JPINFV

I'll bite, so to speak. Equipment that I think we should have: AEDs good map books [some of my [soon to be ex] company's map books date back to 2005. These are maps that are on units run 12 hours a day, 7 days a week. They get abused and are, in some cases numerous, missing pages. Jump bags Training: more than 1 formal CE event every 6 months [normally it's an "EVO" course and a MCI drill] on rotating days [i.e. not ALWAYS on Saturday] professional EVOC course [i.e. not having an FTO teaching people how to use the siren when he doesn't have any idea how it works and having another FTO drive a car though a simulated intersection that ends up with the ambulance and car going in circles around each other]. Actual drills with our WMD suits that were supplied by the county [basically they're escape suits, nothing special, but the people trying them on took about 10 minutes to put the entire thing on.] Other: Maintaining and repairing units. When a unit hasn't had a working AM/FM radio in 2 years, there's a problem. When the primary/secondary emergency light switch is backwards [intersection lights don't come on when put to primary], there's a problem. When the communications radio DOESN'T work at all, there's a problem, yet these units still go out. The "hire anyone with a pulse and a cert, pulse optional" choice with FTOs that don't really do any training, and sprinkled with crew chiefs who's attitudes are "do what ever causes the least amount of trouble with the nursing homes" then the company WILL get a bad rep. You, as an employee, are a representative of that company, and people will use they're previous dealings with the company's employees to prejudge you. 1. I would probably move on because where I want to be [at least regionally], doesn't involve working with any single company, but with the EMS system as a whole. The EMS system in California is controlled by each county individually [i.e. one protocol/level/scope for the entire county, regardless of the company]. 2. The abuse and indignity [yes, working in a POS unit that's normally understocked and dirty for a company that doesn't care about it's employees past their ability to make money] is simply not worth it. I think it speaks volumes when the waterpark I work at seasonally takes better care of its employees and guests than the ambulance company does of its employees and patients.

Apparently they don't teach nor expect a moderate ability to write either. As said countless times before, but since you're new still needs to be repeated, you will be judged on your grammar ability. This isn't to say that we expect college term paper quality work, but for the love of all that is good and holy, please use complex sentences, commas, and apostrophes. There's no sense in wasting time posting a message if your ideas get lost in a terrible signal to noise ratio.

Just wondering, was the patient a known psych patient? Psych patients play by different rules.

Only time I wear it around my neck is when I'm in the ambulance or going to an emergency call. Never anytime else, including walking into the receiving facility.

At this point they are mostly looking at "Why does it seem that a large number of people with psychiatric disorders smoke?" then doing drug trials.

While this might not help you in and of itself, it is useful information to know. While stress increases memory of a specific event ("flashbulb" memory effect), it also decreases memory recall during the stressful event. Is cards your weak subject, and hence more stressful then the others? Did you feel more stressful going into it since it was the last test of a long day?

Milk run dialysis? Hah. Apparently he didn't get any private emergency calls that should have been a 911 call during field training.

Just wondering, can you be a little more specific than "Southern California." That's a large area with big differences between how each county runs the local EMS.

Better flat than sharp.

I think it's understandable that BLS units transport l/s more often. Simply put, a life threatening emergency that can either be ruled out or fixed by a paramedic can not always be ruled out by a basic. Hence seeking the nearest ALS, which includes the local ER. Of course, this is also a perfect argument for having ALS on scene for any call going to an emergency room.

Just wondering, does this depend solely on time of day, or the menu at the destination? yes, I get the sarcasm.

1. That's Hebrew National hotdogs. 2. While I can't comment directly on the ambulance company, Hebrew National does make some pretty good hot dogs.

Wah. :roll: My company had an ambulance ticketed at the local university hospital a few months ago (I saw it as I was going to my research group). Maybe the hospital hates private companies. OR The ambulance was parked in a stupid area illegally after the hospital has sent out a poster sized map of the facility showing exactly where we are supposed to park and he wasn't parked in one of the spots. So, was this case an example of discrimination or a stupid ambulance driver?

Let me ask you a question. Which arm (the one with the suspected fracture or the one without) do you think has better perfusion?

