rock_shoes

Have a pic or know where they buy them? Sounds interesting.

They are manufactured by PriMed. They look similar to the straps for applying a sager but are set up with velcro tabs so you can us them in multiples to get whatever length you need. They're also great for applying direct pressure to a wound instead of using a loop tie. PriMed didn't have a picture on their site so I'll have to have a hunt around for a picture. If I can't find one I'll just take a picture and post it.

For an unstable pelvis we use "zap straps". At least that's what we call them. They're wide elasticized straps that keep even pressure across the pelvis.

OUCH!!!

As being stated, keep pt. in position of comfort. I've never broken my hip and/ or pelvis, but I have had sciaticas numerous times and that cushioning between the knees makes a world of difference. My mother did too.

Now I personally, usually, if used the scoop stretcher, removed it once pt. was placed on the cot. Now I know how some will leave the scoop under them. I've heard so many arguments to leave it or remove it. How about y'all?

I'll leave the scoop if the transport time is short because it's going to reduce painful patient movement as it will be needed again to move the patient onto the hospital bed. If it's a long transport I'll remove it for patient comfort.

I guess I wasn't very clear, but these aren't medics we're talking about, at least I don't think they are for the most part, not sure how to differentiate in the hospital.

For the most part I believe I am refering to Dr.s and nurses. But again, if medics are commonly used in a like capacity as nurses in the Canadian military I could be mistaken.

Dwayne

That's the interesting thing about medics in the Canadian forces. They spend an enormous amount of time functioning in a clinical capacity and in fact could easily be mistaken for doctors or nurses. Canadian medics are initially brought to the PCP (Primary Care Paramedic) level and from that point on are brought to a higher level in modules as their rank increases. Eventually some of them will be selected to become Physician Assistants. Once they become PA's their scope of practise is a big as the supervising physician deems appropriate. Including actions such suturing, and prescribing of medications. PA's can in fact bridge into physicians.

Well Dwayne I can't really say if this is the norm with Canadian military medics or not. I know it certainly isn't the case in civilian EMS in Canada. I would venture to say the medics you've dealt with may be burnt out having done multiple tours with very little home time in between.

sorry shoes, i have to disagree. We shouldnt judge as we have no idea what this persons background is-- maybe he has been a cop or volunteer FF, maybe he works as an tech at a hospital. Maybe he went with the career daddy wanted, and has now decided to do what makes him happy. Maybe he has been downsized and is looking for something stable. Regardless, we should answer his questions and not judge him or his motives.

And I think it is a smart move to come here first. If I were thinking about becoming a nurse, my first move would be to talk to nurses, not the school that is going to take my money. There is a great cross section from every type of EMS employer in this room, in several continents -- I cant think of a better place to start with some questions, if you want real answers.

You may very well be correct but based on the typical results I've seen that just isn't the case. People who are truly interested in becoming an EMS professional don't ask about finding a school and receiving funding to go there. They ask for opinions on the best paramedic program and why the respondent feels said program is the best.

I can't help but feel as though anyone who is truly interested in EMS as a career would manage to find the required information on their own. I agree with Dust that someone who hasn't expressed any interest in medicine prior to the age of 27 is extremely unlikely to be getting into EMS for the right reasons. It really isn't a path you want to start down on a whim. Pay scales in the US tend to suck (pay scales reflect the medic mill programs not the degree programs) and it doesn't exactly promote a healthy family life.

Get creative, because every situation is a little bit different. Just do whatever you have to do to put the patient in the best position of comfort and eliminate unnecessary movement.

Oh my. :shock: That's just terrible :twisted:

Learning to interpret an ECG is a basic ALS skill. I hate to think that this test will replace that.

WM

Some of the best outreach programs I've seen involve CPR instruction. Ideally every high school student would be taught CPR to a health care provider level as a graduation requirement.

This has the potential to drastically change outcomes for patients. Particularly in rural areas where a 15 min transport time is considered extremely short. Also in areas suffering from "medic mill" syndrome. Everyone knows the shorter the event to balloon time the better.

As everyone else has mentioned use layers. They make it easy to adjust to your working environment. Go for an 8 inch boot with composite rather than steel toes/shank. They cost more but the warmer feet are worth it. If your going to be out in extreme climates for any amount of time your service should provide you with adequate turnout gear.

That was priceless!

My condolences. What a tragic and confusing way to lose a friend and co-worker.

What are the patients prescriptions? Breath sounds (if you can get her to quite wailing long enough to have a listen)? Anything pertinent found on palpation? Other drug use? When was the patients last drug usage? Any other complaints? Patients last ins and outs?

Night-flights to scenes are extremely rare in BC. Very few birds or pilots are qualified to operate at night. That level of risk is very rarely worth the reward. It's no different than anything else where you have to evaluate the risk/reward ratio.

The highest licensed person on car always has the greatest liability. Period. Even if only BLS supplies are available the higher licensed individual is able to do a more thorough assessment and come up with a more in depth treatment plan. If you increase your ability you increase your liability.

I don't have the studies in front of me but there was a study done that showed that the needles we use are often not long enough

I guess it all depends on how "thick" your patient is. Patients get heavier needles need to get longer.

3"

I'm so farkin jealous. This is an excellent opportunity for everyone involved. Too bad I'm so tapped putting the money away I need for ACP school. :roll:

The hospital I work at uses these a lot. They are VERY nice, but are a RESCUE airway. What this means is...they should not be used front line, in theory. Most of the residents use them anyway as front line. The lense doesn't readily fog when compared to other rescue airways, and I've seen it provides a really good view of everything. It is a fairly rugged design, which is nice. The only thing is, I'm not sure how bleach as a cleaner would work with the blade and wire (wire is NOT detachable from the Ranger blade). I would think over time the rubber coating on the wires would be worn down and degrated by the bleach (used most commonly pre-hospital).

Why do you consider it a "rescue" airway when the device is used to place a standard ET tube? Perhaps because people may learn to depend on the technology and cease to be able to do it manually? I would think one manual attempt first then move to the video if it fails.

My problem with pot versus alcohol is there isnt an adequate test for pot. You can test someone for alcohol and get a reasonable result as to whether they were under the influence at the time the test was performed. All you can gather from marijuana is that they have smoked it in the past 30 days -- could have been this morning, could have been 3 weeks ago, which is why i am against the legalization of pot. I want to know if my medic, my neurosurgeon, or my airline pilot is high while i am in their care. And I would argue that if presecription meds have not surpassed alcohol addiction, it is well on its way to doing so.

It is possible to test THC levels. Most don't do it because, with pot being illegal, they only need to prove it's presence. If pot where legalized testing procedures and acceptable levels by blood volume would follow shortly. In my personal experience I would rather deal with a stoner than an alcoholic any day.

My rule of thumb has always been to listen, listen, then listen some more. You can get so much more information by putting your ears to work. Whatever the method be it percussion or auscultation your ears can tell you many things your eyes can not see. Is percussion that useful in the pre-hospital environment? Often not strictly due to the ambient noise. Just don't rule it out all together on that basis. There are exceptions to nearly every rule.

Why are you guy's using Epi-pens? That's a huge extra expense when 1mg/1mL epinephrine amps are so cheap. Is your medical director unwilling to let you draw up epinephrine? Our med's stay within a good temp range by default. The cars stay in a temp controlled bay, and they stay running with the climate control on when the outside temp is too warm or too cold.