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  2. I like this article because it provides relevant information for us and I want to be keep updated with you for more posts. Bluehost discount coupon codes
  3. New member, old reader. Hope there is a good community here.
  4. Looking for small town Ambulance Service.If your running out of funds or thinking about going bankruptcy.Or your town need a Ambulance Service.
  5. Hey Macktheknife, Do not let the number of members fool ya, there are about 10 if not less active members on this site now. We used to have more, a lot more. Maybe we will get a influx of new blood but with facebook and all it's groups, this site is not very popular anymore. I'm one of the old guard, been here a very long time.
  6. Hi Emma, I'd be happy to discuss with you what questions you have. Email me at ruffems@gmail.com and we can set up a time to discuss. I've been a paramedic for nearly 30 years and I am happy to answer your questions. I'll be at work tomorrow for a 24 hour shift so if you want to do the call tomorrow that would be fine. Michael
  7. Hi everyone! I am a 15 year old freshman in high school and am looking for someone who would be willing to answer a few questions for an assignment of mine. It'll probably only last around 10-15 minutes and I would hope we could do it over the phone as that is what my teacher wants. I have always been interested in this field and want to learn all about what it is like to be an EMT! Please let me know if you would be willing to help :)
  8. Hey everyone! Saw we had no representation for the Sunshine State! Let's get it going!
  9. Happy New Year to all! Saw this sight and was impressed by the number of members. I'm retired military, currently an RN and Paramedic. Hope to have a good time here.
  10. Looks like the Mass companies just keep on coming north.... https://www.conwaydailysun.com/business/local/action-ambulance-expanding-life-support-services/article_0fdaeca6-0578-11ea-9a0d-2b2874d78876.html?utm_medium=social&utm_source=facebook&utm_campaign=user-share&fbclid=IwAR0_8A8lkyJehQ5x1NhdYXLnzdTGT4aLgUmKbzmU1z0xcyXAR-dm2ADUmis
  11. Could this be the future? I found this interesting article on ZDNet about the use of the new cellular technology to provide real time interaction with physician at the hospital. Is this something you would embrace or would you feel like someone is looking over your shoulder all the time? https://www.zdnet.com/video/how-to-make-the-most-of-big-data-in-your-organisation/
  12. look up a EMS group on face book called the EMS Experience and ask there. I know the owner of the group. If you still cannot find a buddy, let me know. I'm a medic but I'll help you out if you want. You can study and bounce questions off me and I'll help ya out.
  13. Can't believe my profile is still here after a 6 year absence.....

    1. Show previous comments  1 more
    2. Don1977
    3. itku2er

      itku2er

      Welcome back don! 

    4. Don1977

      Don1977

      Hey Terri! IDK if I'm back, was just seeing if I was still on here and if this place was alive..lol

  14. Jess passed away July 16, 2016

  15. Starting EMT school on monday, looking for a study buddy. Preferably one that has discord and/or facebook. thanks~!
  16. Contraindications for morphine use include (among others): head injury, decreased mental status, multiple trauma. Why? I understand why it's respiratory depression effect would make contraindicated for patients with COPD and asthmatic attacks, and why its effect on blood pressure would make it a bad choice for a hypotensive pt. But why would multiple trauma and altered LOC/head injuries make it so? I'd think head injuries would make rise of ICP an issue, one in which morphine would, if anything, help.
  17. One more thing, our new ambulance we are getting is gonna cost 235K, if you want to put an X-ray on that new ambulance the cost just went up to maybe 300K, no hospital or ambulance service will justify that cost.
  18. So what are you asking us? is this one of those "Our instructor gave us these two topics and we need to write a paper and I want you guys to write my paper for me" or what are you wanting from us? Yes we have had those people come here with just such a request. give us more info please in what you are asking.
  19. There is no guarantee he will continue on and get his EMT license. Maybe he's just doing this for class time or some other reason. I would take Off Label's advice and complete the course and mind your side of things. These things have a way of working their way out.
  20. Good afternoon EMS people. Please assist me. Is there anyone here who has done the FREC LEVEL 5 DIPLOMA COURSE at RONIN SA? If yes, was your qualification accepted in the UK, seeing that it was obtained outside the UK? Where did you do your practical placements? Thank you in advance for your help. 🙏🙏
  21. Good afternoon EMS people. Is there anyone here who has done the FREC LEVEL 5 DIPLOMA COURSE AT RONIN SA? WAS YOUR QUALIFICATION ACCEPTED IN THE UK, SEEING THAT IT WAS DONE IN A FOREIGN COUNTRY? PLEASE HELP ME BEFORE I COMMIT MYSELF 🙏🙏🙏🙏
  22. Off Label

