island emt

WOW 6 emerg beds : that's big time Mobey ! Years ago in the far far away land of OZ , I lived in a place that had a 2 bed clinic and doc in the box shop, where 90% of the folks that showed up at the door got transported 10 hrs south if the flying doctor couldn't come get them. We did have some really senior navy corpsmen that the doc would use as a resource. We had one doc, one RN, & 8 corpsmen and a town/base population of about 4000. We were 250 miles to the next town/ fuel stop and 1000 miles north of Perth

I'm thinking that considering where Mobey works this Patient was at a doc in the box clinic in the middle of almost nowhere without much support equipment including apparently a doctor at the time of his arrival for the transport. I'm thinking that if the PT wants to go we load him up and go until he crashes. Then we abide by his DNR wishes and return back to base with him for the family. The worst that can happen is we actually make it to the big hospital 2 hours away and they get him into the OR. If not at least we tried to uphold his wishes.

A lot of the equipment and supplies will depend on what your state requires you to have on board an ALS level truck. Cric kit, chest decompression kits, does your protocol require RSI meds and training,? Probably not as your talking about using a basic airway such as the King LTD. CPAP or vents, portable infusion pumps are other things you might need to purchase. It will depend on your local protocol's as to how much you need to spend.

My guess would be that the original poster has gone elsewhere to find somebody that will blow smoke up his derriere & tell him what he wants to hear.

Great post Wendy: + 1 Another young member of the profession on the way to the top. I'm really glad to see there are a few youngsters pushing the envelope to be the best. Someone will have to take care of us senior citizens in the near future.

Again young Jedi knight Bieber. OUTSTANDING post +1 You continue to give me hope that the next generations who will succeed us old farts can continue to bring this profession to the next level!

Well young fellow: Where to begin? First : lose the attitude It will not serve you well in the adult world. Second: While you may feel your exposure to real military members due to your exposure to them through the civil air patrol make you wise beyond your years, Think again. third: Many of the folks here you have dissed in this thread, have hemorrhoids older than you. fourth: as a 17 year old you are a minor child in most states, your attitudes proves the theory & reason behind this. Fifth: Finish high school first , then start to worry about which way to go forward in your life. sixth: If you expect to be treated as an adult and a professional, try acting like one. Seventh: Being an officer in CAP will give you about as much advantage in the real military as being a boy scout. Trust an old Navy man on that. It will not make a bit of difference in real life, except maybe make your life in boot camp harder for you.

Crotch: Maybe in the big city medical centers the nurses have all that help. My wife is lucky to have a CNA 1 shift out of 4 per week. They draw all but the chemo infusion drugs up themselves from the pixus machine. Admission evaluation takes at least an hour on the computer documentation & some night she'll get 2 or three. Discharges take almost as much time. Yes some nurses work their asses off.

Hospitals everywhere are trying to contain costs and increase productivity. The most common complaint from nursing staff is not about wage issues or benefits, It's about the number of patients they are responsible to provide care for. My wife is an RN on the med surgical/ telemetry unit and depending on the day she can have as many as 7, yep seven patients she is responsible for. Some are post surgical requiring intensive individual care and as she is a Chemo certified nurse she may be giving infusion treatment to others and then dealing with the overall medication and care issues of the rest of her pt load. Add in all the additional care responsibilities of bathing and personal care , educating pt's in medications and other required treatments prior to discharge. She works 3-11 pm., and usually spends at least an hour past the end of shift after giving report to the oncoming nurse , completing the computerized charting and follow up orders documentation. She is paid a reasonable wage and has average benefits , but the increased patient loads are approaching dangerous levels, which can lead to errors or worse someone getting hurt.To say nothing about the stress.

As was asked above: Does the pt have blood running by rapid infusion & do you have enough to make the 2 hr transport to the big city hospital? Other than that there's not much " care you can provide in the case of an internal bleed. Diesel bolus and hope that he doesn't code while enroute to higher level facility. Sounds like the rural Doc has made the decision that there's nothing more they can do for the Pt , and is passing this off on the EMS crew.

