AnthonyM83

It's an ambulance driver certificate, which is more of an add-on than a different license. And since it's only required if you're driving, I wouldn't say that anyone working aboard one needs it (according to state), though your company policies will differ. Police and fire do not require the certificate. Written test is done by DMV and behind-the-wheel training is done by the ambulance employer/owner.

Not making the gurney because they got a call right before shift change and new they were getting off right after clearing the hospital. Then we get a call right off the bat and have to throw on a sheet on-scene or switch out the portable O2. Also, not stocking enough sheets/blankets/towels. Everything else, I can pretty much take care of myself...but we can only walk out with so many blankets from ER and a trauma patient on a cold day may need a few...and obviously it looks bad making your gurney sheet onscene...

It's a little hard to give actual replies, since I don't really know much about safety standards of ambulances. I'd need someone with a background in DOT or such. As far the EMS service itself, someone from dept. of health or EMS agency. Etc etc... I honestly don't know where I'd start in replying to the post with a worthwhile contribution.

Not sure what that means Kiwi...it seemed to echo the VT classifications, but I wanted to specifically make sure defibrillating a fully conscious patient is appropriate. I've been told the signs of unstable VT before, but was told not to defibrillate (rather than cardiovert) if alert (but with chest pain). (Not sure what CCP is...) Thanks for the help.

Naw...the sky is general levels of our atmosphere. Those atmospheres scatter said light (among other things, I'm told) which transmits that blue color to us. (I'm almost typed the same thing, btw...so when I saw your post, had to contest it)

As someone who's young enough to remember being a teen, but old enough to have a little more maturity. My advice is to only do it if you have strong suspicion. If he isn't using drugs, you'll most likely lose any trust you have left. I mean honestly if my parents did that to me, I would have immediately disconnected from them. There's no point trying to please parents if they're going to be suspicious anyway. Now, if he's giving you reason to test him, I'd be upfront and tell him what specific behaviors are making you suspect. Make it clear whether there is drug use or not, those behaviors must change, or you will drug test him. Make sure he understands the timeline...degree to which behaviors must change. This way he has some power left. And if you do it, it's no surprise and he would have made the choice to screw himself over himself...harder to blame you if you give him clear expectations. (Of course, make sure they're reasonable. If he's naturally a one personality type or going through a teen phase, don't try to make him act like a personality type he's not. Give him room to rebel...but within limits.) Okay, I'm done

If only you'd chosen Los Angeles instead....

If you know the specific amount of morphine a patient has taken, isn't there a formula for how you would adjust your dosage? I remember a doctor with a mostly full beer mug telling me...but I've forgotten... (I know it doesn't apply to this scenario since the patch dose is uncertain).

"Unstable VT * Unstable VT is characterized by signs/symptoms of insufficient oxygen delivery to vital organs such as chest pain, dyspnea, hypotension, or altered level of consciousness, indicating that rate and stroke volume are not providing adequate cardiac output. * In this situation, the dysrhythmia should be immediately treated with synchronized cardioversion, usually at a starting energy dose of 100 J. * In contrast, polymorphic VT is treated with immediate defibrillation as the defibrillator may have difficulty recognizing the varying QRS complexes and thus synchronizing the delivery of energy." As someone who hasn't taken ACLS, it seems this is telling that if a polymorphic VT patient is unstable with a symptom like chest pain, but still awake, I should defibrillate him????? It clearly made a contrast with cardioversion, so it doesn't seem like they mean cardioverting. I thought you never defibrillated a conscious patient...

Haven't read your reply yet, AK (after you saying that it's not that easy), so here's mine: Pick up the elderly lady. You'll be helping her out AND you'll be making a really good impression on the woman of your dreams. Your best friend should not mind, since he knows exactly what you're doing and wants you to get some play, too. If you picked up the woman of your dreams, you'd probably just drop her off at home...whereas now, you can meet up with her later at the bus stop she frequents when your car "breaks down" one day. Is that too sociopathic? I just call it looking ahead at the big picture. Don't be near-sighted. And it's for greatest good. Elderly woman is saved. Younger woman is impressed. You (possibly) get laid. And your friend gets free drinks from you later for you leaving him out to soak

