Chief1C

Denial is a disease.

What were his vitals? >jk Welcome to the city, I guess.

Our ePCR can do graphs and such.. About 47% of our dispatched calls are life-threatening emergencies, based on chief complaint; while 43% are life-threatening based on "provider impression". About three years ago, we saw a sudden drop in "junk runs", or bullshit complaints. Perhaps because so many frequent fliers passed on? Who knows. But I'd say 3 in 5 calls are emergencies which could end a life, without intervention. Folks really don't abuse it that much anymore, but yeah, some do; however call volume has definitely dropped as compared to say ten years ago.

An EMT Certification and an EMT Instructor course.. But I'd recommend several years experience as an EMT, before teaching the course.

First Aid? Call the Red Cross. EMT... Not just yet.

While I do not condone this in the least bit - What I'm about to add, that is - there is the option. If they say no, you can always pull the ADA card. *Most states will be willing to assist you, as needed, to take the course. EMT's aren't just used on ambulances. You can be an EMT, and use that to bolster teaching, like American Red Cross courses. None of the other instructors I took those courses with, were active in any type of organization that required them to perform first aid care. They took, passed and taught the same courses, they didn't have EMS certs, some had no prior expirience. Now I wouldn't want an EMT instructor w/ no expirience. But first aid, it could work. Or you could work in an ER.. Be an ER registration clerk.. That could be a possibility, any of those, for even an EMT that couldn't walk. If you want to become an EMT, regardless of how you want to perform as one - a career, a volunteer, a mentor.. Get something off your bucket list. You do it. Hell, I took the EMT class with people that had no intention of ever using the skills for anything other than. Oh my god, - oh wait, I know how to help this person, type deals. This is part of my instructing speech. Do you know the number one excuse people give, when I ask them to volunteer? They can't stand the sight of blood. Hell, neither can I. My own. If someone else is bleeding, I'm there. If it's my blood, wake me when you control it. Do you know why most people get squeemish, or nervous? Because they have no idea how to help the person. But when they get in the ambulance, or on a scene, with a little education, wow.. The person is no longer an icky mess, that is a person who needs help, and you know how to help them. I respect anyone, that just wants to know how to lend a hand to their fellow man, whether it's in a uniform with a pay check; or in street clothes with a pager.. or just a soccer mom.. or a babysitter who went a step beyond standard first aid. Even if you have no plans to keep up the cert. If you want to be an EMT. Do it, even if its just for yourself. Disregard any spelling errors. I typed really fast, b/c I had a really greasy lunch, if you catch my drift. Is it a bomb? Or an inflatable sheep?

Only once have I returned to the scene with a patient that was alive before we left. Usually, even if we terminate efforts, we're required to continue to the ER. Had a person from an MVA once that was doomed from the start. That call messed with my mind, and left me unable to steady my hands to write for several hours. Patient was alert, carried to the chopper, they started up the rotors and sat there for about ten minutes... then shut down. A physician on board determined there was nothing that could be done prehospital after the patient arrested, called a TOD and we returned to the scene. But the patient remained in the ambo awaiting the coroner. And we just transported to the funeral home; as there is no ME van, etc; and 90% of the time the FH's don't come and pick up a body. Unless it's not something you'd want to put in an ambulance. Like odor issues, which can't be contained to a body bag.

I guess it depends on what you mean by 911 System. EMS or Dispatch? > Ben, have you been sniffing glue?

Why is what they are doing, the wrong thing? Just because it's not popular, doesn't make it wrong. This falls into the rhealm of some kid pounding their feet on the ground, pouting "It's not fair". Tough shit, I'd say to them. When I go back to College, I'm going to insist on being in the all-women's dorm. Just because.

It's bland.

Private club, it's their right. I like to play miniature golf while highly intoxicated. But I've never been to a real golf course, despite having access by virtue of employment, to a large private club. They don't allow etoh on the course. Their loss.

