ncmedic309

Well, to start, let's knock out quick, but important basics... Any scene hazards? How far was he thrown, height? How significant is the mechanism? How far are we from the trauma center? Do we need flight services? Is he trapped? Maintain C-Spine immobilization, he's going on a board... He's alert and oriented and airway appears patent. Lung sounds? Tidal Volume? Radial pulses? Any obvious signs of outward trauma, severe bleeding?

Use this website to upload your pic and then post the appropriate link in the forum... ImageShack

This one can be debated all day long and from a ton of different angles. I understand that in some states you have a duty to act as soon as you identify an incident, regardless if your on or off duty. In the long run, I think there is a major exception to all these incidents regardless of your state laws, if you don't have the proper equipment to provide care, then you can't be held to providing care. Just an example, you are driving in your POV and come across an accident, you don't have any equipment on you, what's next? I have to act even though I don't have the proper equipment? I'm supposed to ignore the core principles of scene safety and put my bare hands on a patient and expose myself to blood and other bodily fluids? What do I do with the unresponsive patient w/ copious amounts of blood in the airway, I have no gloves, no suction, no BVM or airway adjuncts, or anything that's going to help me care for this person. Why should I have to put myself in that situation, just because I have the training? What about safety? Maybe I didn't feel safe on the side of the highway with no warning devices or vehicles blocking oncoming traffic from running me and the patient down, am I still supposed to stop and act, just because I have training? I can't see how any of these incidents would hold up in a court of law, if you don't have the proper equipment to render aid, then you shouldn't be held to doing so, when technically, there is no duty to act. I apologize for getting off topic, as I'm sure this has been discussed 1,000 times in 100 different topics on this forum alone. Did I get my point across?

Were you on duty at the time of the incident? It sounds like your friend, the lifeguard, was on duty and even though they are trained at a lower level than yourself, they have more of a duty to act than you do. (Unless your a volunteer that covers that area or your currently on the clock as an EMT) I'm not saying that you should stand back and do nothing, you should offer your assistance to the lifeguard and inform them of your training (in this case, they were already aware) and assist upon their request. It's almost like pissing in somebody elses pool, and can cause problems. On another note, it sounds like the lifeguard has some issues that needs to be addressed. Her conduct was not professional and obviously caused the situation to get worse, someone should have a talk with her...

I'm backing off, I had my few minutes of fame...knock yourselves out! :wink:

Nah, I had it for at least 2 minutes that time...

Well damn, thought I'd at least ask...I think I had it for about a minute...

I would like to know your supervisors justification for not involving ALS care much earlier in the situation, what was he waiting for?

Can I be on top? 8)

Looks like a little variance in the S wave and ST segments from the first strip to the next but otherwise unremarkable. I don't see any clinical significance in the two strips...

Hmmm.... That's the quickest I have ever seen Narcan work! People still use simple face masks? The reservoir on the NRB mask was never inflated... How did the NUD figure out how to work the PA on the ambulance? Pronouncing the kid after attempting resuscitiation, not in my world... (Zoll was off during CPR) They did suction the mouth before the nose on the delivery, big plus there... The sex scene in the rig was better than any I've ever seen on a fire truck...but still amateur at best... The female latino paramedic, I think I have the recipe for curing her attitude, she just needs a... I give it 2 out of 4 stars, I'll watch another episode...

I'm not to concerned with having a BGL at this point (it would be nice), but I would like to see an EKG. Otherwise, it's a BLS run...with this presentation, she wouldn't get any ALS intervention from me...

The same capability, yes I agree. The same probability, not likely. The potential always exists for anything and everything on any scene, but violent acts are not encountered on the majority of calls EMS runs. When there is a known violent act that has occured (assault, suicide attempt, etc.) the call requires more defensive tactics on your part and much more caution when it comes to personal safety. You shouldn't be complacent at the SNF for the nab run, nor should you be complacent at the scene of a GSW or assault. The point of my post was to just once again show the stupidity that we encounter on a daily basis from people that do this job that neglect the most simple ways to keep themselves safe.

