island emt

Worse yet::: I bet the Taxi driver got stiffed on the fare..... :-}

You don't say how old you are::: Many companies won't hire under 21 yo as their insurance companies won't cover them for liability reasons. As long as the ticket you failed to pay wasn't for criminal speed or felony, then you should be OK if over 21. As said above be prepared to show all court records pertaining to it. You will have a background check & license check done before getting licensed .

Came to us from U N.C. chapel hill. ???? Don't know the rest of his background He definatly is a southerner , talk grits & gravy just fine.

mine was 2 years ago. He was a young new Doc though. Maybe he had never done one on a live pt ???? Then again ::: it seems as most of the Docs today are kids. Maybe I am getting old

Been there done that ruff: Came in with a post arrest ROSC and had a perfect 18 ga in one forearm and another in opposite AC. Pt had been down < 3 min prior to our arrival & was in V-Fib. 2 shocks, converted and ACLS followed to a T. Pt has perfusing rhythm on arrival and is semi conscious. ER doc decides he want a central line , so proceeds to do a femoral cutdown.???? Come to find out they had seen it at a conference a couple weeks previously.

Ugly: We had a call this fall where an alarm was sounding at a home. We went to check on occupants while fire was in the house with multi gas meter. Reading in home were very low background levels. But of the three family members that we evaluated , teen age son was fine, Dad was fine , Mom had elevated CO levels that were five times normal . We asked about her car, [brand new] where she worked, where she had been for past 8 hrs. Come to find out she and a couple other co-workers had been getting headaches for past several days while at work. I placed a call to department in that town & asked the deputy chief to send a crew to check the building. He called back to say they found CO levels high enough to be fatal over a few hours time. They had a furnace with a cracked heat exchanger that was spewing exhaust gasses into heating ducts. Just a lucky catch on our part, but it turned out well for everyone.

Ugly et al: Thats The reason to carry a RAD -57 and check every ones carboxyhemoglobin in addition to Oxygen saturation level. Especially this time of year when homes are closed up tight and various heating sources are in use. We all get those calls where the CC is weakness , general illness, Just not feeling right, possible having a headache for a couple days, Yes most providers would suspect Carbon monoxide poisoning. But how high a level??? With a quantitative level provided by the RAD -57 transport decisions are made with intelligence and knowledge of whether they need to go to a facility with hyperbaric medicine availability or not. How many services are spending the money for this technology?? We bought ours 7 years ago when they came onto the market. Also every Firefighter gets checked on the rehab scene as well as any occupants . Again It is just a tool and shouldn't be how you decide they have elevated CO levels, as we should ALL recognize the S&S of it, but a laboratory quality means of providing information to the ER docs and possibly change our destination to the appropriate facility.

20 days & counting

We all need to remember that Mike works for a cheap , crappy transport company that only spends what is mandated by statute. They require a pulse & a patch for hiring . They don't provide transport crews with any equipment that might actually prove useful unless ordered to by the state. Having to wait for an ALS truck to show up with a defibrillator is almost criminal behavior. You do know that CPR doesn't cure fatal arrhythmia's don't you??? Cpr attempts to circulate blood in the condition of non perfusing rhythms, while defibrillation will possibly correct those fatal non perfusing arrhythmia's. Do they always work ??? NO Just a hit young emtb. you are challenging many folks with far more experience and knowledge than you will ever gain working for the empire. Many of us have been in this profession since your parents were playing hide the sausage in high school.

which one was that ruff?

Mike I learned to close my eyes and get a nap whenever possible when I was in the Navy. All these years later still can do it. a short 30 minute nap will get me refreshed and ready for another five or six hours. Night or day when my head hits the pillow by the time my wife counts to 60 , I'm out and into deep sleep. I don't move at all or roll around for 6 hours. Too many years of shift work has definatly altered my normal circadian rhythm. I've always been more of a night owl anyway so daytime sleeping isn't hard for me. Now a days with her 2nd shift schedule we usually get to bed around 01:30 and up at 07:30 ish. somedays we are really lazy and sleep in till 08:30

So your saying your licensed ambulances don't have an AED ??? Can't imagine any state not requiring at least an AED on a transport ambulance Even fire trucks are required to have them. Do you work for the empire by chance???