    CRASH 3; TBI and TXA

    The issues of hyperfibrinolysis and fibrinolysis shutdown are issues that bring to the fore the importance of timing of TXA, TBI aside. Multisystem trauma is pretty likely in patients with TBI, and I think one of the CRASH trials does suggest that if you don't get the timing right, you may do harm.
  23. Kmedic82

    CRASH 3; TBI and TXA

    Let’s talk about TXA and brain injuries. Maybe we can put to rest the suspicion that TXA creates further injury in patient’s with a TBI. TXA is an amazing tool to use for our trauma patients. There has been so much success TXA that there are trials to see how effective it is for GI bleeds. As with most medications new to a service (mine has had standing orders on TXA for about a year), there are always questions and concerns. One that continually comes forward is, “does TXA create further harm in a patient with a brain injury?” Curious and in an effort to self educate, I searched and found an article on my favorite blog, EMcrit. The CRASH studies were used to see the effectiveness of TXA and the trauma patient. The CRASH 3 study was specifically a sub study for the TBI patient. It was ran as a pragmatic study. Meaning, it was a non-controlled atmosphere and based in a real life setting with unpredictable variables. Much like a bad trauma patient. “CRASH-3 was designed to further investigate using tranexamic acid for patients with traumatic brain injury. This study utilized the following inclusion criteria: Enrollment within hours of injury Either Glasgow Coma Scale <13 or intracranial hemorrhage on CT scan No major extracranial bleeding This was a massive, pragmatic, double-blind RCT involving 175 hospitals in 29 countries, with a target enrollment of 10,000 patients. Patients were randomized to receive either saline or tranexamic acid (1 gram loading dose over 10 minutes followed by a second gram infused over the following 8 hours; this is the same regimen used in CRASH-2). The primary endpoint was head injury-related death in the hospital within 28 days of injury.” The utilized saline as the placebo versus TXA. The results showed a reduced mortality rate in patient’s with non-severe TBIs. With an emergency room study such as this, the results were “not statistically significant.” The criteria for a TBI patient is vast. There are too many complications. What proceeded forward was the need to take out the obviously brain dead patients (GCS>9 and fixed pupils). The severe TBI patients would not benefit from TXA just due to the impact of their injury. More severe, the less of a chance of effectiveness. Now, the mildly injured patient’s proved effective. There was a significant increase in the decrease of mortality with in 28 days of the patients who received TXA while suffering from a brain injury. To receive the proper and fair outcome, it was just a matter realizing that some patients were too sick to save. “ Subgroup analysis shows benefit from tranexamic acid among patients with a greater hope of recovery. Specifically, tranexamic acid reduced head injury-related death in the subgroup of patients with GCS>8 and also the subgroup of patients with reactive pupils.” What were the take away and conclusions of the study? “The conclusion of this article sums things up nicely: “tranexamic acid is safe in patients with TBI and treatment within 3 hours of injury reduces head injury-related death. Patients should be treated as soon as possible after injury.” The greatest strength of this study might be an extremely thorough evaluation for possible adverse events among 12,639 patients. Tranexamic acid was found to be safe, without increased rates of any adverse events (including thrombosis, seizure, and stroke). The primary endpoint of this study was technically negative (p-value slightly above 0.05). This likely reflects the inclusion of moribund patients, who diluted out the signal of benefit from tranexamic acid. Numerous subgroup analyses indicate that among patients with a greater hope of recovery, tranexamic acid is beneficial (figure below). As a statistical rebel, I would consider this trial to be positive, despite having a technically negative primary endpoint.” Check out the article at; https://emcrit.org/pulmcrit/crash3/ View the full article
  24. The guy is probably there because of some well intentioned charitable gesture someone is making. Is there really a concern he'll make it to something more than routine IFT's if even that? I'd just consider graciously tolerating him part of my training. Take the high road and just complete the course work and go.
  25. Radiographic interpretation is an advanced practice/physician level skill that requires credentialing and a formal privileging process. Out of scope for pre-hospital use.
  26. 1. alternative funding for fire and EMS organizations. While several options exist, it is important to identify which options are available for non-profit and for-profit organizations. Which alternative funding option do you feel will result in the highest return on investment? Include an option for a non-profit organization and a for-profit organization, and explain. 2. Messages to the community are usually one of two categories: newsworthy or noteworthy. Based on your experiences, share with your class at least one example from each group. Which one had the most reaction in the community?
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