Makes sense. If you have a shampoo bottle that's almost out, you can make it last a couple more days by using it slowly (as the body's own glucagon would be doing in hypoglycemia), but if you squeeze every last drop of shampoo out with force, then great you cleaned our hair well for that day, but now you're totally out of shampoo. You're not getting any more out now for tomorrow. I don't know what the best course of action is, but the theory makes sense. As mentioned, glucagon might potentially better your veins enough to get a line, so must consider that when deciding. The other issue is if someone decides to sue you, will that thinking (even if smart) be a good enough defense? Or will they say the standard of care is to give glucagon? Don't know. PS Are there ever any problems giving dextrose by IO...clogging up or anything since there's not an enclosed vein...just a maze of bone matrix? Question just to came to mind...

Woah, woah. Who said don't try hard or to hand them the ball. I said it seemed the problem was showing off and bad sportsmanship. It was a Catholic school, right? I think teaching good values was the highest priority (which means being able to win properly...remember, I said win) A lot of the attitude of the players and dynamics of the game don't come through in the article.

I don't know about legally wrong, but I'd say ethically wrong. You get a call for short of breath from the patient (not third party), you respond promptly to correct address, no answer at the door. Use your head, if it's severe enough how would they get to the door? What's normally done in their service when this happens. I would like to hear their side. Maybe they had extra info or were following a policy or were directed by their supervisors. Don't know, but sounds pretty dumb with the info the article gave...

I would start pre-reading my textbook right away (go find out what it's going to be and buy it online). Then, you'll have more of a big picture view while learning things in class. You can also play around on EMTB.com, but that's more for reinforcing what you've read in the book already.

Had already closed this without reading, but decided to come back for a moment and let you know a more organized post with more line breaks and spaces that's easier to read might lead to more people reading or scanning through it. I scan through a lot and if it's all in one huge paragraph, I usually skip it. Since I thought your cause is probably good, I took the time to write this. Not trying to be mean, just letting you know.

I think the problem was an issue of showing off and bad sportsmanship.

I have heard that, but it usually refers to unusually cold or where there is reason to suspect an environmental emergency. As soon as the body stops producing heat, its temperature starts falling to equilibration with that of the room. So, you're going to have a lot of cold bodies. You don't warm each one of them up before determining them dead. I would leave up whether or not the spot was lividity for sure to the original poster, though he must be sure he knows about other skin and tissue conditions and be sure it was lividity (or not be sure, valid reason for posting scenario). BTW, LA County will also allow immediate family to refuse resuscitation if all are in agreement (and patient is over 16, I believe). If there was not lividity, I would go with my gut on whether family was acting shady or not.

Ya have to pass up a girl cause of it?

Don't knock my 2 hour surefire (1 hour at full power, 1 hour at half). It's never failed me. I usually use it in .5 to 5 second intervals, only. One $20 box of batteries lasts me 6 months. And it's small enough to fit in my pocket without anyone noticing it, but sure lights up a room. So there.

Naw, wouldn't fire just for that video. Find out exactly what was going on, driver's experience (accident record or lack of), training given, etc. That's something potentially correctable.

Argh, please don't fall into that. We're the same generation. When was the last major attack on US soil? and before that? and before that? until the pattern significantly changes, don't start freaking out. Everytime there's a plane related emergency, everyone wants to know if it's foreign terrorism. Why would that statistically be your guess or worry? (not picking on you, btw scuba, just saying in general why conciously add to your worry)

They usually setup with local EMS plus other medical contacts they keep on standby. I'm sure it'll be some modification that...

A proofread for spelling would have helped the author...but everyone's a critic, I guess

I got five on it JK But really, why pay so much. Speaking honestly, I think the allure of the virgin is the whole introducing her to something new and having her see you as the source of pleasure, etc etc right? If it's a one time thing and you'll never see her again, what's the interest. She probably doesn't give to s**ts about you, it's likely to be awkward/painful whatever, and not to be repeated. But I guess if you have the money to spare . . .

I think the value of the speed interviews is overall vibe. You can get a LOT of info from a 3 minute conversation. Not enough time to throw them different scenarios, but it is to get sense of them as a person. Do you want this type of person influencing your kids? Maturity level? Manners? Pushover? Education? Etc. Yes, yes, 3 minutes isn't a lot, but the point is that it's MORE than a lot of sitter services give. Why knock em for doing more?