fireflymedic

Did another posting list his as dead though or was this an entirely separate issue? Edit that : Was looking at the caustic ingestion thread - moot point.

We went through a period that we were the state that was having the issues - looks like New Mexico is taking the new lead for the dumbest state medics award...

Aside from the fact that they look like they were quite the fan of methamphetamine (courtesy of general appearance and picked at facial sores are a give away there), it's overall a sad issue. Too bad they didn't utilize their employer to get assistance with their drug problem and overcome it, but rather attempted to use them to sink further into it. And making matters worse, the potential diversion of an ambulance resource that may have been needed elsewhere. Sad, truly sad. They worked way too hard to get those certs to lose them to such stupidity...

Awww were you so excited when you got yours P that you ordered NREMT boxers? HEHE

I've spoken to several CRNA guys that I know and NONE of them have heard or played with this despite it being the 2009 Jems new hot toy. Most of them suggested some of the better known things over this. Upon going back and reviewing it though - I really do wonder if it is technique that's obstructing their view rather than the actual blade. Lose those teeth and your obstruction is likely to be worse I didn't watch their technique to start off with, but on the review it's certainly got me wondering ! Evidently they're supposed to be at the EMS deal in Baltimore this year. For the people off here that go (specific to medics please) - report back and let us know your thoughts. I had planned to go, but some things happened that's not looking like a possibility now.

The vast majority here follow same protocols as post dispatches us. We have a panic button on our radios that is supposed to give them a heads up and we get a response. Also, a certain code can be used and they will come. Now (since radios have been checked all over the county and verified we are to state whether everything is okay via code, then at 10 min dispatch will check on us, if no answer, they'll check again in 2 min, if no answer they'll stalk us via GPS and send post our direction). If in the meantime response is made assuring all is okay, then they'll cancel. Otherwise they are coming to check on you. You are expected to tell dispatch if you are going to be on scene for extended periods of time and also check in at fairly regular intervals. Unfortunately, it took a fatal incident where EMS couldn't call out for help and dispatch couldn't reach them for nearly an hour before someone realized they were missing. One person was killed, another shot, and another suffered a more minor injury. This was in a fairly urban area (for our state) but they were on the far outside edge of the county where reception was poor. They had complained repeatedly about the problem and that they couldn't reach out. Unfortunately it took the tragic incident to get them to change. There are still several surrounding counties that have the same problem. They claimed they didn't have money for the changes, but once the deaths occurred, miraculously they found the money for it. Sadly, I think it is going to take the same for other counties to do something about it - you'd think they'd learn. However, in these counties, it's not uncommon for dispatch to not be able to reach EMS for an hour or upwards due to transport time/areas and they do not have GPS tracking, so if they are missing it may be quite a while before anybody comes for them and "protective" things are in place and in certain areas they've gotten better and started sending troopers with them to known questionable areas, but otherwise they're on their own.

It goes on the right shoulder below your state patch. That was what was in the instructions when I got mine. However, that was ages ago ! I've not worn mine though ever as every employer I've had has had us place patches on both shoulders and didn't want anything below 'em. I highly suggest what AK said - that keeps it from getting lost. A word to the wise though - keep your certs up because they are a pain to get back if you drop them and it is a little easier to move around with NREMT than without. Look forward to seeing you on the streets !

Lying to a patient - absolutely not. Now using persuasion of things that might possibly happen should they choose not to come with you to the hospital, a totally different issue. Even if the chance is remote or unlikely, I find it well within my bounds to say yes this may happen to you if you don't come with us. If I have to do the dance if I seriously think a patient needs to go I will. Now there is one exception to this rule : A disoriented or elderly confused patient - some of them can be a challenge to convince to go due to financial concerns, confusion, or just plain stubborness. Also, many are afraid that if they leave their home they won't be able to return to it and would rather die within their home than be placed in a nursing home. Especially if they are having difficulty caring for themselves. I don't lie per se - but dance around the truth a bit - I'll say they'll do their best to get you back home even if I know it's highly unlikely that person will be returning - you never know ! But I don't believe in ever flat out lying to a patient just to get what is productive for you. That's just bad form.

