island emt

We have a Paramedic interceptor available to us here also. They are auto dispatched to certain calls,ie chest pain ,arrests diff breathing, major trauma etc. Most of the time they rely on the ILS & BLS folks to call if they need them on other calls. It's been working great for us for about 12 years. The interceptor covers about a 30 mile stretch of the coast with multiple small services on the peninsula's and islands. They work for the hospital on the mainland. Due to our weather, we don't use the helicopter flight service very often. Often below flight minimums here with fog or low cloud cover. I'm with you on having a medic on every truck for every call. A waste of education and knowledge for a large percentage of the everyday calls we field.

Let's take this down a slightly different path for a minute: We complain because the fire departments get better publicity. We know that we can't be "heros" in the public eye, because we can't really talk about what we do outside of the vaguest terms. Why? because of privacy laws and issues we can't discuss what we provide to our customers. The fire service learned long ago to get the media involved in covering their calls and what's more newsworthy than a fully involved building with flames reaching hundreds of feet into the night sky?? Try to get your local TV reporter to show up the next time you go & help grandma up off the floor or assist someone in a diabetic emergency. OH wait we can't. Thats why they get all the press. There is a department in our state who always submits footage from car crashes and many other interesting everyday rescue calls. They come off as self serving glory hounds and it's always the same person who's mugging for the cameras. He's trying to promote their service in the public eye, as being just as much "heros" as the firefighters. In my opinion we should do our jobs and leave the Hero worshipping to the fire departments. Getting good press for us is a thank you letter from a family who lives you touched upon by providing the best care possible , even in a difficult situation.

Being a person who suffers fools lightly is a common trait among EMS providers. We set our expectations high and have little patience for those providers not meeting our high standards. To learn to temper this outward attitude is a hard thing to do. When faced with such a position where you want to be snarky, just do the job yourself and after the call, make an attempt to use it as a teaching moment. Sometimes it works , and other times not so much.

Holy crap Trevor: Where was that from? Bet they had an all hands changing of their shorts after that one.

In Joisey the First aid squads are BLS only. most have several fancy ambulances and a couple officer mobiles set up for fast response, or going out for pizza & beer. :-{ ALS is provided by hospital based Paramedics that respond to intercept with the BLS crews. It really is a strange system they have and it's pretty much the same whether in the big cities or in more rural NJ, Yes there are some fairly rural areas in the western part of the state , once you get away from the coast.

It is PA , home of the bubbaville smoke eaters company and hose wagons. Someones crack is going to be in a sling over this. Be surprised if there's not jail time involved for child endangerment.

New Joisey has always been one of those places that boggles the mind. FA Squads with million dollar buildings and party halls that have a hundred members of their social clubs. They have all the fancy trucks and rescue squads , but don't require state licensure to practice ??????????

Bieber: Outstanding post young JEDI knight; +5 Well thought out and well documented. I've long been a proponent of providing appropriate pain relief to our customers. As Medicgirl said, Pain is one thing we can control and it does not need to be withheld from them. Could be as simple as an ice pack or two, or require narcotics. Yes there are seekers out there that have every non specific pain known to mankind. Do your assessment properly and use your education to make an appropriate decision based on that. Don't get buffaloed by the regulars that know the buzzwords to get narcotics. Ask them to describe the pain location, intensity and duration. Ask what causes it or relieves it? , do they take a prescription medication for it? How much & what dosage? When was the last time they took it? Ask to see the scrip bottle and see when it was dispensed. count the pills. is the usage appropriate as prescribed? If any red flags pop up, then pick up the phone and talk to the doctor at the receiving hospital. Let them make the call on their license.

I am going to set a cutoff date for the essay submission of October 31st.

Our hospital based Paramedic interceptor car just got a new decked out LP15. It was $35k and change with all the options. That was hospital pricing. It has all non invasive functions and the new Masimo CO monitor. I've always known that you Canukistanians get robbed on medical equipment.

