JPINFV

Besides the lack of glitz and glamor, is there any reason why the state governments or the FAA doesn't mandate at least instrument flight rules (IFR) for aeromed, if not IFT and forward looking infrared (FLIR). I think that with the recent Mercy Air crash in Riverside, CA that it wouldn't be too hard to get an incitive started out here to require it.

There's a reason that fark.com has a tag.

Just another reason why Riverside needs to be destroyed. Riverside, the ghetto OC.

My understanding is, locally, if you dial 911 from a hospital location then you only get a police response. Apparently they've had this from a patient on the floors a few times when she wasn't happy with the hospital's care or the doctor's orders (last I heard, the rule was that she either needed to put up and follow her treatment plan or sign AMA and free up the bed).

Woo, wait a minute. Since when does the hospital decide when ALS is needed and not County in So Cal? I've told many a RN to essentially STFU (Generally more of a "If you are uncomfortable with me transporting 5-10 minutes without paramedics, why are you comfortable with me waiting 5-10 minutes on scene for them?") because "the patient needs a medic." As far as speed, it really depends on where you're at in So. Cal (example, freeways. Max speed limit is 65, traffic is going 75-80, CHP is passing you). Technically, the maximum speed law is on the long list of laws that emergency operators are excused from when transporting with a "forward facing burning red light." Sirens are supposed to be used as prudently needed (I went rounds with my FTO during driver training about sirens in the middle of a neigborhood and ended up having a nice little chat with my companies operations manager about this. My companies policy is an all or nothing, but with all things it depends on the situation/timing. Looking back, I should have just reached over and shut everything else off till we reached the main street).

Close, but the majority of ATP is produced in the Electron Transport Chain (32 ATP/glucose), not by the Krebs (2 GTP/glucose) or Glycolysis (net of 2) [note, ATP numbers are for each glucose that goes through aerobic respiration. Glucose only enters during Glycolysis]. That said, the majority of NADH and FADH2 which runs ETC is produced during Krebs. This is why, for example, you get a "false" SpO2 reading for patients suffering from cyanide poisoning. ETC is disrupted in the cell causing aerobic respiration to halt. While the Sp might really be 100%, the body just can't use the oxygen anymore.

When the SNF nurse says, "Patient very sick, you take patient now" and the really large O2 tank is by your patient's bed.

Isn't this how right turns are supposed to be made when driving lights and sirens for the explicit reason that people are supposed to be pulling to the right?

I'm not a doctor, but I play one on the computer.

First we would have to convice the world that what we do is removed enough from medicine that we don't have to be surpervised. My understanding (which might very well be wrong) is that the reason why podiatrists, dentists, and oral surgeons don't require MD/DO supervision is because, as a general rule, the MD/DO's don't want to do it in the first place. This will be kinda of hard when there is a medical specialty called "Emergency Medicine"

At least that makes the driver be proactive on not driving like an ass.

My father had the unpleasent experience of making mustard gas once while doing pool maintenance. In an effort to save time by only walking around the pool once, he mixed chlorine and acid together before he poured it into the water. Luckly he was outside when he did it and realized what he did before taking another breath.

20 minutes out, no ALS, patient in arrest? Most probably. You can't get much worst then dead. An apneic and pulseless patient that the AED is refusing to shock isn't going to get better. Assuming picture perfect CPR with combitube (arguments aside on the BLS use of rescue devices, let's give the patient the best chance possible), what do you think that patient's status is going to be 20 minutes later at the hospital?

I was interested in knowing the rhythm because if it was treatable by other methods, then I would try those first. True, I should have assumed PEA given the scenario. I would attempt the procedure because the worst that could happen would be the patient dies. If you do nothing, the patient dies, if you attempt but screw up, the patient dies. If you successfully evacuate the fluid, the patient might die, but you might end the conditions leading to the electromechanical dissociation.

Just wondering, what rhythm does the patient arrest into?

I've heard several uses for the term "code" that is always understood when in context of the conversation. "Transported code" = code 3 (L/S) Full/partial/no code = DNR status (Full code= no DNR) "Gave code" = When my company transports ER calls BLS, the crew calls in the information (age, sex, CC, PMD, ETA, other info as needed [DNR status, code 3, v/s, etc only if needed]. The radio code for this is "code 1." This normally gets shortened to just "code" when used in a proper sentence (i.e. "unit 75 transporting all zeros [trip odometer set to zero], code 1" would normally have the response from dispatch of "Unit 75, go with code"). [since we are a BLS company, if we have paramedics on board then they either contact a base hospital, if required, or the receiving hospital. In this case we just let dispatch know that we're transporting with medics and that they've made contact"] "The patient coded" means cardiac or respiratory arrest.

/me puts on grammar nazi hat. Your wrong Dust. It should be "It is licence [brit spelling, but what do they know about English?], not license." Adding the "a" makes the licence/se particularly about the NREMT certification. The problem is that NREMT hands out certifications, not licences.

Yes. I do not want people who have neither the capacity nor the inclination to educate themselves about the issue to vote, especially if they would rather not vote, but vote because they "have to.' Government elections should not be a high school popularity contest. People should vote for who they think would do better for the country.

Maybe in my young age I'm just being a tad nieve and ignorant (won't be the first time, to be honest), but aren't x-ray machines starting to get small enough so that you could probably set up a boom arm on a track in the ceiling of an ambulance? Done with the x-ray, secure the boom arm and slide the carriage forward out of the way? With ultrasound machines becoming smaller and the introduction of hand held blood testing machines (I-Stat, for example), we are starting to be able to take diagnostic tests to the patient instead of taking the patient to the tests. I don't think it would be too long (decades, sure, but that's short in the long run) till we see the "medical center in a glove" that they had on the TV show Earth 2. To be honest, I think economics might be a bigger problem. A healthcare provider in the ER sees several patients at the same time. A mobile fast track/urgent care center can only see 1 patient at a time. You lose the economy of scale that the ER has when you go 1 on 1 with the patient.

Care to elaborate?

I wounder if this would work better if ran though a hospital based program. If the ambulance is already leaving from the hospital then why not load it with a NP/PA/MD/DO and a EMT-P instead of 2 P's. You should still have the same response time, but more could be done on scene, including definitive treatment. If the patient needs to be admited or is more serious, then you still have a paramedic and a NP/PA/MD/DO on scene to treat and transport.

Do you really need a command structure on scene if all it is is you and your partner if you're both the same cert level? I've never had a "I'm in charge because I'm (the attendant, FTO, been here longer, different cert that's not recognized locally, in medic school, passed the didactic part of medic school but failed clinicals, etc) argument." Personally, I refuse to get into an argument on scene unless it is really FUBAR (ex: cancer patient looking like taking a turn for the worse, husband and daughter insist that they want nothing done for the patient and to take the patient to their PMD's hospital 40 min. away instead the hospital 2 minutes away. I'm 99% sure we can accept verbal requests to "withdraw or withhold resuscitation" [as it's worded in local protocol], she has no clue, especially if the husband is willing to ride with us to the hospital). You really can't get that FUBARed treatment wise as BLS though (BLS argument: 15 LPM O2, no 10, no 15, etc?)

There are some places that MRSA shouldn't visit.

Ask her if she'd help you demonstrate...