AnthonyM83

And the 20% wage increase even it's over the next four years.

Throw in an iPod and we're SET.

Oh, follow-up: So, when the number isn't between 35 and 45, you modify your ventilations so that it stays within it, right? Even if it goes beyond 10-12/min, right...how far off do they need to be before you assume it's not a problem with your ventilations rather with them. (BTW, thought I'd share I had a dream last night where I was tracking the capnography wave...least I remembered all this stuff in my sleep!)

One guy who came to my company from a different one seemed to have taken a pretty good ambulance operations class. He explained the idea that unless first on-scene it should be parked ahead of the accident not only for easy exit and safety, but if one of us got hurt on-scene that ambulance was the way we'd be transporting them. If fire truck gets hit, oh well. If ambulance gets hit, we have to call for a second and delay transport. He also told me about those little hooks that stop the back doors from opening all the way out (into traffic or against another vehicle) in the van ambulances. Wish I could take that class...cause we got none of that at our company.

It's sure hard to pay $300/visit (which might be often if a medical condition develops) when you're making either minimum wage or close to it (for those in other states who make less than $8/hr, remember the high cost of living here), plus associated costs (lab tests, prescription fills with ongoing problems). At least at our company, everyone is scrapping, at least those who don't still live with mom and dad or get support from them. Without overtime (and before my 3% 1yr raise), my base paycheck was $25 short of paying my monthly rent. Then add in paying back college loans, gas, food, and household expenses (laundry machines, soap, etc) and I had very very little to myself...a few office visits in a month would have broken me.

Where in SoCal do you live? As far as I know, this stuff is only in AMR's Los Angeles area...they cover 911 for the north-northeast part of the county for the most part...non LosAngelesCity areas that LACountyFD runs with...like Lancaster and Palmdale

There's a few threads on this, you might try to do a search (though honestly I hardly find anything with the search function except a hundred unrelated posts all within the last couple weeks or so). But anyway, I hear good things about Seattle area and a few places in Texas...

Has anyone heard the other guy's side? Not that I think he's in the right at all. You don't try to steal a patient. But did he in his mind think he was going to give better care or maybe take him to a different hospital or that original medics missed something he didn't or something like that? Or was it completely about service area? As has been said, this stuff is ridiculous. Especially that promotion only a couple months after the incident.

As far as the cardiac arrest I mentioned, the medic kept making repeated intubation attempts, failing and telling EMTs to hold off on CPR so that he could try again. At two points, we spent almost a minute each time confirming lung sounds by two medics each time. In addition to the difficulty in intubating, I think he said his waveform wasn't right, but the number was around 35-40 and there was condensation and color change....I THINK. Doc confirmed placement at ER (Medics have to get their PCR signed off on that). Then it took forever to get patient loaded, because FF's would stop doing CPR to get the straps ready, so I would take over, but when I stopped to get straps on my side and asked them to continue for me, they wouldn't...so I'd stop the straps and keep compressions going. This woman had pulses come and go, too, so she actually had a bit of a chance....(of course they never documented that we kept getting and losing pulses...) Sigh

Thanks everyone. I got a lot out of this thread. I feel like each post led to the next post in an almost pre-planned lecture series. Now, I certainly learned more than just the following, but to summarize the main click: The capnography tracks level of CO2 being exhaled which should go from 0 to 35-45 mmHg, because even during full arrest, the body is still working on the cellular level with good compressions and ventilations. In general, lower numbers mean either ventilations (by patient or by you) are happening too quickly for body to use up O2 and produce CO2 or there's a cardiac, lung, volemic, or cellular problem, since O2 isn't being transported and used up. High numbers occur when circulation returns during a code because the body is suddenly using up a lot more oxygen from each ventilation, thus exhaling a lot more CO2. The target area is 35 to 45 because that keeps optimal pH and CO2/O2 levels in blood. PS I imagine checking for condensation on tube is because water is the other byproduct in breaking down glucose...

God Bless Gene Roddenberry and his vision of the future....

Holy mother of Zeus . . . Just hold on for an EMS culture shock . . . Actually I've never run with the medics from up there, but I can't imagine them being too much different...some good, many bad, most neutral.

