island emt

I'm wracking my brain trying to remember the medic that was a member here back in the beginning who worked in the Houston area and got arrested by the cops for transporting a patient into a town where his company wasn't licensed to provide service. Long story short, even though he was just doing his job , he did get arrested, did go to jail and ended up with a record because of it. Do you really want to Piss off a redneck cop over a little stupidity? There is a difference between being stopped and let go after 20 minutes and getting arrested and going to see Judge Bubba in the morning.

Just a guess on my part is that there have been cases in the south where a stolen ambulance was used to transport Illegal substances across several state lines. The profile of an out of state vehicle and his curiosity to see if it truly was a legitimate ambulance transport call make the scenario you gave seem likely. That said: Showing him the pt record really doesn't violate HIPAA to the extent of an unauthorized dissemination of PT information. He was probably looking to see if you really were transporting a legitimate PT or using that as an excuse or ruse to haul drugs through his state. You could have requested he call your base to verify why you were there and to verify your legitimacy in doing so. The following too close was just a reason to pull the truck over and if you contested it , your crew might have ended up in kangaroo court answering to judge BUBBA, why they had done violated his laws. If you file a complaint , be prepared for this pattern to repeat again if you ever send another truck through that area. Only next time they will find a reason to take your crew to jail and hand out fines. BUT do you really want to risk pissing off a redneck state trooper in a case where he could have found reason to put the truck out of service and the crew behind bars? Not saying this is right:::::: just the way it really is ! Been there, done that, got to spend a night in the Elizabethtown kentucky jail for a transgression by another company driver previously. The jailers wife makes really good cornbread and salt cured ham! :-}

OK : thats a start. Have you studied a good A+P book to learn the venous pattern in the extremities? You can practice on anyone by simply holding their hand and feeling for veins , then looking for them after you feel them. The more people you do this exercise on will give you confidence in your ability to find them. practice this simple vein finding drill on as many folks as you can. Skinny folks and well padded folks , A carpenter with big muscular forearms and a little old lady with tissue paper skin and aged veins are all very different in feel and how deep the mass is on their arms before you get to the vein. A nurse that taught me many years ago in a day surgery unit, taught me to place your tourniquet then close your eyes while running your fingertips up the hand + arm. FEEL them and be one with them first. Then when you have made the determination of which vein feels good , look at it for size and valves, bifurcations and scar tissue. Then decide what size catheter you feel comfortable in that vein. Bigger is NOT always better. I'd rather get a good secure 22 flowing in the hand to gain fluid access and then after, if I feel the need go for something bigger further up the arm. The problem with always going for the AC is if you don't get it then you have wasted that site and need to go find something else. The AC is good if it is prominent and yes it's a big vessel, but thats where all lab techs go and many folks have developed scar tissue from repeated cannulation there. I worked with a lot of newbies over the years who were taught to go big and go to the AC because it's easy, but not every pt needs big needle or big fluid. The other problematic issue with the AC is the PT needs to keep their arm straight or it will occlude the flow and it can kink the indwelling catheter causing shear, which is a big no no. Do your prep of the site and then tell the pt to expect a little sting as you make your approach. That way they are less likely to flinch and pull away as your making the skin poke. Contain the vein above & below with your other hand while making the approach. One steady advancement until you feel the catheter enter the vein and then lower your attack angle to allow the catheter to advance. You should see a good flash in the chamber before retracting the needle back leaving the plastic catheter in place. What type of Catheters are you using? Some places are using the push button retractable units which I personally find cumbersome. We use the J&J manual retract caths which are shorter and fit in the hand better. More to come later.

If it's such a crappy neighborhood , then no crew should be sitting posted there.. SCREW what some computer geek says! When I worked in the hood of a major league getto city, we would just sort of follow the local cruisers around for protection. I've worked with women partners that could bench press me with one arm and I'm not light.

