HellsBells

In your rural area, spenac, I know your the only game in town. In the city I'd have to call for a backup unit, as the kid would have to be transported to the childrens hospital, no point in driving all over town to drop two patients off, even if they are both BS.

I think that perhaps a little more research needs to be done on this subject before the nation of prehospital acupressure is considered a success ( as this article seems to gleefully imply). One test group of sixty people is hardly an adequate number. First off, I'd like to see these results measured against inhaled analgesics, such as entonox, which I find ( when used PROPERLY) is fairly effective for minor injuries. Secondly, should we really be in the business of providing pain relief for the most minor of abrasions and contusions? Good grief, I think the patient should be able to shoulder the burden of minor aches and sores, and if it gets to the point of unbearable pain, then by all means administer some narcotic relief, and be done with it. Whats with the whacky pain scale in this study? Rate your pain between 1-100? I guess the 1-10 pain scale wasn't specific enough. I suggest if the researchers desire more accurate results in further studies, they take off the kid gloves and go directly to a 1-10,000 pain scale for really definitive data. This last sentence made me chuckle to myself. It is written as if this study was the culmination of some long, tiresome, scholarly body of research that is finally complete. The last word has been spoken on the subject, and NOW, all ambulance personal are at last free to practice acupuncture without fear or shame.

To reply directly to emt's 179 proposal (as it were) , priority dispatch is the solution. If the information gathered by dispatch determines the call to be a Delta or Echo level response, then Fire will be dispatched along with an Ambulance crew. So, in the proposed scenario with a 500lb man on the 39th floor in cardiac arrest there is a good chance that a pump or rescue unit will have been dispatched already. That said, speaking from long experience, Delta responses (at least in my system) are dispatched quite liberally, as I find myself downgrading or cancelling fire far more often then requesting additional manpower.

So, I'm taking the ITLS course this weekend. I haven't done ITLS since I finished my EMT education 4 years ago, and I honestly don't remember anything about the course itself. For those of you who have completed your ITLS recently, what did you think of the course? Was the written portion difficult? Is the scenario portion complicated, with a lot of interventions required? Any advice to give me about the process as a whole?

I would be inclined to agree that acupressure is best left in the clinic, for those with ongoing, chronic problems. I think that EMS, in general, has enough deficits concerning education as it is. We really don't need to compound the problem by teaching massage techniques that will have limited effectiveness at best.

Hmmmm, signatures are pretty low on my list of compliants. I dont find it all that tricky to get patients to make their mark. Working in Alberta, I've never needed to get a signature from a nurse or doc. I simply note when and where I dropped the patient off, and carry on with my day.

spenac said I'm kind of unearthing this post from the dead, but as we regularly check our BGL's from IV sticks, I thought I'd actually read the manufacturers directions to see what they say. Our test strips are called Ascensia Elite. Here is what they have to say on collecting samples. "Sufficient blood to perform the test may be obtained from the fingertip... If desired a venous whole blood sample may be used. A venous whole blood sample usually reads higher than a capillary sample (approx 7% higher on average)." So it would seem you're covered for taking a venous sample by the manufacturer, but ultimately, the finger stick is the most accurate route.

Sorry Andy, but that is just an epically moronic statement. Why exactly does your extensive volly experience make you think that combat vets are a hell of a lot smarter than street medics? As has been stated earlier (ad nausem), there are plenty of valid reasons not to toss military medics into the emergency system without making certain that they have the same qualifications as anyone else doing the job. I'm sure lots of these combat vets are really "nice, smart" guys, but having warm, fuzzy feelings for vets does not change the fact this is bad public policy.

I'm so glad there are so many fans of Boondock Saints here, that is one of my favorites ever. My favorite line from the movie is when Rocco is yelling at his drug addled girlfriend: " I can't walk across the street without running into 12 guys you fucked" Or something to that effect. Another good one is from Fear and Loathing in Las Vegas. Hunter S Thompson (Johnny Depp) has just drove his caddy up on the curb in front of a hotel lobby. Valet- "sir you cant park here" Thompson- (high on ether) " Is this not a reasonable place to park?"

Dust I agree with your point, if, you are working as an EMT in a transfer, volunteer, or shabby BLS service. However, I think that if one is working for an ALS service with a good Paramedic partner, there is a lot to be gained by working while going to school. I might be biased in my opinion, as I plan to continue working in an ALS service while going to Medic school, but I fail to see why working while attending school is a bad idea.

As stated before, do we even have the tools to preform such a procedure? I suppose one could try to use the scalpel in the surgical airway kit. Furthermore, if the car is burning, how long is the medic going to be able to hack away at the patients limb before he is either burned or overcome by smoke inhalation? I think I'd much rather spend my time trying to use the ambulance's fire extinguisher, then attempt an amputation.

I find it interesting how we work in a profession that depends on good old rational observation, and proven fact as the basis for protocol and treatment, but wholeheartedly inbrace the superstition of Q, S , B and rubbish such as Black and White clouds.

hmmm, looks like it might be hard to print out a strip on the palm pilot. Do they also come with little mini printers?

yeah, but the class is full. At the moment there isnt any other classes being offered.

Does anybody know where I can find an ITLS course in the Calgary area? I've searched SAIT, PMA, and Alberta Health and Safety Institute, all with no success.

The hallway Medics work for the Calgary Health Region (CHR). The CHR also takes care of the interfacility transfers in the region. The CHR employees are competent EMT's and Paramedics for the most part, and actually make a slightly better wage than we do. Richard B. you are pretty much spot on when it comes to the duties of the hallway medics, and actually a lot of city medics take shifts in the hall on their days off.

This is way I'm glad we have a court system, that actually investigates accusations like this using facts and evidence. Not relying on knee jerk, emotional responses of citizens who go off half cocked after reading a single newspaper story.

Its not out of the ordinary to wait that long here ( Calgary, AB.) when its busy. Our city has a pop around 900,000. We have four hospitals, out of which one is a trauma centre, and one is the childrens. We even have a new program set up with the health region called transfer of care paramedics. It involves one Paramedic, one EMT who sit in the hall their entire shift, they have five beds and look after low priority patients who would otherwise be waiting for hours with ems crews. They act as kind of a pre-emergency room bed.

Thankfully this heroic firefighter has answered the call to save dogs, rabbits, and cats everywhere.

who or what is this "ambulance attendant" they keep mentioning?

Perhaps SSM is "ideal" from managements point of view; But I wouldn't want to work in a system that utilises it.

Yeah, too bad he chose his Dad, but it sounds like you handled things in a mature manner. I think that the media has really twisted the word "hero" to the point where it has become meaningless and the term can apply to just about anyone now.

I wonder if the doctor actually said her pulse was too weak for the AED or if its a misunderstanding of what he said by the reporter who wrote the piece.

I was referring more to the large municipal services. I know that here in Calgary, Ab. the fire budget is roughly three times what the ambulance receives. A lot of the call volume the FD use as stats for funding is based on their response to Delta calls, where fire is automatically dispatched with an ambulance.

Wow, fair enough. I'm not familiar with any services that don't use nitrous.