paraloco

I've seen this twice, both back in the 80's. One was a guy with a cerebral bleed. The doc inserted the et tube nasally, secured it, then just left it like that. the guy was breathing deeply and rapidly. The other was a head injury from an mva. Out in the sticks with no good lz. his teeth were clenched. We had no paralytics back then, just a jaw screw that I almost lost down his throat when he opened his mouth, then closed it again. I had to do something, so I nasally intubated him and put a nrb mask on over it. The little community hospital left it just like that, even when a flight crew came to get him. I heard the doc talking to the receiving hospital over the phone. He told them he did it, then turned to me and informed me that he just saved my @ss.

Speaking out of my @ss, I am thinking that most hang-ups about doing a complete exam are just that, products of our own fears, not recalcitrance on the part of the patient. I have never had a female patient hesitate to allow me to examine any part of her that I believed necessary to examine. I explain why, ask permission, and assure that privacy will be respected. The one time my company got sued over my actions, not even the patient disputed that I acted professionally, or without consent. She/he/it was out for a fast buck. We fought it, the jury saw it for what it was, and she/he /it walked away with jack$hit. Some medics I know will not do a perineal exam, even on a patient in labor. They'll look really stupid and feel worse the day they bring in a presenting limb, Freddy Krueger's hand protruding, etc, and did not bother to check. Having said that, its prudent to have another in there with you, if you have the option.

My brother is a pastor in a small community in the Pacific Northwest. More than once police have come to his office asking him to accompany them to scenes as varied as car wrecks, CPS or APS issues, etc. You can have all the legal authority in the world, sometimes you need moral authority.

afib, check out Beaumont EMS. no transfers at all. 3rd service

we are expecting to get the west side of the storm. they all-paged earlier, cancelled all vacations, and ordered everybody in on saturday morning with enough clothing, etc. for 4 days. the hotels north of here are already full. I think my family is going to go west.

Treadsafe brand, Easy style/model 26 bucks at Walmart. I beat my young partner to the truck at night because she's still fumbling with laces. Fast to get off if I have to bunker up on scene. They are very comfortable, and they don't have velcro straps like one of the Dr. Scholl's styles I used to wear.

We have a device called a med-drafter that is specifically for providing a nebulized medication to an intubated patient. I don't know how expensive it is, but it does not take up much room on the shelf. I can find out more if you are interested.

Where I live it is not worth it. The pilots and nurses make decent money, and have good insurance. The medics don't make much, and they have crappy insurance. They fly because they like it, because they believe they are part of an elite, or because they think it looks cool to wear those big ol' helmets. I take my hat off to the Hermann Life Flight crew who flew my son, gotta love em. But its still not worth it (for me). 2 laws at work Gravity and Averages. I've been in several severe MVA's and walked away without a scratch.

DOn't swerve to avoid anything. That is what gets you injured or killed. Abrupt maneuvers are bad. Hit the brakes.

we spread its cheeks every morning. all fluid levels, function checks on all equipment. expiration dates on drugs, fluids, fire extinguisher. all lights, the cooler. triangles, throw rope. Seems like my shift is the only one that gets oil changed, replaces the main O2, etc.

This was back in the 80's. There were 2 private services in the town I used to work. And yes, we raced each other to calls, just like in Mother, Jugs, and Speed. Nobody had a problem with it back then. We'd pull up behind the other guys on a scene, so that they couldn't open their back doors. We'd 'help ' out while they were extricating, but load the patient on our cot. No triage on mva scenes, no ppe. I now have all the help in the world in the way of extra manpower (firepersons). I think of all the stuff I ran on that me and my partner handled alone back then. It was not an option to call for help. Gloves were optional, sharps went in the regular trash. We were forbidden to take equipment into a nursing home (it supposedly scared the other residents). As I remember stuff, I could go on and on.

Oh, and we justified it by pointing out that response times were short.

In the 80's,we called that scanner jumping. We had not 1, but 2 scanners mounted in the ambulance and were expected to listen religiously to everything that went over the air from every agency. Dispatch did too, and as as soon as a wreck was put out over the air, we were running to the truck. The idea was to beat the competition to the scene. We got really good at it.

good old nepotism helps.

In the late 70's in driver's ed they showed us two films. Wheels of Tragedy, and Mechanized Death. Both were very graphic and made in the 50's.

