any purpose? Is it even indicated?

Welcome. A case discussion! Excellent! What did the 12 lead show? Rate? History of AF? Or is this new onset? You mention that vitals "...were fine so no electricity" yet you describe a symptomatic patient. Do you think this was a stable patient? Did your treatment of GTN and ASA do anything? If you identified AF on EKG why try adenosine? Is adenosine indicated in AF? What adverse reactions can happen if you give adenosine to an AF patient?

I'm not sure why this is a question unless you aren't really an EMS provider. What do you think you should do?

Ran a cardiac arrest at a local nursing home several years ago. When we arrived staff were performing CPR and had a BVM in use for ventilations. As they had already started to use the BVM we just grabbed it and continued to use it. Patient was ultimately transported. The next morning the nursing home called. I answered the phone. It was the on duty nurse. She asked about the BVM we used. I explained that as NH staff had already started using it we continued to do so. The device was used during transport and disposed of at the receiving hospital. She then said, "Can you bring it back?" I replied, "No. It was trashed at the completion of the code." She then told me that was the only BVM they had for a 200 bed nursing home. The only one. A single BVM for a 200 bed facility. A facility full of people who were full code. They did not have another BVM in the entire building and needed the one we used back. The conversation went downhill from there. I maintained a professional posture. She didn't care for the course of the conversation, though. I may have mentioned the State Department of Health once or thrice.

What color are you now? Reminds me of a Muppets gag...

Yes, that Dr. Heimlich. Of Heimlich Maneuver and Heimlich valve fame. He died this weekend at age 96. Link 1. Link 2. Having successfully used both of the above in my career to the benefit of patients I treated or cared for, as I'm sure many of you have also done, I thought it was worth noting his passing.

Facebook is the devil. I shut my account down a few years ago and don't miss it. Not sure why the change in traffic patterns. It is a little discouraging to see it drying up the way it seems to have done.

Please clarify: are you a volunteer FF and first responder at work? Is this why your job is paying for the EMT-B class? Will you be volunteering as an EMT-B as part of your volunteer responsibilities at work? If so then your employer should be providing a response bag for you to use while at work. And really, if this is for work and for while you are at work then the employer should be providing everything you'll need as far as a response bag and equipment.

Hi Mark. Welcome. Unfortunately, I can't help with your question. Just didn't want your post to go unanswered and seemingly ignored. Care to expand on how your program is a hybrid class?

Nice story up until the last two sentences. Then it lost me.

Agree with ERDoc. If one has been a nurse for a while and is looking to go back to school that's one thing. For someone in high school just starting out it's completely different. Seth: if you really want to do anesthesia go to medical school and becom an anesthesiologist. You aren't a nurse. You don't know if you'll even enjoy being a nurse to make the decision to become a CRNA. If you *really* want to be a nurse then be a nurse. If you *really* want to do anesthesia go to medical school.

Welcome, Faridah.

I agree with your points. I'm not saying don't use it when indicated. I'm answering the OPs questions as directly as I can. Does it save lives? There's no clear evidence that it does. Does it have therapeutic value beyond pain relief? There's no clear evidence that it does. These are the same positions held by the OP's medical director and governing body. Based on the current literature this is what we have to work with. I also don't think that improvements we're seeing are despite ourselves. Research advances leading to practice changes (e.g. ASA use), more emphasis on door to balloon (or, more importantly, symptom onset to balloon as is being practiced in some areas) and more all contribute to a better patient outcome. We, all of us from specialists to the grunts on the streets, are collectively working towards improving patient outcomes. At the end of the day the evidence we have to support our practice is one of our biggest justifications as to what we do and why. It can defend or support us medically and legally. Yes, there is much in medicine yet to be studied to the point of showing clear benefit or detriment. Yes, there seems to be a dearth of EMS oriented evidence based medicine. Yes, new evidence will change our practice. Yes, in many cases we continue to go with what seems to work despite clear evidence one way or another. Let's be clear, though. OP asked a couple of specific questions in what appears to be a quest to support an idea not shared by either his/her medical director or governing body. The evidence we have is the evidence we have. Until the questions posed are studied more specifically we have to go with what we have available. And what we have available supports both the medical director and governing body. Lastly, since we're sharing research links, I also found this from December, 2015. Interesting read. I learned a few things. And that's what we do. We read. We study. We learn new things (even if we sometimes don't like what we're learning).