BAYAMedic

Shouldn't it also have one of those euro/aussie funny spelled word in it too though?

Central washington university also has a paramedic BS degree.

I personally like my otterboxed, Samsung galaxy tab 7in. It fits in my left bdu pocket and I have a silicone rollup Bluetooth keyboard. That way I can type up my student run sheets with the tablet on the dashboard. Fireman1037

Flumazinil (ROMAZICON) although once in protocal, has lost favor in the ems setting. With its potential to cause intractable siezures when used appropriatly, the general consensous has been if they are on a benzo overdose, they can be more safely managed with an ET tube and vent time, letting their body process out the benzos on its own schedual and prevent the possible siezures.

Not a terrible list asys, but why a duty belt? I personally wear a 5.11 trainer or operator as my pants belt and get the best of both worlds. And the tape on a cotter pin screams whacker, in my 8 years on the job I have never once needed tape with out any sort of bandaging thus never saw the need to carry it on my person. But if needed I have found a roll of tape on the ear bows of my steth works sufficently This kinda goes along with carrying flushes. Doing so enables your medic. If it is a needed item for that provider, it belongs on their person not on a rookie. When I started, I fell into the trap of Galls mania, ebayed my butt off to make a pristine car kit, and carried my weight in crap to the point my bdu pockets were as bloated as Donald Trumps ego. Now its: phone in otterbox case, keys, wallet, steth, sunglasses/safety glasses, gum, 2 pens and a powerbar. FIREMAN1037

An MRE in my day pack, and two power/clif bars in my knee pocket. Gatorade or the like powder form that I grab when I get to the hospital. And I force my self to drink a glass of water every time I stop at the ER.

I had wondered what your pioneering work was. Since your the cardioausculatologist, could you share some of your ground breaking work? How can I differentiate between Puseless electrical activity and asystole? I work in heavy equipment before I got into ems and I fear I may miss the subtlety. Now does v fib just have the sound of electrical vibration? Like standing next to a transformer? Nerd, the sound you are listening to are the sounds of the heart beat. You can call a tachycardia if its too fast, or a Bradycardiac if its too slow. If your really good you may hear murmurs or gallops but those are mechanical problems with the structure of the valves. Dysrhythmias are an electrical problem. So essentially you would be using a plumbers tool to do an electricians job. Great question though. Apparently it will educate others of the limitations of our tools. Fireman1037

Paramedicmike, Congrats on 1,500 posts. You are a great asset and well respected voice in our little corner of the interwebs. And now back to our regularly schedualed cheap eats debate... Fireman1037

Wow, I have gotten a few discounted coffees while on duty, have gotten a few take-n-bake pizzas on duty, and gone to the local theme park on "heros weekend" with free admission. But seriously! To talk to a manager because you didn't get you discount is utter BS. We had a thread not long ago about professional courtesy and what it was but wow man, I rarely am suprised by the selfishness of human nature, but to pull a stunt like that is unforgiveable. I certainly hope that your local "discount program" ends soon because of entitlement issues. Fireman1037

Another factor to consider is the dynamics of the individual population. Not knowing the citys in question I cannot adress that directly. Nursing facilities out here make up a healthy percentage of one of my agancys call volume. They contract for evaluation and transport, and when you end up with a higher number of these mega facilities you in turn end up with a sicker than average population base creating an outliar of the stats, as well as having protocals in place of when a nurse ships some one outa to the ER vs. when grandma finally decided shes too sick to stay at home. So a less sick patient gets transported in that urban environment. I believe that whoever said that thoses in a rural area are heartier has a valid point. I never ran on a 3 am stubbed toe call in they rural areas I have worked. That leads to question the reason why with a lower percentage of poverty in some urban areas, why is there a greater use of social programs. Availability and access. Many of my rural patients have no insurance so refuse to call for fear of a huge bill and don't realize there is other options than self pay available and havent had someone sign them up for state insurance etc. . Although the ambulance is available the patients who have called in my rural area, the people often apologise for the inconveniance of taking them in. Whereas my urban job often have suitcase curb waiters. I realize I have generalized a bit and addressed the question with a broad sweeping brush stroke , thoses have been my experiances.

I was catching up on a few posts without logging in, so I still had the ads on the right side. As you know Google does its best to put relevant ads to the page on which they are to be displayed. I got a laugh about what Google had to say to the OP. Fireman1037

I was very surprised to see some of the responses to this. Although I am in complete agreement that we shouldn't be doing nurse aid work in the field, I believe this program has some merit, as well as some steps in the right direction. Although I understand Dustdevils sentiments as us being EMERGENCY MEDICAL SERVICES, I have ran enough calls that fail to meet that as well. I prefer to embrace the concept of paramedic, as in the extra set of hands the doctor has out in the field. I didn't spend two years in school to earn a bigger paycheck ( if that was the case I would nave gone to nursing school), nor to get the privilege to perform the godlike still of intubation (insert angel chorus ), or to have a card that says I am smart enough to decide who gets what meds, I became a paramedic to provide a greater level of patient care to each and every patient I encounter. Not all paramedics operate in a system where those kind of care would be beneficial or appropriate, and no I don't think we should be home health nurses, but I can see where there is a place where a trained medical provider can do outreach and referral with a minimum amount of training. We recently had a thread on education and studying in our down time back at the dorms, and although self improvement is respectable, I got into this gig to help people and if I don't get to read up on the latest new England journal of medicine on this shift because I was out consulting brittle diabetic Mrs. Smith on her need to followup with her endocrineologist and diatition and setting those appointments for her, I will be happy catching up on that article on my next shift, rather than giving her her eighth amp of d50 this month. Fireman1037