Would of been three : but I already dinged somebody even more obnoxious

In order to assist you we need to know what technique you are using to start them now. Choice of vein, ie back of hand, wrist , forearm , AC, EJ. Do you jump right in with a big gauge catheter to the AC or do you take the time to get a nice flowing 22 or 20 ga in the hand? Are you jumping at the first vein you think you can get or are you checking all options. Are you starting IV's because you can ? Or because you have come up with a treatment plan that requires fluid resuscitation or medication administration? When you miss, is it because you didn't get access to the vein with flashback? Or are you missing because of holding technique? Don't take these questions as an attack on you or you new skills. Most of us have gone through a period of misses over the years. Many times it's a combination of pt's with crappy veins and a lack of confidence in your skill, mixed in with a little bad technique. Most of these can be corrected, but there will always be patients with crappy veins. Thats when you need to look at the places where everybody else hasn't. Don't fall into the mantra of every PT needs a 16 ga in the AC. Can't remember the last time I did a 16 or 14, it's been years. The bigger the bore the greater the chance of blowing the start. The majority of the IV's I start are small ga in the hand unless it's big time trauma or a potential arrest situation.

I don't think they get very much for stud fees in the UK Sorry couldn't pass that pun up. Don't know for sure , but the odds are you will have to contact the Paramedic registry in England to see if they will accept any of your education credits towards theirs.

our current protocol for severe bleeding control is to: A. Apply direct pressure dressing to wound. B. Apply pressure point control to artery above injury site. C. Use of a mat type tourniquet 2 inches above the injury site. This protocol is for all license levels from first responders up to Critical Care Paramedics. We all carry a commercial tourniquet such as the MAT, which was designed for US military troops for use in the field.

When in danger: I don't need to run fast: Just faster than you! :-}

Not saying it was right or wrong. Not something Most of us would do, and in retrospect she probably wouldn't do it either. It must have seemed like a good idea at the time. The victim wasn't going to use it any more even if it had been found in a timely fashion.

You don't mention what part of the country you are in. Are the services in your area mostly paid or volunteer? Most volunteer services are glad to have new members want to join , especially younger folks. Some are a good ole boys club and it takes a little more than walking in the door to get membership. Others have a waiting list as they are limited by rule or by-laws to the number of active members they can have on the roster. Be persistent, but not annoying in your pursuit .

The only question I would have is were the commentaries made about passing females what would be considered derogatory? If they were did you mention to them that it was making you uncomfortable? It is your right under the law to not have to put up with this and it could very well be considered sexual harassment on their part. They should know better and maybe they wanted you to feel like part of the crew with all it's warts. Different crews look at ride alongs in many different ways. To some it's as if they are babysitting and others take it as a chance to share the knowledge they have learned , AKA street smarts. Once you finish school, it will take some time to really understand the requirements of the job. Things that if you get a great preceptor crew they will share with you and help you understand things that might save your life in the future. For twenty years I was a preceptor in charge of making sure all newbies were taught the street smarts to keep them healthy and alive in an urban system with some very scary neighborhoods. I was a taskmaster in making sure they paid attention in the hope that they could learn to love the job and not get hurt or killed on the job. Thankfully most paid attention and turned into long term providers of prehospital care. Good luck in the future and don't let one bad experience color your views of the system.

Earth to Crotch: This is wicked old news, The guy was gone to the hospital it was hours later the foot was discovered in the wreckage , He wasn't going to get it re-attached , and she runs cadaver dogs for the office.

Glad your first three shifts in the business went well and you managed to not shit your pants. Do yourself a favor and stop referring to yourself as the "lead medic". You are a one week EMT BASIC working on a transfer truck. Note to the hecklers: This is not an attack on Basic EMT's. Also got to wonder why you were checking a female patient for blood in stools, what would you do if you were able to find some?

Good for him! Putting up with little punks who think there bad only lasts for so long until PAYBACK time. At least he didn't come to school with guns . Too bad the school management doesn't use this video as part of a training program to show the bullies.

Gotta ask: What the heck is a ground support person? Do you mean you wash ambulances? Put air in the tires? Obviously you are young and have managed to piss someone off if as you state "had problems with him since high school". Anyone stupid enough to post anything on any social media platform that is derogatory towards anyone else is opening themselves up for legal action. Also you'd be surprised how many future employers are searching the web to check on the moral character of potential employees, and will use that info to make a determination of suitability for hire. Have you thought about giving this business owner a simple phone call and asking what the issue is? Why are you going through a friend? Or grow a set and walk into the office and ask for an appointment.

Here's a link in regards to the most recent sale of the Empire that points to the corporate mentality of big business. http://www.denverpost.com/business/ci_17597440

a bear hugger is a heating system in a blanket that circulates warmed air through channels in the unit wrapped around the pt. Very common in the more rural areas.