I know exactly what you mean. To be honest and up front, I never understood the meaning of flashback, or having a flashback. Until about the last six months. Vivid, things/people trigger it out of nowhere. I don't wanna say any more than that at this point. I have someone that I can vent to; and I like to go on long drives. Although that can get a little pricey. Mostly, I just like to go somewhere and be completely alone, so if I gotta cry it out, I can, and the only person to judge me - is myself. And I'm a pretty harsh judge, and a sore loser when it comes to EMS. I know these people, I take it personally (the care I give) and it takes a toll. Esp. on the GI system. Acid reducers and bottles of Maalox. Can't take anything with Iron, so I know if what I'm doing isn't working.

I prefer ones that are free, and of a color that nobody would want to carry on their person. I also don't carry them on my person. What is some nutcase going to look for on you, when they want to hurt, subdue or kill you? Something to carry out that wish. So, I also don't carry my keys. And I tuck pens deep down in my pockets. Although I would never try to cut a coin in half, b/c you're gonna ruin the shears, if a pair can do that. It's prolly safe to assume it will cut jeans, leather, etc. Most will, but you'll end up with a cramp between your thumb and index finger. I don't put any money into shears, and I don't with the EMS accounts either. I go to Moore, select their brand, and get 10 pairs of hot pink every six months. B/c chances are, 8 of the 10 will be lost or stolen in that time period.

We won't do scheduled transfers, usually for similar reasons. The last time we ran a "requested BLS transfer", the patient was dying from some sort of illness contracted by drinking spring water. They thought anyway. They met us at the door, and walked him to the ambo. The patient looked like a corpse, I don't know how he was walking. Pulse was so rapid I couldn't count it, and it was over 200 on the pulse ox. Couldn't get a BP, hadn't been eating or drinking fluids; so he was just about dehydrated to death. So.. I called for ALS. They met us, treated him, ER said to take him to the floor. So, we did. Nurses on the floor went up one side and down the other, and started back up again...for treating the patient enroute. I was just supposed to "provide a ride". I excused myself, and retrieved a little pocket size protocol book from the clip board. Went back into the room, told the nurse we aren't a stretcher van. They called an ambulance, they got an ambulance, and I did what I was supposed to do. The patient had a DNR, but it said IV fluids, etc. were okay. She kept spouting off about a DNR. I told her calmly that we didn't resuscitate him, we treated him, and tossed the protocol booklet at her. Someone else signed, and we left. I tell docs all the time in the clinical setting, that unless they want to ride along and run the show, I'm following protocols and set guidelines. "If that's a problem, write your congressman".

I prefer the term pop, as opposed to soda.

You should print it out, and keep it handy. Like in a clip board. I keep a little card in the actual burn kit. I seen the rule of 9's on a first aid slide when I was younger; then in the EMT class, then never again. Until about a year or so ago, I was aware of how to treat them from a BLS stand point, and I was aware of the rule of 9's. But I'd never treated a burn patient. I'd been on scenes at house fires where we lost several people in one shot; women and children. The smell, bitter sweet, sickening. It's like a GI bleed, you never forget it. It wasn't until about the last 15 months, that either b/c of bad luck or industry; or sheer stupidity, I've seen at least 7 burn cases, and that's out of only maybe 150 or 200 calls. After the first one, I looked into and took Advanced Burn Life Support (as an EMT). One thing I've learned, is that if a sick person is severely burned, it's likely a death sentence. If they can feel the pain, it's not a bad thing. If they can't, it's definetly a really bad thing. Deep burns tend to cause nerve damage. The nearest burn center is like 200mi from here, so I'm also big on flying these patients. I've been a strong supporter of increasing the supplies on an ambo ever since the 1st burn patient. We had the basic crap, what was required. But there are so many helpful resources you can add, that make care better for the patient. The first is education, there are some really good burn classes for both BLS and ALS. I'd recommend one, even if you just sat in on it; the same as I do a first aid class, or BTLS (PHTLS now a' days). Not con-ed, but bolstering your knowledge with more tricks to add to your bag of ideas.