Holy Monday morning quarterback Batman! If he has been in jail for 18 years then this happened 1993 or before. As you know medical literature and research changes on a continual basis. If I did 5:1 CPR now people would question me bit if I did it years ago, I was considered the best practice. The point is, the protocols listed are current, based on best current evidence. It's a tragedy if some one died because of a misunderstanding of equipment, and I could see if the oncoming emt understood the contraindications for Thorassic trauma, not wanting them to be placed and not understanding the results of a rapid field removal. I have not been in EMS long enough to know old protocols, perhaps there is someone here that can reflect to the Time frame in question.

Although I very much agree with Ruff on both of these points there is a bit of a Caveat to these. Multiple pairs of shears agreed, but Dear Lord only carry one pair on your person, and two pens. The rest keep in your backpack on the truck. Those nifty 5.11 pants hold far more than you would ever need. Carrying more will make you look far too whackerish. I also suggest carrying two spare pairs of gloves in a belt pouch. You have mentioned in your posts that you intend on going straight on to paramedic school, although the proper legenth of time before proceeding to paramedic school has been done to death and is a very controversial topic I would tell you this. Buy a good stethoscope (My personal preference is a Littman Master Classic II) and engrave your initials on the bell, rather than buying a cheap one and upgrading later. Fireman1037

Beiber, I have only been back in the city for a few months but your posts are getting respect from me that typically only old guard deserved. You are one of the more ambitious students / new medics I have seen and your striving for knowledge shows me a medic I would want working on my grandma. Having never worked with you I can't say anything for sure, but my gut tells me you may be more prepared than many 3 years medics that I have worked with.

Agreed that it is better to overstock than under-stock for your own self, However I have a larger issue with you putting a rig in service without having personally cleared your inventory. I have learned better than to trust the off-going shift on their "yeah its good to roll" word. Me and Mr. Murphy have had our dances in the past.... Fireman1037

QUICK Ban zippered pants! http://gulfnews.com/news/gulf/uae/painful-zipper-trauma-for-six-year-old-boy-1.796992 I understand that every childhood loss of life is a tragedy. No one would ever dispute that. But gun regulation is not the answer. I reference the works done by Lott, that time and time again it shows that gun control solves nothing. The Brady campaign is a huge anti-gun advocate here in the US, and in a paper I wrote this spring, I discovered far more fear mongering than hard science behind any of their studies. Do I think that there are irresponsible gun owners out there and that guns are misused/mis-stored? Absolutely. But to make a legal adult jump through hoops to exercise a constitutionally given right is off base. If we can teach evolution, sex ed, and other controversial things in school, why can't we teach a proper firearms respect in the same manner. I was a member of the National FFA organization in high school and was a Trap shooter. Proper usage through education... Fireman1037

I have stated, PD will take custody of said weapon Agreed, they would voluntary surrender one one of the above. If they are going to be treated by me, then they are going to the hospital, Where firearms are prohibited. They now have the choice of leaving it at there home,where I responded, they could leave it with spouse or friends, if out in the community. Or in the event of a car wreck, with Law Enforcement. I have never been to a car wreck where injuries were involved, where I cleared the scene before PD arrival, therefore not stalling PT care. I would very calmly inform the patient that I see that he/she is carrying and that the hospital forbids it. Would you like to leave it with the officer over there or with your spouse/friends. Then document it in my chart, just as I would with any other valuable. As stated in previous posts, I myself carry off the job, I don't have the "Holy crap a man with a gun" mentality. I just know that my job as a Emergency service provider doesn't give me the tools to deal with this regularly enough to be fully expert in all weapons. If they are with it enough to make a decision of where to leave it, I would offer that to them, If not, I am using my best judgement to leave it with the most appropriate person of responsibility. I can manipulate perceptions of myself to best suit my needs provided I am not severely altered. I credit my patients the same abilities. I also can reason with them and I have the ability to run like hell if need be. They called me there for a reason, I can address the reason for the call and buy time until police involvement. Do you not have radio language in your local area that translates to "I'm trapped in a bad situation but cannot elaborate on the radio, send help to last known location." Fireman1037