I do not see any disadvantages to a provider being bilingual and could definitely see it as an asset. The english language is one of the most difficult to master and those that are willing to put forth the effort to speak effectively and are able to write a successful run sheet in english so it can be read by all, should not be barred from working EMS. Now considering the fact it is so difficult, and some of the questions are awkwardly worded on NREMT exam, I have no objection to them taking the written portion in their native language (be it spanish or anything else). I know at one point, one was able to request an oral exam (and I know other licensing boards still offer this option, but I'm unsure about NREMT)and know nothing about PA's options. However, I would expect them to speak english during the skills portion and be understood. But I think an effective compromise could be reached be it through oral testing (if they understand spoken english better than reading), or doing the written portion in their native language. I know working within a large spanish (among others) population, there were several that had extremely limited skills reading the english language, but were able to effectively communicate verbally what they needed. I don't think they should be penalized, but with ESL (english second language) classes being offered for free, then it is their responsibility to be educated, and I am not aware of any EMT classes being taught bilingually (though there may be some out there), so they should have at least a minimal understanding.

If the woman is in a sports bra (and very large busted women may wear two to prevent excess movement if they are very active) you may have to remove the bra(s). However Vent makes an excellent point about preserving dignity - a sheet, towel, or most ambulances carry a gown or two draped over to maintain a bit of modesty goes a long way. I would also do this in the back of the truck where interaction with others is minimal at privacy is at a higher level or within their home and politely ask those that aren't needed at the moment to step out. There have been several times I've seen a patient brought to me with no covering of a blanket, sheet, gown anything. One of the first things I do is take care of some modesty, then assess removing only what I need to. It's bad enough you're in this situation and trauma naked I don't think I need to make it any worse. Especially depending upon the population you are dealing with - some are considerably more modest than others. There is a fairly large pentecostal population here as well as a good amount of amish (in addition mennonites) and both are extremely conservative about ladies showing themselves to others so something to take into consideration when treating a patient. They are more likely to be compliant if they know you are concerned with treating ALL of them with dignity and respect. That's professionalism people.

Often if the female is larger busted and the caregiver is male (and I follow the same even being a female) - if the patient is alert, I will ask them to lift the breast to preserve dignity and also prevent the question of you doing something inappropriate. I am guessing this is more what you were asking?

Pretty darn close to what I utilize, with one exception - I put what dispatched to and what I found on arrival in case there is a conflict with dispatch and chief complaint so they can be reviewed on both sides. Also throw chief complaint in that section, and if accident - what surrounding features were found - ie intrusion, height of fall, what landed on, etc. Other than that, it's almost very close to what I follow.

So very true - I can think of a few incidents over the past few years - none of which involved covington fire, but other services in the area that cams would have been extremely useful ! I think it's a great thing !

Wow - a fire department that's utilizing their fire money for EMS ! Go Covington

I think that was referencing the glidescopes - not sure on the price of a complete set of these toys.

Very sad - please be ever so safe on the roads while driving both on and off duty. Prayers for friends, family and coworkers.

Yes that is the link - but finding the person to get a right answer may be a whole different story. Had that fun experience with PA myself. They seem to find humor in circulating you around the office only to end up back at the original person you spoke with. Would be amazing if people that had titles actually DID what those titles said ! What a novel idea. Sorry for the grouchiness coming through, just still playing with paperwork. for your process PA !

3 am little old lady that stubbed her toe - doesn't get anymore exciting than that folks !

There's other toys out there for those really anterior airways, and sometimes it's tough to see especially with a higher M score (mallampati) when you aren't going to see much anyway. This might give you that little additional visualization though to place like a bougie that could guide you in once you get it placed. For services that can't afford some of the more expensive things (not saying it's cheaper but probably cheaper to maintain - closer to regular or fiberoptic blade cost) it might be an option and utilized for improving first attempt success. Granted as I said before, I've not played with this, so I'm giving a potential opinion at best. Gonna try to track it down and see. Have a friend I talked to though that is currently using them (demo deal) and they are quite satisfied. They use it in conjunction with other things and they've had good success so far and are looking towards placing them on their trucks. Just one more tool in the tool box kids.

I've not utilized it, and am not familiar with it, but looks like it might be interesting to try. Going to do some OR time next month, so I'll ask the anesthesia guys around there if they've got anything on it or one that I might can give a look at. They get all sorts of trial stuff around here. If I can round one up to try, I'll let you know what I think - if you get to try one please do the same !

I have to disagree there - if someone that I knew nothing about was showing up for an interview and their car was trashed, it gives me a good clue that they don't value cleanliness and well chances are (not always, but oftentimes) they won't be too concerned with keeping the station or their truck up to the standards I expect. All things considered equal, I'll take the one with the clean car over the dirty one (though to note - shoving everything in the trunk is acceptable lol !)

Glad to see ya got a sense of humor there Jake !