I don't get paid enough to become a possible target when they are or may be an active shooter present. Thats what the law enforcement teams are for. Will say I've had rounds hitting the wall over my head on a scene that had 4 police officers present in the apt. They had cleared the apt and were as surprised as we were when homey came out of the closet with a MAC 10 and sprayed the hallway. Luckily we dove to the floor and the gun barrel rose to the ceiling.. God I hated the drug wars of the 80's in Holyoke.

A little bit of vitamin "N" would have most likely kept them breathing on their own. Narcan can be given I N , so it should be a med that any inner city transfer truck should carry. But then the empire would never spend 6 bucks it doesn't have to.

But does the "global consensus" aim for a very high standard of care ??? or do they teach to the lowest common denominator????? Maybe somewhere in the middle??? Who decides what is appropriate care and how to train to that level? Sounds like an even larger bureaucracy than we deal with now , only on a global scheme.

Ruff: thats the whole problem with the "system". Because some elderly have a higher risk for a bleed thay all have to be treated as if they due in "COVER YOUR ARSE MEDICINE". The cost of healthcare has skyrocketed because every pt with a simple head lac needs to go to CAT scan or MRI, depending on whats available in order for the facility to covers it's butt and run up the bill.

Never know Kate: We might go through CO either going west or coming back.. We might time the trip to co-inside with dog shows around the country as we have Labs we work in breed , obedience, rally , agility and do hunt tests with them.

only one asa ?? standard is 325 mg po per AHA. Why did you not have IV access? With that pressure he should have plenty of choices . Did you start low & small or jump right on a big bore @ AC? I'd much rather have a good flowing 22 or 20 in the hand or wrist than blowing big bore in the AC's. Have to ask as I see this regularly with new medics. what did the veins in his feet look like? or didn't you look? We're not picking on you here, just triyng to figure out the why of the pt and call. and the care provider involved .

I recently had the riot act read to me by a young snotty ER nurse who went running to the ER doc about me bringing in a 92 yo male with only a collar on and not boarded. I told her my boots are older than she is and to go bother someone else. {I know , must play nice with the ER folks even if they are idiots ] He was A+OX3 with no pain or deficits on spinal exam. He had fallen an hour prior to his daughter calling 911 as he did have a minor <1inch lac to his forehead which was still bleeding. Full head to toe exam and pressure dressing to forhead. Placed collar just because he wasn't sure of exact mechanism and stair chaired him out of house and up 80 ft in elevation to the paved parking area.. He has kyphosois so the thought never entered my mind to force him to lie flat on a board for a 35 min ride to ER. After several X-rays and sending him to cat scan they were ready to send him home when the radiologist consult service called and noted that he had a c-6 fx of undetermined age. They packaged him up and sent him by ambulance to the trauma center an hour south where the ortho folks redid x-rays and determined the fx to be several weeks old and of no consequence or risk of insult to the cord. They sent him home in a soft collar 5 hrs later with a huge bill plus the original ER tab and transport ambulance taxi ride south. Problems developed were extreme lower back pain and tissue breakdown from being tied down flat to a board for the ride south. We have a spinal protocol for a very good reason. To allow us to rule out with reasonable certainty & avoid torturing pt's by putting them on a board.

I really am Mike. It's been a long interesting ride and we've seen too many changes to remember them all. It used to be enjoyable, but the past 12 years as manager/ administrator/ lead responders have really burned me out. I still love to run calls and meet people, but the admin load is brutal. Between niosh, osha, dept of labor and the state ems office there are more hoops to jump through with compliance issues than you can shake a stick at. Have been getting some really nice notes and letters from past patients and their families , since we announced our retirement. Already planning a long vacation trip for next year. Going to pack up the camper and the dogs & head out, Might end up heading out to nevada to visit some friends we haven't seen in almost 25 years since we were stationed together in Australia.

25 days and counting. I'm almost short enough to walk under the bus

had an ole fella who looked like one of the ZZ top boys with the long beard. 4 pack/ day lifelong smoker and on O's 24/7. Set himself & his car on fire after sparking up his lighter. Apparently the beard became saturated with oxygen and the flash took off like a jet engine. Luckily he didn't survive as his face was just toast. You never forget THAT smell !

following maryland state protocols is a smart thing to do as a basic just starting out.. However don't become a protocol monkey that loses the ability to think and use the mass between your ears to evaluate and make proper decisions on providing quality prehospital care. Golden hour went out the window years ago along with many other myths as current science based studies have shown us better ways.

He was a regular poster here back in the beginning of the city. If I need a tazer , then odds are we probably have gotten way past the point of putting ourselves in danger anyway.