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We use needle port systems and despite doing some med administrations in pretty rough situations, I have yet to have needle stick. I think needleless systems are the way to go, but at the same time, I think we need to have some professional standards of not being a clutzy idiot.

As I've said before, the whole notion of having to "prove yourself" at an EMT-B or EMT-I level is utter bullshit. No one asks a nurse to prove themself at any level lower than their own. Some of us don't feel like spending 10 years of our life putting on band-aids before being allowed to move on. EMS needs to get over itself already.

Dust, you need to get out more. The porno shops were replaced by Disney outlet stores a long time ago. I'm not sure which is worse.

I think this classic 'Outland' strip by Berke Breathed says it all:

Windsong, did your know that in the new 2007 edition of the Merriam-Webster Collegiate Edition dictionary, the word "gullible" will no longer be listed?

Nasal cannulas, the things that go flying through the air while I say loudly "Why the f--- do w have so many nasal cannulas in the cabinet?"

Get a Ghostbusters shirt while you're there. Unfortunately, unlike the firefighters, the EMS crew will be outdoors hard at work, so a visit to an EMS station would be fairly pointless. Check out the bars on Bleecker street.

:shock: Do any of you know what would happen if I tried to buy alcohol (I'm well above age, BTW) while I had any part of my uniform showing? First of all, someone would probably have a camera, and then someone would call the complaint unit, and then I'd probably end up with my picture on the front page of the paper with some sensationalist headline that was only partially true. Ak, this goes beyond who's giving who private EKG lessons in the back of the ambulance, this is a matter of some serious offenses, if you don't want to say who it is, I am of the humble opinion that it is your duty as a public safety provider to take whatever steps necessary to make sure this behavior is alerted to the proper people. I sure hope it isn't who I'm thinking of.

Okay, so breaking people's ribs and hysterical wives just roll off your back, but taking tests and people saying less than supportive things to you on the internet get you bent out of shape. Well, I guess we all have our hang ups.

The article I read today said that basically short of Pataki intervening, these hospitals are goners. I know a lot of great EMT's and medics that run out of St. Claire's (St. Vincent's Midtown), its going to be really sad to see them go. The way I look at it FDNY is going to have to put some more units in service out of Stations 08 and 04. Cornell I'm sure will fight with Roosevelt to grab up everything north of 42nd Street on the west side. As for the rest, I really don't know what's going to happen, other than the areas that have insured people going to the voluntaries, the Medicaid areas will go to the municipals. The article I read also stated that Medicaid spending accounted for something like 41% of the state budget :shock: Next time someone hands me a medicaid card while talking on a cellphone that is more expensive than mine, I'm going to ask them to refund part of my taxes for the year.

I don't think its strange that the rescue company did not initiate transport prior to contacting telemetry. However, ideally, after spending 20 minutes on scene you should be on the horn with telemetry. Again, that is an ideal situation, and the day I run into a code that is going anywhere close to ideally, I'll be sure to let all of you know. Perhaps this woman was in a megacode situation and went through a bunch of different rhythms while they were on scene. Doctors tend to get annoyed when you call them up saying "Hi, I'm on scene with a 80 year old female in asystol...wait, wait, I mean a ventricular...nope, its ummm a PEA, wait, I mean..." Generally stabilizing the patient's rhythm is necessary before contacting telemetry, and if the patient goes through a couple of different rhythms, you gotta do what you gotta do. 40 minutes does seem excessive prior to telemetry contact, but who knows what happened on scene. Shit happens. Thats why we have EMS. In regards to transporting, say this question was on the legal/ethics portion of your EMT or Medic test. TRUE OR FALSE: It is ethically correct to take a family that has just suffered the loss of a loved one, give them false hope, endanger the crew and the family following you, possibly saddle them with unwieldy ER and ICU bills, and take a limited ALS resource out of service for not only transport but BBP decontamination to transport a non-viable cardiac arrest victim. A. True. B. False. (Hint: Not A)

FDNY EMSC is going to have to do some major tap dancing to figure this out, particularly in the Manhattan Midtown area. If Cabrini's and St. Vincent's Midtown go down, I believe that knocks something like 2 or 3 BLS and an equal or greater amount of ALS units out of the system. That is a gap of 27 EMT's and a similar number of medics that the department will have to fill. St. Vincent's Downtown isn't really in a position to step up to the plate due to the financial situation of CMC. I think my tours are going to get a lot busier.

