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BAYAMedic last won the day on May 30 2015

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About BAYAMedic

  • Birthday 07/10/1985

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    Eastern WA

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  1. Old folks Still here?

    Sorry I missed out on this thread until now. Fireman1037 a lowly volly emt became BAYAMedic then a Battalion Chief EMS manager and solo paramedic serving a rural county. After a couple years of that, I have had a bit of a breakdown and now am looking to a new start in which direction to go. You asked about reunions, My self and Eyedawn won the Rob Davis Memorial scholarship and went to CAP lab. Dwayne met us out there. That was in 2011. Each of us independently chose to go back in 2014 and had a nice reunion. Oh, Chris was there too. That crazy Canadian Emt turned Doc. BAYAMedic
  2. I want to become a paramedic

    *Edited to finish post, after accidentally posting* We all have different experiences. Much of the exposure/experience you may receive, will vary greatly, depending on your locale. This is my experience only, offer is void where prohibited, no warranty is implied or expressed, always follow your local protocols, and local, state, and federal laws where applicable. I receive no compensation for any product recommendation, The opinions expressed herein are my own and may not represent or reflect the position of any company/department of which I am currently or previously affiliated, results not typical, etc. On my 16th birthday, I was working my summer job at a roadside fruit stand and bakery. We had just say down to enjoy birthday cake, between tourist buses, when a Chrysler Concord rolled up in front of the shop. It parked perpendicular to the way the stripes were, and started honking his horn. I remember joking "What does this guy want, drive up service?" I put on my best customer service smile and opened the door. In the drivers seat sat a 300ish pound, 60's year old guy. He was flushed and sweaty. He gasped "I need help" I called 911 and EMS was dispatched. He said "I think I am having a heart attack." This was back when the Bayer aspirin commercials had just started, so we dug out the first aid kit and gave him two adult aspirin. The ambulance barn was 8.5 miles away, with volunteer staffing, so what was likely 15 minute response that felt like an hour. I felt totally and completely helpless and wanted to help this poor guy, but didn't know what more I could do. One of the owners of the fruit stand was a captain of the local fire department, which also is a Ambulance service. He suggested that since I was now 16, I should become a Jr. Firefighter. Never wanting to feel that helpless again, I agreed. That Thursday night was my first fire drill. I remember searching through the station attic and finding my first set of turnouts and trainee helmet, They were 20+ years old when they were issued to me. I also found a pair of nomex coveralls and leather gloves, wildland fire helmet and belt for fire shelter. We ordered a pair of wildfire boots, which were the only equipment I received that wasn't "hand me downs." This was a very small department, where only the officers had radios, and a few had Motorola voice pagers. The rest of us found out we had a call, by the 2 minute air raid sirens blaring and responding to the station. We had a mini academy to get myself and one other recruit to a functional level. This opportunity gave me exposure to public service, and I loved every minute of it. I had spent nearly every Saturday from November-March at a local ski hill, since I was in 1st grade. One of my friend's dad had been on the volunteer ski patrol for ages and talked me into joining as a Jr Patrol Candidate. The "Outdoor Emergency Care Technician" course by AAOS was based on the EMT course and met the DOT requirements. This gave me a foot in the door to expand my medical knowledge base and allowed me to network with other healthcare professionals. The ski hill medical program director, was an ER physician and fellow patrolman, graciously offered to allow me to shadow him in ER. Through ny high school, I was able to secure a "school to work" internship at the ER, and was able to collect both school "elective" credits, and could rack up community service hours for my Senior project. I had completed all of the required classes at the school, and simply needed credit hours to graduate. A few weeks into this, I realized the really interesting cases were coming in via the ALS ambulance service, so I approached the company and the school to see about ambulance ridealongs. The fall and winter of my senior year were spent M-F 8-5 on the Ambulance, and a mixture of weekends at the ski hill or the ER. During this time a First Responder (now called Emergency Medical Responder) class became available, so I took that class, as I hadn't graduated school yet so was ineligible for EMT. I logged over 1,000 community service hours between the internships, ski patrol and fire department, and qualified for and won the Presidential Freedom Scholarship for Volunteering. These experiences gave me a laser focused plan on what direction I wanted to go after graduation. I took my official EMT class that fall of 2004. Since that time I have worked or interned in many styles of EMS Systems: Fire based transport, Fire based first response, Private for profit, Private non-profit, Industrial non-transport at an underground Zinc mine, BLS event standby, BLS non-emergent transfer, ALS rendezvous, and even some time doing wheelchair van/Cabulance. I have been in and out of the industry a couple times, but have been active this time since 2009 when I began a degree track Paramedic school, and am currently a Paramedic Battalion Chief for a rural Fire department that transports 50+ minutes to critical access hospitals and 90 minutes to a Level II Trauma center. I was a total nerd in high school, and didn't really fit in. I found a camaraderie and friends in Fire/EMS that I didn't have with school. That being said, the others are absolutely right, you only get to do high school once. You have your whole life to enjoy a career of your choosing. Lastly, academically, push your self in the sciences, a functional understanding of Biology, Chemistry, Psychology, Communication and English Composition are tools you will use everyday as a Paramedic.
  3. ASA and NTG or no?

