island emt

There is no afterlife except to feed the worms and micro-organisms and enrich the soil. When your dead it's the end. Live life to the fullest and when you are no longer able to enjoy it or control it due to debilitating disease ::::: pull the pin!

Patience young Jedi : Do an analysis of your recent failures and think about what is causing the issue. Are you getting class 4 airways ? Are you intubating pt's that truly need it? hence the pressure or are you just not seeing the cords and trying to rush without proper prep? The issue is a simple mechanical act brought about in times of sheer terror and usually in the heat of battle. Can you nasally intubate in your system? Do you have a backup airway such as the king that your comfortable with? Do you have CPAP? Time to hit the mannequins and practice , then go down to the hospital and try to get some time in the O R.

Yep : looks like a toad rescue. 185 k when your buying that many trucks is high especially with the gas motor which is 6k less than a diesel. Our PL Custom on a E-450 diesel with the 170 body, 6 ft interior headroom, ALL LED lighting , more compartments, inveter, 110 & q12 volt outlets in every compartment and 4 inch lowered skirt on passenger side , arctic insulation pkg , on spot chains and many more extras was 145k 2 years ago, bought as a single unit. Add in the PL Custom warrantee and you guys got taken for a ride. 23 trucks should have gotten a much better price as a package deal.

Having an accident is not as big a detriment to getting hired as your being 19 yo. Most commercial insurance carriers require 21 years of age to be covered. As a basic EMT you would be hired to drive an ambulance or chair car for the most part. At 19 they cannot insure you

In the 40+ years I've been in EMS, I can count on one hand the rosc's that survived to walk out of the hospital w/o major deficits. Three of them were witnessed arrests [by us] and the other two were rapid bystander CPR with defibrillation in under 5 minutes from arrest. Had a Save last week who was in resp arrest and pulse less than 30 by carotid on my arrival at the dock where he was brought in by fishing boat.. Went pulseless several times over the next 10 minutes. with a non shockable rythm. Got airway opened with a nasal as he was clenched tight. Regained spontaneous pulses at 50 bpm. Lungs were tight all fields with wheezes & rhonchi. neb tx by mask and he started breathing normally. Still unresponsive, ????/ maintained airway and monitored 12 lead showed a-flutter with non st elevation & some wierd depression waves irregularly, along with a few runs of psvt along the way during the 35 minute transport. To quote Paul Harvey: Now the rest of the story!!! Come to find out he had been chewing fentanyl patch with his morning bagel and had OD'd on it As they were getting set up in the ER to paralyze him for intubation, someone decided to try narcan, 2mg got a little response and 2 more brought him almost fully awake. Didn't see that one coming. He was sent to ICU for three days and released.

Enjoy the thrill of a save. As others have said they are few and far between.

Very poorly written article. What I interpret it to mean: The crew was doing an off cape transport to plymouth hospital from Bourne. [ Very common as there are no large hospitals on the cape & Bourne is just over the canal from the mainland. ] While enroute the Pt became violent and the crew pulled over and were assisted by the Plymouth Police Dept. At that point I would assume the Pt was in custody for assaulting the Medic. Hard to find fault With the Fire medics for this one. Could happen to any of us.

We had this discussion at a regional chiefs meeting a while back. My answer to the question of: what would you do if a major attack happened in the major city which is located 20 miles across the ocean from us, was that they would see the taillights of my camper heading North to my property up in the deep woods of northern Maine.. My Family and our dogs are way more important than trying to be a hero and ending up on the casualty list. When asked about helping others who were not my neighbors, I explained that in the case of a nuclear dirty bomb scenario or biologic weapon release , the fewer folks in the area the lower the casualties will be. My job is not to protect folks from a large city, that we visit a few times a year. I can be loaded up and on the way out of town in a very short time. Comes from spending years in the Navy and having 48 hr mount out times to respond to disasters.

The only thing that stands a chance of saving him is a thoracic surgeon standing at the door to the OR and with a team ready to cut him open. His odds of surviving this are less a chance than kiwi getting into med school.

The same first amendment allows the FF to turn the hose on the asshole. free speech and all that!

You politely ask the FF on scene to pull a line and hose the asshole down. they usually get the idea they're not wanted. This works particularly well with a straight tip nozzle. FF's are usually willing to help solve these problems on scene.

To add to what dwayne said If you need to see then do it. Don't expect that a fall from standing height with a broken ankle gives justification to cut a woman's clothes off exposing her for the public to see . Use common sense! If your gut says trauma center then they need to be exposed , & examined from head to toe. Medical pt's probably not so much. Some things will scare the bejesus out of you when exposed. :-} Dwayne has this small pony fixation due to being in PNG among the little people hung like horses.

Tats are a way of showing individuality::: Unfortunately now a days EVERYONE has them. Had a mid 50's female pt not too long ago that had a tat on her upper chest , What was probably a cute little butterfly 30 years ago when applied. NOW it's a hideous looking teradyactyl which with the force of gravity is now a 38 long if you get my drift. Remember that you will have to explain them to your children and grandkids someday.

