dahlio

Thanks, I did google, but there was also a bi-polar deal there too, not sure which was used. Thanks! -dahlio

What does BPV stand for when you're talking about a patient's medical history. I heard a nurse talk say something to a doctor about it, but not sure what it stands for. Thanks -dahlio

Weight does affect job performance. Take it from someone was 248lb 5' 11". I work with partners bigger then myself, and it gets bad when we walk up a flight of stairs. Forget about trying to carry a patient. There was even one person that I felt unsafe with as a partner just because we couldn't carry a 150lb patient down a flight of stairs. I told my superiors, and I no longer work with him, however, I feel sorry for the people who do. As much as I'm in favor of equal opportunity, there should be parameters in place. Not saying big guys and gals can't pull their weight, just saying there gets to a point where it's unsafe for both your partner and patient. Saying all this, I have dropped down to 233lb and my goal is to get below 200. Already I can feel the difference while carrying patients, and walking up flights and flights of stairs. (I'd also love to be a flight paramedic one day as well, and definitely need to be within limit.) stay safe. -dahlio

I'll be the first to admit, that I get nervous on scenes. It's gotten better since I was first an EMT, and I've definitely mellowed out. Most of the time it's just me asking myself, "Did I forget to do something, Am I Missing something in my assessment?". Most of the time this happens when I'm working with certain partners, or while ALS is coming in. I've gotten much better, and much calmer, but I believe I'm very focused on scene. Of course those more intense calls, I do sweat, especially once we're moving, I think about, "What can I do now?". I've been better and just take a second to take a deep breath, and continue. I'm sure with experience, it will gradually get better.

Those contaminated with whatever hazards there are.

They also have BDLS - Basic Disaster Life Support.... no hands on like Advanced. Really didn't get much outta this class, except to get them wet and naked.

NJ is made up of all ALS in vehicles other than ambulances. SUV's, and those Puppy Trucks (Built on a pickup truck) comprise all of ALS in NJ, with the exception of the agencies. ALS has to camp on scene is such situations where BLS is not exactly speedy, or mutual aid is needed. The main thing is, Patient Care was started earlier. Sounds like a normal situation to me.

Don't think it's so much of an issue, rather situational thinking. Sounds like we're just giving experiences on seizure calls, and kind of showing what to do in certain instances.

Waiting is not always the best thing to do. I once had a pediatric seizure patient, who didn't stop seizing the 7 minutes we were on scene, and the 20 minute ride to the hospital. At that point it was a carry him, strap him as best we can, and intercept with ALS. (This patient was also hot to the touch, and cooling didn't work to well.) ALS pushed a variety of drugs, but he didn't stop convulsing even in the Pediatric ER. This kid did had some type of disease (can't remember, was long ago), and the only thing he had going for him was the fact he had a trach stoma, making it easier for us to breath for him. Waiting would have had worse consequences, and we would have been on scene way too long. It all depends.

Where I work, we have both 12 hour and 24 hour trucks. You're allowed to come in up to 15 minutes early and get paid before your truck needs to be in service to check the truck and what not, however it is not a requirement. (Then again, if you don't have something, and you have a call a minute after you're in service, you will be ripped a new one with the uppers, which is good because it holds them responsible). So typically I come in 10 minutes early (15 if I actually wake up on time), and check the truck prior to being in service. When coming in on a 24 hour truck, the previous crew will let us know what we need if they had a late run, or if oxygen is low, etc. (Because they like to leave as soon as the next crew is in) That way, before going to the truck, I can stop in at the supply closet and get what I need before I check the truck. It seems to work out well, and I've never been caught with my pants down...yet.

Interesting. Unless the above device I listed counts, don't think I've seen or used one then.

Are we talking about a Reeves type of device here? Not sure what you mean by a soft stretcher. I have used devices like these http://www.e-firstaidsupplies.com/ems30.html to move a bariatric patient, and works like a charm.

BVM with O2, suction, OPA. Reeves down to the ambulance. Secure to stretcher and elevate feet. Ventilate, meet ALS on the way.

Pretty much quick assessment, and transport under implied consent. Request PD to the location for the other children. Walk up, any major bleeding found? Arouse to Verbal or Painful Stimuli? Look at Airway, Breathing. She's cyanotic, hi-flow O2, adjunct and bag. Check for a pulse? Radial? Carotid? Request ALS if not done so, and move to the hospital.

