Ridryder 911

As well as ASLS (advanced stroke life support) http://www.asls.net/introduction.html R/r 911

Declare death, LEO is usually at scene, or will be notified. They will in turn notify M.E. after discussing with EMS, and then funeral home will transport. R/r 911

Don't know how this is "funny stuff"? We use Strykers power cots. I have seen advantages and disadvantages both. Cons: Weigh more, costs more, hard to get preventative care. After about year, start wearing down with little to moderate usage. Pro: Definitely decreases back injury, can lift those > 500 pounds to 700 pounds. Especially good for those with repetitive lifting. Adjustable height to be able to move patients from bed to bed, etc. I personally like them. Although, they have limitation and con's over all they have reduced our back injuries stat's. The additional weight had to be dealt with by using other devices such as stair chair, etc. in which should had been really considered anyway. R/r 911

We don't have one! .. I.M. me and I can give you the info... I work there. R/r 911

I am an old ICU nurse, used to monitoring in MCL1 and like it; however it as well has its limitations. Personally, perform a XII lead, and identify the problems, then use the best appropriate lead (usually MCL). R/r 911

Actually an employer has the right to ask your previous medical history in the form of .." is there any medical condition, that might restrict you and your perfomance in this position?..." I believe pyschological problems should be one of those problems, due to the nature, environment, we work in. Otherwise, employers might be stuck with having to accommodate those with disabilities, that cannot perform the job or purchase high dollar equipment, just to perform a basic task. If one does not, ADA will have the employers rear. I believe, psychological screening should be more emphasized in lieu of "happy med.'s" . Sorry, I am so tired of hearing and seeing the effects of those that do not have their medication level up to par or to the see the side effects of such medications. Just like any other disease processes, such as diabetes, HTN, medications, employees should be cautious in the environment they perform in . Would we not be cautious of those on prescribed analgesics? R/r 911

Hmm..maybe you to reconsider whom is skilled. Just because you do not see any active bleeding, does not mean there is not any hemmorraging. Did you perform a rectal hemmocult or check for their hematocrit? Did they (SNF) have lab results showing a decrease in H & H ? Was there evidence of anemia, slow leaking bleed, etc. What caused them to call EMS or suspect bleeding? Then why would EMS want to refuse so fast? R/r 911

Ditto to Dust's responses. I have as of yet had any formal "safety" classes as a Paramedic. (Albeit, I do have a degree in Fire Science and Safety Engineering) I can assure you, we are not Public Safety officers. This is why I do not understand why we ever wanted to be removed from hospital based systems. We should be considered mobile health care. Even labeling ourselves as Public Health Care is incorrect, in regards to what is defined as Public Health Care at this time. Well, at the least every one would have to have a bachelor's degree to be perfoming in that field.....Yet, then maybe we should attempt to go that route, it would mean increasing our minimal educational level... !

You did the right thing. They are foolish, expecting to be excused from any liability having someone sign a waiver. If there are other Basics that continue, they are asking for litigation and possibility of removal of license and or certifications. R/r 911

I usually ask what "allergy" symptoms that occurred. If it is that they did not have any true allergic reactions , rather they are on an anti-coagulant, then I will administer ASA anyway. Many practitioners are misinforming clients that they are allergic instead of teaching them correctly, to be cautious in using any potential blood thinners. One has to be cautious in administering any ASA products, but the recommended one time dosage should not be that detrimental. All else fails, I will consult medical control. R/r 911

Most Paramedics around here, would love to see $12 an hour! I agree education is the key, yet supply & demand goes on with the admission(s) to the education area. Just like nursing, physicians, there is never a "set" amount of number of admissions. It is usually based upon the demand and request by local area. Professionals are smart not to "flood" the market, and lower the salary range and demand. Whenever, we start requiring EMS instructors to be EMS Educators with a formal degree, and requiring the minimum to have an associate degree before job entry level, then and only then we have a legitimate gripe. R/r 911

Update: Ron was moving his feet on his own. He is off the pressors and paralytics , he has a few minor ICP spikes but not of much concern in that they self reduce. He still remains critical but only time will tell at this time as to his outcome. Prayers and thoughts are still requested, at this time. R/r 911

That's the point. An EMS is call is an EMS call, no matter where it is. Like you described, I too have been in rural America where there is NO F.D., or any other rescuers for literally 40+ miles, or worked metro; 15 stories up in an apartment building; and never seen the need to carry such crap. Sorry, if my units are not that prepared to respond, either I deal with it, or they go to the shop! How much crap do you need to run a medical call or even a trauma call? The same with oxygen keys... chain the damn thing to the regulator! Yet, after thirty years of working MVC (yes, we have low & high speed impacts here as well) I have ever needed a window punch! Our trucks are required to carry some form of rescue tool, type axe, gloves, even a tool box. In which that is where it belongs. Your F.D does not respond with you? If I wanted to look and walk around like a Maytag repairman or a lineman, I would had done that. Even they don't wear all that crap all the time. Seriously, if you are using your pliers more than once a week.. what are you doing on a call? My job is patient care, let the fire guys deal with removal of doors, disassembling things, that is what they are there for. It gives them something to do. I agree, it must be a N.E. thing. We make fun of anyone with more than a key ring and a radio on them. Just how many pair of scissors does it require to remove clothing? So far I have seen trauma sheers cut through any clothing the I have encountered, even the clothes of patients that came from the N.E. :wink: If you want to jingle and waddle as you walk, then that is your right... I guess. Personally, I already hate the weight of my kit and monitor. I even let F.D. carry that if they will. I will have to lift and carry more than I should already. R/r 911

Sorry, they have the monopoly, If it is that you are worried about difficulty ...don't. R/r 911