You are the "new Guy " in this company. No matter what your experience level is, you are a probie there and the FTO wants to make sure you know he's the top dog, even with a lot less time in grade than you. Bite your tongue , BUT document all these episodes in a journal. Then when you are no longer on double secret probation, you can show it to the supervisor if it continues. I agree with Kat about the spelling, if he continues to point out your errors ask him for help in writing your reports better. Then let him show you how to speellll correctly. :-}

Thanks young Jedi! We pretty much ignore them when they decide how to tell us which response mode to use. With our narrow roads you might only be going 15-20 mph anyway. We very seldom use L+S on calls here as it only annoys the locals. Siren only gets used if the tourist aren't paying attention to the truck with flashing lights in their rearview mirror. We don't do transports , only 911 emergent calls. We do get the lift assists and other public service type calls.

Dwayne: while not scientific in nature, when I was responsible for 100 employees at a large racetrack venue , we used the criteria of: If you don't have to pee at least once an hour then your are not consuming enough water. S+S of dehydration as you have noted, dark urine , headaches and muscle pain due to electrolyte imbalances , odd cardiac arrhythmia's and up + including heatstoke. At the grandstand aid station we would spend all day starting IV's in dehydrated customers. It was like a shooting gallery some days. You could start and run as many as 200 IV's in a single hot day. Fluids by the case lot. Our criteria for them to sign off was they had to come up with a normal set of vitals and they had to PEE before we would sign them off. Some took 3 litres IV before that would happen. Temperature didn't always prove to be an accurate indicator of increased risk, as I have seen S+S in 75 degrees temps as well as temps in the 90's. Eating balanced meals and keeping hydrated are very important in keeping the employees healthy and productive. The company I worked for would send someone out to the different positions at the track with lunches and coolers of water for the crew dogs as a way of keeping them happy & productive. Very important when our 75-100 EMS providers were responsible for a crowd of 110.000 guests and crews + track employees and vendors.

Are the billable' s tied to what the dispatch was for the call ::: or What the EMS providers determine to be wrong & how to treat? We just had a memo from our dispatch center telling us they were going to start with the apco coding of calls per their EMD software. That would be fine if they got ALL the info needed to make a determination, & they had eyes on the pt to know if what they are being told is what the pt is actually having as a problem. Their new system will tell us how to respond Just what I need is a dispatcher in a bunker 65 miles away telling us how to respond. They have a hard enough time figuring out which island we are responding to.

Let's add in another big question to the equation: How much is your service charging for : A. BLS calls B ILS calls C. Als calls D No charge for service Do you charge a flat rate or by the cafeteria menu plan? ie base rate plus so much for O2, IV's Cardiac monitoring, medication administration, mileage etc? I've seen BLS rates range from $250.00 on up to close to a thousand dollars depending on where in the country you are. All of these variables would make it hard to give an accurate accounting to a Pt. Ruff This is a topic that could go in a lot of different directions and have a lot of different potential answers.

I think the big issue here is that it's not been done that way as a normal practice in the past. I have had folks ask me how much the ambulance service will cost them. I tell them that I honestly don't know as the billing department handles this and works with the insurance company to get as much covered as possible. That said: I am a carpenter in my real life outside EMS. When I am asked to do a job, I always give an estimate prior to ordering materials and explain that unless unforseen issues come up that can't be seen , such as hidden rotted sills or things discovered after starting the job, then the estimate is the maximum I will charge for the job. I try to envision all things and 95 % of the time my final invoice comes in lower or at the estimated price. When the job is complete and the customer is satisfied with the work, I hand them an invoice, & expect to be paid within a reasonable amount of time. Say 7 days or less. Had a regular customer held up paying a 2 grand bill this winter for 4 weeks. The next time I write them an invoice,[ this week] it will include an additional cost for me financing their bill last time. It would seem to me that EMS is a service just like any other and Pt's may want to know what it cost for these services. However many abuse the system and have no intention of paying for it anyway so they might just laugh at us giving them an invoice. A follow up question would be: What is your services collection rate on billable's? Are you actually collecting more than 60% or 70% of what you send out?

I thought an ambulance was considered a locked unit ::: At least that's what they told me 40 + years ago. I have conversations with myself all the time. some days it's the only way to have a conversation. :-}

Trying to get into OR's here is next to impossible. Even when you do get in , they use LMA's more thanET tubes . Could tak half a dozen Pt's before you get a tube.

I was comparing other health professions that can be gained with a similar 2 year degree as Paramedicine. I also have several friends who worked the streets as Paramedics to put themselves through PA or medical school. One of the very best practitioners I know is now an Emergency medicine Doc who still comes out and works as an on call Paramedic. He worked his way through collage as a medic, and maintains his licence. Nothing like introducing the crew to a pt and saying this is Dr. / Paramedic "smith."

Defib: You are correct, there are some really wicked smart, wicked educated, & really intelligent folks in EMS. However our profession is looked down upon by many "healthcare professionals" that feel we are nothing more than ambulance drivers or first aiders. I know quite a few of my peers who have gone on to other healthcare occupations for many reasons, things like better pay, better benefits, better schedules, better retirement benefits, and the biggest of all Greater recognition as a professional healthcare provider. Occupations such as RN or radiology technician, or nuclear medicine tech, or respiratory tech all hold a greater status than being a lowly Paramedic.

I didn't get that memo :-} Must have been off that day!

We can't ????