AnthonyM83

I don't see much wrong with that? We've already discussed how EMTs are basically first responders for paramedics. It's a great course for simple life skills and understanding processes of medical emergencies, which as a federal agent in the field, he might come across...but maybe just emergencies with his own family one day. If the course is easy enough that anyone can get in and take it as a sideclass while pursuing another career, it's not the course-taker's fault...

But you're asking us info on what equipment to get...so that equipment that you're talking about, you still haven't gotten...and your uncle doesn't have it...so it won't be free. They're saying get college education from that (past your EMT class). Why not? Fill out your FAFSA form and see how cheap you can get your community college at, then transfer to a 4-year (still getting federal help), then work for a little bit to save up money for medic school, then go work as a paramedic and build up that credit again.

Is that rhythm SVT? I was assuming so, b/c someone mentioned it was. Is there then a narrow complex tachycardia within that rhythm or are they the same thing? LA is working on getting cardioversion (we'rer way behind in the times)...but for now I've seen adenosine correct SVT everytime it's been used...immediately.

I just went over this... My life is FULL of coincidences, many that end up saving me from trouble. I pickup the phone all the time when people I don't talk to regularly are about to call. BUT I think it's more likely to attribute it to a cause that has some likelihood based on scientific support than on a cause that has none really.

So how do you correct HR if you don't have cardioversion in your county? I was told adenosine is what corrects the HR...if you slowed the rate down, then you don't need adenosine in the first place. But those are just verbal explanations I've gotten...I haven't studied ALS drugs much, yet...working on EKGs still.

So, I'm big on finding out explanations for the seemingly "weird" or crazy coincidences. Often it has to do with the subconcious recognizing patterns that we don't conciously keep track of or notice. So far I've got the reason I perk up like the radio's about to put out a call is because when dispatch clicks their mic, there's a second or two of an electronic buzz...it's even subtler than that...almost like a little charge on the radio...I didn't even realize it did that until I started studying my responses. As far as waking up in the middle of the night for a call...the best I can think of is that we have patterns to when calls happen. There seems to always be a 3:05 to 3:15 call...I don't know why. But I've come out of sleep for this one, think about how we're going to get a call, and then hear the phone ring. Stuff like that.

My question was about how his local volunteer agency was run...equipment given and when they can respond directly to calls. I understand not an EMT now, so he's not going to be showing up on scene at all and the equipment list is for a over a year from now.

What will you be doing that one year before you're allowed to go directly to a scene? Go to station first and respond with other responders? How does that whole thing work? The basics for me would be Steth, BP Cuff, O2, O2 Masks, Gloves, Light, Gauze, and BVMs/OPAs...as far as things you'd need right away on-scene, but best way to decide what you need is to get experience answering calls in YOUR area and then keeping track of the things you use most.

You get no equipment? So, if you can't afford any, you're expected to show up to scenes with nothing at all?

Speaking of SVT...have you guys ever walked in on a patient and just thought "SVT" immediately...? This is by no means scientific...but I guess just categorizing patients...like when you walk in and think "respiratory distress". I'm not sure what gave it away...I think it was that the call was for chest pain (none on arrival) but she looked pale, far away look, slow to respond, lethargic even, but fully oriented.

Or if you're an LA County FF/Medic, just BLS it to the EMTs :D

Dust, Dust...you must visit Hollywod and Santa Monica....Woahwa

Not commenting on the scenario one way or the other at this point, but just commenting on the logic in this post. If the patient is currently dead, then keeping the poles in place to prevent bleeding should not be of concern. What would bleeding do? Kill her twice? BUT if they happen to NOT be preventing large amounts of bleeding and you pull her out, you might be able to do effective CPR. Deciding not to remove based on protocol or liability, I'd understand...based on the above logic, I would not.

If only LA had cardioversion....it'd be medical control for us to get an order of adenosine.

So, you're saying there's ONE master list of abbreviations for every EMS system? If Stanford makes a change, then MiddleOfNowhere County makes the change, too? Looking at the two lists you posted, they aren't even identical...soooo how do you know DIB is a slang abbreviation? Doesn't seem that far out that a medical director didn't like SOB, so changed it to DIB...

Realistically, I've never needed medical control. Medics respond to every call (we can't cancel them) and are usually there within 3 minutes of our arrival. If it's a rapid transport situation, they're usually arriving as we're loading the patient. Only time I can think of calling medical control is if we had a patient crash or we transported before medics arrived, but it would mainly be to inform them of an incoming critical patient, not for online orders. I've contacted once by cell phone to inform of an incoming. Transport times are short here and there's not much we can do in LA as EMTs...

