akflightmedic

My business is anything to do with these forums. My business is to promote EMS as a profession and raise the bar so that we get the recognition we deserve. My business is to sometimes defend some people on this site when egotistical, arrogant, cocky individuals get all high and mighty and spew BS upon them. My business is to post anytime I feel like it. So to address your statement, I think I did stick to my business.

You just validated my statements with regards to the KTD. In 17 years you have used a traction splint 3 times... why waste the space and cost on something used so infrequently, plus you state Hare provides best traction and most comfort for the patient. How did you come to this conclusion? Did the pt tell you so cause they have broken their femurs befoe and had different types applied and actually know the difference or is this antecdotal biased information? By your own own admission, you have never used the KTD, yet you can speak negatively of it. KTD works as effectiely as the har and is easy and compact. No I am not a salesman, just believe in makig and keeping some things simple, especially on a skill we hardly ever use.

Yes people, Paragods do exist!! Do not test your resolve...interesting. I like how you imply no one here is up to your standards because they have not been a medic for 17 years nor deployed to several different countries. Interesting how you think time in grade equals good paramedic. That doesn't mean shit. Show me how good a medic you are by telling me the education you have (not training), tell me what you have done on a national or even local level to further EMS education, tell me about how you educate your students...these are all rhetorical questions because I really am not that interested in you, I just want to show everyone what makes a good medic. Being able to pop a sternal IO, insert a chest tube or hang some blood in "austere" environments does not mean didley. There are several of us who have been there, done that yet we are not bragging or stating that no one here is at our level. If we are so beneath you, go find a level playing field for yourself. Show me how good of a medic you are by posting and educating in a professional way. Stop these antagonistic, off the cuff remarks that you notoriously deliver on a regular basis. Short, condescending remarks are a sign of inferiority. When one lacks intelligence or knowledge in a certain area, they constantly attack to keep everyone off balance to cover up for their shortcomings. As for the topic at hand, there is a need for doctors in the field in certain situations. One case in particular I had was a man that had his arm captured between two rolling presses at a newspaper plant. We could not free him no matter what as he was involved almost up to his shoulder. The mechanics could not remove the rolls due to their weight. Well, gues who showed up? A surgical team from the local trauma center. They did a field amputation right there and then we transported. It was truly amazing. The attitude of us versus them is the wrong one to have.

Well, the questions you ask are exactly what you should ask your preceptor at the beginning of each ride time. Ask them how they want you to procede. When I precept, I let the student run the show as long as they are displaying confidence and competence. I am ready to intervene on a second's notice if they start drowning. Something else to consider, is I used to use a code word if you will, that the student could utter at any time. If they said it, I would step in until they regained their composure, thought process, whatever and was able to take back over the management of the call. By having a predetermined word, it eliminated and alleviated the patients concerns about having a student work on them in the first place. This made for a very seamless transition that a lot of pts never caught onto. It is much better than the student turning to you with that stupid ass look and saying help or I dont know. It allows the student to save face and be able to rebound quicker, especially in the confidence department. There is nothing worse or demeaning as a student than screwing up early on in the call and then hanging your head low, defeated for the remainder of the call or the shift depending on how bad you screwed up. I need to stop all this explaining, I am beginning to sound like a softie...lol.

Good advice so far. Forget about this one please. You are a student. I would never, ever allow or accept this. Could get pretty expensive if you add up all your ride times. You are not expected to do this and no one would ever hold this against you. Now if you are a new hire, it is a different situation. If you want to be nice and bring in something home baked or doughnuts or something, fine but do not do this every ride along and do not spend money you may not have. We have jobs, you do not (in EMS anyways).

Great refresher! I feel smarter now. Thanks Dusty!

Ok Dust, educate me. Yes I am well aware of the anatomy of the airway. However, it has been my personal experience on many occasions in different scenarios to increase a mouth breather's O2 saturation levels by placing a simple face mask or lowering the nasal cannula to where it blows in the mouth. From my years of working the floor in PCU, I have been around many geriatric pts that have the permanent "O" look when sleeping. When this occurs, their sats would drop into the low/mid 80's, I would let them sleep and simply adjust the nasal cannula so the stream would blow into their mouth. Immediately their sats would come up. This is where my question lies. Applying this same logic to a CHF'er who is heavy mouth breathing, gasping, how is it possible they would recieve plenty of O2 from a nasal cannula? I ask this with all sincerity. Make it rationale for me.

I highly recommend the KTD. Pros: 1. It is cost efficient. 2. It is compact/lightweight. Takes up about 12 inches by 6 inches by 4 inches when it is stowed away. 3. Very easy to use and just as effective as the others. 4. Easy to be trained on and the color coding makes it idiot proof. 5. One size fits all. 6. Setup time is a few seconds, application in under a minute. Think about how often you actually use a traction splint. Do you want a device that takes up space, costs more and requires 2 different sizes so you can treat all age groups...or do you want one stop shopping? Cons: You can not splint both legs like a sager, but again how often is this needed. Other than that, I really do not have too much negativity about the KTD. I have carried it for 4 years and used it 3 times. Loved it!

I agree Dust. Sounds like the lady was in CHF and the idea was to turn a NC up to 10L, when we all know people in CHF are not breathing through their nose, they are huffing through their mouths. Now I have to ask, who made the call for the EMS crew? DId they relay all pertinent information or just say we have a resident that needs transport? Was the crew 911 or interfacility truck? Not condoning their behavior as I go nowhere without my O2, that was irresponsible but their could be many factors that have led up to this behavior. And yes I agree with you Teri, you said some are inefficient...I say a lot are inefficient but I am just looking at this from the angle of what caused them to act this way. History of BS calls from this home, inadequate training in that service, a whole myriad of things could have caused this. But since you are ranting on it this time and not all the time I am assuming this is a fairly isolated incident in your area. Maybe the crews just had a bad day and forgot and instead of being honest about it they thought the lame excuse of "her sats are up" was better to say. I dont know, but as with everything...there are always many different angles to consider for every situation.

