AnthonyM83

We had this a couple months ago, with a pro player. Fortunately, we only had to restrain him long enough to get some sugar into him. As soon as he came too, "Uh man...uhh, sorry". Guess it wasn't the first time he awoke to PD/FD/EMS holding him down. Knew exactly what had happened.

I don't think cops around here know the "little damage as possible" part of it . . . And I don't know what protective custody is in the legal sense for cops, unless they're going through with a 72-hour hold (threat to self, others, or gravely disabled...guess the latter), but then you have to have paperwork to go with it. But yes, Richard's advice is generally the way to go.

JP, That's how it works in Los Angeles County as well. Of course, I don't think most EMTs know that. Partially, because most have never even glanced over protocols. Those who have probably have their computers freeze trying to load each individual PDF file from the county site for each sub protocol.

Your skin is your largest organ. I have never heard that the integumentary system is the largest system.

Well, our portables use the dial with specific flow rates you can click to, but the house O2 uses the floating ball and tube regulator. My concern with the ball/tube regulator that sticks is that smaller patients with low tidal volumes with quick respiratory rates might be rebreathing their same exhaled air from the mask and not even using the pure O2 from the reservoir bag. If it's working, I just make sure it's above 8lpm or so, THEN adjust flow rate to patient without really looking at the number. If it's lower than that (or meter not working correctly), you might end up with a flow rate too low to mostly displace patient's exhaled air from mask. Or so, I think.

As long as the girls think that way, too, I'm set

I guess that's stringent hiring process is the way your particular agency prevents immaturity from happening...though I've seen the most mature have moments of weakness...in my opinion strong oversight is key, which seems like you guys do have.

Brentoli, do they have their two stations 55 and 155 (the fact I actually know the numbers is a reminder I've been around this stuff and FF hopefuls way too long) respond to beach calls as well or do the lifeguard paramedics handle?

San Francisco City itself if run by the FD. They had recent changes, so I'm not exactly sure it how is now, but I know they are now hiring non-FF (single function) EMTs to drive the ambulances, I believe stationed not out of the fire station anymore. For surrounding cities, it depends...some are FD based and some are primarily private company where FD also responds.

That list doesn't seem complete...what about pacing, Intraosseous IV, amiodarone? From that list ones I believe we can't do: © perform pulmonary ventilation by use of endotracheal intubation; (Not For Peds) -(4) Obtain venous blood samples for laboratory analysis. -(5) Apply and use pneumatic antishock trousers. -( syrup of ipecac; (?) -© lidocaine hydrochloride; (as of recent) And we recently go: cardioverting, pacing, and IO IV, and adult intubation is shaky

Once again, I don't think it mattered (in affecting the mess that ensued) what dispatch said, rather the fact you told them to stick it at any point in the conversation. Anything you say can and will be used against you by management, especially out of context. Not that you weren't justified, but it's just a lesson to learn. Thus, I wouldn't repeat it.

ZZ, sorry, I've been trying to learn about a Kern County, San Bernardino County, and Riverside County lately and momentarily confused yours with Kern County, where the call volume is much lower. Could you please write more about Mt. SAC? It's supposed to be the most academically rigorous course around. I've heard the teaching skills isn't as good, but I've only heard it from non-medics or students from other schools. What I'd like is to find an experienced medic who has worked with medics from the different schools and can actually be a good judge. I like the staff at Daniel Freeman / UCLA and have been volunteering as a role-player whenever I can to get exposure, but my worry is that I'll be doing my internship under such a limited scope. It's basically only O2, EKG, IV, transport for every call. Who did you do your internship with? Note: I'm trying to keep the convo in the thread, as I'm sure it'll come up on a lot of people's Google searches trying to find opinions on S. California paramedic schools. It's hard to come-by online.

As an FYI, thanks to those who replied here and on PM. I've just started writing something up. I got distracted from it after my needle stick, then things became busier. I'm working on a very rough draft.

Yup, it's definitely good for, us, the EMTs. But really, I wouldn't take the results of that questionnaire personally. It didn't say medics disliked EMTs, it just said they would prefer other medics, since a medic can offset the workload by doing all the things an EMT can, plus more.

I'll ask about ordering different ones. The main problem we have with them, is the ball getting stuck. We endup doing it by how inflated the reservoir bag is. Smaller patients who take small rapid breaths might keep the reservoir bag inflated, but be rebreathing a good amount of exhaled air.

She might be able to make it work, if she can get her doctor's signature and a state seal tattooed on there as well (or whatever is required in her state).

If they require restraint for medical reasons, our private ambulance uses soft cloth restraints tied to main frame of gurney. Kerlix and the like are not allowed due to concern of cutting off circulation. The FD can use leather restraints. No chemical restraints. No backboard sandwiches. PD will respond if necessary, but they are often hesitant to use force because they're not medical professionals and often question legality of restraining them. OR they come on-scene and treat them like suspects, slamming them on the ground, using pepper spray, carotid chokes, or closed fist punches.

Reminds me of UCLA's BLS ambulance service. I haven't confirmed it, but was told 100% of their EMTs go on to medical school. It's an extremely competitive program with few spots open. These aren't kids who are doing it just for kicks, but rather people who plan to devote their lives to medicine. The criticism is still that they are not ALS, but being such a small program they can have a lot of oversight and can probably have every single PCR and ALS request (or lack of it) reviewed for QI.

I would disagree with the statement that age doesn't make one more prone to misusing things in an EMS service. Perhaps you particular service has ways to prevent it from happening, but as a general rule, late teens and early twenties (college years) does make people (young population as a whole) more likely to misuse. Not saying it's a good enough reason/risk to not have the program...just picking at the logic.

Heheh, yup. Well, not technically "room"mate, but apartmentmate. And I've yet to get spam or any non-legit email from that site, so far. Been on it about a year.

I was just wondering if any other people were on http://www.linkedin.com/ It's basically a professional website for resumes and recommendations/endorsements from supervisors and coworkers. Employers can scan through potential applicants and extend offers or you could network with others in the field. You have access to people your friend are connected to, as well. My roommate told me about it (many people from his non-EMS work regularly receive work offers through there). Employers on the site include larger ambulance companies like AMR and many hospitals. Just thought I'd share. (BTW, It's generally free, unless you're an employer. No referral bonuses or anything like that.)

Wasn't this what started the whole mess in the first place? Not necessarily the fact that you couldn't run the call, but that you told them where to stick it?

Once again, it's a hoax, like the bonsai cat website. And at least in California, the age of consent decreases if you're lawfully wedded. But still good advice to watch out, though.

Intubation is standard practice. One of the main things done during full arrests. THOUGH, there's talk of eliminating in the future because of all the time wasted on the failed attempts, when they could be going straight to the combitubes. Apparently it's standard to only get 3 intubation practices during hospital clinicals at one of the main schools (that preaches about quality training) put on the by county that most FFs are sent to.

Extremely interesting. Glad to see we're still studying the topic and trying to improve resuscitation. I do, though wonder, what the studies were based off of. What the actual resus rate would be. And what downsides or side effects there might be? (damage to internal organs?) Does the automatic inhalation and exhalation cause more/less buildup of air in the stomach? Looks promising, though. I'm interested to hear the rates, both to standard CPR and other systems like CPR-Only-No-Breaths systems.