I would like to clarify something in my last response. That was never meant to condone driving like an idiot or an asshole. That said, there is a difference between, for example, taking an extended time to accelerate (thereby sacrificing time for less g-forces on the patient and attendant), driving normally, and alternating between full accelerator and full brake to minimize transport/response time. The last can never be condoned. The distinction I was trying to make is between the first two styles of driving. As a side note, Orange County has time tables for code 3 (l/s) and code 2 (normal) responses for emergency calls. Those times have to be met 90% of the time.

Slight problem there sparky (I'm gonna start using terms like sparky, sport, etc when people bring out the tired old cliches like "BLS before ALS," "treat the patient, not the monitor," "you lose 1 BLS skill for every ALS skill you learn [wow, doctors must be screwed by this one]," etc). Why would the hemoglobin be any less saturated? Sure, you might have less RBCs passing the Fx due to decreased perfusion (along with things like changes in color, decreased sensation, decreased pulse, increased cap refill time), but that wouldn't change the percent of HGB bound with oxygen. 2. Cliche time: Sure, you don't just act like a monkey and go, "OMG the pulse ox is reading 50, TRANSPORT CODE 3, TRANSPORT CODE 3!" You use it as tool to help determine the patient's status, the needed interventions, and how well those interventions are working. I guess, after all, if a 12 lead is indicating an acute MI (human interpretation, not the machine's), but the patient doesn't have chest pain, then there isn't an MI? After all, we should fear machines more than inadequate providers that gives rise to such cliches. 2.a. That said, basics do save paramedics. [spoil:46d2e19d7b]from doing manual labor[/spoil:46d2e19d7b]

I think one thing to remember is that there is a difference between responding to a call and transporting. When your responding you only have to balance speed against safety. On the other hand, transporting requires balancing speed with smoothness (especially breaking and accelerating) as well as safety.

Oh, come on Anthony, being in So. Cal. you should know well enough that should/shouldn't and does/doesn't are two different questions. If everyone did what they should than there wouldn't be the term "California Stop" and the average freeway speed outside of rush hour would be 65, not 80.

Wow. 1. You get a sheet for every transport? We get a page saying, "run #, pick up time, call type [emergency, immediate non-emergent, ALS [CCT calls], Scheduled return, dialysis, hospital discharge] location of patient, destination, reason/CC/additional info." 2. Directions? If you don't know where the place is, dispatch will provide an address and you use your Thomas guide to route yourself. 3. Psych issues are a medical issue. Sorry peeps, I know this a rather unpopular view, but psych patients belong more in an ambulance than in a police car. There's a reason that, unless you commit a crime, in-patient psych wards are found at hospitals, not jails. Unless, of course, police officers are more of a medical professional when dealing with psych patients than EMTs (B or P). Granted, unless the patient is on a hold, hold eligible (danger to self, danger to others, grave disability), or a conservatorship, then a taxi could have/should have been used

Any of those medications new? theory: Based on the labs, it looks like her kidneys are shot. Either she isn't on dialysis or maybe she hasn't been going to dialysis like she normally could due to her stomach problems. Over that time, the concentration of the drugs in her system have built up and are causing the symptoms seen now.

Meh, last time I drove L/S I didn't come remotely close to the speed limit. Too many stop lights in the area

http://ajp.psychiatryonline.org/cgi/content/full/155/11/1490 http://www.ps.psychiatryonline.org/cgi/con...ract/50/10/1346 This, of course, ignores the suggestion (i.e. not really a strong association yet, but it really hasn't been examined in detail either) that nicotine is helpful for people suffering from schizophrenia (and possibly bipolar disorder since it also affects sensory gating).

Not nearly as bad as wearing a sweatshirt for a college you didn't go to or claiming that you graduated from UCLA because you took your EMT-Basic course there.

Not all of our vent patients have drips. A lot of them are either going to or coming from a sub-acute center or the aforementioned vent patient on home care. If the patient does have a drip, then an RN would be with the transport along with the RT.

I've never seen my company's RTs push meds or titrate, but that doesn't necessarily mean they don't. The vast majority of vent transports that I've been party too have been either discharges or transports unrelated to the need for the vent. I know that the RTs do not carry any IV meds and the RNs do not normally stock narcs or benzos (they can pick them up from the transporting hospital if need be, for example seizure patients). My company provides backup 911 services to a few cities, but paramedics in the county are solely with the local fire departments. If the fire department doesn't transport themselves, then a local ambulance company is contracted to provide a BLS ambulance that the fire medics use to transport.