firemedic37

Also these times are only from the SUCCESSFUL intubations. Here are the Paramedic Stats: Combi-tube - 37/45 (82.2%) ETT - 31/45 (68.9) KingLT - 45/45 (100%) Here are the EMT-Basic Stats: Combi-tube - 21/24 (87.5%) KingLT - 24/24 (100%)

70.0 seconds does seem like a long time to intubate, however in Iowa state wide paramedic get anywhere from 0.4 (rural) to 5.3 (urban) intubations per year. Paramedics are rarely allowed in the OR or ETI to maintain their skills. And when the paramedics need to intubate a person they are dealing with less than preferred conditions. I understand some Paramedics may intubate a patient a lot faster than others and this is due to the fact that they intubate a lot more people per year. Most services in Iowa do not even run 3,000 calls a year because we are a rural state.

I do not know where ccmedoc intubates his patients in 15 seconds. A recent study completed by the University of Iowa Hospitals and Clinics found that the AVERGAE time for a Paramedic to intubate a patient in the pre-hospital setting was 70.0 seconds with a success rate of 68.9% on first attempt. Compared to the average time for the King LTS-D was 22.7 seconds with a success rate of 100%. I do agree that the ET Tube is the Gold Standard for ALS, however, it is not available to BLS. As you can see that the King LTS-D airway is very effective in the pre-hospital setting to manage people without a patent airway. This study was done with 69 working EMS Providers (45 Paramedics and 24 EMT-Basics). It was conducted in the back of an ambulance using the standard airway mannequin. Providers had no previous training on the King LTS-D airway. ETT and Combi-Tube evalulated first. Allowed 30 seconds to read the King LTS-D instruction card before attempting. Time elements measured time to placement and first ventilation.

Sorry for the misunderstanding, I met this for all EMS Systems both Rural and Urban. All BLS Systems should have this as the "Gold Standard". I just posted it under the Rural EMS section.

My service recently just added these to our protocols (Sizes 3-5). The University of Iowa did a research project on the effectiveness of the King LTS-D Airways and showed a 100% success rate on first attempt. So the State of Iowa now allows all levels from First Responder and up to use these. I personally found the King LTS-D to be an excellent alternative to ET intubation and combi-tubes. Iowa also currently allows all levels from FR and up to use the combi-tube which is not as successful. I personally believe that the King LTS-D will be the new Gold Standard for BLS airways. If you are looking to use these or are currently using these I recommend the King LTS-D because 1) Suction Channel, 2) Distal Cuff was redesigned to have a better seal.

I know of a ambualnce service that is a "PROVISIONAL" ALS service and they only have two paramedics and run approx. 250 - 300 calls a year. This is in Iowa where the states allows a "PROVISIONAL" service, meaning if they have a paramedic on board then they are ALS, if no paramedic shows up then they are just a BLS service.

funny.

The Volly Fire Department I am on issues you the standard turnout gear which is about two years old, tranditional fire helmet and a rescue helmet if you want (Usually only EMTs get them), 2 t-shirts (one rescue and one fire) and of course a CPR pocket mask. We recently purchased a $221,000 rescue truck, new amkus electric rescue equipment, resque jacks, little gaint ladder, LifePak 12, Suction unit, and all the other BLS stuff. We provide most of the extrication in our area and we are buying all brand new air bags too. We have got a ton of grants and raised the rest. We also have a cammand/air trailer, all new MSA 4500 SCBAs. We have really good equipment for a volly department in a rural area. On our ambulance service we get several shirts and a couple coats, no ems pants though. We have the best equipment available, LifePak 12s, power cot, 2 Type III ALS Ambulances, and a brand new ambualnce base. As for POVs we can buy a jump kit if we want one or just go and get a small duffle bag or backpack and put one togeter ourselves. We do not carry any O2 in our POV.

I start in a couple days and was woundering if anyone on here has been through the program.

Iowa currently provides the following certs: Iowa Law Enforcement Emergency Care Provider (Very Basic Skills less than FR) First Responder (NREMT-FR) EMT-Basic (NREMT-Basic) EMT-I (NREMT-I/85 not NREMT-Basic) EMT-Paramedic (NREMT-I/99) EMT-Paramedic Specialist (NREMT-P/98)

The course would be approx. 250-300 classroom hours including more A&P, Truama, Fluid Administration, Cardio, Respitory System, Airway Management, and Neuro. Then you would have to complete 100 hours clinical and 150 hours ride time. With a minimum skill requirement. Comparable to the EMT-I/85. Would remove the EMT-I and just have the EMT and EMT-P.

