island emt

I agree with metformin toxicity. While it is a very commonly dispensed drug , it can have very serious side effects leading to renal failure and organ shutdown. We had a female pt that had sudden onset of loss of vision low back pain and altered mental status. She was a type 1 diabetic and had been taking metformin for many years. She had a recent UTI and was on antibiotic therapy. . The combination of meds caused her kidneys to be overloaded and decreased liver function, which caused the toxicity. She ended up coding several times over the next 3 days until they had put her on 24 hr dialysis and flushed the excess metformin from her system.

We had a regular summer visitor that has an LVAD. It is quite disturbing the first time you feel for the pulse and don't feel one while the Pt is answering your questions the only thing was the whirring of the pump and the wires from the battery pack into the chest. I think the rate is set by the controller to get the desired perfusion flow. Our Pt had about 1 year on the pump while letting his heart rest & recuperate. Last I knew he was doing fine running on his own heart muscle.

No different than the poser in NJ that bought an old crown vic , put light bars , radios and stars of life decals on it and passed himself off at accident scenes as a Paramedic. Had every known whacker tool on his genuine Galls batbelt. There are losers in life who wish so badly they could be a hero.

In my spare time I pull the wings off flies and noobs. OK just kidding. We raise, breed and show Labrador retrievers. hunt tests, field work , breed ring, obedience, rally, and most recently our 10 yo grandma is learning scent work & tracking.

WOW Kiwi: For an ambologist that was almost profound. :-} Must be drinking tea today! Yes many place over use rotary wing ambulances . In some areas there are multiple air resources and locals tend to want to hand off, even if it delays getting the Pt to the trauma center.

What I meant is to think carefully about his/her options. Me I know what I would do, but I'm almost to retirement age so they couldn't affect me. The OP is just starting out in trying to get into the business. Life may not be fair , but karma is a bitch.

Denny: Thats actually pretty good pay for a part time per-diem Basic. I know your in NY and the cost of living is high, but I know Paramedics here that are working for that pay scale on IFT services.

Thats because the insurance carriers really want the best odds in insuring drivers of emergency vehicles. Better drivers with clean records = lower insurance premiums. Risk management is a very strict thing today as far as expenditures. Look at it another way: if you have ten applicants and three have perfect driving records and 2 have property damage crashes , and two have convictions for motor vehicle violations of a more serious nature, and the last three have felony driving offenses . Which 5 do you think the insurance company will be most happy with?

What are the things that an ALS provider can do that are above your scope of practice? Most likely airway and procedures such as chest decompression and surgical cric. Probably pain medications and other interventions that are limited to Paramedic level only. If a serious trauma pt needs help then you want all the help you can get to be on that call. What does your medical director want you to do? Some places want a Paramedic on any call beyond a stubbed toenail . Not saying thats right or wrong , just what the decision makers want.

You can blow the whistle if you should choose to. However the downside to this , is you may not be able to find work in the area if he is connected as you say. Can you say Pariah! Maybe a little note to him to let him know that their are folks that know whats going on would suffice to correct the action. How much cheating does one need to pass a first responder class anyway???? Sometimes the right thing is not always the smartest course of action to take !

Boundtree gives us a discount of about 20-30% off the listed prices as a regional buying co-op. if you ask them they have room to negotiate on pricing.

I use Boundtree medical for supplies & www.swmedical.com for refurb AED's

As Toni said above they will look for driving convictions and a pattern of bad driving. speeding tickets or driving to endanger charges are much more of a red flag than one accident. It will show up on your records when they screen you , so don't try to deny it. Just be up front and explain the incident. Good luck!

Have you ever used a "Q" tip twirled just at the opening of the Nares? It takes a deeply unconscious person to not react to that gentle stimuli. Especially the "unconscious" fake seizures. Just be care to not get sneeze on.

I say that because we have a subgroup of granola crunching isolationist here that don't have their kids vaccinated, Don't allow their kids to go to public schools, relying on "homeschooling or alternative schools, and tend to eat only homegrown foods in fear of contaminates. Last year they had an outbreak of some mysterious illness among their community members that ended up being some toxic fungus that grew in their storage barrels of backyard ground flour. That incident nearly cost several of their kids lives. While I have no problems with most of this. They had an outbreak of measles in their little playgroup last fall, and before that it was mumps and scarlet fever. Why does a Dr. have the need to treat these kids whose parents shun normal medical practice? Of course when these little darling are really sick they call 911 for us to deal with them and spread these contagious diseases far & wide.

Good for them: Why should they have to accept whiney ass Parents who refuse to follow the accepted norm in preventing childhood disease and potential life threatening diseases. Not to mention the fact that these unvaccinated kids are more likely to spread these diseases to those with weakened immune systems which could prove fatal to them.

Good plan: The life you save might be your own. It's good to see that you removed your name and have started to think. Try also removing the ridiculous commentary under your avatar

Isn't Arsenic used in the processing of gold??? I know you said he's an accountant or numbers dweeb, just thinking outside the box. S&S of arsenic exposure.

AVOC/EVOC will teach you the skills needed to safely operate emergency vehicles and the laws pertaining to that operation. Pay attention. Far too many of our brothers & sisters are killed every year in preventable ambulance motor vehicle crashes. There is no such thing a an accident!

A lot of used ambulances end up being sold to the trades. Plumbers, electricians, HVAC, carpenters. etc. However they need to have all EMS insignia and markings removed. No forward facing red lights or light bars or Caduceus decals. The beer ad in that picture with the lightbar would gather a $1,000.00 fine here, and if the officer was in an ornery mood might end up being hooked to impound.

My last entry on this: Herbie : you are correct that those in the business have to develop a gallows humor and tend to be crude at times. However young grasshopper is just starting his career and is actively out applying for work .He was very easy to find by a quick web search using nothing more than his name and a location mentioned in his posts here. What do you want to know about him??? My point on this is: If you are going to be out looking for work , you really can't afford to be putting such statements out on the web. A human resource nightmare to be certain. When reviewing the files of applicants most places I know do a web search and check such places as facebook for info. How many teenagers and 20 somethings thought it was cool to post pics of them doing something questionable on their FB photo wall? How many made comments on a website they though was anonymous? In the past criminal background checks and driving records were the only thing checked in the hiring process. Not anymore. I sat on a review board for a career department , that gave us a complete electronic search of the potential hire's. Several of the candidates were dropped at the recommendations of the review board due to inappropriate postings on the web. That shot of you in HS with the beer in hand or joint in your lips is public record once it's on the web. The offcolor or racist comment made as a joke doesn't play out that way with human resources. Me : I'm not too worried about what I post as retirement is near after 40+ yrs working the street.

Our state protocol book has a page specifically for this .. [ paraphrasing] : To medical providers. If you wish to intervene in the care at emergency scene, you must accept responsibility and travel in the ambulance to the hospital. You will be the attending physician. WE have had Dr's , PA's NP's happen on to a scene and offer to help. No problems with that. But if they want to go outside the scope of the state protocols then they must assume responsibility.

Happiness: You really have far tooooooo much time on your hands out there on the left coast. All the same I really enjoy Fecken Brit humor

Notice the -101 points under flaming's name. You don't want to go down that road.

When it comes to situations like this: I don't take wild ass guesses. The facts will come out in the investigation. The facts are , he skied into a tree at speed suffering chest trauma. The facts are skiing takes a few lives every year. The ambulance service will make an announcement along with the state.