BVESBC

Ok, I'm going to stir the pot. We as providers agreed to care for all comers. I agree with that 100%, there are provisions to inform us of potential exposures s/p (Ryan White Act) where as the recieving facility must notify us of any confirmed communicable condition. (My wording may not be exact on ryan white act feel free to correct me!) The question I pose is this, As a private sector ambulance at any level of care could we refuse to transport anyone with a communicable disease? (AIDS, HIV, Hep)?? Would this constitute discrimination if we did?

Refuse twice, after that its cash only with no supporting documentation. I have never been offered a tip while working 911. I have accepted some while working private sector. Fifth floor carry up comes to mind. I have noticed that the people that can afford to tip rarely do and the ones that cant offer tips more often.

I think it holds more for firefighters than EMS, I have seen many EMT's leave and never look back. But I know several firefighters that retired years ago that still find their way to their house for coffee with their brothers. Maybe someone else has seen the reverse I would like to know.

Who knows, that was the same company that had their ambulance Reposessed while I was in the ER with a pt.

[The reason you should not do it to provide a baseline prior to treatment is because you will not be the one doing the treatment. The time that passes between your dubious diagnostic test and my evaluation and treatment of the patient is too long for your test to be of any value to me. Do you really think any doctor is going to just take your word for what the patient's blood sugar was half an hour ago and start treating the patient based on that number? Of course not. It's a waste of time, just to stroke your ego. We already provide the BASIC treatment, every ER tech in the state that has little to no education can do this. Yet we are restricted by state protocol. The ALS providers in the area I provide service are severly overtaxed, this is not something which I cant do anything to change. The amount of time we generly spend on scene and the amount of time that is used to get to a acute care facility normally will be less the 15-20 min. We cant get ALS for a full code on a regular basis. The amount of harm possible from this Basic test small at worst.

No they were brand new when we got them, they sent them out after we recieved them for restriping as they had the FD striping on them, when I asked why it would only go 50 I was told because thats the way FDNY spec'd every piece, Maybe they were just fedding me a line of BS do you know something?

1. there are tools for getting ms really big to that cot and if it was my full time job like that of the services that I mentioned I would be more than willing to go into great detail on them. As I already mentioned that is not my job. send me you email adress and I will send you the contact information of the cordinators for both services. 2 It was not a slam agains the people you work with. It has been shown in many studies that we as a group are less healthy than other groups. 3. Our protocol set forth by the state has no reflection on my copetency, it reflects their intrest in dumbing down the EMT-B curriculm instead of culling out the stupid EMT's they usher through the system. Good EMT's take shit from people all the time due to a few hacks.

To the best of my knoledge they were spec by and for FDNY 96-97 very distinctive ac unit mounted to front of box above cab, they were bought by a private service in Northern NJ which is now defunct. As best I can rember we only used them for critical care jobs, they were junk.

Just don't speed and you wont get caught, HA HA LOL well it sounds good, I don't have any stickers I do have a fraternal embelem in the back window (small less than 1.5 inches) it is discreet but readily recognizable up close and it has saved me a few times.

We had two FDNY Spec ambulance's they were governed to 50 MPH, It really sucked going to a job and not even having the option of keeping pace w/ traffic! They didn't last long!

It is unfortunate that the kids will suffer for a long time mentaly if not physically, The mother will probably get sent to Greystone to live out her natural life with people like herself. The down side is that we will be paying for it.

Thank you! That was my point why can't we do it to provide a baseline prior to TX and it is usefull for other providers to continue the continuity of care. THANK YOU!!!

Thank you well said!

No, I didnt even bother to read it, its uncertain and doubtfull that I ever will.

No one ever said anything about IV D50 it is clearly beyond even some veterans in this field, This post was about the EMT-B using a glucometer on a altered known diabetic prior to admin of oral glucose which we already do.

Getting back to the original post. Some ideas for EMS research would include: 1. Means to better lift the severely obese patient. 2. Means to reduce injuries to EMS staff. 3. Means to be able to get military field procedures into practice on the civilian side I think that you will find that these issues have been researched to near exhaustion, 1. There are many products available to move and lift morbidly obese PT's several mfg's sell equipment for this, it is expensive and few services are willing to spend money on equipment that get little use, I know of at least two hospital based services in my area that have at least one truck dedicated to this. They are the people we call when the pt exceeds the limits of our equipment. 2. Limiting injuries to providers is has many facets, Look around and take a good look at your co-workers you and will probably notice that we are not the healthiest individuals. Many don't care for ourselves as well as we care for our PT's This by it's self has and will continue to be a factor among many others. The mfg's of the equipment we use has made great improvements, example do you remember two man cots, now we can push a button and achieve the same results. I am sure that equipment will continue to progress. 3. History repeats, many things have trickled down to the civilian world from the armed services I'm not a expert on this I will let some one who is more familiar with it comment on it. I dont claim to know every thing but it is my willingness to see the flaws that allows me see forward, eventually there will be no EMT-B, everyone in the field will have more education, and do more, take a look at the EMS system in London England, they are at least 50-75 years ahead of us. It is our pride in the past that prevents us from moving forward.

Lets talk about how the EMT-B treats a diabetic alone No Medics, our protocol says if PT known diabetic, responsive but altered you give oral glucose and transport. Our protocol also says not to delay transport. How do you feel that it would harm the PT to perform a blood glucose test (glucometer) to find a baseline prior to administration of a intervention? We take baseline vitals prior to any intervention, why should we not be able to use a minimally invasive diagnostic tool? It would appear that you are more concerned with provider autonomy than providing the pt with the best care in the least amount of time prior to arrival at a acute care facility.

SORRY! But I was never educated in that I was busy learning latin medical terms! PS I never suggested that a EMT-B should or could push any drugs, but I will stand behind my statements about advanced airways and diagnostics, IT IS TIME!!

Apparently you work within the perfect EMS system, So First Educate yourself on how to use spell check! After you complete the prior task, you can take a look at the profession you claim to take so seriously and realize that it is not perfect! I agree to some point that there are providers in the field that should not touch anything on or near a ambulance sharp or otherwise. I don't post my life on here, I am very well educated and have professionally served several communities for nearly a decade. At this time I will point out that other states have very sucessfull EMT-I programs in place. The (I) stands for Intermediate just in case you didn't know. don't be so quick to judge people I know several MD's that ride BLS because they enjoy helping people, Is that not why most of us are in the profession? Thats right I'm a paid professional have been for a long time but you dont see me bashing volleys.

I noticed that only those of a higher medical authority responded, don't sit there and act like you are not overworked, or say that it would not benefit the patients, maybe "GIVE" was not the best choice of words but you got the point. Treat it just like Epi-Pens, I agree train, test then certify. Believe me we EMT-B's dont want to take your job!!

Is it not time to let EMT-B do more, Examples, Blood Glucose for AMS and known diabetics, CombiTube or LMA for advanced airway, In the area I work in there is no EMT-I and Medics are not always available, Give the EMT-B more to work with and lighten the load on the rest of the system. With or without ALS we are there every time, Give us the tools and we will do the job!