It's not discrimination or reverse racism Ruff: It's called affirmative action ! It came about to allow the underprivileged to compete above the level of their upbringing and education. The goal was to allow minorities to have all the good government service job opportunities that the mighty white folks had. In reality it has become a joke and a failed experiment. Many of those hired under this program can't compete on an equal basis with anyone else so they are given a special allowance for their perceived disability. there was a recent court battle in Connecticut where a fire service exam was administered and the top scoring members of the department were passed over to put in place minorities that scored as much as twenty points lower on the advancement exam. The passed over members sued and the state appellant court overturned affirmative action. I Believe that an individual with a disability deserves a fair chance and accommodation to be able to take an exam, but the score is what it is. Top scores get the hire or the promotion with no regard to race, creed, sexual preference, or any other perceived bias.

Hey brother: while I respect your thought process in waving the flag, I will stand by the statement, A pulse & a Patch. As long as I've been in the business and worked in several different states , the perception of the Empire is pretty much universal.. I know that many of the employees of the company are good providers and try to do there very best as an advocate for their customers. It's just the problem of corporate management mentality that revolves around turning a profit for the shareholders. Some regional managers actually are medics from the street that took collage course to learn management skills. However many times the local supervisors have zip street experience and wave the beancounter spreadsheet when telling the crewdogs what they need to do to cut costs. The company invented the idea of parking ambulances in convenience store or gas station parking lots [sSM] because a numbers cruncher figured out that they could staff fewer trucks by keeping the crews hopping from one place to the next based on analysis of where a call might occur next. They think nothing of using a SSM truck to do a nursing home transfer while moving a truck from the other side of the city/ county to cover a 911 contract. even though it means a delay in response time. They prefer to keep the trucks in constant motion whether loaded or empty. Besides it cuts down of basing facilities and places where the crew could actually sit and take a dump thats not in a convenience store or restaurant bathroom. As was pointed out above by Lone star they come into an area take over on a lowball price and then raise the costs to make more money. If they don't make a profit they will close up the doors and move onto the next unsuspecting town/ county. They will succeed or leave and the employees are expendable. There are places where the company does a good job and treats the staff responsibly,but they are the exception rather than the rule. Fiz: I'm glad you like the Empire. you seem to have lucked out in your management staff. I do know personally many employees of the Empire , including management staff in several business profit centers. Some are very good , some not what would be called cream of the crop. this really isn't about them it's the corporate mentality that has been passed along through the last 5 changes in ownership of the corporation. All have one thing in mind : make the most profit with the least amount of expenditures. Running trucks until well over 300,000 miles because they can even though the doors need a pry bar to close properly as the hinges and mounts are worn out is not a safe practice.

Remember Mike: A pulse & a patch are the requirements. :-}

Sounds like someone forgot to pull far enough out of the bay before turning the wheel!

The evil empire is just that. A large corporate conglomerate where you will be a number in the system. For the most part profit is the only thing that matters to them. EMS providers need a pulse & a patch to apply for employment. Screw up once and odds are good you will be gone. Yes , I worked for them for one week after they bought out a wonderful family run ambulance service, took our new trucks away "to be painted" and gave us three clapped out 5 yo trucks with 300,000 miles on the clock to work from. We took them to the motor vehicle department and had them do an inspection for mechanical deficiencies. They were condemned on the spot by the state. All of us left our notice that day when we went to pick up our personal cars from the lot.

We purchase our supplied from Boundtree: The King LTD airways are $40.00 list and with our discount we pay $29.00 Just ordered some last week. We are part of a regional buying collaborative that gives us group pricing on about everything in the catalog , and we can order direct from Boundtree in any quantity we need. We had the same arrangement with EMP in the past, so check with their sales and marketing team. I'd wager a guess that our cost to upgrade to full ALS was around 3500.00 in additional equipment. But a lot of that depends on what equipment your required to have. Did you include a Pediatric ALS bag with all the things needed for it?

We purchase our supplied from Boundtree: The King LTD airways are $40.00 list and with our discount we pay $29.00 Just ordered some last week. We are part of a regional buying collaborative that gives us group pricing on about everything in the catalog , and we can order direct from Boundtree in any quantity we need. We had the same arrangement with EMP in the past, so check with their sales and marketing team. I'd wager a guess that our cost to upgrade to full ALS was around 3500.00 in additional equipment. But a lot of that depends on what equipment your required to have. Did you include a Pediatric ALS bag with all the things needed for it?