mikeymedic1984

I always administered Benadryl for phenothiazine reactions. I may have missed it in here, but Phenergan is also a phenothiazine. I probably have not seen one in the last 8 years, because other meds have taken the place of commonly prescribed phenothiazines.

Well Condy is a new member, I think they bowed to advertiser's pressure.

I am not sure that you have the legal standing to force an early drug screen, unless your school mandates a drug screen for all students, or has a policy that mandates drug screening upon suspicion of drug use (Come'on, which student isnt high or drunk every Saturday night on your campus). The good news is that once they get this sloppy, they are usually on multiple meds, and will fail the drug screen that you have coming up. The bad news is that if they have a prescription for the meds, they have not violated any rule or law. Should you try to ruin their potential career through your fears and actions, you may face a lawsuit from the student (their Dr. says its OK, who are you to question the Dr. and violate HIPAA possibly -- that's what a lawyer would ask). So be careful. As others suggested, bump it up the line to a supervisor and let them decide whats the next best solution. And I wouldnt worry too much, most reputable employers will do a drug screen before hiring.

Giving high flow O2 to a child with hypoplastic left heart syndrome can be very deadly.

Not reaching at all. Dispatch can prioritize calls made to them because they have a scientific method that is an industry standard for triaging patients by phone. A patient is a patient, and all patients are equal until proven otherwise. So if this patient in the new MVC has called 911, and has been triaged as a low acuity, you have some grounds for passing them by, but if not, and you are the highest level of medical care passing by them, I think you have a duty to stop and at least assess. To me, it is similar to ER triage. Imagine if the triage nurse assigned acuity to every patient in the ER by how they looked, without taking v/s or doing any assessment other than they are "up and walking", so they can wait behind everyone else. The statement about the kid drowning in the lake was in response to someone who said you had to blindly follow protocols and policies.

I think you maybe putting too much focus on life happiness, on the career. What job is it that you think would be so much better if you could change tomorrow ? Also, you cannot base your happiness on outcomes you cannot control. There is only so much you can do, you cannot control what other people do.

The answer to your question is simple in theory, but impossible to pull off. We are the problem. As long as we will continue to work 2 jobs for barely above minimum wage, that is what the market will pay. We lost a great opportunity in the 90s when there was truly a shortage of Paramedics at least, and before fire departments starting pushing everyone to EMT mills. If we would all get together on a particular month, and say. "Sorry boss I am taking a sabatical for one month" and if all of us refused to work a part-time job for one month (on the same month nation-wide; dont quit, just take a month off), wages might go up, but if your state has the chance to put EMTBs in your place, then it may be a losing gamble. You can't compare California to any other state, the wages are high because the cost of living was/is ridiculous. A 2 bedroom house used to cost $300k, and I believe gas is around $6/gallon. Taxes are higher, everything is higher. Why can't you make 100k, because most services collect 40-45% of what they bill, 60-120 days after service was provided. If you are a 911 service you are probably only transporting 50-60% of your patients, so the revenue is far below the cost. If you are a private service in this economy it is very difficult, no banks are lending, fuel is high, and you never know what kind of revenue you will have from week to week. But anywho, if you want to change, rally everyone together to take that month off from all part-time jobs.

I think it is time for a real conversation about guns in our country. I am a republican and in favor of the 2nd amendment, but I don't believe any citizen needs access to a 100 round clip and an assault rifle to "hunt" or protect themselves. These weapons should be reserved for military use only.

OK, so you see a child drowning in a lake that has a sign posted that says "No Swimming". Do you honor the rules and let the child drown ? EMS is all about gray areas that lie in between the rules.

I see it as no different as being dispatched on a chest pain call, and before you leave the station a patient drives up with chest pain. Do you tell them to wait on a second ambulance to respond to the patient ? I know it is easy for us to say that since the patient we have just come across is not critical (in the wreck scenario -- but how can you claim that with no physical assessment performed), that is OK for us to defer them to someone else and leave, but no hospital is allowed to do that, they can be working 5 cardiac arrests, but if another one comes in you just cant let the 6th one wait in the lobby; once a patient has presented to the hospital property, the hospital has a duty to act. Do we not have a duty to act when we are less than 20 feet from a patient ? I know our answer, but I am guessing lawyers would have a much different answer.