It wouldn't surprise me if the hospital has already contracted with an agency to provide RN coverage in case of a walkout. Nurses at a hospital north of here threatened a walkout a while back and the hospital brought in a crew of travelers and locked out the union nursing staff for a couple days to show them that could be replaced.

In the first scenario: Two 15 yo have consensual sex, the age of majority is above 16 yo. NO there was no crime committed. She was not assaulted or forcibly raped. Doesn't mean it's going to give me warm feelings . but no crime : no foul; no mandatory reporting. If it wasn't consensual experimenting and coercion was used to accomplish the deed, different story. In the second scenario: There is not a Legal requirement for us to report illicit activity to the police. However as it involved illegal substances being present , I would ask for PD response so that after we transport the "cocaine Heart attack" the drugs would need to be be secured to avoid them being discovered by a child.

Nice job Dwayne.

As a new EMT basic, you can be hired. There are many transport services that prefer a new fresh from the box Basic to train and teach their way of doing the job. It's easier than re=training someone with preordained bad habits. If the evil empire has contracts in your area they require two things : A pulse & a Patch.

Good for you Ugly ! Everyone has the AH Ha moment at some point where everything you have learned and been taught just clicks.

Don't know how many of you are using this airway, or if you had received this notice. This is caused by a possible lack of sterility in the surgilube packet that is included with the King LTD & LTD-S airways To All Chiefs, You should have received this from Bound Tree this is just a follow up. Re: King Systems – Urgent Recall for Sterile Lubricating jelly in LT-D and LTS-D Kits Bound Tree Medical was recently advised about a King Systems recall for Sterile Lubricating Jelly, which is included in their T-D and LTS-D kits. This recall includes Bound Tree Medical Item #’s 477-KLTD2125EA, 477-KLTD212EA, 477-KLTD213EA, 477-KLTD214EA, 447-KLTD215EA, 447-KLTSD413EA, 447-KLTSD414EA, and 447-KLTSD415EA. Their records indicate that you may have purchased one or more of these kits. Should you determine your inventory contains recalled product, please set it aside and contact Bound Tree Medical’s customer service department at 800-642-5464. If you have any additional questions pertaining to the recall, please contact Kings System’s customer service department at 800-642-5464.

When I was in Oz back in the 70's the folks up in the northern territory were a pretty good unit. Worked with the crews in Darwin for a time after a cyclone hit. They sure did know how to have a party after work Fair dinkum!

Another quality post young jedi knight. +1 Bieber you are one of the few that obviously stayed awake and paid attention in class.

Just another <point in the quality of her character. Can't say it surprises me much.

If you get hired on with the county department , will they pay for some or all of your Paramedicine degree in return for indentured service? If so go that route to save some money. You'll be working and learning at the same time.

Any manufacturer will build a box that way if you spec it. Just gives more interior compartment space.

At one point Laidlaw out of Canada owned The Empire. In recent years corporate ownership has been EMS out of Colorado At the evil empire you are just another number on the beancounters checklist.

PCP: based on the presentation given, the correct thought process and care rendered would be to collar ,board and transport by ambulance, That said , you cannot win the minds of idiots over to thinking this way. You can't cure Stupid and there are no laws against a competent pt making possibly stupid decisions. You did what you could and it would seem that the hospital staff felt the same way.

You wrote that on arrival she was sitting in chair, & you used the stair chair to move her to the stretcher, then stretcher to hosp, then stretcher to hospital gurney. So you had to move her four separate times in total. How did you move from one to the next? Did you completely lift her or allow the leg to carry some of the load in transferring each time? Elderly FX's can be caused by the slightest insult. She probably had a previous FX or breakdown and the multiple moves might have been the final trigger , since you noted no displacement on initial exam ,. Yet at the ER she has ecchymosis, shortening & rotation. Been there done that got the T shirt.!! Always have that high suspicion in the back of your brain. One Doc calls it your "Spidey sense"

Bieber: I'm sure that from your postings here , you'll be fine. When in doubt let your brain take charge and go with the flow. My first shift alone in the back [1972] We had a motorcycle vs guardrail high speed crash with bilateral amputations below the knee. A 14 yo giving birth in a getto tenement basement. and a code in a 5th floor walk up. You want to talk about stressed out. Not trying to make you nervous, Good luck