tskstorm

No I have not had the pleasure. My partners are pretty steady, rarely bang out, mostly mutual.

So the crew could have been smelling ketones and they went ahead and gave d50 to a pt who was A+O X 3 ? Nope can't think of a single reason to bash anyone. ******** Next everything that was said was said as a generalized post, not to any specific crew or crews. Everything that was stated was dead on. You certainly seem to be getting very defensive considering you were not on the call. After years of not having glucometers, we got them last week, I know huge breakthrough there so my use with them is limited. So even if I was concerned about a failed reading/misreading I'm confident in seeing the 'whole picture' and treating accordingly. Had the patient been having an MI yes it could have had a poor outcome if you pushed the D50, however my question is, what was the outcome of this patient? Did they have an MI or were they just drunk or what?

Probably. I'm a metrocare/transcare person myself. So I got my chance to work 9-1-1 after 6 months of transport bullsh!t and started 9-1-1 as a medic before my cards arrived in the mail!

If you're going to be a career EMT in NYC do it. If you have aspiration to further your education do not do it.

He will give him a few hours. haha

Depends what you want from your EMS career. If this is a temporary job for you, and not a 25 year career, I would search for other opportunities. That's my opinion there are no "right" answers to this. If you want a better and more explained opinion, please tell me what you are looking for in your career and where you are in your career currently. ***Side note FDNY EMS will check your internet activities. I would suggest using proper spelling, grammar, and punctuation. Not to mention people from the board can and will crucify you for this.

I have the basic arrhythmia's book, brady, by Gail Walraven. Only like a chapter and a half written in it. 50$ plus whatever shipping is. from 11377 I paid $80 last year oh P.S. I have the flashcards, however they are not attached to the book.

BSI? PPE? Forget that! My only study tip is to find a local EMT/Paramedic and ask them to help you, they know the in's and out's of your local system, and the things the local test push!

Anyone got their shirts yet? I'm still waiting

He must want to wear bunker gear/turn out gear to every job .. which does insulate, and does keep you protected from BBP.

Dust, if you have any other suggestions on what should be added in a letter of this type I would love to hear it. I don't even know exactly how to say what I want. I just know, I have had an onslaught of students who want to(yes in this order): 1. walk in room, 2. apply monitor 3. start IV 4. obtain chief complaint 5.meds 6. leave scene. No BLS, no compassion, no empathy, etc... I get tired of having to tell students to stop doing what they're doing and having to take over and put them in the 'backseat.' I kind of want the letter to motivate them and remind them to do everything from the top, and to not develop bad habits. Along with knowing I don't want to hood wink them just for them to do what I know they are capable of and should be doing.

Very interesting tool here. I can't wait to hear, the conversation that comes from this.

My partner and I (double medic truck) Have recently had a new student on our truck every shift. We find ourselves repeating the same thing so we have decided to write a letter of expectations of students, that we can just leave in our ambulance and all students can see. I remembered reading that letter, and thought it would be a good start to my letter of expectations. I want to convey I'm not trying to jerk them around I just expect certain things that will make the shift go smoothly and lead to the most learning. Once again thank you for pointing me in the right direction, that was all I needed.

Thats the ticket, that was all I needed to find it. Thank you. http://medicscribe.com/2007/03/letter-to-a-new-preceptee/

I remember reading somewhere a letter from a preceptor to a student basically giving the student a list of expectations, I believe the first thing was to introduce yourself to your patient, anyone familiar with what I'm talking about ? Searched all the precepting and preceptor threads I could find, no luck. I would love to get a hold of this. Thanks

WoW okay thanks.

I'm actually looking for information about being an NREMT-P and going to Canada specifically Montreal ...

Oh and P.S. I beleive they want to add to the amount of CME's required within those years... but not certain.

Dust I must say I learn more from doing CME's then a "challenge refresher" where I take an exam, do all he state skills then just show up for the state exam ... CME's are not required if you take a refresher, and you can challenge almost any refresher around here. So where do we learn more? in proving I can still long board a patient and start an IV or sit down with a doctor and do case review ?

We do not have gucometers on our trucks, so checking the bgl is out of question. As far as the fluids go, we have no protocol dose for fluids, there are maximums for certain type of patients but the lowest maximum is 500cc for cardiogenic shock, after that the lowest is 2L ... Our protocols leave a lot of room for fluid interpretation, but the best answer I would give that medical director was I was titrating the fluids to maintain a b/p of xxx/xxx or to just maintain the blood pressure where it is.

The initial suspension had to do with the "look" of things. They wont be suspended indefinitely because of the rules and regs of FDNY EMS (read union) My initial reaction to this incident and my current feelings remain the same there is not enough information to make a final decisions on the matter. They made mistakes no doubt, did they cause, or 'not help prevent' the death of this young woman one may never know. FDNY recorded lines routinely take weeks to get a hold of, as a contracted unit of FDNY EMS when we are accused of saying something inappropriate to dispatch or of not taking calls on purpose to go home on time, our supervisors ask for the tapes. Usually we get these tapes in 1-2 weeks if FDNY is right 3-4 weeks if we were right and FDNY was wrong. A land line to Dispatch is still recorded UNLESS the duo in the store did not call an official number that being the dispatch boards number, or through the 9-1-1 system, but rather a non-recorded line or maybe even the dispatchers cell phone. If the call was dispatched as a Diff Breather That is a priority 2 call in our system (Lights and sirens only jobs with higher priorities are cardiac/resp arrest and choke" The BLS was assigned not as the primary unit but to back up the ALS unit. As the ALS unit was greater then 10 min away, and the BLS had a closer ETA (based on computer estimates) Also just to clarify, the computer recognizes the BLS as the closest available BLS it does not give us the ability to say their ETA was less then 10 min. All this being said my point here, is this was a high priority dispatched job as close to the top as it comes without being an arrest, the pair should have known better to leave and to at least attempt to portray that they cared until a unit arrived. *****Side note***** the LICH (Long island college hospital) crew was said to have left(forgotten but I read left as I've seen it done too often) their AED in the truck, who is to say that the time it took them to go back retrieve and apply the AED didn't turn her rhythm from V-fib/ V-tach to pea/asystole etc... Their were multiple screw ups on this job. We haven't even the slightest information on the ALS care rendered either. How many intubation attempts on an already hypoxic patient? was the code run perfectly (all too often its not even close, and in an evolving world rarely can it be.) Any problems in route we are unaware of, tube displacement? meds given inappropriately, telemetry/OLMC orders? Was she ever pulsed again after ALS/BLS arrival. If you want to go back before that why didn't the patient have a MDI with her to self treat her asthma? It seems I could ask endless what-if questions, nothing changes a woman and her unborn child died and that's a tragedy. I just can't completely fault the morons who did nothing as the cause of her demise. A contributing factor sure, but they aren't the only possible cause.

lol ... news robot beat me .. boo

no one with an opinion on this ?

Sounds good