Redcell19512

What equipment do I need to perform this procedure? Do I have it on the ambulance? What gauge/length needle do I need? I have a feeling a 21ga 1 1'2 inch aint gonna do the job and that's probably the biggest, longest needle I have. I don't have an alligator clip to put on the needle, is that a problem? If I did have one I wouldn't have any way to connect it to my LP12. Or would I? Do I even need the clip? The only reason I know about the clip is because I saw them use it on an episode of ER. Does the ordering physician know that I don't have this equipment? Does he even know what a LP12 is? Will I understand his directions? Remember, I went to school part time for 12 months. I never even had a college level A&P class. Gee, there's an awful lot that I don't know. If this lady dies am I going to look like a jackass at the deposition? My answer is no. I would not do it. And also no, I don't believe I have the equipment necessary to do it.

Ok...I about wet myself when he asked if they could stop the screaming. That's some funny stuff right there.

"That guy's a genius! He's gonna change the way we think about getting hit by pies!"

My wife woke up one morning with tingling in her pinky and ring finger. Long story short, her ulnar nerve was pinched in a notch in the bone. This is something that just happened, no injury. She had an "ulnar nerve transposition" which is a fancy way of saying the orthopod surgically moved her nerve and wrapped it up in the muscle to keep it from slipping back into the notch. Without the surgery she would have lost most of her hand function within 6 months to a year (per the surgeon) and the damage may not have been reversible. Is that whay you have? I got no idea. But you're a mechanic and we're talking about your hand here my friend. Get your butt (and your hand) to the doctor pronto.

Why did the medic lie on his chart? Because he knew what he did was wrong. For those of you who don't think it's a big deal who pushes the plunger so long as the right drug and dose requirments are all met let me ask you this. Would you let an EMT administer a medication and if so, would you document that they did it in your chart?

In the case described I don't understand why the medic couldn't just give the morphine himself. He had the time to start the IV and look at the drug (assuming he actually did that). Why couldn't he take the extra minute to push it himself? An EMT performed and illegal action. The paramedic lied on a report, another illegal action. So what else are they hiding?

How bout something like this: http://www.diamondbacktactical.com/BattleL...8-P750C251.aspx

Now that you mention it I do remember hearing about the revisions to the EMS Act. Still, it seems kind of strange to be training EMTs to a certification level that does not yet exist (officially). Thanks for the link.

One of our PT EMTs is taking an EMT-I class in the pittsburgh area. Who ever is teaching this class has put the idea in this guy's head that if he takes this class as of next year he'll "be able to intubate". I'm not aware of any movement to add EMT-I to PA's certification list, at least not in the near future. In fact, in terms of intuabtion I hear a lot of talk about how prehospital intuabtion may not be a good thing when performed by medics, let a lone EMTs. This guy is a bit gullable and I'm thinking he misunderstood or is being out right mislead. I also assume he's putting out a ton of money to take this course. I'd like to check this out before other people start getting the idea that they want to attend too. Anyone know of a school that is teaching EMT-I in the Pittsburgh area and why they are doing it?

We have several eating establishments that give on duty personnel a discount. Papa John's gives us 50% off every order. I wonder, is that policy specific to that particular store or is it a company wide policy? Are they under the impression that we're volunteers? Seems kinda silly for me to get a discount when I'm making more per hour than the three guys putting my order together combined. I've never been comfortable with this and I cringe when guys say "hey, make sure they give us the discount this time" when a crew goes out to pick up the food. There are plenty of people out there more deserving of a discount than me. Give it to the volly fire fighter that buys his equipment with his own money. Better yet, give it to the WWII veteran trying to squeak out a living on social security. Don't get me wrong. I appreciate the effort on the part of the business community and I certainly don't look down upon providers that take advantage of the generosisty. I just don't think what I do is special enough to be worth special treatment.

A few years ago I did something really, really stupid. I stopped at the local pizza joint on my way home from work to pick up an order my wife placed. I was tired and kinda irritated that we had company over on a work night but that's life. So I had one of those shifts where youre just going non stop and you look and feel like a zombie. Anyway I grabbed some chips, soda for the kids, and two six pack of Coors for the adults. The guy asks me if I want a bag for the beer so I can "sneak" it into the ambulance station. This guy actually beleived that we were going to have beer and pizza at work. It hit me like a ton of bricks. I quickly, and loudly explained that I was off duty and had company at home. I'm not sure what was worse. The fact that I was absent minded enough to do this or that the guy selling me the beer didn't seem to have a problem with the idea of EMS folks having a few beers with dinner.

Mental health calls are incredibly easy for ems providers. Identify a chief complaint, try to determine if the patient has harmed themselves (OD or other self inflicted damage), and run them to the hospital. We have no real mental health training so our involvement should be limited to a pleasant ride to the hospital. I have no tolerance for providers that make fun of psychotic patients or treat them like garbage. Mental health patients seem to fall through the cracks. I once thought that every intentional suicide attempt winds up admitted to the hospital for treatment. Nope. Doesn't happen. Know it for a fact. Even when they do end up in the hospital there is no real treatment. In patient psych care, in my experience, is a joke. The real action happens on a weekly basis when the patient see's a counselor. Unfortunalty many patient's don't do the necessary long term treament that they need. Family doctor's prescribe meds for depression and anxiety and don't require the patient to follow up with a psych provider. The patient relies on medications instead of learning proper coping mechanisms (when that's possible). How do we help EMS deal with mental health patients? Education. Contact your local county/state mental health agency and ask them to send someone out to your service to give an EMS targeted lecture. Heck, just having a dialouge between your ambulance company and a social services agency would be a step in the right direction.

