Ridryder 911

The difference between experienced competent health care providers is we perform across the room assessment. From experience and education, I can surmise within 1-2 seconds, the condition my patient is in without stopping and assessing airway, checking for pulse, etc.. etc.. As well, one should be able to identify poor circulatory and hemodynamic compromised again immediately.. by looking at the patient when you first enter the room. Not actually having to perform each step by step. Of course we check for perfusion levels. I do not know the last time I did a head tilt and put my ear down to see if the patient was breathing, and personally I would look poor on someone whom is supposed to be experienced and knowledgeable doing it in the field. Hopefully, they would have experience enough to be able to detect respiratory movement , amount of Vt and perfusion, just by a quick assessment. If they don't they better have either be in training or new.. otherwise we will have a talk back at HQ. Can one imagine a physician assessing ABC's on each patient?....... I see Mr. Jone's you complain of oozing fluid from your urethra, but first I need to assess your ABC's...... As well, the MCI drill... not all patient's get ABC's... Sorry there are the mortally wounded and the walking wounded... If they have a fence post through their head or chest.. their dead or yellow prime (soon to be dead) in a large MCI.. and if they are up walking around.. they are green to go. So the question in the post is misleading and appears to be from inexperienced student, that is attempting to make textbook material as a functional step. Remember, like protocols they are to develop from and use as a reference. Medicine is just as much as an art as a science, that is why physicians practice at it. R/r 911 R/r 911

Ditto.... poor ventricular filling time. R/r 911

Wow! I just wasted 33 seconds of my life watching a third grade production of a so called film. Just when I thought ..."Saved "...television show was horrible and nothing could be any worse.. I just suggest the producer, film maker, actors, etc.. can this immediately! Surely, they don't want their reputation be based on this piece of feces. I would promote other EMS forums not to watch this film, but their trailer does a good enough job. R/r 911

It all depends. Does my patient have an obstructive disease process along with CHF. Detailed assessment along with the use of EtCo2 capnography will help determine this. As well is your med.'s going to be effective? Sometimes, obstructive problems can be relieved by an beta type bronchodilator, then treatment of CHF can be administered to shift the fluids. However; caution has to be sure of diuresising the obstructive respiratory patient. Atrovent with its anticholinergic properties can actually increase CHF problems. R/r 911 R/r 911

More proof positive that most Basics do not even know what they can or cannot do. Individual states may allow certain procedures such as combi, king or intubation, but not according to the National EMS and Basic EMT Curriculum. Other than those special skills that was mentioned, ARC Advanced First-Aid can do the same, even my Boy Scouts. So what is your point? I would be sure before defending one self, that I thoroughly knew my education, skill, and expectation levels before making such claims. It makes one look very foolish. The first part of Basic EMT training should be to know what the national standards and ability they can perform. Obviously, this too is another thing lacking in their education. R/r 911

I agree with others. They should never had received any resuscitation efforts to begin with. As noted the only survivors (3.5%) had severelyoutcomes.. Which means ? Brain dead.. TBI.. End Organ ?... As well, you have to compare their EMS and flight services. One of the pilots I used to work for had worked in EMS Italian Flight service. They utilize large aircraft, and the whole country is smaller than my state. Again, why fly a traumatic arrest other than for the study? Then again the whole study only had a little more than a 150 patients, in which only < half received ALS care. So the stat.'s can not be accounted as accurate without a large measure of being skewed. I believe the emphasis should be placed on more how to prevent resuscitation, than attempting to revive the traumatic dead. R/r 911

Never seen anything exactly like that, but it appears to have an S-tube with an extension tube? I guess they thought the vomit would exit through the shortest route? I have seen something similar with a BVM style face mask and corrugated vent type tubing to a mouth piece attached to do the same purpose. It did have a "filter" that would prevent emesis from going up the tube.... R/r 911

Too much old reruns of Quincy M.E. Hope no one will actually attempt this, and hopefully someone will report his instructor for being stupid. We will read from our friends, on how a battery exploded or burned someone. Then how will they know if they are in "fib"..? R/r 911

The 3 Lowest Life forms in order of significance and importance from left to right poop---->-----> protozoa------------>lowest form------>EMT student

I would had RSI as well, (traumatic patients needs a patent airway) and intubated if not able to intubate then alternative airway such as a Combitube..etc. If not able to perform this then surgical airway.. really no biggy. A Paramedic should be comfortable in performing these skills they are part of the job. As well, I do NOT recommend needle crich's as they are almost as harmful than helpful with retaining of C[sub:cabf2ce5ba]O[/sub:cabf2ce5ba]2 level and inability to ensure V[sub:cabf2ce5ba]t[/sub:cabf2ce5ba]. Yes, if and after the airway is managed I would attempted to obtain a XII lead, but most of the diagnostics I have seen and used for identifying a tamponade has been through physical assessment and MOI hx. Bruising over the pericardial area, and yes even decreased muffled heart tones can be obtained. We carry dopplers on each truck and they do assist in the ambient noise. Again, common sense should be used and really how long and difficult would a XII lead be able to obtain? As additional reasons for RSI is to < and maintain ICP, as it is essential to maintain the SPC[sub:cabf2ce5ba]O[/sub:cabf2ce5ba]2 < 30mm/hg. R/r 911

10% ethyl alcohol has been an alternative method of slowing the contractions on premature labor with other types of treatment, such as terbutaline drips...etc.