I keep an 8-10 gallon trash bag in my ALS box and use it to clean up trash on scenes. It comes in especially handy on codes when you have a mess of trash scattered all around you. You can quickly pile it all in the bag and take it with you, not leaving a mess behind. And as others have mentioned, it's just good manners, nobody wants your trash.

We were dispatched to a GSW the other day and we arrived just ahead of the fire department. We're staging until PD arrives and secures the scene. The fire engine pulls up behind me and a firefighter approaches my side of the truck and asks if we can move our unit up some so they can get around us? Why I ask? "Because we're not going to wait for PD, it's self-inflicted" was the response I got. Ok then, suit yourselves. It was a self-inflicted GSW, but the patient was sitting on the couch, alert and oriented, and very capable of mowing down a fire crew as they walked through the front door of the residence. Complacency can be a killer...

I think one of your biggest problems is going to be finding a service that will carry you under their insurance with the driving record that you have, as others have mentioned, it's not impossible and not necessarily out of the question, but you are behind the 8 ball...

Your not being a racist, your stating your observations, and your not alone... It has nothing to due with being racist, it's all about how you choose to live your life. It's sad that a lot of people are content with living off the government or more specifically, us, the people that bust our ass for a living. I disapprove of their lifestyles and wish that the government did nothing more but make them help themselves. But instead we unwillingly get to help them support their lifestyles. There's no doubt that being in EMS you see the facts of these situations everyday, we deal with these people on a routine basis. There's no doubt in my mind that they account for the largest percentage of our work and the largest percentage of non-payment for services. I'm not going to single out any one or more race(s), because it's not just limited to one. We see the harsh reality of it all on a daily basis. It has nothing to do with not having a fair chance at life or anything else, it's about caring enough to make the right decisions and working hard to get what you want.

There's always the possibility that something could turn up missing or just be overlooked while being stocked, even by the crews that staff the truck for the day. The people who stock our units do more than just stock trucks, they are operation support technicians. They are full-time employees and some are even EMTs and Paramedics, not just somebody hired to come in overnight and stock a unit. The great thing is, everything I will need for the day is in one of my bags/kits that remain on my stretcher. The equipment in the cabinets is just back-up supplies to re-stock what I use out of my bag/kit. It's also quite easy to visualize most items in the cabinets, even when they are sealed. I don't leave headquarters unless I'm readily equipped to handle anything and everything that gets thrown at me within reason! :blob7:

I check everything before each shift! We're lucky enough that we have a logisitcs division that checks off our units for us before each shift. The only thing I don't check is the cabinets that have been checked and sealed with a tag. Everything else comes open and gets explored.

There are way to many folks out there that think EMS providers do nothing more than haul ass to your house when you call, then scoop you up, throw you in the back of the truck, and haul ass to the hospital. I want people to have a better understanding of the emergency care that we can and do provide on a daily basis. I think when more people realize that there's more to EMS than just being an ambulance driver, we will be recognized more as a profession.

I do the same thing. I will usually use a 16 ga. cath for the fluids and put an 18 ga. cath in w/ PRN adaptor just to have in place if needed and for the hospital to pull blood for labs.

Where did you get out of my post that I was comparing the North Carolina exam to the NR? Or did you just assume that I was comparing the two? You know what they say about assumptions... :roll: The only thing I will give the NR is the quanity of skill stations that are required vs the NC state exam, but any monkey can remember enough material after studying the skill sheets that are provided before the exam to pass the practical stations, where's the challenge in that?

Why should I pay to take an exam that's not going to challenge me? What do I get out of it? An ugly gold patch, woohoo! :roll: I'm all about improving the continuity of care and learning, but the NR is far from the answer to our problems. It's not going to get any better unless we find something better...

I just shave mine all off, between EMS and marriage it's all falling out anyways...no point in attempting a comb-over...

If your state was to do away with the National Registry, it wouldn't hurt you, nor would it make a big difference. As pointed out earlier, the NR is good for just about squat unless you plan on moving from state to state. Most places don't offer extra pay for being nationally registered and could really care less if you have the NR. I hear some people talk about how hard of an exam it is and how much better of a medic you are if you pass it...bullshit. Unless your state requires you to have your NR, why even bother with it?