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  2. Just got an email from the City of Pittsburgh saying that I can sign up to take the "Civil Service performance examination for Paramedic". (I applied around half a year ago.) What is this exam? Is it math? Is it body mechanics? Is it about city codes? Is it everything? I haven't been able to find anything about it online. Anybody have an idea?
  3. I just read an article on FireRescue that said that San Antonio is looking to purchase an "armored medical vehicle" for the agency. What are your thoughts about armored vehicles? Is your department seeking one? https://www.firerescue1.com/fire-products/specialty-vehicles/articles/san-antonio-looking-to-buy-armored-ems-vehicle-for-fd-VVglt8cuZEedUfxi/?fbclid=IwAR2epvyNOsUJosfgJe98brOqc3OOv0Zwih3Iq_pWdKBh8XizR74enqOU3WI
  4. @yakc130 I agree that inconsistency is frustrating. I think a lot of the issue is the lack of a clear message from the local level to the president of The United States. The lack of leadership all around has created a monster that they cannot get back into the box.
  5. My gripe is is about all of the inconsistent stupidity going on. It seems like the rules don't just change from day to day, they change by the hours or minutes within the same healthcare system! I'm doing transfers for an"internationally known" system. One hospital doesn't check us. Another takes our temperature. A third takes our temperature, puts a wristband on denoting that we don't have a fever, and are allowed in the facility. And then, they make us foam in, because now "it's all being recorded." All require masks. At least that's consistent. If anything, it's not the v
  6. FireMedicChick your reply is top notch and makes an entire lot of sense to me, mainly when mentioning nasal cannula. Would it be honest to say that the usage of nasal cannula is usually recommended while the affected person has lots of mouth secretions like this website? What approximately using both nasal cannula AND oxygen masks? Is that even possible?
  7. Hello everyone, I have a question regarding law enforcement dealings with unresponsive patients at the scene. For background on myself, I successfully completed the EMT-B course at TEEX in College Station, Texas back in 2010, but never actually worked as an EMT. The training was a requirement for a contract in Iraq. So what are the rules regarding police moving an unresponsive patient that's in no imminent danger. I realize that some departments have EMT trained and licensed officers, but what I witnessed from the officers was complete incompetency at the least, or an attempt to cover their tr
  8. Back in 2004 the service I was with started with Panasonic Tough Books, but we only used it as our CAD Link and mapping device. When I came on to the service I'm at now, we started using them for E PCR and mapping. We switched from those to the Panasonic Toughbook CF18, which was just a tablet, that you could attach a key board to via a docking station. They weren't user friendly or all that tough given it's. We switched to the CF 33 Toughbook that has a detachable keyboard and we use it for all our documentation, CAD Link and mapping. They are user friendly and fairly tough. We had all our tr
  9. I love it when a plan comes together. The heart of the concept is minimizing cerebral oxygen demand while maintaining a sufficient cerebral perfusion pressure and flow for tissue oxygenation. Assuming an ICP of 20mmHg, it would take a MAP of 80mmHg to maintain a CPP of 60mmHg (I bet MAP guidelines for the management of TBI are suddenly making more sense). Some sedative/analgesic medications balance those considerations better than others. This brings in the concept of flow metabolic coupling (Propofol is particularly good at this as sedative agents go). Agent's with good flow metabolic couplin
  10. Hey, good research topic. our service does not do hypothermia because we are so far away from a STEMI/Cardiac center that there is a real possibility that the patient will begin the re-warming process before they get there. The only thing we even remotely do is cold packs to the axilla, groin, small of the back and behind the neck. Any further and we feel that we run the risk of doing more harm than good. Now if we have ROSC and put them in a helicopter from the scene, then we very often put cold packs in those places but thats only if the paramedic thinks of it. So to m
  11. So am writing a research for college about inducing hypothermia after cardiac arrest by paramedics out of the hospital, So am trying to find the safest ways to start targeted temp. management earlier. gonna be thankful if you shared thoughts and experiences.
  12. So question, in your next service, if they practice lax infection control will you quit that service again? Not to be the negative nelly, but did you bring up your concerns to management and if you did where did it go? I have a co-worker at my other service that believes that because he is in great health he won't get Covid regardless of whether he practices infection control or not. I care if he gets it but it's on him and not me. if you practice good Infection control habits you should be ok, honestly, screw your partners, in the end, you have to go home to your family and if
  13. That would fall more under the definition of emotional support animal. You would have to consult your agency's SOP regarding what to do with those. The agency I just left generally won't take them because the hospitals won't. We could only take service animals as defined by the ADA. BTW...a dementia patient should have a caretaker or family member who can answer those questions for you. Just be sure to stick to the same ADA allowable questions you would ask the patient.
  14. Yes, as the others have said, you need to be more specific. Find out what your supervisor means, with examples. I am mainly 911 service but have worked entertainment, mostly concerts and festivals. Without more info it's hard to guess what your boss is talking about.