Around here, we are 'emergency workers'. I guess that means journalists are media workers.

from what I'm reading here, it sounds like they want to run off the single role medics. They be "phased out" by attrition. they'll make them the station duty b*tches, make them go polish the floor at HQ, wash the battalion chief's Tahoe, etc.

It is provided for us where I work. There is a policy that states you must wear it during extrications. That's the city covering their butt. Few folks put it on the truck in the morning, fewer still have complete sets. I wore my helmet today (first time in about a year) during an extrication.

I notice you are wearing an Acadian uniform. You can live alot better in Texas on what Acadian pays than what AMR would pay in HI. Even in Austin. If I wasn't so close to retirement, I'd jump on their 20k bonus for the Austin area. But you are young. Got for it.

It can be more fun to whisper something in your partner's ear, and watch them almost herniate trying to suppress their laughter. Years ago, went to a self-inflicted gsw to the head. Guy used a .38. He was dead but had not yet been informed officially, so he continued to breath (albeit sporadically) . His cranium was in pieces, blood everywhere. We opted to fly him, but we still had to package him. We got him intubated, got 2 lines going, etc. We put a collar on him, and it seemed like there was something we should do to prevent all the blood from getting all over our cot, ourselves, the back of the truck, so we can get in service faster. Now. Have you ever taken a class, or discussed as length a new technique, only to apply the new knowledge several times shortly thereafter? Like taking ABLS, then having a few bad burn patients? Or maybe talking about how you can use the bag that the BVM came in (the kind with a drawstring) to put around an intubated head trauma patient's head to contain blood? I leaned down to my partner, who had just put a multi-drama dressing on the guy's head, and whispered in his ear "Sir, would you like a bag for that head?" I have to admit that he contained himself well. I know. I'm gonna fry in hell.

Baytown EMS has at least one opening now. We have about 3. Also Harris County ESD #1. , Montgomery County Hospital District EMS. Another option with Acadian is their Austin , Tx operation. hot & sticky summers, mild, almost negligible winters. affordable cost of living. hurricanes, but few tornadoes (and the ones we do get are little pipsqueaks compared to the ones you get up there in Ok. Historically, Galveston is on the low end of the pay spectrum, but they are progressive and hi-volume. You'd use all your new skills. Harris County and Monkey County both pay very well. Beaumont is barely competitive, (but hi-volume, progressive, good benefits) Talk to the medics from each one. Find out about how they get CE's, talk about vacation issues, benifits, retirement. How they are funded, are they the red-headed stepchild next to PD & fire? Ask them about their stations (this is your second home, you know). Old farts like me avoid places that use SSM extensively, like EMSA or Medstar.

1. She's protected by HIPPA, just like anyone else. 2. If she requests EAP before they take action, they can't fire her. 3. This is one reason it's better not to work in the town where you live. Though I believe she probably should not be on the street, I think she should have someone advocating for her, then let the chips fall where they may.

you wouldn't need as many folks for 24/48's. the schedule you use sounds like one used by a few agencies here, but without the long (8 day) break. Ya'll are 3rd service under a health dept.? We do 24/48s, and with at least 2 extra 12 hour shifts per pay period (26 of them), I made in the mid 60's. One guy I know with no life and a shrew wife (meaning he doesn't like to be home) made in the 80's. We have constant staffing problems, too. Usually from injuries. It's made getting in house CE's a thing of the past. The OT makes it hard to get them elsewhere and still have a life. We were close to being fully staffed for about 1 week.

Bullmedic, that's for 24/48 right? Ya'll are set up very much like us. Are you fully staffed?

For a medical call, airway & med bag. For Pedi medical, the pedi med bag & airway bag. For trauma, the trauma bag & airway bag (which has O2 and a v-vac in it). We will take in the suction unit if confidence is high that we'll need it. If we are going in to a nursing home or retirement apartments, we usually throw all this stuff on the stretcher before we go in. The f-monkeys bring the bags back down if we transport. If its upstairs, I also take the clipboard so we don't have to go all the way back to the truck if it turns out to be a no-load. Some of the elevators we go in are barely big enough for the cot, even broken down. At one second floor apartment, we sent the monkeys to get the cot. We were going to bring the patient down in a wheelchair to the lobby. They were pretty slow about it and when I went out to check on them, I saw the elevator door open and inside was the cot, on end. I looked over at their capt. He shook his head sadly and said, "I'm just along for the ride."