ERDoc

Welcome back

Welcome to the city!

Stupid question probably, but have you tried contacting APS?

I'm with you Rock. I have no problems with crews bringing in a pt with nothing done as long as it makes sense. I know I am the exception rather than the rule but actually working in the field gives you a different perspective. I hate it when EMS brings in a tubed pt, because then I don't get to do it.

They are basically comparing the two thoughts of trauma care by EMS. Which improves outcomes, stay and play or load and go? We can all make guesses about which is better and why but there is a lack of evidence to support either side, although this is starting to change. The best we have for comparison right now is to compare conventional EMS interventions (treating at the scene) to no intervention and rapid transport. The only way we have to evaluate the latter is to use data from homeboy ambulance since there is no significant data from EMS for this arm. I think OPALS came closest to making some recommendations, but I haven't kept up on it recently.

As for fiddle fucking at the scene, yes that is done since that is what protocols say. Try delivering a trauma pt to a trauma center with an unsecured airway and no IV. Best practices will require changing the thought process of both prehospital and hospital providers.

You do understand why they are comparing EMS to homeboy ambulance, right?

So we take a set of patients involved in some major trauma and study their outcomes. Someone has determined we are doing more harm than good? Does anyone else think that people with serious trauma have poor outcomes due to their injuries and not neccesarily because of EMS? These people are ALREADY sick/seriously injured their likelyhood of poor outcome is most likely due to their traumatic injuries. There seems to be too many factors to be able to make a reliable study. Every injury is not the same and neither are the patients reaction to those injuries. Do people stay and play with trauma patients? I load them up and do everything en route.....

So we shouldn't bother trying to improve care? It's too hard, let's not try. Trauma registries are full of hundreds of thousands patients. It's not too difficult to control for variables and compare outcomes when you have such huge populations to pull from. No, it's not the randomized, double-blinded, placebo controlled utopia we all hope for but it is good enough to make changes.

You would be surprised with the force you need sometimes. It's just used in a different way. It's sturdy so I wouldn't worry about that. The batteries and keeping the contacts clear were always out biggest issues.

I've used the McGrath, both 1st and 2nd gen. It's pretty easy to use since you have similar technique to a normal laryngoscope. The screen on the 1st gen was a little small and fogged easy but the 2nd gen was better. The batteries in the 1st gen crapped out at the worst times but this was corrected with Li-ion batteries in the 2nd. There is no peds blade. It's probably good for in the field, but I prefer the glidescope but it's a bit bigger and not nearly as portable.

I don't think I would want to be in a plane, at altitude, if he has an outburst. It's a lot easier to jump out of an ambulance than an airplane.

Did the article in that link not contain the exerpts from the call? Let me see if I can find it since it provides more info.

EDIT: Here is a small part of the call from CNN.

http://www.cnn.com/videos/us/2015/02/05/dnt-md-911-operator-to-caller-stop-whining.wbal

This sounds like it might require a higher level of care than a paramedic. There is no way you should be sedating him for the entire trip, especially if he does not need it.

http://www.wbal.com/article/113247/3/911-operator-who-told-teen-to-stop-whining-reassigned

Discuss.

It's a bit old, but probably still pertinent.

http://www.apa.org/monitor/jan01/suicide.aspx

Make sure the scene is safe first. Are you sure it is a suicide and not a homicide? The pt is your primary concern not forensics. You should still try to remove the pt from the scene as quick as possible to minimize damage to the scene. Save anything you take off the pt. The noose is interfering with the airway, get it off however you can.

And Columbia was lost on Feb 1.

Per aspera ad astra

First, welcome to the City. You will find many different opinions here (some you will like, some you won't). I'm sorry to hear about your friend and you community. Can I make one suggestions and please don't take it as me trying to chase away someone new to the site? We all like to help and answer questions, but none of us like to try to decipher a difficult to read paragraph. I am no grammar nazi and make plenty of written mistakes myself but it would help us help you if we had something a bit more coherent and paragraphed to go off of.

I'm going to assume that you meant what arctic said. No one is going to begrude you or give you a hard time for wanting to change fields. We have all thought about it once ot twice, I do it on an almost weekly basis. Make sure you understand what EMS really is. The experience you have had is the exception and not the rule. Disasters like that are a once or twice in a life time deal. Do more ride alongs and see the real work involved with EMS before you decide.

I don't know the first thing about EMS in Alabama so I can't help you there but have you tried google? Be careful going out of state. An EMS card does not transfer from state to state as easily as your nursing license does. Check with you state EMS office to see what the policy is.

You will find that most people on here despise the accelerated card mills. I generally agree with this, with a caveat. If you have been through nursing school, you will probably find EMT class easy. You already have more knowledge of anatomy, physiology and pathology than you need. You know how to do vitals and provide first aid. It is just a matter of learning the more EMS specific things such as traction splints, immobilization, etc.

Pretty typical. We shouldn't be spending so much money on those rich doctors and all of their fancy tests. Except for me, I want the best and most expensive care I can get.

I think a lot of it goes back to changing medicine from providing medical care to making it a business. What is the purpose of any business? To make as much money as possible. Medicine is not a business, so let's stop treating it that way.

How do we improve ???? Not sure since I am "memeograph paper" (still love that smell) in a texting age; but some thoughts:

1. This generation is all about the cell phone (they are all going to have tumors), does this site work well on a cellphone ?

I don't use it on my cell, just the computer and like I said, it is much more enjoyable back with this format

2. Are our topics IN TOUCH with what the younger generation wants to talk about ? Do we need a "relationship advice" tab, or a "You won't believe what my dumb ass company did" tab.

I hope not. If it comes to that, I think will need to leave the planet. Maybe a revamping of the topics, but I wouldn't be the one to know how.

3. Should there be a tab just for vollies ? Should Admin award a free subway sandwich card to the best post of the month ? Should all posters have to put their nude pics up as their icon image ?

Now I want a spicy italian, thanks. I don't think we should have a separate area for volley vs paid vs fire vs etc. In the end, it should all be EMS.

Most importantly, I think there needs to be respect for all posters, no matter how dumb --- we recently had several adults beating up on a 14 year old for his stupid post; is that smart ???? I remember reading something about how all the "Christian TV stations" that beg for money all day, did not have a problem with the channels that were in direct conflict with their so called christian beliefs, on the satellite/cable package. Why, because they were all lumped in, in the same tier, if one of them failed, they all failed, so the Church channels were happy with the stations that sold vibrators.

Maybe being "EMS Purists", with no tolerance for the ignorant, is our problem.

I think we all have agreed that we can be quick to jump on new posters.

I didn't mean for that last post to sound as obnoxious as it does. I meant it seriously, is there anything that could be done differently that would improve the site? This isn't just for ambo, anyone is free to jump in here. I think we have a pretty good community and I would hate to lose it and be forced to that other site. I think going back to this format has helped quite a bit. I think if we could find some new memebers and expand the ranks it would help. How do we do that?

And what do you recommend could be done to improve the site?

What he said, and I'm still not saying I am batman.

It's all good, Ruff. I know you wouldn't do anything like that.

Thank you for telling me who Triemal and ER doc are.