Familiar, and expert in use and handling are two entirely different items. I am not an Armorer or a Gunsmith. I don't know the trigger pull on every weapon out there, let alone someone who has been chopping, filing or otherwise modifying a "stock" weapon. Some weapons but have the magazine locked in to rack the slide while others do not. I am proficient with many on the market today but if I have the slightest question about it, I am not going to assume the risk/liability. The special equipment I referred to is the trunk mounted clearing tube in their cruiser that in the event of accidental discharge the projectile is contained. Agreed thats why law enforcement should take custody. Have you never had a patient have a change of level of consciousness over the duration of the call? In the OP, the person was in a car wreck. What if they had a brain bleed and became combative? Wow, your "first concern" is separating them from their weapon. (or fleeing totally appropriate, no question) Last time I checked, my first concern is my patient who is injured or else I would not have been called to this scene. In the original post it is in regards to discovery of a weapon during patient care. None of my weapons have bright flashy lights that turn on when they have been used in a crime nor do I have my concealed carry permit tattooed to my chest. How exactly do you expect to differentiate the legal vs. illegal carrying of a weapon with out compromising patient care? We have a professional relationship with LEO's for mutual benefit. Fireman1037

This topic came up in my basic class and lead to a very interesting discussion. I carry off the job, and consider myself proficient with a variety of firearms. But a LEO is going to be more proficient, as well as having the proper equipment to clear the weapon. So correct, they would be the best carrier of the weapon, as weapons are expressly forbidden at local hospitals and I am not comfortable leaving someones CCW in there car to be towed. The next issue is the very atypical patient, The US Marshall. They are trained to never surrender their weapon to anyone, for any reason. With such intense training ingrained into them for years, I fear you would have a rodeo on your hands if you tried to disarm said officer if they had an altered LOC. I really don't have a good answer for this, but it was something that came up in class. Lastly, I am a bit concerned on the thought of it not being discovered on initial/rapid trauma assesment. I carry In Waistband Strong side, and it would be discovered as I checked pelvic stability, Appendix carry during ABD palpation, Or Small of back carry during log roll inspection or KED placement. Ankle Carry during extremity checks. My thoughts are if you were to miss a Weapon during the Initial Assesment/Rapid Trauma, How many other things are you going to miss. Fireman1037

I know this is off topic and for that I am sorry. But I wanted to take a second and congratulate Fiznat on his 1,000th post. Thanks for being such a great part of the city man. Fireman1037

I believe that the primary problem to address is the budgetary concerns themselves. Schedule changes and pay cuts across the board may just be a band-aid on a broken dam. You referred to this as a County problem, Is it a fully tax supported agency? If so did they just fail multiple Levys? Is this agency the only one with 911 response? Has this agency worked to secure IFTs? Does this agency have volunteers? Have they considered a structured schedule of volunteer rotation to fill in budgetary gaps? Has the agency failed to apply for grants that would benefit the agency long term? Has the administration failed to hire someone who knows the billing and coding that gets transports paid for, that may need to be sent to a refresher? Did management just make a lot of unnecessary expenses to upgrade perfectly adequate equipment? Did someone ignore the budget? Ultimately there is a issue or mistake made by someone higher than the providers, who are most effected in the scenario as written. Perhaps its time for management to accept their mistakes and tighten their own belt. Fireman1037

If there are EMT's and Medics choosing to work double time and make sacrifices to the amount of time they have off the job, they should be punished by having to work less desireable shifts because of their own initiative? It just doesn't sound like logical thinking. The management is out of line to ask you to make a hard decision that they are paid to make. To give up something you have worked hard and long for to benefit someone who has not, seems a little to socialist for my liking. Just my thoughts. Fireman1037

Back to the matter? How so? Being new to the forum I will happily explain where the true matter herein lays. Are we to toss our experiance and best clinical judgement aside to follow a written piece of paper that doesn't follow that minutes problem? We are medical professionals who are globally spread and sit on this forum not to quote what our Medical Program director has written for us, But rather to share our experiances and to learn from each others successes and mistakes. I have heard it said that "A smart man uses all of his brain, but a genius uses all brains at his disposal." We talk here to cause ourselves to be better practitioners and back our methodologies with hard science and medical research. I understand not to treat based on what I have learned on this forum but rather can use this as a stepping stone to getting protocols changed, to ultimatly provide best care to our patients. I can't remeber whos tag line used to state a waiver of "follow your local protocols". I believe that there is a best of both worlds here. I believe that to be by the book, Online Medical control could have been contacted. But I also can't argue with positive outcomes. Fireman1037

Emtcutie- Washington is a large state with two very different demographics dependant on the side of the cascades you are. I know the Eastside far more in depth, but even over here it is a broad spectrum. Some citys have a fire based EMS system that transports where others have fire based initial response and a private company doing the transport. Some EMS systems are funded through the old hospital districts and are mostly volly, and some are fully paid. We have fly-car medics and we have some Medic/Medic rigs. There are citys where private EMS does 911 and fire doesnt respond at all. We have a few air based ambulances but they run on a RT&RN staff or RN/speciality nurse. Washington is also the home of MEDIC ONE over in Seattle and King county. They are a fire based, research driven agency. We even have a private non-profit agency. Some agencys run a station/dorm/motel room system where others run System status. The pay varies as much as the agency type does. I have heard of medics making $10.00/hr and I have heard of tenured fire medics making close to $100K. I have worked with 7 different agencys through out the state over the last 10 years and have seen alot of change between them. Over all it is a great place to live and work but I would need to know a little bit more to guide you more clearly. Fireman1037