We have all been there, you are either enroute to an emergency or you are transporting a patient emergency, and you come upon an MVC. Let's take the lowest extreme and say it is a minor fender bender and everyone is out of their vehicles and walking around. You slow down, yell out the window are you OK, and everyone says yes. You state that you will call in their wreck to 911 and get help to them, and you continue on your call. Are you at any risk for not stopping and waiting on help to arrive. Is it abandonment ? Can you cite a specific law in your jurisdiction that protects you should one of the accident victims later sues and says they had neck injuries that were worsened by your lack of care, and/or the delay in care ? I realize that you may have a policy in place, but does that policy protect you ? What do you do ?

1. Send out surveys to your crews about what they want and don't want (doesn't mean you have follow all of their advice, but it might give you some good ideas). 2. Meet with other area services to find out what successes and failures they have had with various manufacturers. If you are tied to one manufacturer, talk to several of their customers to get feedback. 3. Be anal, as you will be stuck with this vehicle with several years. 4. Try to negotiate for increased perks and warranties (competition is a good thing). 5. Ford is moving to gasoline engines, the rest will still be diesels mostly; consider if gas is better. 6. Consider fuel economy; what would you buy if fuel was $6.00/gallon (it could happen). 7. Go to an EMS trade show if there is one nearby, in-time for your purchase. Manufacturers tend to show off their "best" trucks at these shows, and afterwards, they may still have this truck sitting on their lot until the next show. I would'nt necessarily buy it, but it should give you ideas of what is possible.

I would just remind everyone that there are people who walk around with some pretty funky rhythms everyday that have not been diagnosed --- everything from >20 PVCs, runs of VTach, sinus pauses greater than 4 seconds, and some rhythms that 3 cardiologists would give you 3 different interpretations on. In my eyes, Chest pain alone is not enough to shock people. You need to look at the overall picture and decide if they are critical or holding their own. I would hope that just because I have chest pain and a funky rhythm that I will not get electrocuted by an overanxious medic. Start an IV, put the pads on, be ready to shock if needed, try meds first, but dont freak out because the rhythm is not what you percieve as normal.

The various parts of the human body were discussing which was most important. The brain said Iam the most important as I control everything, the eyes said we are most important as we guide the body, the knees said we were most important because you could not walk or sit without us, Finally the asshole chimed in and said I am by far the most important part of the body; the other parts laughed and said you really think you are important at all ? So the asshole decided to clinch shut for 5 days. After that, the brain got fuzzy, the eys got blurry, and the knees buckled, and they all agreed the asshole was the most important part. Everyone plays their part in society from garbage man, to construction worker, EMTs, teachers, doctors, lawyers. No one job is more important than the other, and no person should be defined by their job title, its how you live that is most important. And for God's sake, never let the attitude and comments of others change the mood of your day. Rise above them.

AMR has the national contract through FEMA, FEMA also keeps databases on personnel so they know who to call state-by-state, and of course your local/state EMA should have similar

I believe in bringing the patient to the equipment when possible; think about a cardiac arrest that you know is a confirmed arrest: Bring all that equipment to the patient, or take 5 minutes to bring the patient to the equipment --- much easier. I agree with the policy of using the stretcher, if they can walk to the bus and sit upright, why do they need an ambulance ride ?

Never let a cert go, until you have actually obtained the new, higher cert. I know it seems certain now, but life has a way of messing that up. To keep your other cert is a nominal fee, pay it to keep from being unemployed, you can do the cost comparison.

Three cases in GA this month, probably not a statiscal anomaly, but what do you guys to protect yourselves, is normal PPE enough ? http://news.yahoo.com/georgia-woman-flesh-eating-disease-critical-condition-201616109.html

Follow the golden rule; if your family member were exposed under the same circumstances, would you be upset ??????????

It's volunteer, what the hell decision needs to be made ?????

Since flightmedic is the most dangerous job in America, I cannot recommend subjecting patients to this danger on a regular basis

If urine is yellow you are dehydrated, if it is clear you are fine.

I agree with Mobey, your "base plan" should encompass "all" MCI scenarios, then have off-shoot plans for specific disasters that require a unique response. I imagine AMR or RM in California would be willing to share their plans with you.

I always consider it bad medicine to overdose a patient on the wrong airway med, instead of using the right one. Services who do this are doing a shortcut to RSI without having to go through the proper steps of proving that you are competent to do RSI. Do it the right way and remember, patients do not die because you did not intubate them, they die because you did not ventilate them.

Of course she is hot, do you think he would post this question for a 300lb male slave ???