flapsdwn

I have alot of general over-the-counter meds such as antihistimines and decongestants and aleve. I don't like taking meds but if a disaster comes in my area, I don't want a sinus infection kicking my butt too on top of things. I got alot of the stuff onsale.. such as a couple large bottles of contact solution and case with extra contacts. I also have a couple older pair of script glasses and reading glasses. For water, I keep several extra camel back bags in the lower part of the fridge and rotate them every week so the water is kept fresh. The camelback itself stays in the back seat of my truck and goes to work with me. Thgink about everything you do over the course of the day and take the appropriate steps. I got several MREs from a local surplus place.. kinda pricey but will worth the price if something ever happens. Ohh.. by the way.... if you save the zippered pouches that the blood pressure cuffs come in, they work great for organizing your kit. I have a couple dozen that have been accumulated over the years. One has rolled up toliet paper in sealed ziplock bags. I'm a big fan of the sealed bags and have some OCD issues in organization that might actually benefit me in this case. I have several types of bandaids and kling/rollergauze with saline "bullets" and peroxide, etc. I know some folks can successfully get everything in one bag/pack etc. Mine has four different bags/packs that can all be carried/hauled by myself without difficulty. I have three LED flashlights and one 3-D cell maglight with extra D batteries and double A. Those batteries also support the AMFM Radio. I have an extra battery for my F/D radio on the charger at all times and also have an aviation radio in the back (bought from "Sporty's" that has a double A battery pack. I am also a private pilot so this purchase wasn't an extravagant after I thought about it awhile. The clothing pack has triple underwear, socks, moleskin (ask your local wildland firefighter), a couple tshirts and long sleeved winter shirts, an extra belt and two different kinds of winter hats (you loose alot upstairs as I'm sure you know). I dunno if mobile/cell phones will work in the event of some disasters but I also carry an extra battery for the blackberry (verizon is damn proud of the price on those) which also helps as I can use it as a modem to go online with the laptop. My fifth wheel RV has a solar panel on top to recharge the 12 v marine batteries and the inverter gives me enough 120v to run a few things if I don't get carried away. I try and keep extra gas and oil onhand for the generator. I know I got carreied away on your request. Hope it helped some just to see another approach. Ohhh.. btw... I know its not politically correct to talk abut some subjects but l also keep three different firearms ready to take with and enough ammuntion to "last awhile." I do think of myself as a doomsday type person at all... just try and couple a few hobbies with 'being prepared," thats all. Have a great day. If anyone would like to expand on that subject away from the board, I'd be happy to visit awhile. flapsdwn@aol.com

I am faced with these issues every single tour. We have large ammounts of UDAs and we have several come up to the station asking for water, etc. We also run automatic aid with dets that go all the way to the Mexican border. It is also not uncommon to have "coyotes," (smugglers) run from border patrol with a load of 20-30 people in an average sized pickup packed like sardines. When invariably the truck leaves the roadway and rolls, we now get to use the handy dandy triage kit and start setting up an unreal response, figuring out landing zones, level two staging.... its crazy. I've had everything from twenty-something healthy young guys trying to make it better and send money back to their families to 16 y/o F with nursing infants to little grandmothers needing a cane to walk. We have a duty to act in providing care to these people. I do what needs to be done in an unjudgemental way and go on. It pisses me off later that I launched 4 helos at six-eight grand plus a pop.... two engines for extrication and a "just in case" hose on the ground....six to ten ground units (some with multiple patients) and my tax dollars get to pay for it all.... so many can go to a level one trauma center and rack up hundreds of thousands of dollars in bills.. so an ICE agent can ick 'em up at the hospital and put em on a bus south with a good mean an airconditioning.. yeah, pisses me off. If it were me down south broke as hell I'd prolly be trying to do the same thing.. but I resent the ones that risk women children and others with a seventy mile trek through hell. I also resent the SUPPOSED advocates and church groups that put water towers with flashing beacons in the desert. It gives them a false sense of security. Its like putting a cute barney the dinasaur bandaid on a chain saw lac... Looks purty.. aint gonna do shit but get in the way and make folks think the problem is helped.

I've seen Soilumedrol come two different ways.... one by itself and you have to out a filter needle on a syringe and draw some saline out of the bag you just hung and mix it with the power contents. The most common way hospital pharmacies give it to me is in the unmistakable bottle with the orange "stopper" between the powder on one side and the saline on the other. Very user-friendly to mix and administer IVP. I like the fact Solumedrol could never be confused with anything else in your drug box... i.e. the smaller ampules of epi and MS04 for instance.