We get patients with cellulitis every so often and everyone freaks out about isolation. We didn't go over it in EMT class, but it was my impression that it wasn't a particularly contagious thing unless there was wound to wound contact? I've heard different things. OBVIOUSLY, it requires BSI, but it seems like it's treated like a major thing, worse than just a cut. So, thought I'd ask here for info on it as it pertains to EMS.

Just wondering if anyone was interested in writing a littles something on basic capnography as it relates to intubation in the field. Basically, we had a full arrest yesterday where the medics kept going on and on about the tube and capnography (sacrificing a LOT of CPR time for it) and the CO2 levels and the color on the CO2 censor....and I realized I didn't know that much about it. Why do we want to keep the CO2 levels at 35-40ish? range, what does it mean when it stays at that level, how does CO2 level tell you you're in or not etc. Kind of the why's and logic behind it all. Thanks....I know someone wants to take this one!

You could certainly help by opening the airway and holding c-spine, as well as emotional support. The fear of a being in that situation alone not knowing how seriously injured you are or aren't can be more painful/fear-causing than the injuries themselves. I think that benefit would outweigh making the ambulance park a little farther away... I'd hope being out of the lanes of traffic are a given. Was it daytime? I've seen and heard of relatively low numbers of daytime accidents on the side of the road WITHOUT flashing lights being rear-ended. It's not like you stopped at a fender bender...

I timed my first patient's signature this morning. 58 seconds...that's 58 seconds of her fiddling with the pen and me stabling the clip board in an awkward position. Did it kill me? No! But it's definitely unpleasant so I can understand aversion to it. Then, I had to about 8 minutes to get a signature from the triage nurse because they had three patients lined up and in between each she was running to do stuff. I hate being the EMT following around waiting for her to turn so I can ask for her signature. I'm sure they're tired of it. Then, I waited another 5 minutes after that (yes, I know it's not that long, but we're at like 15 minutes now) next to registration guy until he reached my patient's sheet and entered her into the computer. Then, gotta find a place to balance my clip board, open up the PCR, write in the MR, fold the facesheet the way the company wants it, then copy the PCR number and call number onto the facesheet, then put it back, then I'm set to go. Times that by 5 to 12 patients transports a day, every day of work...I totally have an aversion for it...still do it, but it's not exactly easy peasy.

No, sir, I don't care that you're holding a gun, cops are not on their way.

Welcome to Los Angeles County...you get the triple threat...unless it's a station house with an engine and a ladder truck...then it's x4

Anyone have recommendations on where to find ambulance bedsheets? I need new ones to sleep in on the station and want a totally juvenile one with cartoon ambulances. I've found one and wondering if anyone knows other places. I just need the bottom sheet that wraps around the bed, as a joke. http://www.sweetpeachesbedding.com/sheet-s...16220-c273.html

Oh, except we don't sign our the new ePCR's (they're not actually electronic, just have a lot of boxes for easy scan and keeping track of them later electronically in billing and compiling data, etc)...so not sure how we're getting around that...but I know we've been getting about 20% of a compliance rate with getting insurance to pay.

Oh man...I usually like stuff like that...I like watching chest tubes, watching ER crack open chests, needles, decompressions, watching leg IO's, but I couldn't watch through that all the way...eggghs, *squirms*

We have a triple check...We get 1) Patient Signature 2) Nurse Signature 3) Medical Record # / Facesheet If we fail on one, we still have two others.

Good Job Dwayne!

Around here I think everyone actually kind of gets along, for the most part, big picture. Police, EMS, and Fire don't are on calls with each other all the time and rely on each other. No real reason to hate each other. Ambulance loves Fire because 90% of Ambulance wants to BE Fire. Fire is whatever about Ambulance, because most of Ambulance kisses their ass. The 10% of Ambulance who are into it for EMS (mostly) hate Fire (but many still want to BE fire) because Fire hates doing EMS and does a bad job at it. Fire then doesn't get along as great with that 10% because they don't kiss Fire's ass. YET, in the end a lot of people get along no matter what because they're still personable, but the EMTs really have to make a big effort to be accepted by FD and medics. It's like every single thing you do at work revolves around looking good for Fire. It's a weird dynamic. Hard to explain. Many variables and exceptions. You gotta experience it to explain it I think.

I've never understood the pro union or against union stances. Guess we never talked about them growing up. Why don't some people like them as a concept? (I'm not even talking EMS here, just in general)