johnrsemtp

Like the last person said; they have great classes, and great motivated instructors; who work out in the field and don't just teach. If you (or anyone) can get your county or city or state to sign off on you going to the classes; the Federal Government pays for them, there is NO, repeat NO charge to your service. And there is quite a few classes: WMD, Explosives, Terrorists, How to reconize Drug labs or bomb labs, etc. They will also come and do some of the classes in your home area if you can get 40-60 people to attend (Think lots of different departments); and again those classes are free. They have a good gym on base: so if you like to work out, bring clothes. Talk to your class mates, there is alot of things to learn from others. I had 2 people from Israel in my class. I am trying to take at least 2 classes a year in our slow times. They also have instructor courses: to keep your certification with them to teach, you have to teach 2 classes every 2 years (I think that is the number): they can be the classes in your local area, or there in Anniston, and they pay you to teach. If you can go to any of the classes, DO IT. The full name is Center for Domestic Prepardness (my computer is having issues, and I can't bring it up right now to give the web address): but I think it is www.cdp.dhs.gov . Enjoy your classes.

before I left Indianapolis we got written protocols for Versed IN (IntraNasal) 10mg (5mg each Nare) for combative patients, We had to call for Orders from Medical control; but I never heard of any one being refused; Docs just wanted to track it happening before we came in with Sedated pt's.

At station one night at 2am, (awake): person knocked on door, father having chest pain. I put pt at table at back of bay, got bag, radio and O2 (we were BLS) and hit dispatch for medic truck to be added to run (they were at our station). Medic crew walked by us at the table; said hi: got in their truck and drove off station. They then asked dispatch for the address again; was told that the run was blank address at station XY. They pulled back to station and came in and said hi again; asking if we were the ones having chest pain. I told them that he was, I was just the confused one.

another good book is called 8.4 about what would happen if New Madrid Fault let go. Im in Indy; and they figure buildings here would go down.

EMT B on a medic truck spiked a 500mL IV bag of Lidocaine, ran in about 300mL bolus by the time they got to the ED. Medic couldn't figure out why he got in more trouble than his 'stupid' EMT. RN in ED gave a 3 y/o with an allergic reaction 1mg Epi 1:1,000; "if they were only supposed to get 0.15mg, it should come that way". same nurse, same shift gave Ketorlac instead of Ketamine, IM for a hip reduction. told for both times: don't do it again.

where are you at?

In Indiana; Care Ambulance Service in Indianapolis, which is owned by Louisville Transportation Service in Louisville KY, both have pensions, (401K) both hiring EMT-B, I and P's

you know it is going to be a bad call when you arrive on scene and the crime lab is there, even before the police. we went on a cardiac arrest after the crime lab was waved down by apartment complex management. he had been dead long enough for moss to grow on him. fun day.

Dust; I apologize; It has been approx 2 years since I joined and I don't remember the rules, and can't figure out how to find them. I posted this on both ALS and BLS since BLS crews have a larger chance of running into this than ALS crews and may be able to learn from it. Also just to see if anyone had seen this before. thank you john

I, personally didn't have a problem with it, but it was surprising how many people thought that I did wrong because I didn't do the 'correct' thing of working the patient and then calling for ok to stop working the patient. I just put it out here to let people think about it, and that it might happen to someone else someday: and maybe they have something to go with if it does. thank you

I also posted this on the ALS site. I work both private EMS and 911 this happened on the private service 2 weeks ago my EMT-B partner (1 year experience) and I (paramedic * 2 years); were transporting a pt from a extended care facitlity to home for hospice care and to die at home. At the ECF we found out that the DNR (Do Not Resucitate) order was invalid due to not being signed by a Doctor. Family wanted him transported and we did. His BP in the parking lot of the ECF was 131/83. 12 minutes later as I was backing into the driveway it was 42/19. We got him into the bed, my partner was getting signatures from the wife, and I was talking to the daughter about how to get a valid DNR; get family Dr to sign one. Also telling her what needs to happen when he dies. about 3 minutes after getting pt into his bed, a 20+ y/o grandson comes running out to say that grandpa was dead. great, invalid DNR and we were still in the house. partner grabbed the monitor and I called there ER. pt was showing asystole in all leads. I talked to the ER doc, and explained the situation and he gave me verbal orders not to work the code. so then we stayed there and helped them to call family dr for death certificate and the funeral home for picking up the body. what would you do and what could you do per your protocols? I shared this at both jobs, and got all sorts of answers. also got told by more senior medics that I can't do that, and others said I did too much, and others said that I did right. Most of the Basic EMT's just stated they were glad they weren't there.

I am also posting this on BLS to get more input. I work both private EMS and 911 this happened on the private service 2 weeks ago my EMT-B partner and I (paramedic * 2 years); were transporting a pt from a extended care facitlity to home for hospice care and to die at home. At the ECF we found out that the DNR (Do Not Resucitate) order was invalid due to not being signed by a Doctor. Family wanted him transported and we did. His BP in the parking lot of the ECF was 131/83. 12 minutes later as I was backing into the driveway it was 42/19. We got him into the bed, my partner was getting signatures from the wife, and I was talking to the daughter about how to get a valid DNR; get family Dr to sign one. Also telling her what needs to happen when he dies. about 3 minutes after getting pt into his bed, a 20+ y/o grandson comes running out to say that grandpa was dead. great, invalid DNR and we were still in the house. partner grabbed the monitor and I called there ER. pt was showing asystole in all leads. I talked to the ER doc, and explained the situation and he gave me verbal orders not to work the code. so then we stayed there and helped them to call family dr for death certificate and the funeral home for picking up the body. what would you do and what could you do per your protocols? I shared this at both jobs, and got all sorts of answers. also got told by more senior medics that I can't do that, and others said I did too much, and others said that I did right. Most of the Basic EMT's just stated they were glad they weren't there.