These are the advanced skills EMT-Bs need: Establish IV (NS, LR, D5) Dual-Luman Airway (King LTD or Combitube) Nitro ASA Narcan Albuterol Glucose Monitering Acquire 12 Leads These skills will cut back on the need to have a Paramedic on every Ambulance. They will be able to handle most of the calls we run. I beleive these are the most common treatments and procedures Paramedics provide. My service came up with this list several months ago. Really how many times do you intubate a patient? If you run 10 or more calls a day your chances go up however the King LTD is a great alternative to ETT. Well thats my 2 cents worth

I have a question for all of the older ones (over 30 when entering EMS), why do you not want younger people (17 - 20) entering EMS? I agree that 16 is to young to handle the situations that we find ourselves in, however why not 18? Is everthing still revolving around 21? I recently was looking for work at a larger service but no one would hire me because I am not 21. Also I want to point out that not only young people end their careers because of something they have seen, but every age group has people that end their careers in EMS because of soemthing they saw. Yes I have bad memories of calls but I know that I did everything possible for them and that nothing could of changed the outcome of the call (I am on a ALS Service so I usually have a Paramedic with me). I may be 19 but I know how to do my job.

I took an EMT course a year and half ago during the summer break from school, the entire class was made up of high school students, the youngest was 17 and the oldest 18. In the state in which I live in you must me 17 years old for the state and 18 for national. Anyway we all took the National EMT-Basic test and all of us past on our first try. I do not believe that a 16 year old should be in charge of a patient or even certifid in EMS, they just started to rive and experience some sort of indipendence from their parents, I know I could not of handled the calls when I was 16. I am now 19 years old and am starting my Paramedic course in a couple weeks. I love EMS and am going to be in EMS for a very long time!

I am a volunteer on both a fire and ambulance service. However in the area I live there is a lack of full-time EMS jobs so I currently work at a convince store as a cashier and pizza maker. Not a glamorous job but a job. I have flexible hours which allows me to cover the ambulance more often than my last job as a night manager at a local grocery store. I also provide EMS coverage at a local raceway on the weekends.

I am currently a EMT with a Volunteer Fire Department and a Volunteer Ambulance Service. I am employed as a Customer Service Representative for a local business. Also I provide EMS coverage at the local Raceway on the weekends.

I do not know if the pt. was a rapid extrication or not. If it was not a rapid extrication then use the K.E.D. board. If he was a rapid transport then do your best to immobilize the spine and extricate quickly. The K.E.D. board is used not enough in a lot of services. Yes it can be hard to place the K.E.D. board, however if you just saved the individual from being injury further you did your job. I went thru the PHTLS class recently any they do instruct you to use the K.E.D. board. Was this individual the one that was pinned or not? I do not know where you are located or the distance to the closest hospital. Our service requires that if the individual is pinned that we air lift them to a Level 1 Trauma Center, however we are 30 miles from the closest hospital which is a Level 3 Trauma Center and the closest Level 1 Trauma Center is 60 miles away. We air lift all MVA pts. that are pinned or death in the same passenger compartment.

I carry the following: 1) Stethoscope 2) 2 pr. gloves 3) Pin Light 4) Trauma Shears 5) Pager 6) Radio (If Needed) 7) Pen and Small Note Pad (Vitals, etc.) 8) Cell Phone (Has all the numbers that I could ever need in it.) 9) Certification Cards 10) And Always Have a Watch that works. 11) CPR Mask (You never know.) When I took my basic class I was always told to keep a watch, stethoscope, gloves, and trauma shears on me at all times while working. When I was doing clinicals at the hospital they did not have any trauma shears except at the nurses station, and they only had two pair there. And always the watch so you can take quick and accurate vitals.

The correct thing in this case was to do as you did. Get a set of vitals and call on-line medical control and explain to them the situation and listen and do as they say. If they say run the code, then by all means run the code, on the other hand if they say do not run the code, do not run it. What ever they instruct you to do be sure to get their name, title, and time. Then later talk to your medical director and see what you should do the next time you transport a hospice patient. I think getting a valid DNR before transporting a hospice patient is a excellent idea and should always be done.

I would not carry Latex gloves just to be safe. There are a lot of people that are allergic to Latex some minor rashs, some more severe life threating reactions. To be safe I would carry Nitrate Gloves, they come in about any color you can imagine. As for me I carry a EMR Kit in my Car even though I am a EMT. Some States (or Countries) vary in what you can do if you respond diect to the scene. Where I live you can only provide Basic First Aid (The First Aid taught by AHA) until your unit arrives than you can provide your level of care. As for my person I always have a Mask Sheild for CPR on my key chain and a pair of Nitrate Gloves. As far as responding when I am "off duty" or "off call", if I see someone that needs help I will help them only if there is no medical help there already (First Responder Unit or Ambulance), or if I see just a couple people I will approach them and see if they need anymore help. Also I dial 911 to confirm that assistance is on its way, then I help. I have been told a thousand stories about people dying because a "off duty" or returning ambulance did not stop to assist them.