"If memory serves me I've done about 100 hours worth of unpaid work at home for the company this year. Maybe I should put in for overtime. What's that? Sure, I could use a pillow, thank you."

Nursing home has a patient that needs a G tube replaced or a Picc line replaced. It's 2 am on Sunday night. We know from past experience that the ER won't deat with these problems but the nursing home insists we send them out. What happens? we arrive at the ER, charge nurse says hang on. ER doc looks at patitent and note from the nursing home. Pt is registered and discharged with instruction to call IR in the morning for an appt. Pt never leaves our litter. Round trip transport is $1,150, not including what the ER charges. Here's how we handle it now. If it sounds like a BS run for a BS tube change we call in to speak with one of the command doctors at the recieving facility. We give him/her the run down...doc asks to speak to nursing home staff. If it is a service the ER doesn't provide and there are no additional medical concerns...the transportation is canceled. We don't make the decision...we merely find the appropriate people to make them for us.

I have a general rule. I don't debate guns, abortion, or same sex marriage...and I'm now adding flu shots to that list

Coach, if i'm out in my car, odds are I have one or both of my kids with me. That being the case, I would not stop at any scene for any reason, especially a wreck on a highway or busy road. If I was alone it would depend on the circumstances and how safe the scene appeared to be.

I'm in PA. If I am off duty and in my personal vehicle I have no obligation to stop and render aide to anyone, anywhere. Doens't matter if I have a giant sticker on my rear bumber that says 'PARAMEDIC ON BOARD' or an EMS vanity plate issued by PENNDOT. If anyone knows differently I'd be interested in seeing a link to that law. As it stands my car is without markings. I live and work in the same area so I don't want my car to stand out to some whacko who may recognize me from a call. I see a lot of drunks, druggies, and just plain nutty people in the course of my daily duties. I have run into more than one of them off duty as well. That is why my car, and clothing, never reflects my career. It is also part of the reason I carry a handgun while off duty.

The worst part was going to the pharmacy to fill the Valtrex prescription. I kept hearing a commercial in my head.."Genital herpes got you down? Try Valtrex!" :oops:

Try going to a notary shop. Any place that would do title transfers and such should be able to help you out.

Ever heard of shingles? Do you know how you get shingles? Any idea how painful they are? Ever have a patient that was suffering from chronic pain as a result of shingles? Do you think narcotics relieve that pain? :?: If the Varicella vaccine had been available to me as a child I wouldn't have this giant crater like scar above my eye. I also wouldn't have had searing pain on the tip of my nose for two weeks (felt like someone ripped up my skin with sandpaper and dumped salt on it for two weeks).

The flu shot is meant to protect you from Influenza. The nausea, vomiting, diarrhea illness is not Influenza. The common cold is not Influenza. If you want to learn more check out http://www.cdc.gov/flu/ It's a government site so use a public computer so they can't trace it back to you. :wink: I stopped trying to convince my co workers that the flu shot can't give you the flu.

Cardboard splints are cheap and they work. I used them for several years and had no major difficulties. Main disadvantage is that they take up some space and you prolly won't get them in your jump kit. There's a learning curve with the SAM splint. Cardboards are pretty much self explanatory and you can cut them to size if needed.

Just wondering how many people get them and if you don't, why?

I can understand why EMS providers feel psych patient's are a waste of time. It seems like it's a never ending cycle. How many of you have transported the same psych patients for the same problems over and over again. You take them to the ER, a week later you see them again on a 911 call. They never seem to get better. The patients that OD do it on their psych meds. Kinda ironic. I work regularly with an EMT who's wife is a psych/social worker for one of the local hospitals. Through her we have learned a lot about how to deal with psych patients. Our attitude toward them has changed. What would you rather do at 2 am, work a code or sit and talk with a 40 yof who is depressed about life. If you spend a few mintues and listen to their complaints and acknowledge their suffering, some times it makes the patient feel just a little better. Gives you a kinda warm fuzzy feeling. You've helped someone feel just a little better. I still have an issue with violent criminals being transported in an ambulance just because they have been drinking or claim to be suicidal. The police transport DUIs without EMS intervention all the time. Not saying that's right, just saying that there's no consistency. So why do we see these same psych patient's over and over again? Part of the problem might be the fact that they are not recieving proper treatment. Psych patient's get no real treatment in the emergency room. Suicidal subjects get no real treatment during an inpatient psych admission.

Yeah, the idea of having a police officer remove their weapon just to ride in the ambulance isn't gonna happen. That's not something I'd want to even suggest they do anyway. Most of the officer's I know are issued Level 2 holsters and as I understand it the gun won't just fall out and is not easy to remove by anyone other than the officer. If you can't trust a police officer with a gun in an ambulance then they shouldn't be trusted with a gun at all. If someone is violent enough to be handcuffed they are violent enough to be cuffed behind their back. They can be transported on their side easily. Now, most of these people are acting like jerks so of course they won't stay on their side. Oh well. When we transfer from the prison the guards cuff in the front but the prisoner has on a waist belt that keeps the cuffs at the waist. Oh, and try telling the prison guards they can't carry a firearm in the ambulance, lol. Actually that's not a bad idea. They'd end up putting the prisoner in one of their wagon's and taking him themselves.