Was it a copy of yours ? Or a version that is similar from another state. We have had selective spinal immobilization as a protocol in place for over ten years, that came about originally from the Wilderness medicine folks and progressed after the Nexus study verified that we really could do the procedure correctly, and were having proper results.

Everything above 4 lead and AED is an option. You would think thats crazy, but reality is there are services that don't want to spend the money and as you found out hospitals and clinics. When i bought our Zoll we had 4 lead, nibp, AED & manual defib, pacing, and a choice between endtidal monitoring or 12 lead. Both were 5 grand upgrades. At the time 12 leads weren't in fashion , so I went with the end tidal capability. We could use that and did. Have since upgraded to add in the 12 lead option. Now a new LP15 or new Zoll goes for 30k plus loaded out with the options.

It is just a name the street crud put on them to subvert the laws on selling drugs. Also known as incense and plant food or Monkeydust. The packets were stamped not for human consumption. They were initially available over the counter in head shops and some convenience stores. Maine has passed laws banning sales and possession of them. You can still get them off the web unfortunately. Several other states have enacted laws banning them also. Here is a link to a story:http://bangordailynews.com/2011/09/26/health/bath-salts-drug-use-spreading-throughout-maine-officials-say/

Not an uncommon event around here. Tourists from away driving around in a big ocean full of rocks with their fancy boats.. Locals actually use charts to know where the bottom is close to the surface. We have 10 ft tide changes twice a day so places where it's safe at high tide are high & dry at others. Georgetown is a few miles East of here on the next major peninsula.

As Doc said. there are too many variations of chemicals involved to have a clear cut answer. The cookers are dodging the FDA rules by altering the substances used to make them . As soon as they ban one chemical they change it one molecule to make a new compound.. some of the S+S are hyperthermia, delusional, hyper aggressiveness, and lack of pain receptors functioning. Others describe an LSD type of hallucinations and delusions. Do not try to control them without law enforcement on scene. Even Tasers do not have much of an effect on them.

Know that your trip though the brotherhood is not alone. Many folks start out with unreal expectations and find out that it's eating them up, because it doesn't happen according to the script. Then a touch of reality sets in. The patients we care for today are different. They may only have a "minor" illness or injury. But to them it's very traumatic and upsetting. We need to remember not to judge our customers and do our job. Yes in many systems there are a large number of seekers and abusers of the system. But thats part of what we are expected to handle.

Gooday!

Especially after the auditor general starts collecting for all the medicare billings done for runs by all the illegally licensed EMT's & medics. That will bring the BIG fines.

Recognized it right off the bat. I wish i had a dollar for every one of these I've had to package over the past 4 decades. I'd be able to retire in style. Had three just in the last two months, when tourists decide to climb down over the rocky shoreline to take photo's for the folks back home. They are very ugly and extremely painful, with not much holding the foot onto the leg outside of tissue & shredded ligaments. Takes a lot of fentanyl to make that pain go away. edit to add: This is the kind of injury that needs to go to a hospital with a good ortho surgeon. This is not your everyday E R repair.

What if the underlying cause of this whole cascade was a Metformin toxicity?

Welcome street: Don't loose sight of the fact that you want to be a Paramedic. In many areas being a two hatter increases your chances of employment and better pay & benefits than being a single hatter

You were RSI'd for a ankle dislocation??? Seems like overkill to me. Relaxation & a neuromuscular block would be normal procedure, at least in all the reductions I've seen done.

BATH SALTS for those of you who have not encountered them yet.

Should probably add Armstrong, Fallon & ea scare to the list of privates. There are others, but I have no personal knowledge about them. In the PAST I have worked with folks from most of them in my former employment at a major racetrack / motorsports venue. They hired a lot of part timers to beef up our crews from all over New England. most of the privates have 911 contracts in suburbia, along with transport shuffle.

Exactly what your picture shows. Vacuum splint it. make sure pedal pulse is maintained. IV, pain med of your choice titrated to maintain pt's comfort, & stability of his vitals. Nice gentle ride to hospital with ortho capabilities. Looks to be a combo dislocation with possible tri maleolar fx.