  15. the agency I just left requires N95's only with suspected or confirmed Covids and just released a memo detailing a plan to sterilize and reuse. Other covid PPE consists of gown, bonnet, eye pro. Face shield for intubation. Surgical mask for all other cases. Surgical mask on patient if they tolerate it. My headache was my fellow providers. I have had partners not want to wear the surgical mask in the day room or in the truck as directed and fire isn't required to wear them at all. I pulled the pin and resigned. Volunteers here don't get the job protections that paid personnel do. If I beco
  16. I recently quit not out of fear of infection from patients, but out of fear of infection from fellow providers. We have many who seldom practice infection control measures spelled out by the agency such as masks and social distancing, especially indoors. I won't work with people who think so little of their own lives or those of other people's. One must wonder why they work in medicine in the first place with such nihilistic worldviews.
  17. Hello, everyone, Richard B the EMT here on an overdue visit. Hope you and your families have been safe from the CoViD 19, and you have not lost anyone from your teams. As I'm now almost 9 years being medically retired from the FDNY EMS, I'm relatively safe. None of my family, around the country, have been affected, but in the last month, I've lost at least 10 colleagues in the New York City "Tri-state" region, 3 of whom I used to work with, or under their supervision. You know the drill. If dispatch, or you and your partner(s) are the least suspicious of a call, not just the gloves
  18. Rock_shoes, First, thanks for the response. I appreciate the time people with experience like you take to answer questions from people like me who are in the process of starting out. I have no idea why I find all this so fascinating, but I do. Unfortunately, I'm not sure I understand your point - I'm still just a student without a single ride to my name yet searching for a class that's open during COVID without much success. Can you check my analysis below and tell me if I'm right? The Monro-Kellie Doctrine (which was a new one for me; thanks!) says that if any one of the
  19. Thanks everyone! I appreciate the feedback. It's tough enough to feel comfortable in knowing what to do in a critical emergency, worse to have to juggle conflicting standards of care. But what's really worse is the feeling that it leaves us vulnerable to lawsuits if things go south. I could imagine a lawyer saying, "Mr. EMT, please read here, from the AOSS textbook, the standard in the field, about whether to provide O2 at 95% saturation. And, yet did you provide O2 anyway against this guidance? And let me ask the expert, is it possible unnecessary O2 administration could cause O2 to
  20. This is a dead topic, the original poster never came back and gave us more info. Cell phones on a call are a NO NO. Don't even pull em out unless they are provided by your service. Here are my reasons and I only have a couple 1. They make you look stupid - like you cannot even stay off your phone for the length of a EMS Call. 2. Your EMS Agency should be providing equipment for you to communicate to the hospitals and other agencies, NOT you. Your phone is your property not your companies - unless they want to pay part of your cell phone bill. 3. If you are on any
  21. So this scenario just reeks of a national registry scenario from years gone by that hasn't kept up with the times. Evidence based practice dictates that patients with Oxygen saturation of 95% and no significant LOC changes do not require supplemental oxygen therapy but the scenario says the passing criteria is applicaiton of oxygen and in the competency they even suggest Non-rebreather. You are on the right track by not wanting to put oxygen on this guy but again like any other education that we go through these days, we are taught to the test not taught to think independently.
  22. My old service upgraded to HP. They were bigger and supposed to be tougher. Yeah. We broke one.
  23. This sounds like a question that needs to be directed to your medical director. As an instructor/preceptor, we taught that if the patient's Spo2 was 94% or greater, you don't really need to apply O2, unless they are having increased difficulty in breathing. Then, you could to supplement and stave off hypoxia. However, based in the scenario you provided, not enough information noted. Remember this though: treat the patient, not the equipment unless you're an equipment technician. But like I stated in the beginning, this sounds like a question for your medical director.
  24. A service I used to work for put phones on the trucks to be able to do much of what you're talking about but not strapped to your forearm. You could carry it in (which I didn't), use it to take pictures of an MVC to send to trauma team (again, I never did), and send up reports while enroute to the ED (which I did do). I think that if you're thinking of using a phone for communication while on scene, that's inappropriate. Especially is in contact with family. I tend to think that sort of activity should be done away for others not connected with the family. These phones could be a good th
  25. I'm detailed to the ICU right now. When we are in direct contact with patients, minimum of surgical mask. Unless a COVID patient, then the full PPE with PAPR's. Our medics on the units must wear N95's with ALL patient's. ER policy.
  26. It would be nice to get hazard pay, but many services, especially those that are tax based, would lose money and have to cut services. Corporate services could afford it, but would prefer not to pay it and would cut hours first. But, in answer to your question, it truly depends on where the heck you're working. NYC EMS, Chicago, LA, St Louis and other hard hit cities deserve it. Pay them!! Washing your hands would help curb the spread but so does the social distancing and the stay at home orders (which many in my town seem to think does not apply to them!). When I started EMS in 20
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