FireMedic65

Doesn't matter what training you have. You must go through Florida's academy.

Like I said brent... it depends on the snake. Best to contact an expert. Some venom will cause the tissue necrosis if it is constricted.

I always made it a point to allow the students to handle the situation until I felt I needed to step in. I also always taught them to expect the unexpected. You will always have to adapt to different situations where as a scenario in the book is too text book to base off of in the field. You are also the patient advocate. Even if they tell you they are alright, it is still your responsibility to ensure they really are. If the patient refused to go, then that's that. But your job still isn't done. You should make sure the patient will be okay after you leave. Ask a neighbor to check in on them or a family member if they are close. Sometimes just talking to the patient like a person and not a patient can go a long way too.

It depends on the snake and where you were bitten. I was taught at a class (taught by an MD that was an expert in the field of venom) that you are to bandage and keep the wound heart level. Applying any sort of constricting band can make things worse (or better). Your best course of action is having dispatch get you in contact with someone that is an expert on the subject. Most hospitals are not capable of handling many of the venomous snakes out there. They sometimes carry a limited supply for snakes local to the area, but not much because it expires. Get in contact with local hospitals to see what their capabilities are for handling snake bites and what anti-venom they have. If you are rural, you might be looking at flying a patient. The closest hospital to me that can handle such things, is down in Philly. They carry a lot on hand because of the zoo being so close. Way too far to drive What kind of standby? Their will probably even be experts on site.

Like hell I will let a spider bite my weiner!

What do you think the cause of the back pain was? You think anxiety caused the decrease in Sp02? What was her rate/quality of breathing? What was on the monitor besides the co2? What was the rhythm? What makes you think she needed 2li of o2? Why were you looking to start an IV? If the medic didn't listen to lung sounds and you though it should have been done, why didn't you listen? Why didn't you speak up for what you though the patient needed?

glad you and your family are ok scotty

I am a firm believer that over education is better. I see it way to often where many students are taking the easiest route possible. They complain about having to do work "they don't need to know". Why is this? Would you want a bare minimum educated person taking care of you or your loved ones? I would assume your answer would be NO. There are many aspects to our education that may not be immediately relevant to our everyday practice in medicine. But, there are times when they will come in handy. I for one do not like to look stupid when talking with my peers or a patient. You will be more respected by others if you know what you are talking about above and beyond the normal standards. Do you have to know how much force is caused on a persons body when they are traveling 50mph and strike another vehicle coming at them at an equal speed? Sure, the actual formula may not be useful in the field, but if you have a basic understanding of the forces at play you can much better judge the patients condition if they say "I will be ok."?

I always considered being fearless with being ignorant. Once you stop fearing something you become ignorant to the dangers. You should always have a bit a fear in what you are doing. You might be thinking why.. because you get tunnel vision, you think you know it all. You can be confident and educated and experienced and still have that fear in you. In my honest opinion, when you stop having that fear in you.. you are going to hurt someone or yourself.

There was a very good podcast I listened to a while back that dealt with physics. Primarily dealing with fluids and how they flow through the body. Something to do with more fluids flowing at a fast rate causing more harm than good due to some "law" that I also forget the name of. helpful aren't I?

good point.. but at least I am trying to get people together

Alright everyone the chat has been open to all members for awhile now. The chat is usually empty or has very few people. I was thinking of setting up designated times where more people can arrange to come chat with other members, and get a chance to meet and talk with your fellow posters. I made a poll to see when would be a good time for the majority of members to come chat. If we can decide on a day and time that would be great. Also, this doesn't mean if you can't be around that time doesn't mean you can't chat at other times! People are there once in awhile. I am merely trying to arrange a gathering of sorts. edited: to fix poll questions

hmmm nothing for the droid in resqshop bummer www.medscape.com has a good app out and it's free also merck medicus is free too

Good video. The CPR was kind of poor but the person looked to be a bystander. At least CPR was being done though. I am just curious why didn't try moving the guy like.. 5ft so they wouldn't be forced to work under the only obstacle for a few miles...

Oh don't worry Richard, I know a few sites that sell prescription drugs online! They come from Nicaragua.

