Fox800

+1 for Big Shears.

Pt.'s saliva > milk > saline > water.

I'll be moving up to Fort Worth in late June/early July to start graduate school. Can you guys recommend any good places to work as a paramedic? I've got four years of 911 experience as a medic. Places I've currently got my eye on: -MedStar (not currently hiring paramedics) -AMR Arlington (ditto) -CareFlite (ditto) -Cook Children's Thanks!

I really applied for Pridemark, which is owned by Rural/Metro so it's a moot point (same application). Pridemark has the 911 contract for Arvada, Wheat Ridge, Edgewater, and Fairmount. I think Northern CO may be too much of a drive. I've thought about Colorado Springs AMR but I've heard mixed things from my two friends who worked there. CSFD goes on every call and I don't want to deal with that drama. I submitted all of my paperwork yesterday, hopefully I'll get my certification in a few weeks.

Do you guys know of any Colorado agencies that are currently hiring? I'm moving to Colorado between now and July and I'm looking for a 911 paramedic job. I've already applied to Denver Health, Pridemark/Rural Metro, Northglenn, and Platte Valley Medical Center EMS. Currently working on Clear Creek EMS. I'll be living in Parker so I'm looking for something within a reasonable driving distance. I don't want to primarily do IFT and I don't want to work in a system where EMS is subordinate to ALS fire first respondse. Any other ideas?

I'll be moving to Parker, CO (20 minutes from Denver) next summer to start graduate school. I'm looking for a decent spot to work a medic shift here and there for extra cash. I have four years of paramedic experience on a 911 ambulance so I'm not entirely brand new. Can anyone recommend any decent agencies that don't require fire certs and hire part time folks? Thanks!

I've found ammonia inhalants to be a safe and effective tool for determining responsiveness when used appropriately. Intentional misuse should be grounds for serious disciplinary action/termination (crap like dropping them in a nonrebreather and putting the mask over their face, putting them in the pt.'s nostrils, putting them in a syringe and depressing the plunger to shoot fumes up their nose, etc.) If I ever see someone doing that, there's going to be a come to Jesus moment ricky-tick. My typical continuum of testing to establish responsiveness: Loud verbal > Painful stimuli (nailbed pressure, pinch trapezius, no sternal rubs) > Ammonia inhalant held next to nose > NPA/OPA (judgment call)...after that, they're likely to get an ET tube if I can't find something to do to wake them up (i.e. D50 or Naloxone).

We used Entonox at a prior job of mine, with pretty good success. You can't really overdo it, when the pt. is good and lit up, they will no longer be able to make a seal with the mask. When used in conjunction with fentanyl (for paramedic providers), we had some pretty awesome results. I miss having it.

Working a service with both large urban/surban and rural areas in the same district, I'm starting to favor dual paramedic transport units in the larger rural (county) areas, and dual-EMT transport units in the urban/suburban areas backed up by dual-paramedic squads.

Feel free to PM me if you have any questions. I went through the academy in 2008.

I can't fathom the idea of an ambulance without an AED. But then again, NYC isn't known for being a model of EMS...more like fail central, along with Fail Jersey, Maryfailand, Failiowa (for calling NREMTP-99's "paramedics"), and who can forget Failifornia.

What Spenac said was pretty much spot on. Our website is at www.atcems.org, check it out. If you're about to be certified as an NREMT-P I'd apply for Austin as soon as you get your card in the mail. You won't be able to apply for an ambulance position until you are certified as either an NREMT-Paramedic or Texas paramedic. If you have to wait for whatever reason, I'd recommend Marble Falls Area EMS (not sure how easy it is to get on as a basic) or San Marcos/Hays County EMS for a little 911 experience. Search and Rescue...we have three "rescue" trucks, the people in rescue are trained in swift/still water rescue, land rescues, high-angle/low-angle stuff, trench rescues, cave rescues...all of that stuff. We also have a tactical paramedic ambulance that gose on all APD SWAT calls, and a HAZMAT truck for all of the methyethyldeath scenarios. There's a testing process to get into rescue after you've finished the academy and cleared to independent duty. The bike medic stuff is all run by ATCEMS paramedics, unless a special event chooses to contract out to a private company like First Medical Response, AMR, or S.W.E.A.T. Let me know if you have any other questions.

Ooh they rolled their SUV! Now I get to practice my EVOC driving, yo!

Our new protocols will have a 1.25mg IV dose of enalapril for CHF/pulmonary edema with a systolic BP >140 after NTG paste/tab administration.

So, the patient calls your company on the phone directly? Is fire allowed to tell people they're not transporting them/deny transport, or are they obtaining legtimiate refusals of transport? If the patient has no legitimate medical complaints, I understand the frustration. If you are consistently getting bad attitudes from ER staff, it sounds like it's time for your supervisors/medical director to have a talk with hospital administration. It's not your fault that the ER is poorly staffed. They have an obligation to evaluate and treat your patients, no matter how minor the complaint.