NREMT-Basic

Angio is only an abbrviation and a prefix...when combined with something like gram or plasty or cathether it becomes medical terminology. I spent a year taking med terminology. I think emts should have at least a few weeks of it.

In fact, in my home state of IL, an EMS employee, private or public, has the AUTHORITY under the IL Compiled Statutes to order bystanders, media and lookie lous of the scene and to have them arrested if they do not comply. I have said it once and I will say it again...Dust- You do know alot...You dont know it all. Dust off your imagination and realize that there is a whole big world out here that you have never even scene let alone know the rules of. Tonight when you go to bed, just quietly say to yourself..."Sometimes I am wrong." Then go vomit if you have to.

A pt on a long board for two hours with no care is not just cruel, it borders on if not wades completely into negligence and or abandonment.

If your protocol allows for it, why would you not have requested 2.5mg of IM MS to take the edge off, even if you were only a couple minutes out. This would have eased the pain and also gotten around the pt being a hard stick. Pain management is on of the biggest problems we face in the field it seems to me. I have run with many medics who seem not to care. I am a Basic/D but it seems to me that if a patient were reporting UPS of 8/10 with a midshaft long bone fx and it was in my scope to offer relief, I most certainly would have done it, if we were 30 seconds from the door. We have to learn to look at pain in a much different way in our culture: it affects healing, patient compliance, patients ms....you had the MS that could have been given IM by the sounds of it...just curious why you didnt. I would have if it had been in my scope. Look forward to your response.

While I understand that you could be hard-pressed to stop benzo withdrawal seizures in the field, thought it sounds counter-intuitive, would not a small loading dose of ativan do it. Yes I know it is another benzo, but if you worry is stopping the seizure, this seems like a way to do it. And actually, according to the National Poison Control Center, Benzo overdose is a significant factor in either intentional or accidental overdose related death. But then, as I am told so often, I am only a Basic/D and would be happy to hear what others have to say.

While you make several valid points, this is really a useless argument. Some people carry badges and some dont, each has their own reason for doing so or not. It may be ego in some cases, or it may actually be that the individual has a valid "tactical" reason for carrying a badge. One that comes to mind is that I recently stopped to help at an auto accident...elderly women, 6 cm forhead lack, bleeding profusely. I said ma'am, I am an EMT and if you let me get my gear I can help you until the ambulance arrives. She said how do I know you are an EMT (actually she said EMT Guy) I showed her my ID card...she couldnt read it. I showed her my badge which has EMT-B/D, Illinois, the great seal of Illinois in the center and my EMT cert number on the bottom. This satisified her and she let me treat her. So big deal, I carry a badge. Not on my shirt, but in my wallet. If it were truly ego, I would be one of those guys that wears a shirt that says EMS or EMT everywhere they go no matter if they are on duty or not. I carry it as a valid form of identification because it has badge numbers which correspond directly to my ID. Can we please move on. Heres the solution: if you dont want to carry a badge...dont. But dont bash those who do simply because they work in a different way than you do. That, my friend, is the ultimate display of ego.

In Illinois, EMTs of all levels are required to carry their license cards. This is nothing less than a form of official identification which is all that a badge is. One is paper, one is metal. Who cares. If you use it appopriately and for the right reasons, carry one. If you it is for your ego, leave it alone.

Dust- While I agree with much of what you have to say, your way of saying it is so often so completely offputting that it is difficult to wade through your insulting nonsense to get the valuable pith of what you have to say. Perhaps if you try to tone down the ego and use your experience to offer advice rather than scold and degrade it would be much more well accepted. 1. Municipalities do require badges on uniforms in most areas...often this is because the medic or emt is also an ff and is hence an officer. 2. A badge carried in a wallet by a private agency emt or medic can be valuable whether that emt or medic is in uniform or not. In IL, emts have the authority to clear crowds from an area, to remove media from covering an accident scene or violent crime scene and a badge, while perhaps in some hands is a mark of ego, can be very helpful in doing this. 3. At the risk of being bashed in the usual way by Dust, I will admit that I carry a badge in my wallet which identifies me as an Illinois EMT. I have used it to identify myself along with my license wallet card when I have stopped to assist at an accident scene and I think that this is a most useful reason to have a badge. Dust, if you believe that symbols, badges, brass, etc are only ego trips from fngs, then why do you display yourself in full uniform in all of your postings. Is it ego, or is it to clearly identify yourself as what you are. You are also a nurse if I understand correctly, and nurses where no such insignia proving their rank. If you are in the military, of course this is necessary, but it seems that that photo of you sends you on the very same ego trip that you claim fng, emts and medics are on. Lose the double standard and the ego and perhaps your mind will open and you will have the experience of learning from those of us who perhaps have less experience, yes in some areas, but also more and different in others that you could learn from.

Ace- The information you provide is great, but for the love of god would you just link the articles and not reprint the whole thing so that we can read it if we want to and not have to texas two step around it to get to others if we dont.

PS- Most decent agencies will pay for one or two full uniforms minus gizmos and toys. If they provide one, get two more . If they provide two, get one more and stash it in your locker. If I have to tell you why...well you will see. I have lost uniforms to everything from barf to blood to prankster paramedics.

