firemed665

An engine company or other rescue vehicle should always accompany an EMS unit responding to a roadway call of ANY kind. You will find this in any IFSTA manual, your new EMT or Medic text book, and just about any major Fire or EMS publication out there. The reason for this is to provide scene safety and protect both the rescuers and the victims from traffic. By parking the transport vehicle ahead of the scene and a secondary vehicle behind to block and redirect traffic around the scene you provide a safe zone of operation on the roadway. It doesn't necessarily have to be a big red firetruck, for those that have angst for the FD, but it should be something visible. And as an extra perk, the guys on the FD units could probably give you a needed hand if it turns out to be a nasty call. The patients might appreciate being cut out of a mangled car quickly as well. As far as research on this goes, go to www.firefighterclosecalls.com, or research it on the web. And by the way, I'm pretty sure your local OSHA office and the company's insurance agent may not be to happy to hear this. I'm guessing that the brain stud that made this decision based on monetary costs hasn't provided you with your Federally mandated ANSI safety vests either. Sounds like a bad idea to me. Good luck!!

Make sure you go and take your National Registry Exam for EMT and Paramedic and maintain the certifications. If you are National Registry you can pretty much go anywhere in the USA without a problem. There are only a few states that like to screw that up. Good Luck!

Not much to say here. Doesn't matter about skin color or any other info. If she is complaining of chest pain 8/10 with no history of trauma and hasn't moved in days you'd better hook her up, treat her with cardiac protocol including a 12-Lead and consider PE protocol if you have one. Even though she seems whiny and her symptoms are probably from sitting in the chair for several days remember it all started with increased pain in her right leg and she does have a history of PE x 2. It's a good chance she may have another PE. Her headache is probably caused by dehydration and possibly low sugar since its a good bet she hasn't been eating right as well. Gotta love getting old.

Your in Urban EMS when you have to pick up the drive by shooting from the doors of one ER and take it to another because the doc wont go outside. You have to drive around the block three times with lights until someone opens up the door and flags you down because there aren't any numbers on the houses. You have a list for new guys of what neighborhoods that you turn off the lights and sirens before entering with police escorts You have to lock ALL the doors on your rig when you drop patients off at the ER. You have to pass through a bank vault door to enter the ER. You pediatric asthmatic patient's parents ask you if the ER waiting room has a TV so they can watch the Bulls game. When you bring home a regular dialysis patient and her son invite you in to join the party, have a few drinks and anything else you see that might interest you. (Like the girls he has over, or dope on the poker table) You get contact highs on a regular basis while waiting for patients to open their apartment doors. Ever hear of a "hoister, ya know, you get when from hoistin something to heavy." When you get to the apartment building and you know to go to the floor the three bangers at the front door tell you, not the one your dispatched too. When the patient can smell your food in the front of the rig and asks which rib joint you ate at. And then asks if you have any leftovers. And you know your in Urban EMS when you know whether or not to run for cover because you can now judge how far away gun fire is.

We responded to an elderly woman with abdominal pain. As I was assessing the patient I hear the husband telling the Captain that she has been constipated for several days and earlier he had to put his hand up her *** and pull out some of the ****. "ya know, just slid my hand in there and pulled it out like a backhoe." (he did this with hand motions) I don't know what was funnier, him telling the story or the look the Captains face. As I look back on this, all I can think of is, now that's true love. But then i get an image of what this would look like in that "Love Is" cartoon in the tribune, and realize that I have been doing this job too long.

Maybe she had really bad breath?

Collars? Collars? Collars? We don't need no stinking collars!!! Ok, just kidding. The Philly is still alive and well in Indiana. We have both Stiffneck and Philly's. Just depends on what hospital we restock at.

I think they did right. As long as the systolic is over 90 all vital organs should be getting adequate perfusion. Additionally, although this patient probably has a GI bleed pushing more fluids than necessary to maintain a perfusing pressure may cause the bleed to become greater. Even though its not a "trauma" remember the rules from PHTLS when it comes to fluid resuscitation. Working in an ER I'm sure after he got there they gave him a liter bolus while he was being typed and matched for blood. However, the IV pumps don't run any faster that one liter per hour. So when your crew gave a 250cc bolus it provided the patient with more fluid than the ER most likely would have given him in that time period. Therefore, when your crew said that 250 was all that was able to be run in during transport, they very well could have been right. I think your medical director is probably off base. However, not to say that they did, but I have found that even though you may have provided excellent patient care a poorly written PCR will always cause you to have to explain your actions further. Your crew did the right thing and was prepared witih a second line in case the patient crashed. Good for them!