Now THIS is funny:

Doing stupid things on duty is one thing. Doing stupid things while on duty while someone video tapes is another. Doing stupid things while on shift while someone video tapes with your patches and face are visible is another, and then uploading it onto Youtube is yet another. Letting off steam is fine with me. I've done some silly things while at work to relieve the tension, although I have another 20 bucks that says the worse calls these guys have is when someone's dialysis shunt pops off. But as its been said before, videotaping yourself with your identifiers visible just makes you look plain dumb. I do hope they lose their jobs, maybe the next one they'll find they'll take employment a little more seriously. What's worse is the replies by the other viewers. Dust, Rid, if I don't see some good comments on Youtube about this video, I'm gonna be really disappointed. They say they did this in 2004 in Western Ma. I think its time AMR corporate headquarters got an e-mail telling them what type of image their employees are sending about their company.

I agree with everything that has been said above, although I'm still not sure what a 'mall ninja' is, but it sounds really funny. I'm not sure who ever came up with the idea of tactical medicine, but I have a feeling they had a subscription to Guns and Ammo. If you're really interested in care under fire (an attraction I've just never understood), the Army or Marines would be over joyed to have you, plus you get to shoot back and not get in trouble. Otherwise, concentrate on being in good physical condition and knowing your stuff. Most of these tactical places will pretty much rip you off and send you home with a nice tee shirt and maybe some knowledge that if you ever used would land you in jail with a felony charge. Our EMT's (and us medics too, to a lesser extent), are expected to do stand bys at high risk warrant executions and go in if someone done gets capped. They have no specialized training, nor are any of them armed (or at least they SHOULDN'T be), but to my knowledge no EMS provider has to date gotten done in on one of these operations. I like to think its because the professional law enforcement officers are doing there job while we do ours and everybody goes home safe.

I have a 20 that says she wasn't really choking. Any takers?

Jolly, you're not confusing endotracheal intubation with a combitube are you? I really have never in my life heard of anyone doing a "blind" intubation, or it being taught. Nasal, retrograde, even digital, sure, but blind I have never heard of. Fill me in here. I checked at the state of Vermont's EMS website, I found the usual skills under the EMT-B portion.

I'm not in Alabama!

Okay, now, I think that is just a silly policy. If its 3 a.m. and there's no traffic on the road, I'd like my lights to be on, but having the sirens on is just silly.

If I had my way, every person in the United States of America and the world would have access to 24/7 coverage of ambulances staffed by two paramedics. The arguement against this is that very few calls require ALS intervention. My answer to that is that while that may be true, patients do not lay along the lines of ALS or BLS. Patients are patients and should be treated by appropriately trained and educated providers. Not only that, but I believe there are some calls that are traditionally thought of as needing only BLS could benefit from ALS. My best example of this is a non-critical extremity injury. Just because having your leg broken in a few places won't kill you, doesn't mean you won't benefit from some ALS pain management. In an ideal world, the people on the ambulance would be well trained and educated professional specialists in their field, able to recognize and treat life threatening illness and injury, as well as being able to handle non-critical patients with appropriate management. A good paramedic should be able to switch roles and perform what ever task is necessary to aide the patient.

The police aren't going to be held responsible if your response is delayed., and your company will hang you out to dry if it comes down on you. Go with your local ordinances when it comes to responding to calls. If the police or your company have a problem with that, refer them to the appropriate codes. Until there is a specific law stating emergency ambulances shall not use warning devices on freeways, do what you have to to get to your call, because that is what it is going to come down to in court.

If your medic program qualifies as full-time or even part time, you should try applying for FAFSA, or Federal Student Loans through your school. You may even be able to get a subsidized student loan which has little to no interest on them. In the mean time, try to polish those skills that we all promptly forget after graduating high school, spelling, grammar, basic math skills, if you maintain or improve those you will be lightyears ahead of many students. Good luck and congratulations on your mature and well thought out approach to your career. I wish you the best.

Oops, I mean 2007 of course. Friends don't let friends Drink and Post. The new protocols do seem a lot easier to implement, all though I'll now have the extra challenge of getting the stubborn old timers to do BLS for 8 minutes rather than reaching for the med bag, and convince the firefighters to actually touch the patient rather than play with the beepy toys.

A 75 year old male with little medical history who is in a dangerous heart rhythm who says he feels "Fine."