New Jersey isn't all about that, in fact, there are some portions of Jersey that are quite the opposite (Part of it is below the Mason Dixon Line). Anyway, the failure with EMS in NJ has to do with non progressive ALS, and unlicensed BLS. From a BLS standpoint, the standard of care varies from two emt's on a truck, to two 'first aiders'. EMT's have a very small scope of practice, and much of that is prevented by the New Jersey First Aid Council. BLS primarily provided by volunteers, the First Aid Council is pretty much an assembly of all of them. I know ALS wise, many Paramedics I work with would like more aggressive protocols, allowing more to be done on standing orders. It is from what I know, a very "mother may I system". The whole EMS system is trying to be changed, as a new EMS study came out last year, providing recommendations to improve the system. We'll see how much of that gets changed. EMS Report: http://www.state.nj.us/health/ems/emsreport.shtml

As I do agree to a point, it's done for redundancy. You think it's bad to have a county communications in each county? Try having a county communications along with each municipality who doesn't want to go to county. Some towns are, some aren't, now thats overkill.

And yet, another one. http://www.nj.com/news/index.ssf/2008/11/p...ng_statewi.html How about to expect an ambulance in less than ten minutes at any time? Why should 40 minutes even be close to acceptable? Why, as a citizen, can't I get two professionals, and get a high level of care. If they're having that much trouble, why aren't they going paid. How is providing a higher standard care doing more harm? It's all about the numbers with the politicians. Maybe setting these standards will provide a wake up call for townships that EMS is unacceptable. The only ones complaining about these standards are the volunteers and the politicians, wonder why the professional services haven't spoken up? Coincidence? Think Not.

Indeed, I've had two witnessed code's and both had early cpr and defibrillation, and both were discharged from the hospital. I'll look it up.

Now I'm not a Paramedic, nor any type of ALS provider, but I must say, this statement is absolutely true. I.E. Why do EMT-Basic's go in to detail asking about abdominal pain, whether it's dull, sharp, radiating. Why do we palpate it? Let's face it, it will not change our treatment (Oxygen and Transport). But it's one more thing that you can relay, and get an idea of what's going on with the patient. It just puts one more piece of the puzzle together, which in turn, saves time to find the other pieces. Just wanted to point that out. -dahlio

Not our medical director, the state's DOH is preventing us from having pre-filled syringes rather then the auto-injectors. So how cold does the inside of the ambulance get in 30-40 degree weather... I'm surprised we still keep them outside.

At my system, we have epi-pen's on all our trucks (2 Adult, 2 Pedi). We have about 10 trucks, and keep them outside for the most part. What are the risk's keeping these medications outside? Remember it's New Jersey. What are the limits this medication can take before going bad, or maybe the constant warming and cooling hurts. Thanks in advance for the input. -dahlio

I want to say this has been brought up before. But let me just say I seriously doubt that.

I'm in all favor of the nap. I mean, EMS stands for Earn Money Sleeping :wink: All joking aside, I believe that you've gotta do what you gotta do. I understand running 10-12 jobs in a 12 hour shift. Going home, getting 5 hours sleep when all is said and done, and doing another 12 hours where your call volume is 2-4. I have no problem with people sleeping as long as they can wake up promptly, and be ready to move. We've all had the days where you've had 3-4 hours of sleep, and run 12 in 12 hours. As long as you're able to maintain an excellent level of care, and serve no negligence, then I find no problem with this practice. The current place I work for now has 12 hour shifts, with a maximum 18 hours (hospital policy). Sleeping on the job is a fireable offense (hospital policy as well), but something that's completely overlooked. If everything gets done (Truck checked, daily chores done) and your call volume is down, then it's perfectly acceptable to take a nap. Obviously if you haven't had a job all day, and your truck is a mess on the outside, and you have decent weather, your expected to clean the truck and preform similar chores. A 20 minute nap can go a long way sometimes. My two cents.

As much as I enjoy having a chance to catch up on my schoolwork, It gets really boring. We have one base at work where the call volume is about one or two or day in a twelve hour shift. You just get plain bored sometimes, and want something to do. Critical Calls are definitely great learning opportunities, and very much enjoy them. Non-Emergency Transports can be boring, but you get to learn about procedures done in the hospital, and get to see what kind of definitive care patients get. A good mix is a great thing.

Service carries both the stryker and ferno stair chairs with tracks. I feel the ferno's are lighter, although I could be completely wrong. But my preference is the strkyker, because it's easy to find the levers and bars and such. Personal Pref. really.