That large... wow! Now, I am curious... R/r 911

Alcohol drips have been used for O.B. patients for decades as well..... R/r 911

It's called an "S" tube, like a double ended OPA. They were used before pocket mask were invented. I used to carry one in my personal kit, decades ago; when I was a whacker... R/r 911

I would say "Greeter" at Wal-Mart, but most medics are not that friendly ... R/r 911

Thanks for the mention of the pic... I received a E-mail from one of the readers in here that turned out to be a medic married to one of my fellow classmates, in which I lost touch with almost 25 years ago. It turns out that he too is still in EMS and is operation manager in a very progressive EMS. Another one that has maintained in EMS. Congrat's again... FYI we have some potential openings.. i.m. me if you are interested. R/r 911

Now, that pic would be funny to see again. I have to admit, I was skinnier, had more hair and no gray. Ironically, even though that pic 24+ years old, as far as I know of, all of us are still in EMS in one form or another (ER Doc to ER P.A.C. to flight nurses, etc..). Something to say about the program and type of individuals that attend it. Congrat's Brock on a job well done! As many has referred to that your real learning will now start. You have a good foundation to start at and progress in your new career. I wish you all the best of luck and success! R/r 911

Wow! Post one and you get 4 ! Still bugs in the system.... R/r 911

Well, there we go again. Someone again is trying to compare something they yet have not even completed, yet assume they know what the "job" or knowledge base is. This would be like a nurse aide, CMA, etc.. comparing themselves to a RN. All because they have "some similar" descriptions in their role, this definitely does not mean they have the same knowledge. Just stating that "medics are medics, because of the drugs they push" just illustrated ignorance of the job, the role, and the education required. Again, you can't compare or even evaulate if you are not one. As well, I do not treat signs and symptoms, you might, but that is what first-aiders do. I perform differential diagnostic examinations, and by obtaining a detailed history and other tests, procedures, I make a field diagnosis. Then afterwards I adminster medical treatment. "Not just push med.'s" as I hope you don't do. Again, another example of too many alphabet letter EMT attempting to compare or justify themselves to the real thing... R/r 911

Well, there we go again. Someone again is trying to compare something they yet have not even completed, yet assume they know what the "job" or knowledge base is. This would be like a nurse aide, CMA, etc.. comparing themselves to a RN. All because they have "some similar" descriptions in their role, this definitely does not mean they have the same knowledge. Just stating that "medics are medics, because of the drugs they push" just illustrated ignorance of the job, the role, and the education required. Again, you can't compare or even evaulate if you are not one. As well, I do not treat signs and symptoms, you might, but that is what first-aiders do. I perform differential diagnostic examinations, and by obtaining a detailed history and other tests, procedures, I make a field diagnosis. Then afterwards I adminster medical treatment. "Not just push med.'s" as I hope you don't do. Again, another example of too many alphabet letter EMT attempting to compare or justify themselves to the real thing... R/r 911

Well, there we go again. Someone again is trying to compare something they yet have not even completed, yet assume they know what the "job" or knowledge base is. This would be like a nurse aide, CMA, etc.. comparing themselves to a RN. All because they have "some similar" descriptions in their role, this definitely does not mean they have the same knowledge. Just stating that "medics are medics, because of the drugs they push" just illustrated ignorance of the job, the role, and the education required. Again, you can't compare or even evaulate if you are not one. As well, I do not treat signs and symptoms, you might, but that is what first-aiders do. I perform differential diagnostic examinations, and by obtaining a detailed history and other tests, procedures, I make a field diagnosis. Then afterwards I adminster medical treatment. "Not just push med.'s" as I hope you don't do. Again, another example of too many alphabet letter EMT attempting to compare or justify themselves to the real thing... R/r 911

Well, there we go again. Someone again is trying to compare something they yet have not even completed, yet assume they know what the "job" or knowledge base is. This would be like a nurse aide, CMA, etc.. comparing themselves to a RN. All because they have "some similar" descriptions in their role, this definitely does not mean they have the same knowledge. Just stating that "medics are medics, because of the drugs they push" just illustrated ignorance of the job, the role, and the education required. Again, you can't compare or even evaulate if you are not one. As well, I do not treat signs and symptoms, you might, but that is what first-aiders do. I perform differential diagnostic examinations, and by obtaining a detailed history and other tests, procedures, I make a field diagnosis. Then afterwards I adminster medical treatment. "Not just push med.'s" as I hope you don't do. Again, another example of too many alphabet letter EMT attempting to compare or justify themselves to the real thing... R/r 911

Well, there we go again. Someone again is trying to compare something they yet have not even completed, yet assume they know what the "job" or knowledge base is. This would be like a nurse aide, CMA, etc.. comparing themselves to a RN. All because they have "some similar" descriptions in their role, this definitely does not mean they have the same knowledge. Just stating that "medics are medics, because of the drugs they push" just illustrated ignorance of the job, the role, and the education required. Again, you can't compare or even evaulate if you are not one. As well, I do not treat signs and symptoms, you might, but that is what first-aiders do. I perform differential diagnostic examinations, and by obtaining a detailed history and other tests, procedures, I make a field diagnosis. Then afterwards I adminster medical treatment. "Not just push med.'s" as I hope you don't do. Again, another example of too many alphabet letter EMT attempting to compare or justify themselves to the real thing... R/r 911

Again unfortunately, another posts initiated from someone who does not understand medicine or ethics. Three units of blood (PRBC's or whole?) is not that much. Hell, I have given 3-4 units to many "younger" patients that have a history of G.I. bleeds from alcohol abuse, or have cirrhosis of the liver, HIV, etc.. is this fair to others as well? It is a dangerous slippery slope, when we start basing treatment upon personal feelings than upon scientific data. Albeit, the scenario did describe poor outcome, so does mine, would you withhold on them as well? I checked the web site for my area and there is no increased shortage than normal. R/r 911