What branch are you interested in? Army: http://www.cs.amedd.army.mil/ems.aspx Navy: http://www.navy.com/careers/healthcare/medical-support.html National Guard: http://www.nationalguard.com/careers/mos-guard-jobs/medical?highlight= Air Force: http://www.airforce.com/careers/#health-and-medicine Coast Guard: http://www.uscg.mil/

The only time I've ever had issues with patients totally flipping the f*** out, were usually under the influence of something, and on a backboard.. or a combative hypoglycemia patient. Apparently I get pushy in the latter situation, but I've never -knock on wood- required emergency care by EMS. Never had an ALS provider give a patient something to calm down, not once. They get dispatched for every altered mental status call under protocol, but if the patient is (as it would be dispatched a Mental Patient), they may ride in and monitor them. But the only time I've seen drugs used like you're talking about are pediatric seizures, and it every case, it was always diazepam given rectally. I'm usually able to break into the rhealm of the immobilized and "feeling closed in" patients, and talk them into calming down. Though, I have received minor injuries in the process. I have an absolute policy, when I'm done with the stethoscope, even between vitals, I put it in the cabinet. B/c it hurts like a bastard if you get whipped in the face with it.

I think I'd rather have the shrimp on the barbie, than Ben on the barbie.

Absolutely, Rich... More than once I've feared for our safety because a lone family member realized it was just too late. It's almost always a case of wait till the last minute, and they're down, and you can't fix it with all the doodads and tricks in the ambo. I take on almost a mortician like attitude, in that you talk sitting beside them, or you hug, hand on shoulder, hand in hand.. something to show them you are concerned for them now that nothing can be done for their loved one. By the time a dispatcher even taps out a run, a very high percentage of the time, it's far too late. I had an issue with closure once in my life, and it takes years to overcome that feeling of something you should have done. So, in the case of an in-home death, where we arrive and either determine it to be far too late; or that we won't be able to resuscitate them, I offer the family a few minutes to say goodbye. I believe that it truly does help. Now if it's a grusome scene, that's different, and each case has to be handled as you find it. Suicides, dead for a while, crime scenes, etc. You just have to find something inside you to explain that their loved one has passed on, left the body, and they wouldn't want said family member to go through the grief and suffering of seeing them that way. Etc. Take it as you will.

Maybe the slippers... I used that code for shipping, and actually purchased something. Never seen that site before. I absolutely LOVE surplus stuff. Dunno why.

In 1989, I was skating down our driveway in classic roller skates; four wheels, ankle support, steel wheels.. Required a lot of grease to keep them freely moving. I was pretty good, unless like a blade of grass got in the way. Dunno what happened, but I fell forward on a down slope, knocked unconscious, broke a tooth, which tore open the inside of my mouth. Sitter carried me inside, blood all over the place, nothing the good old steel J&J first aid kit bolted to the towel cabinet couldn't fix. Yanno, back when it was okay for kids to bleed in the streets, and nobody called an ambulance. When first aid kits had more than tylenol and 300 assorted bandaids. Plopped my displaced tooth in a glass of milk, and off to the dentist. Also back when people actually cared enough, that they would come into their office on a Sunday afternoon and not charge you any extra. Dentist glued the tooth back in place, and it stayed put till I pulled the tooth out several years later.

It's my radio identifier. One. and my name.. C.. 1 C. Wow, judge, jury and executioner.. No desire to learn. The little bottle that I put things in, within myself, the metaphorical bottle, has been begging to be emptied in the past mehhh eight days or so. You're just going to have to give me the benefit of the doubt, If I seem callous in my replies. I may mean one thing, but type something else. That's not an excuse, it's just a personal observation. So, until I either curl up in a ball and cry; or have a small stroke. I'll try to refrain from posting anything.

Well, one would expect that if I did, I would know it. So... The answer is negative. I could Google every term, and pretend I know everything. But, alas, I'm human and I don't. Ouch, that's rude. If I were a paramedic, et al; I'd say that were true. However, I've gone 13+ years, and never needed to know that. I've never had a complaint, never been warned or disciplined, and never failed an exam. I fail to see how my comment casts a negative light on the entire US EMS System.

I have neither a clue what Hypotonic means, nor am I required to know what it means. It does not fall into the scheme of things, where by I would use it in the duties I am educated and/or trained to perform. I was trained to look at the IV bag, before opening it, and verify it's the correct fluid. However, I doubt it would show up in an ALS bag, unless there were to be a purchasing error. Otherwise, I have no idea what anything that you said means. None whatsoever.