I have several clips of my own that I use when teaching I can not upload them now due to technical difficulties, however an unrestrained passenger absolutely poses a greater risk to himself and to his fellow passengers. I have an excellent video of crash dummies in a rollover. The restrained driver stays in place and probably would live, however the unrestrained passenger is all over the place including striking the driver several times with enough force to cause signifcant injury to the driver before being ejected himself. As a driver of any vehicle, I do not move until everyone is buckled. The only choice provideed/allowed is buckle or or find another ride. This is not for THEIR safety, it is for MINE and the passengers that have no problem buckling.

Cool your jets. Ruth, you asked a question and he answered it. He told you exactly where to go find the information you are looking for. A smart ass wouldnt be helpful. In the same statement of him answering your question, he also informed you in case you were not aware that these are not that new. You said that bit of information was not helpful, I do not see how as the AHA website is the "go to" place for anything new concerning AHA material. You can also order to your hearts content from there.

As for the actual cost of a flight...Good Luck! Walk up to any car dealer and ask him what is the bottom dollar they will take for a vehicle, think you will get a response? You will not find actual quoted prices as the flight industry is highly competitive. No one wants to post prices for many reasons...competition for one and people being afraid to call or utilize it due to the cost second. Several services I have worked for will even negotiate prices. This usually occurs on long distance transfers, but insurance companies will call several different companies shopping for the best deal. As for the unmanned Israeli drone, I could only find the info that I originally cut and pasted. You just will have to do more research on your own. Hope it helps. http://www.emtcity.com/phpBB2/viewtopic.ph...ighlight=#82897

The typical cost for a life flight varies as to how far they had to go, what procedures were done, etc. However the average cost is in the 10K-20K range. What is UAV? Are you referring to an unmanned life flight response? If so, search this forum as I have already started a thread in regards to this very device. Our Israeli friends already have such a device and are field testing it now to hopefully have it implemented with a year or two.

No insult taken. Its a professional forum, we can disagree and argue points without taking offense. If you said the same as I, I apologize. SOmetimes the way you word things leaves me at a loss of what you truly mean. Sorry, my Irish translating/understanding skills wore off when we left a couple hundred years ago...lol.

Sorry Jmac, have to respectfully disagree with you. Yes, when in doubt you should fall back on your basics, such as airway and that is what he did, however he fell back on it why???Because he was responding to a set of numbers that were taught to him. His pt fell out of the range and he thought something needed to be done. Do you have something against teaching or trying to instill critical thinking skills in an EMT. This is why I presented him with so many options and scenarios, not so that he may learn them and then try to treat them(which is out of his scope) but merely to show him there are many different reasons for why his pt responded the way he did. I also wanted him to realize he need not react or over react just because numbers don't match what he was taught. A very wise EMT once told me, "Yes we read the textbook and know how the pts is supposed to react, but did the pt read the same textbook?"

My first year, I had all kinds of gadgets. For about the past 10 years I have survived just fine with the following: 1. I always carry shears with me. I carry them shoved in my boot or in my belt behind my back. 2. I always...ALWAYS carry 2 pairs of gloves on me. 3. I bring my stethoscope to work but it stays in the rig, I don't wear it. I have one in the bag if I ever forget mine. 4. I have a maglite that I keep in the rig. Doubles for my penlight at night or a self defense weapon. 5. BREATHMINTS!! 6. Photocopy of my certs (leave the originals at home) driver's license and a check card. Anything else is junk! If you are with a paid provider, all the things you need should be in your bags.

I think she is hot!!!! I think I had a moment, but then again I have been isolated for a bit out of the country so maybe that has something to do with it.

ok ok I digress You win

Taken from your link....LOL Smart-Ass lurkers The "smart-ass lurker" is a person who watches a discussion take place, only to intervene with a derisive comment or "gotcha" gag-link that sends up the active participants (from a smug, detached position).

I like badge bunnies and as Richard Gere said in the movie "An Officer and A Gentleman" I GOT NOWHERE ELSE TO GO!!!!

I did not say hiding...I said lurking.... Lurking means in the eaves waiting to pounce at first chance..... You just proved my point. I think you have an alarm on this site, anytime your name is mentioned, you post within 2 minutes, pounce all over it, because you are lurking..awaiting..striking with stealth I have never seen someone retort so fast, again and again at odd times of day or night... Does Michael ever sleep?? Or is he forever lurking?

****On a serious note***** Logistics and pre planning You said this maze is expected to take 2 hours to get through so it sounds as if there are lots of twists and turns, in addition to being very dark. What emergency lighting systems are in place? Do you have a good map of the maze? Go to the farthest point of the maze and determine what routes you would take to egress. Should there be an emergency, make sure you have the adequate resources to carry the pt out. DO you have a stokes? Do you have reliable help? Do you have access to a loudspeaker system to halt all activity in case of an emergency? Other things to watch out for are: Freddy Jason ....and the most dangerous one (he lurks here as well) MICHAEL

Ok I feel better now. I did my own homework because I just could not believe any state would have such a requirement. I went to this list of nursing schools in IL and after clicking on many different ones, I have come to the conclusion that you are severly misinformed. None of the ones I saw had CNA listed as a pre requisite for admission... http://www.nursingprogramsonline.com/nursi...ls/illinois.htm ignore the "online" in the llink, this list is of traditional schools