    I purchased 2 CombiCarrier II backboards this spring for this exact reason. Still function as a LBB if "needed" but allow you to use the same muscle memory to board a patient, (no one up here had used clamshells) and two clasps later they are off the board and on the cot mattress. The big downside was the cost at just over $800USD each. BayaMedic
  4. ASA and NTG or no?

    Chappy, remember your STEMI foolers, BLEPPP. One is present in this tracing and DR Lifepak picked it up too. ***Personal experience alert*** I had a Stemi Code who was revived after 1 shock. He became A&O within 5-10 minutes post arrest. When he arrested he fell to the ground from standing and had a small raspberry on his forhead. I withheld ASA for fear of head bleed. I was told by the receiving physican "Treat what you know. You know he has a STEMI, the head will require a scan and is only a maybe. Treat what you know. 324mg ASA!" BAYAMedic
  5. Stump the Chump/medic: IV Opioids AND IV Alcohol

    Vodka would be good at a 50% water to 50% alcohol to get the best of both worlds. While I don't know about the solubility of narcotics in alcohol, I read in a druggie forum it takes about 1.8 mL of water per oxycontin tab to get the best cold water extraction. If they can achieve more with the alcohol and have a easier access to "sterility" vs what comes out of the tap, I can see how this would be an interesting logical move for your local IV Drug Users. BayaMedic
  6. Metoprolol IV for Heart Attack

    I seem to remember reading somewhere, that there was a study done that took into account pre-hospital Metoprolol and the outcomes showed no positive effects if given pre-hospitally, provided it was given within the first 24 hours. We had it previously and had it removed from our protocols. BAYAMedic
  7. Thanks to every one who informed me of the educational requirements of the Japanese system, I had no idea. This is by far the best post I have seen on here in awhile. Good work all. BAYAMedic
  8. Reading this peer reviewed article, it seems EMS is in its infancy in Japan. I would be interested to compare the educational benchmarks between a the two countries ALS provider performing the intubation. BAYAMedic
  9. Fun EMS Books

    It's hard to go wrong with Kelly Grayson's book.
  10. Difference between airways

    The risks and complications are noted but that doesn't mean its not the gold standard. As artificial airways go, I challenge you to list an airway that adequately prevents aspiration, prevents gastric insufflation, and can be used long term, while not being so invasive to need to be surgically placed. Every artificial airway on the market must prove itself in relation to the ETT. The Gold standard of which all others must be compared. BAYAMedic
  11. Glucose, What's your highest?

    1274 mg/dl on a CCT from a rural hospital
  12. IO access

    Very true, I heard the same thing last year at CAP lab from that MD that miss Eyedawn took such a fancy too *wink* infact, he said that he has successfully used Adenosine through an IO placed in the humeral head. BAYAMedic
  13. Intubation in 2012

    For what were you allowed to use propofol?
  14. Intubation in 2012

    Ok guys, lets start with pre-intubation meds. My protocols give me the option for Etomidate 0.3mg/kg, or Ketamine 2mg/kg (if etomidate not available) Anectine 2mg/kg for Induction, with Vecuronium (very rarly used) at 0.05mg/kg (Continued, detrimental agitation in the intubated patient that does not respond to midazolam and analgesia.) Versed for post intubation sedation. 2-4mg every 5 minutes. How many of you have rocuronium or other non-depolarizing paralytic for initial intubation? LIke wise does anyone have Propofol or other seditive in the field? Please post if your protocol varies from mine BAYAMedic
  15. Tardive dyskinesia treatment?

    Ey, With known HX of Haldol, that presentation lead to extra pyramidal unless I see something else jumping out at me. Giving the Diphenhydramine first you have a (semi) conclusive R/O of the Dystonia. With a complex focal Seizure, the Benzos will break the Seizure, but what caused it in the first place? Any time I can treat something that treats a causative issue or gives a diagnosis versus treating a symptom, I would prefer to go down that track. BAYAMedic Secondary thought and answer. Harm in going with the dyphenhydramine before Benzos? Its a stretch but I would say the potentiation between the two would cause increased somnolence and possible respiratory depression. BAYAMedic