I never seen dog food in a hospital. But I am sure arrangements could be made if the patient was staying there for an extended period of time. Taking the dog out for a walk to use the bathroom might be a relief for a few staff members. A chance to get outside and a break from patients. Also, an excuse to go smoke for those who do smoke.

PA requires two per ambulance. Usually we take them from linen closet at the ER and replace them. They are uber cheap ones that are covered in a plastic bag. The good pillows somehow always end up in the crew quarters.

Dinner? All jokes aside though, you are correct. If the patient was unconscious or something like that and was unable to give the dog commands, this might change my opinion. But, he WAS able to make a request to bring the dog with. This means he was conscious and alert right? These dogs aren't something you pick up at the pound and put a collar on them and have at for a service dog. They are highly trained to be with their owner. They see for them and look out for dangers. They are not a threat unless they are threatened... ie forcefully removing them from their owner. As for allergens... seriously? You work on an ambulance and you are worried about pet dander? Yeah, sure I understand people have allergies to these animals but this is a bit much. You are an EMS provider that responds to numerous calls a day to various locations with unknown occupancies in these homes. There may be 20 cats, 3 dogs, gerbils, snakes, birds, etc etc... would you refuse to treat these patients because of your allergies? You should expect to run into these homes with pets. If you have an allergy to them, then you really have no place to complain about going to homes where they are when it's your job to go there. Put on a mask, get some visine and grow a set. edit: Only the 'dinner' part was directed towards you Ruff.

Not a good idea to try separating the owner from the dog. They are trained to look out for them and protect them. If the blind person is capable of telling you he won't go without the dog, then he is capable of giving the dog commands. I say, take the dog.

I fully agree with being competent using the meds you are giving. But don't you think the patient would benefit from quicker treatment?

I honestly cannot really see a need for this in a normal run of the mill ambulance. Transport times are often way too short for it to be cost effective. Rural services that have long transports or doing a lot of IFT might benefit from it. Personally, I think this could be a downfall for a lot of services. It would lead to providers getting lazy and using it for docs to do all their work for them, unless, of course there was a strict criteria for using it. How often do some providers slap on a pulse ox and use that for a pulse? Or use the monitor for the same thing or all blood pressures? It happens. But then again, having such a tool could not be bad. All that being said, I would rather have it and not need it over needing it and not having it.

The CIA e-mailed me the other day from their Albanian yahoo account. I was offered a job but I had to front the money for expenses and travel because of their currency exchange. That wasn't too much of a problem since I just won the British National Lottery and luck has it, that there is a prince from Niule that is moving to America to attend college. He heard I was a nice guy asked if he could transfer his millions in funds to my bank account so he would not be poor when he arrived. This seemed like a great deal since he offered me full use of the account with his funds! Who wants to party!?

Sorry to hear about your cousin. I agree with crotchity's thoughts on this. Without a better history and all that jazz it is hard to tell.

Thanks Annie. My chief is in full agreement with me about this and will back me up. I do not expect crews to line up and wait to get a BP taken or anything. I just wanted something in place in case someone decides to be a hero and run off when they aren't physically capable. This is meant more or less for my current station. My first priority on the fire scene is to be a fire fighter. My goal is to train people at our one vehicle that acts as a rehab and a cascade to look for these signs and symptoms and all that jazz and have them sit out for a little. These are more or less guidelines, not procedures. I will talk to the medical director though. Since, most of the time I would be the only EMT with our station. Everyone else is first aid trained, but first aid training doesn't touch anything like this. It is a fine line though since I cannot always be there, not everyone will want to comply, and won't always have someone available to check vitals. But, if I could at least show people what to look for I can at least put it in place that they sit down for a little and cool off, or warm up for that matter (since it is winter now). I like crotchity's idea a lot. It would be a great idea to have baselines for others to go by. We we have numbers on our tags so it would work out that way. But, like like I said, this would only be a guideline if myself or another trained/qualified person deems them unfit to return to duty at that time. I should have made that more clear in my original post. I do not want to make this a SOP. I will start with one station where I operate out of and see how it works and expand later if I must. Thanks everyone!

Thank you Richard, I appreciate the input and I will bring it up with the Chief.