A couple things (sorry I ramble folks) One - I worked for the same outfit involved in the fatality accident in question once upon a time and... just interviewed the EMT driver from the incident for a slot in our upcoming paramedic program a week or so prior so I am privvy to some info that was not in the news. Two - we have a couple frequent fliers (don't we all? lol) where one always (?) wants to ride in with the other. Like many frequent fliers they have serious underlying medical issues... I hope the cry-wolf thing doesn't bite em in the butt someday. Other crews may do what they wish but I no longer allow them to ride in with each other. On one call, she is riding up front with my EMT partner while I'm "treating" her boyfriend's fake seizures in back (fails arm drop test among other things) and develops her pseudo-chest pains enroute. Wow. patient number two is now upfront. Wonderful. On peds calls I love having Mom in back (belted in) helping with blow-by, etc. Making Mom feel a part of things helps her not to freak out. I've also had a few 15 y/o full term pregnant kids. I want Mom (or someone) on back for.. well... just because. Our area covers about 175 sq miles with one (sometimes two if we are lucky) ALS ambulances and we have mutual/auto aid with other depts covering alot of area (one other dept we have aid aggreements with covers 275 sq miles with two ambulances). So its not uncommon to have our f/fs ride in ... thier f/f's ride in.. a private ambulance company also sometimes covers for our area when get slammed so someone from our engine might ride in with them.... they might ride in with us. Everywhere is different... boys and girls... wish we could all play better together.

Wow, no "rolling codes?" Well, like most of the subjects here, there is no one size fits all solution or answer to the issues we face. I'm glad my last rolling code saves were not aware that "no operation worth anything doesn't do them" or however the last hero stated it. I'll be sure and tell the one gent that the next time he walks into the station to visit with us.. as he often does. He got lit up at 360j, he got an EJ.... he got a couple rounds of drugs... he got bagged.. all as we hauled ass through Sahuaro Nat'l Park code three on the way to NWMC. Being a very rural dept on the west side of Sahuaro Nat'l Park from Tucson, we also launch alot of helos... often times for trauma. The last several times I requested a bird while working a code, re returned to quarters, closed the door so the bird could land on the apron out front. The flight crew continued working the pt and ended up calling it after a patch with their base hospital. So.. now... I sit here with our rig out of service for HOURS with a deputy drinking coffee with us waiting on O.M.E. to come get our stiff-guy. Is this being a pt advocate? If I do a rolling code, I do the exact same things the flight crew does and my transport time is practically the same as if a helo was launched (to closest facility). We all know the usual outcome of codes but I'm glad we don't count them all out right away or the couple of people walking around today because I did a "rolling code" would not be here. The possible exceptions are RSI and level one trauma. Even though all our medics at this dept are trained in RSI (and do the CEs) we don't carry succs or etomidate in our drug boxes. We will occasionally launch a bird for the drug box and the flight crew ends up riding in WITH US (the flight crews we work with are as good as they get) and the pilot repositions the aircraft at the hospital. Flight crews have worked rolling codes with us many many times. (Can't do good CPR in a helicopter, huh?) It is sometimes better (for us) to use a BSI airway, bag 'em and go vs screwing around if we can't get the tube. The level one trauma center is wayyyyy further so we package 'em on birds for obvious reasons there. What works here may not work there and vise versa. There are so many variables, manpower, equipment, hospital locations, BLS vs ALS manpower available... all KINDS of things. There is no one size fits all somution to the issues we face and its too bad we try and beat up the other guy because they don't do it the way we do.

Right on. There is alot of really GREAT experience to be had working in an ER. As far as protocols, you guessed it.. things vary from area to area and hospital to hospital and even certain departments. For instance, some prehospital providers here can administer RSI drugs to get those really difficult airways and some can't even though we both schools of thought have the same medical direction/base hospital. As far as the "type" of CPR, some agencies here are having great success with the Sarver Heart CPR (no breaths, just chest compressions) but even so, the rest of us still have to go with the standard American Heart CPR until it is standard and not a trial school of thought. I'm sure what is expected of you there will vary with the crew you work with and perhaps vary from one call to the other. You might be directed to do BVM ventilations with supplemental oxygen on one patient (don't hyper ventilate) and then do chest compressions on a subsequent patient. On your first few times doing chest compressions, don't let the crepitus/cracking cartilage get to you. Better they have a sore chest tomorrow than too little 02 today. Watch the height of your compressions on the monitor for awhile. Don't be timid. Push those hands down. Listen for the team leader's instructions... they may want you to pause from time to time to get an advanced airway or check a carotid pulse. You may find your yourself "riding the rail" doing chest compressions while riding on a mobile gurney if an ambulance arrives code 3 working a code in the back. My advice is to ask the charge nurse each shift what they will expect of you each shift until they know you and you know them. Some RN's will toss you to the wolves right off and get your feet went... some might want you to observe for awhile and then ask questions later when the crew critiques the event. Some folks are approachable.. some aren't. Don't let the few crabby ones discourage you. It WILL happen. Some folks are just grumpy.. especially in an emergent event. Just remember that it is the patient's emergency NOT yours and don't take it personally. Its just a job. A very very wonderful job. Have fun and good luck. EMS is everything it is cracked up to be.

Why take a rig out of service for something where you don't need a rig? In my area, the rig isn't going to be taken out of service for a stand-by. It is either (1) In service i.e. staying at the football game, etc so long as there isn't a call for service.. or (2) Its a "special" circumstance in that a promotor (or ?) is paying for an EXTRA box and off duty personnel to man an event for a specific ammount of time and paying for the manpower hours and use of a vehicle.

I've done stand-bys at oval track racing, motocross, high school, college and pop warner football, marathons, bicycle baces and prolly a couple others if I thought longer. Its nice to see/do new things, huh?