Be careful with the LBS boards; A service here in Indiana was using those and the instructions stated that they are good for up to 1,000lbs: but they go on top of a cot that at the best is only good for 650-700lbs. they dropped a 900lb patient when the cot broke under the weight.

We have a Stryker Bariatric cot; nice cot can be used in any ambulance, but better in the box trucks. It is 26" wide can hold 850lbs in any position and up to 1600lbs in the lowest position. (which of course is lower than any hospital bed, so that will be a fun transport). The truck that it is normally in goes out on the street every day and night. the cot will lock on the normal Stryker catch, and the left front wheel goes into the left 'V' and the right wheel is on the out side of the 'V'. but locks in securely. we used to have a custom built cot in a large box truck that was good to 2000lbs (its record was 1380lbs; which I was on that run and it sucked, even with 4 fire crews).

Just got an update; Wayne township is looking to combine with IFD also probably around July 07; IFD does NOT want transport services; but they are keeping the township transports going.

Care is still doing Private service and is the busiest private service in Marion County (Indianapolis) and is hiring alot of people and looking to expand into other areas, both 911 and transport. Rural Metro does do alot across the state. and the other private services mentioned are fairly busy also. Wayne Township hires Civilian EMS, PT EMS and Fire and Full time Fire. JeniF371 which Jen are you. let me know if I can help in anyway,. good luck

sorry for the 1st post; It wasn't that they didn't have stocked ALS trucks; they didn't have enough narcotics to put another medic out on the street; After talking to dispatch I would have been working on a medic truck, just with no narcotics, which we have had medics get in trouble with our medical director for that since they couldn't do what they are supposed to do in the ALS protocols, much less while calling a hospital to tell them what is coming in.

I know that if I was working on a BLS Truck I would be working on a BLS level; BUT I would still be a medic: If I was dispatched on a pt that was deemed BLS, such as 2 weeks ago: Altered Mental Status, BLS non emergent due to the fact that it had been going on for 3 days and the V/S were stable: got there V/S were 6 days old, and pt's b/p was 72/40. as a medic on a medic truck : O2, started 2 large IV's, O2, monitor blood glucose checked and transported. closest ED was 20 min away. If I was on a BLS truck that day, on an ALS service: all I could do was O2 and go. if the pt died enroute (in some areas this has happened; Iowa, Florida and washington state); I could be sued because I was not working at my level, and I allowed it to happen to me. ALso the services would be sued because they had me working BLS, and I have even heard that the Medical Director can be sued, because he allowed it to happen (and he has deeper pockets); but I have not seen that for sure.

Since I last posted about it, my old partner had spent 1wk in an inpatient mental health facility, which seemed to help (aug 29-sept 4th). then he had the brilliant thought that stopping his medications cold turket would not affect him and stopped taking them on the last Thursday of September, on Sunday Oct 1st he was found in a local park alive after cutting his Left wrist and taking 7 Darvocet. He spent 4 more days in patient; and has been in Intensive Out Patient care, 3 days a week, 3 hours a day. He still says that he has never been homicidal (willing to kill himself but running the ambulance into a tree with his partner and/or a patient on board); and I still believe it from him. he has about 20 different people checking up on him 2-3 times a day. thank you for all of your input and suggestions.

Confusing topic I know but I will try to make it easier: I am a paramedic, working for a private ALS Service: today I was asked to come in and help cover shifts, but was told that they didn't have enough ALS stocked trucks so I would to have to work on a BLS level. Would you do it? During medic school our class followed 2 or 3 lawsuits happening across the country where paramedics did that and were sued because a pt crashed or needed ALS procedures that were not able to be done by the paramedic due to being BLS that day. 2 the patient/family won, 1 the medic won because he was working at a BLS provider part time. just curious of peoples thoughts on this.

Myself and another friend, (his old partner) talked to him and called his counsler and he finally checked into (or was actually taken in by the sheriffs department in handcuffs) a Inpatiend Mental Health hospital for a week and he got some good help. he is feeling better and talking to his counsler more than he was. He is on 2 different depression meds now, and he also agreed to talk to his counsler or 1 of 10 people that knows what is going on; before he ever does any thing stupid again. he also has never had any desire to physically hurt anyone else. thanks for all of the inputs, I printed them off and gave them to him to read.

how about taking everything out of the cabinets and putting it on the cot and hanging the cot from the overhead hand rails with Kerlix.

Has anyone ever had a co-worker tell them that they have been having suicidal thoughts? how do you handle it? what do you tell them? do you have them ID'd so fast that their head is spinning days later? I am in that situation, I know the person is getting help, but I don't know what I should do to help them besides letting them talk. thank you all for your input

I have had to do it a bunch of times: 1st time I was found down and out in the parking lot at work, slipped on the ice, hit my head on the bumper on the way down. 2nd time I was attacked and trapped in drain auger, (long story). 3rd, -6th times: anaphlatyc shock; the worst was being transported in my own ALS rig (private service) with a FF/medic teching, and my partner driving. I have gotten even though, I have taken her in twice.

the article on our cot was in JEMS, January 2002. "Caring for Karen"