Critical care transports is part of the norm of the transfers where I work, and one better be used to vent care, IV pumps, central lines, sheaths, etc. before they even apply. We do not have CCP positions nor pay additional for it since we consider it part of the Paramedic knowledge. We are considering of placing our own continuing education in, doubtful there will be a pay raise, rather to keep their position, they will have to attended. R/r911

The trauma station is pretty simplistic. The examiners are supposed to ask..."Is there anything else, you would like to add?".... If you scenario included a tension pneumo, yes you were supposed to decompress them, as in real life. Remember, upper airway and lower airway are to be corrected in the primary or initial assessment. Review the skills sheet that is on the NREMT web site. It goes step by step, and as well the critical criteria that cannot be missed. Good luck, and study hard... R/r 911

Here is an idea, instead of purchasing camera's and potential litigation, how about separating crews that are suspected, or actually supervising them. If they are caught, automatic dismissal! Period! Common sense... R/r 911

No news, we were informed that they would be E-mailing us up-dates every three days, or if there is any acute changes. R/r 911

Yes, all the studies was conducted in a hospital setting. I agree, in the field setting one has to use commons sense, and like even in the hospital setting; it should be case by case scenario. I have even use family members in participation in the code. I have seen + results as well, that they were able to "do" something. I believe that it adds closure. R/r 911

I believe it is as successful as thinking helmets will prevent head injuries, and pads will prevent fractures. Yes, it might reduce slightly, but actually prevent ... we will have to see. R/r 911

One that thinks flight suits are neat looking, try wearing one for 12 hours. I agree, they look sharp, but very uncomfortable after a few hours as well as very hot. Here is those flight scrubs, (Ihave a pair and are very comfortable) ...[web:61ce924e83]http://www.aviatorscrubs.com/[/web:61ce924e83]

I have some personal opinions from experience. Wearing everything from scrubs to Dickie's, flightsuit, etc. Personally, I hate the eplett type "Police" shirt type uniform, from being confused as a security guard to the local cop. As well, sorry... hate the white colored. I have worn it for the past 25+ years, and yes it does show every piece of dirt, dust, sweat, etc. Sure one can change, but unfortunately most EMS these days are too busy for one to just stop and change uniforms every three to four hours, as well I personally like my starched and pressed. The old white shirt with blue/black pants appears to be the norm. Personally, I like a nice polo type (again good type) shirt. I have seen tan or various colors, that appear very nice and still have a uniform appearance. Far as scrubs, it always appear someone is in their pajamas when working in the field. Sorry, scrubs are far misused even in the hospital setting. Professional standards have decreased when they started allowing med-surg and other areas to use scrubs as their normal uniforms. Now, everyone is using them. From housekeeping to maintenance to the transplant team. They appear to be slouchy, and very few ever have seen an iron. I can see busy areas in the hospital such as ER, CCU, etc. but nursery? So, no personally I think scrubs, especially in the out of hospital arena is poor. I don't even like seeing people in them in stores off duty.. etc. They are not definitely not heavy enough or durable enough, there is a company that designs scrubs in a flight suit pattern (tapered with pockets, and scissor/ink pen holder), that appears better. I agree, we need to get away from the "public safety" type uniform. Maybe, with time we can develop a professional standard type, that will reflect our job. R/r 911

I have done extensive research, thesis and lecture presentations on this topic. From all the research that I have encountered there is very little reason on not allowing the family to view. With that said, each case has to be evaluated carefully with having appropriate staff such as Chaplain, Social Worker, response to family psyche at the time, etc. Pre protocol and procedures should be well thought out prior to initiation of such programs. There are several well thought and studied programs that ED's can obtain through Emergency Nurses Association, American Association of Acute Care Nurses, Hospital Chaplaincy program, etc. One may think that increasing litigation could occur, in which actually quite the opposite has been proven. Families appear to see the efforts and trials that the staff has undertaken. The old saying "the unknown" is worse than the knowing. Studies have also demonstrated that they were able "to handle " the emotional effort as well, more than most rescuers presumed. Very few cases were documented were family became overwhelming distraught. The disadvantages was not having enough staff. Wounds or injuries that might be seen as grotesque, or injuries that may appear "bad" not to allow immediate family to view. Although, studies have also demonstrated that with recent television, movies, etc. most real wounds are far less dramatic than those many have seen in dramatization. The advantage is allowing some closure for the family and possibly the patient. There was an increased in proper procedures in medical care, as well as more increased professionally, and more awareness of staff participation. Very little negative results were found in perspective to those of the positive nature. I personally believe it is a case by case basis. Most families will request to stop the code faster, and I do believe accept the death faster. Also in my experience, they have appeared to appreciate the efforts make forth in treating their loved one. The only down fall is some staff feels insecure, and awkward.. which is more their problem, than the situation. Just a few References: Nurse Management; Springhouse 2004; 35(6) 20:Is Family Presence Practical During Resuscitation; Blair, P. et al. Emergency Medicine Australia 2004 15, 294-305: Family Presence During Resuscitation in the Emergency Department; An Australian Perspective: Redley, R., Bott, I, et.al Emergency Nurses Association; Family Viewing Resuscitation Measures; Program Guidelines and Procedures, 2005 ENA R/r 911

Up-date, as of 8/15/07 Ron still remained unresponsive with a CHI , and on a vent. Although we are hopeful, it appears grim. Ron had been a medic. instructor for several years, and lately started working in a trauma center. Our prayers and wishes are with him and his family. R/r 911

I am not worried, the U.S. Insurance companies will see to it that this idea will be canned. Sorry, they need to increase the age instead of lowering it. There are enough fatalities and injuries without increasing the number. Education is not going to work in this situation, everyone knows that driving and drinking do not mix, so it is not that they lack knowledge, it is rather they ignore it. R/r 911