Oh my God! that is hilarious!!!! Brought tears to my eyes.

It's just a fact that if you put two EMS workers of any kind together alone for a long enough time they will talk about things that should be avoided with co-workers. And usually one of them, sometimes both of them, loses control and crosses the line into the inappropriate. And, yes men are pigs and will discuss their women co-workers with other men. However, women are often just as bad, they just have a tendency to not make it as obvious. Since I started working with mostly women in the ER I will have to say that women are definitely pigs too!

I don't think that t-shirts have a very professional image. However, realizing that management often looks at cost, they are a lot cheaper that polo's or button ups. I have the option to wear anything from a t-shirt to a class B while on duty. I prefer to wear the polo, even at night. At night it goes on just as fast as a t-shirt and looks better if you forget to tuck it in. I think polo's show a professional image yet are still relaxed and comfortable to work in. Most polo's don't cost more than t-shirts do anyways. But, I must be a sucker because I really like the 5.11 polo's despite the heavy price. As far as shorts go, as long as they are uniform I don't care. I like to wear them in the summertime, we just have to wear our turnout pants over them on calls. I don't get the whole BBP thing with shorts. If you spill blood on your pants or have to work a trauma, chances are it will soak through to your skin and you will still have contact with the blood. Besides, if you are making that big of a mess when involved with patient care you have some real issues. Turnout pants, EMS or Fire, are probably the only pants that provide true BBP protection. But hey, like they say at work, I'm just that crazy guy from Chicago.

I have to eyeball it in the rig. Kind of sucks, but I'm old school and never really had the opportunity to do it any other way. However, when I'm working in the ER at the hospital we are required to use pumps for all fluids.

Here in Northwest Indiana there is a huge shortage of Paramedics. EMT's are fairly bountiful. Because the area is growing rapidly the need for ALS service is increasing faster that we can get students out of Paramedic school and onto the street. We also have a problem with funding, so new and existing services are unable to expand to meet the demand. This includes Hospitals as well. Northwest Indiana is changing from a fairly rural area into modern suburban communities. The Chicagoland area just over the border has more medics than the entire state of Indiana. But, the financial constraints that the communities here are under make it hard to pay a wage comparable to the Chicago area. So drawing experienced medics from Illinois is easier said than done. Right now I make more money working in the ER on my side job than I do from the town I work for. As for the competency of the workers it varies, but for the most part is high. The paramedics in the St. Anthony's EMS System are all pretty good. The EMS system holds its medics to a high standard of education and skill. The new medics that come out of school here are usually, for the most part, street ready. The Methodist EMS system is pretty good too. Both are very progressive and have very aggressive SOP's. Unfortunately, you always have the problem of what to do with the one or two companies that allow their medics or emts to become burnt out or just not care. But, that happens everywhere, the last ones to graduate school still need jobs too i guess. No offense intended. Unfortunately, I believe that the number of EMS workers is only going to need to increase until there is a real solution to the health care crisis. Once everyone has decent access to health care I believe we will see a decrease in the amount of EMS workers needed too. Kind of a catch 22. On the other hand, if everyone has access to good health care I probably won't be getting up at 2am for the ill person with a cough and fever for a week.

I suppose it can go both ways, depending on how you use the term. However, I have always seen it used in conjunction with compliments on a medics skills. Quite often "ghettomedics" are complimented on the fact that they run a high volume of calls, handle stressful situations well and tend to do their job very well because of the lack of health care in the impoverished neighborhoods they work in which presents them with many challenges. Having spent most of my career as a "ghetto medic" I often get complimented on my skills and ability to handle stressful situations while maintaining my cool. Where I am from, its often used as a compliment showing that you have been there and done that. By the way George Carlin did a great piece on how words can have two meanings. Check it out if you get a chance, it could help answer your dilemma.

As an evaluator I can tell you that the only things that matter during the practical is what the site tells you. They will tell you whether or not it is a biphasic or monophasic monitor. Try to remember both of them. If in doubt ask the evaluator to describe all of your equipment before you begin the scenario. Bring your books and notes and touch up on anything your not sure of while you wait. Good luck!