That last post was probably the best info. Proppers, in my opinion, makes the best tactical/ems pants available in terms of durability, comfort and space for all your stuff. My service says, where these pants, that width belt, etc. If your department doesnt do this, get what works for you from any uniform supplier. And I too have also found that a geek belt works with the addition of a fanny pack works better than trying to get your sheers and ears out of those nifty little snapped loops on emt pants. Galls has a great pack that slides the shears in from the side, instead of straight up and down so that you can actually grab them the way you would use them (can be put in from left or right side) and not get splats on your pants trying to pry them out of the side pockets. BDU pants work great. I have several pairs. A recommendation about shears...I carry trauma shears and bandage shears for more delicate stuff. I save the trauma shears for flip and strips. Hope this helps.

What is being shown here are not medical terminology, they are more like run report abbreviations and will cause great confusion unless everyone uses them and knows what they mean. For example, I got a call because a nurse, albeit an inexperienced one, did not know what PERRL meant. Again these are abbreviations....for actual med terms, see your handy dandy Tabers.

The only time I have had a photo id was during my time as a student while doing clinicals. I think they would be a great idea. It would certainly help patients to identify emts in cases where inappopriate steps were taken.

Dust- I couldnt tell for sure. I trust and learn a great deal from your experience and knowledge base. Are you advocating the heart thump or fist pacing and if so under what circumstances. Always happy to add something to my tool kit. I just did CPR in an elderly woman today in the local public library until ALS arrived? Would a heart thump have been apporpriate or not so because of how fragile she was to begin with? I look forward to hearing what you have to say on the matter. Please PM so I dont miss your response.

Perhaps it is my minimal experience so far with combis, but i was not aware that you could also place an ett with a combi in place. Would a medic with alot of experience in this area please post and enlighten me as to how this is done so that i may increase my knowledge base....i was taught that it was one or the other and it would be good to have other information at my fingertips.

1. Trendelenburg is not a myth and is a moderately effective method for managing shock. 2. The point is to shunt blood to the core. 3. Leave it to Rid to bash techniques which have been used forever, and with good reason, often just to hear himself talk 4. Trendelenburg is sort of negated by having the head raised as well. Rid, perhaps you could stop bashing emts. Remember, a Paramedic is also an EMT. I know thats hard for you to accept but its true.

Point well taken. If this was a 9/11 photo there wouldnt be so many yahoos writing ill mannered responses. THanks JMac

Unfortunately, once you place your patient in the hands of the ER staff, they are no longer yours. But, despite what alot of others say, I believe that what they physician did or didnt do violates standard of care. I would follow through, but do so through proper channels. Yes, the doctor may get his undies in a bunch, but you dont work for him. Best of luck and good for you for looking after someone who needed it.

First responder is a great way to get your feet wet. Dont listen to all the old curmudgeons around here that say you shouldnt bother.

The only whacker and troll here is an uppity medic who thinks the sun shines out of his navel. Get over yourself and listen to what your brother EMT is trying to say. He is doing things to help his community and I would rather he attended to me in an emergency than a medic like you who is obviously more worried about collar brass and what color your trauma sheers are than truly helping people. One day soon, with your attitude you will get "hosed" and you better pray to God that there is a Basic like this man who gives of his time and volunteers to pull your fat out of the fire.

It is a misconception that programs weed out the less qualified. The programs sets standards and those cannot meet them weed themselves out. Lets place credit where credit is do.

Whenever anyone says something like that last sentence, I always wonder from what source they derive that statistic. Escpecially given that this would be someones thinking. It does not mean one doesnt exist, but I have never seen a survey on how many people who take emt training intend to actually use it

This patient had a angiogram prior to ems contact (same morning if I am reading right)..she is complaining of not feeling well but cant quite describe how and she has unilateral weekness and numbness. All classic presentations of a TIA. This patient could well have experienced a dislodged clot and be experiencing an ischemic attack. High flow o2 with out nasal adjunct airway unless necessary (in case the attending should wish to use an anti-thrombolytic) and C3 transport.

It seems like we are getting so far into ALS intervention that we are forgetting the basics (procedures not the emts). We went through a whole complicated assessment there and while we were doing that, the patient should have been on a PSo2 meter and given high flow at 15 LPM IMMEDIATELY. Remember: if a patient is able to talk, they can talk to you through the NRB just as well as without it. You dont need to hold off on it to ask them questions. If you do, and their c/c is SOB, their sat is likely falling. Someone did miss a meeting because we Basics have been giving ASA in the field in IL as a standing order for years along with nitro. As one of my preceptor/docs once said: "I may not know all the medicine in the world, but I do know patients like to breathe." A patient satting at 88 per cent is on their way to respiratory distress. Give em air, then ask em questions.

Did anyone ask her if she can try to qualify how she "just doesnt feel right?" If she feels dizzy and nauseous, thats a different presentation than if she says that she feels as if she is struggling to stay awake. Lets not hear horses and think zebras. I also agree with 15 LPM and assess in 10 minutes on scene before transport. Also see where she is on the Cinncinati Stroke Scale.