mobey

http://www.ctv.ca/servlet/ArticleNews/stor...0409?hub=Canada I was just trying to post the pics... but anyhoo :roll: this is what you roll up on. Forget the media story, this is scenarioland. (consider yourself on the 2nd car)

Great! in our area it is up to us to tell dispatch what we want. Police are now enroute (15 min responce) Mutual aide ALS ambulances x2 enroute approx 45 min away Heavy rescue 1.5 hrs away (local FD have power tools and are well versed in extrication) Helicopters will not fly due to weather School bus will respond asap. Note: Accident occured about 10min from town. This will be a small town hospital not to used to trauma and 3 General docs.

I would strip her and put a gown on her (If you carry gowns...we do). I am going to continue to observe the area of the bite, given I found one. I also would like to spend some time calming her maybe coached breathing would help. This may allow her to better localize the pain.

You are a BLS service with 2 full time ambulances, a third can be called in if enough staff are around to run it. On a very foggy day you are dispatched to a Cardiac arrest. You and your partner respond with a third EMT to a rural residence. On the way out you hear a call come over the radio for a 3 vehicle MVC on the highway about 3 miles behind you. Gravel truck vs SUV vs school bus with 15 total potential patients. Dispatch states there are at least 2 ejected, no other info. Fire has been dispatched You are about 7 min out from your code..... and 3 miles from the MVA (behind you). Ready, set, go.... (For those of you who know of this call, I will not be replicating the details for respect of the families involved. This is not a replay of the actual events, just a general overview with some omissions and additions)

Hey steve I am a Rural EMS-Addict (Hmm ...think I'll set that as my job) Anyhoo.. are you in AB? I work for a rural AB service that is going ALS very soon, maybe I can bounce some ideas off you in the future.

Hmmm.... So in following the earlier posts, your saying just throw on an NRB because everyone requiring an ambulance could use a "little" oxygen. In my experience throwing a mask with O2 whisling through it is hardly soothing. (Remember we are not talking cannulas here). Patients requiring an ambulance that do not benefit high flow O2: Isolated fracture of a limb Hyperventolation d/t anxiety Most abd pain headache I just don't feel well My car ran out of gas, and I need to get to town lower limb pain I can't pee I can't poo My hemorroids hurt worse today Anyone with SPO2 >90, Pink warm dry skin and RR < 30 & non-laboured

I dunno... I have a problem with all this pressure sore talk. I have heard all the mumbo jumbo about sores after 2 hours, and I am sure that holds true for little old ladies. But for the average adolesent/adult I have had very different experience. I worked for a very remote service with a transport time of about 2.5 hours down some terrible roads (max speed 80-90km/hr). My patients would be on a board for around 3 hours by the time we got a room and god knows how long after we left them. Ya they were definatly in discomfort/pain, but i never heard complaints of sores. I always wondered... would it be that detrimental to put like a 1/4 inch of foam on top of the board?

In that case I don't want to know what the guy under the table was doing :shock:

It would surprise me if this was not a dead guy. He dosent take a breath or twitch for 30 seconds, then even after the joke is over, he still continues to not breath or move... seems pretty dead to me.

This could be so many things, without a full assesment there is no way to give you any answers. as for the HTN at the time of the call, he may be non-compliant with meds. As for the agitation, it could be from < BGL, could be from anxiety, who knows. There is no way for you or us to guess what was going on. What about high bp makes you go with a NRB? Not saying it is wrong... just trying to follow your train of thought

The morning increase in thrombotic cardiovascular events has been attributed, in part, to the morning surge in platelet aggregability *excerpt from American College of Cardiology study in 1996* Thought it was interesting. Our most common call times are early morning SOB, & transfers, and evening chest pains and "I don't feel good"

I try keep my jump kit in my ambulance, i don't think it is big enough to fit the whole ambulance in

linked worked for me. Very funny BTW.

Did you read the original post??

Every day I get more and more pissed off with how much I don't know in the medical field. Saturday night palsy Suspention trauma Now this :roll: Thanks for the post firedoc

We often use the speed splints. I am not much into all the fancy splints we carry in our unit, but i always stabilize fractures when time permits with one of these.

But if the machine can interpret the rhythm, then why do we need to train the providers to do it? I wonder what the accuracy is on those machine diagnosis?

Just wondering how common NPA's are in other areas. I have never used one, never seen one used, and in fact we don't even carry them. I know when and how to use them. I am thinking they may be a thing of the past? Or maybe the underdog of airway management that should be used more often?

OK maybe jump kit is not a universal term, but I mean the standard kit you grab on your way into every call. I will list what we carry, but I am considering recommending some changes and wanted to get some ideas. 1st kit (carried into every call that is not dispatched unresponsive/unconcious) BP cuff & Stethoscope SPO2 monitor 2x nasal cannula, 2x NRB, BVM Med kit Glucose monitor Sharps container IV kit Manual suction 2nd kit (Only brought in to unCx unresponcive, or trauma) All items as above plus: OPA set Non-visualized airway set (king right now) Oxygen D tank And a whole lot of dressings I am thinking one all inclusive kit would be nice, makes my unit checks that much easier!

This action is not necessary. Part of being on public forums is knowing when to stop reading. I have been following this thread and I gotta say I do not see the hostility that you are seeing. I think you are mistaking terms like "counterproductive" for terms like "You are screwing up the thread". Personaly I would like to run your scenario especially if you have ECG's, you have alot to offer to us. I believe there has been alot taken out of context and we would be disapointed if you left due to a misunderstanding.

I agree tniuqs. i believe you can keep up on your knowledge or perhaps even advance it through working the rigs because you can keep your nose stuck in journals and books. But really for most in industry (present company excluded) how many do? Anyone I have talked to that worked industry before 911 for more than a year or two, all said the same thing. yes I agree I am being anecdotal (and I have seen MAST pants save a life :wink: ) but i can only run on my experience and feedback from others.

I have investigated it, and I think I will apply but... LLBiche is like 5 hours from me and Camrose is 1 hour. The courses look pretty much the same, and I have heard good about both.

This is not a personal attack It is sad how many good EMT's and Medics are wasting the good they have to offer on the rigs in AB. A friend of mine took her EMT, went straight to the rigs for about 3 yrs, came back out and had a hard time getting comfortable in a 911 service. She said it took over a full year before she was even remotly comfortable with patients. I work full time 4 on 4 off Have a stay at home wife, and 2 kids in school. I pay my rent and drive a newer Malibu. There is money outside the rigs, but you will have to work for it. Of course that is not as easy as sittin in an MTC, losing your core knowledgebase and skillset.

Well I consider myself and co-workers to be in the late 90's early 2000's, and no, I have never heard of it. I have taken 2 going on 3 university A&P courses (not degree) and feel I have a decent understanding of how absorption works. So it is my Opinion that the lack of vasculature combined with a thicker membrane would make absorption slower through the top of the tongue. Also since the nitro spray would have to "sit" on the top longer there would be a better chance of it being washed down the esophagus or inhaled. I work with veteran Paramedics, Newbie Paramedics, and students and have never seen this done. so my answer is no, this is not a standard practice and I don't think it would be a good idea to start.