I don't know about locking the thread...I know *I* got something out of this thread...and besides rather chance it that people who want to discuss the topic in the future find this thread instead of starting a new thread on it (or at least we can direct them to this thread).

That's pretty much how I see myself...a first responder. I'm there to identify any life-threatening problems, treat at EMTB level, and prep patient for the paramedics' assessment when they arrive in the FD ALS Squad. That way medic can worry about doing his investigation and interventions without having to worry about basic things things like O2 by NRB or chest compressions or getting VS. If we're first on-scene long enough, I'll try to do as thorough assessment as I can with the goal of being able to give the medics the best report possible. The value of doing this (for me) is that each call I become more comfortable and natural at extracting the appropriate information for each call type, so that during my paramedic internship I can concentrate more on analyzing the information, putting together the puzzle, and seeing the big picture and deciding on the best course of action, instead of worrying on getting the information out of the patient and stumbling on what questions to ask. At least that's how *I* view my job and get value from going to work each day. I'm fortunate to have a partner who cares about medicine enough to have a similar outlook. We're by no means experts and there's always the rush to do it all and have patient packaged (if we think it's going to be a transport) before the medics arrive, but I think it's a worthwhile outlook.

Haha, that's half of what we do in the summer in Malibu district (low call volume, low BS volume) and you've got guaranteed celebrity sightings, plus guaranteed motorcyclist down each weekend.

Hey Dust, out here in the real word they have a term for that....it's called a hint! as in take a freaking hint :D

Good topic, one I've been thinking about lately. Other than the concern about them being able to pay, insurances, using up ER resources, I have a big concern about EMS personnel burnout. 24 hour shifts with 10-20 calls take a lot out of you, pulling yourself out of 10 minutes sleep (which is a lot worse than getting no sleep at all) is one of the hardest physical acts I've had to do...several times a night. BS calls lead to cynicsm, burnout, and hating patients. Now, I'm all for a wider role of EMS, such as prevenative health and discussing health concerns with patient and such, but I'm not a proponent of non-emergency ambulance house-calls. This is contributing to even less personal responsibility in society today. Though, I suppose if you have a different number to call for non-emergencies and there wouldn't be liability issues with dispatch classifying calls as emergency/non-emergency, then I guess It could be a good business...

Coming into this late, but I'd say modification of procedure (as long as it won't get you in legal trouble) should be looked at in a case by case basis. If there'ds abd. pain and pt really wants you to keep her covered (being seen might not mean much to us, but the world to that woman, for religious reasons...she might be tainted, afterwards having been exposed...the only way I can compare it in my mind is comparing it to how girl might feel about her virginity...we might not care, but her culture sure might), then keep covered. If it's a trauma, it's a life immediately at stake. What mom thinks doesn't matter one bit, because in this case preservation of llife wins out.

I sometimes worry about that...For critical patients who are altered, I seem to have absolutely no empathy or sympathy at all. It's just going through the mechanical skills to get best patient outcome. Now, for conscious patients, I do have quite a lot. I guess if they die, they die, and it doesn't much bother me, but if it's their feelings that bother me. If they're scared or worried or anxious, I think I go further than most to comfort them. The only way I can see myself going to a patient's funeral is if they were a frequent flyer with a personality and I had forged a connection/liking with them. I can only recall one patient (an IFT guy in his 70s with a mouth as foul as a sailor and quite sarcastic/funny) whose funeral I'd go to.

What do you think of the school there? I was flipping through someone's (a ride-along's?) student binder I found at the station and it had all kinds of detailed information literally 100x more thorough than my class....I'd almost want to retake it, there. Anyway, I've finally worked long enough that I can start applying to medic schools (Dust, every school I've heard of around here REQUIRES 6-months full-time 911 EMT before you're allowed to even apply)...I'm considereing Mt. SAC b/c I've heard it's EXTREMELY grueling ridiculous, which I'm all for, but I've also heard their medics come out extremely book smart, but not as good in their field skills / on the go decision making as other schools like UCLA's. What's your impression of Mt. SAC?

Ingenius! And yes, each of our ambulances has a KED and a short board, but I've never heard of the short board ever being used....not even sure I'd know how to use one properly. Of course, I've never seen the KED used either, but at least I've heard a couple stories of it being used, like raising someone out of a ditch and another out of a mangled car.