LasVegasEMTI

Here in LV, AMR and all Fire (LVFR, CCFD, NLVDFD) all use LP12's. We use Phillips and I couldn't be happier with them. I've used LP12 in the past and I don't mind them, I just find Phillips much more user friendly. Some cool features of them are 12-Lead On-Screen views, AED function as well as Biphasic Defib, continuous end-tidal CO2 monitoring, as well as the standard NIBP and SpO2, and a relief that those of you who use LP 12 will know- in a 12 hour shift of continuous use, we don't even use up an entire battery. It truly is a relief to never hear the "Low Battery" announcement! We have adapters for our defib/pacing as well so that if Fire starts treatment and want to switch to our equipment its simply a matter of snapping on an adapter between the male and female connections. Phillips also does regular maintenance and have taught our supply techs how to service them. We have adapters that connect to the defib cord that test the output which we test every night. The only issue I would say I have is that when someone's pressure is under 90-100, the NIBP tends to be more inaccurate than accurate. But thats what manual BPs are for! I definitely think they are worth the $36,000 investment. Our company believes so too as we currently have over 30 monitors in service!

Urban System here... as a company, we cover roughly 40% of the county. We run over 100,000 calls a year. The other company handles the other 60%... I'd say somewhere around 300,000 calls a year city-wide, but that of course is just a guess. We run approx 40 units daily each 12 hour shifts, plus special events.

Don't speak for all, here in Las Vegas, we've gotta give it like candy. The opiate use in this town is off the charts. Protocols call for 2mg initial dose, but most of us are intelligent enough to start at a quarter of that and use just enough to get them out of respiratory depression, not completely conscious again. Believe it or not, I also used it twice in my last month in small-town New England... you just never know.

5. Although I've already been trained in EKG reading, they did a TON of this in my ACLS class. We spent a good four hours just going over strips. And what the tx would be for each rhythm (electric/pharm/etc...) 8. Medics I've worked with have been very happy that I am able to supplement them with knowledge and skills. Sure I can't intubate here, but I can certainly identify when it needs to be done and I can set up the ET. Same goes for all monitoring, sure I "can't interpret" any strips, but I sure as hell know how to set up 12-leads, pacing and defib. I am happy I took ACLS, I am a better provider for it because my knowledge base exceeds my scope of practice. I'd rather it be in that direction than not know enough. PHTLS- They taught me and let me practice lots of ALS skills. And even though I didn't have to, I still took the ALS part of the exam. Still passed the whole thing with a 96%.

Not true. I took ACLS (I'm an Intermediate) and I passed, with EXCELLENT understanding and a 94%. I've also taken PHTLS and passed with a 96%. PALS is coming up shortly and I do not forsee having any difficulty with the material. Yes, you have to be a Paramedic to practice certain things, but the knowledge gained in these courses is excellent, especially if you have the mind to understand the concepts. It only makes you a better partner to your Medic, because you can be thinking along their same lines and get equipment set up. I've even called out medic partners on things they have missed (ALS stuff) and changed their course of treatment because of it.

I can only imagine which one of the amazing facilities you were at ;-) (All is well out here...)

I think one of our better laughs was in a radio "black hole" next to one of the hospitals... Dispatch: J24, at XYZ hospital....... (static) J24: Dispatch, you cut out. Didn't hear what floor the patient was coming from. I'll give you a landline. Dispatch: I DON'T HAVE TIME FOR THIS! GO GET YOUR PATIENT! So, we went to every unit and asked if they had a patient they wanted to get rid of. Another funny day was when we were bouncing around doing raisin runs... LPN @ Nursing Home A: The patient is alert but unresponsive. She does this sometimes. Me: What were her last vitals? LPN: Oh I don't know. Me: (under breath) of course. walks to patients room... Me: Hello Mrs. So-and-So, how are you today? the patient stares at me, no response. Me to LPN: Did I see that she had a french name? LPN: Yes. Me: Bonjour mademoiselle. Comment ca-va? Je m'appelle Ashley. Es-tu bien? Pt (with big smile on her face): Je suis tres bien! I guess she just didn't like Americans... We were at Nursing Home B dropping off a patient. As we were walking out with our empty stretcher, the front desk nurse goes, "Wait! I've got one for you. We weren't sure if we were going to send him, but since you're here it'd probably be a good idea," Me: Alright, but you'll have to call our dispatch and request it so they don't line any more up for us. Nurse: Ok. Nurse: Alright I called them, they said it's fine. Me: So what's his issue today? Nurse: He's unresponsive. Me: Unresponsive? Is he breathing? Does he have a pulse? Nurse: Yeah, he's breathing and has a pulse, just can't get any response from him. Me: Alright, what room? Nurse: 77A walks to patients room... finds old man laying in bed. Me: Good evening Mr. So-and-So, how are you? Patient: I'm doing great. These women are crazy. Let me guess, you're here to take me to the hospital? Me: Well, I guess its where they want you to go. You look fine right now but I can't say anything about earlier, I wasn't here. But we'll get you checked out and I'm sure you'll be back here tonight. wheels patient to ambulance, find Paramedic unit waiting for us. Me: What are you guys doing here? Medic: Dispatch sent us. Said you guys had an unresponsive patient. Me: Oh god. This is Mr. So-and-So, as you can see, he's fine. Medic: Well, do you want me to join you to the hospital? Me: You know what? Sure. Why not. If dispatch is going to take the liberty of calling for an ALS unit, I'll take the liberty of taking you out of service till we clear the hospital!

I can't keep enough gloves near me. Perhaps its a ocd tendency, but I always have to wear them. Of course it isn't reality, but I assume everyone has AIDS, Hep C and MRSA. I figure the one time I assume someone doesn't have any communicable diseases, will be the time I am wrong. I know I know, there's a lot more ways to get infected, through the hands being the least of my worries. I also like wearing them because some are blue! Whatever works, right? As for this helmet issue... How far does it go? If we are wearing them, are our patients wearing them too? Its only fair. Why should our brain housing group be more valuable than theirs? But wouldn't this hinder our PA, ESPECIALLY when they have a head injury? Just playing devils advocate here. I am ALWAYS hitting my head in the back of the rig, even had a concussion once. I think maybe to find a happy medium we should mandate either helmets or safety belts... one or the other must be worn. I say this because of the mass transfer system that exists. Most of our transfers (BLS) can be done while belted into the crew bench. If mobility is required, then sure, give me a helmet. I've had too many egg heads, bruises, blood and dizzy spells! Ok, so my spacial awareness isn't in peak condition... I've also broken four or five toes walking barefoot into door sills :-P Maybe I should be wearing a helmet 24/7... :-D