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Medic7714

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    Paramedic

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    Male
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    Pennsylvania
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    Music (alternative, screamo, metal, acoustic, pop), Amateur Radio, Emergency Communications, Zombies (The Walking Dead series!), Survival stuff.

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  1. Modify ur search criteria to include the terms ems prehospital paramedic etc. There is tons of info online about cpap Sent from my LS670 using Tapatalk
  2. It makes sense to dilute narcan. Although if you use it IV in 0.4mg increments drawn up in a 1ml syringe and push it slowly you dont have to dilute it. And if u use the prefilled narcan just push it slow and titrate to resp status not loc. Sent from my LS670 using Tapatalk
  3. I can understand that position. My only thing is when a high index of suspicion is pointing towards a drug OD, I don't see any need cutting a girls shirt and bra off. Remove the shirt okay if you really feel its necessary... but the bra and fully exposing the chest? Again, what is someone expecting to find on the breasts that is critical to figuring out what is wrong? Just seems unnecessary to me. To us it seems quite trivial but to this girl it was her only bra. Just because a patient calls 911 doesn't mean we have the right to be inconsiderate of a persons property and clothing and expose them because we can. That's all I'm saying.
  4. I honestly didn't think the computer exam was difficult at all. When I took it I think it shut me off at like 84 or 86 questions. I walked out like most having no idea how I did. I felt like it was up in the air but luckily I passed. I did think that the questions were relevant though. I'm not sure I want to go that route when I recert though....lol. Im thinking the refresher course may be better for me. Thanks for sharing your experience.
  5. I wouldn't have went straight to an IO on this patient. I would have at least attempted peripheral IV access. If no success then I would have went for intra-nasal. Heck, I may have went straight to intra-nasal. But being an OD with hemodynamic compromise I want IV access since we don't know for sure what else she took so I would have tried harder then a quick glance to obtain IV access. What if she took a combination of things and the opiate is maintaining a balance. Now take the opiate effect away and you could possibly have unopposed stimulants taking hold. But yeah, just my opinion I think IO was a bit aggressive and overly invasive for this patient. BP was fine. Assist with ventilations / O2 and you will prob see an increase in heart rate as well. If that ALS service doesn't have an atomizer device they should look into getting one. And I have to ask... why was the patients shirt and bra removed? I don't see the need for an OD to be fully stripped down to expose the chest. What was the Medic expecting to find on her breasts?
  6. Medic7714

    NG Tubes

    I agree NG tubes are a great adjunct to airway management and should be used more then what they are. I don't think a lot of providers really consider their usefulness and how they improve ventilation and increase lung compliance (ie tidal volume). They are within the scope of ALS providers here in PA and have received specific mention in the 2011 ALS protocols. Unfortunately, I cannot get the service I work for to spend $3 for an NG tube in all sizes. Im still working on it though.
  7. I am a Pennsylvania Paramedic and am really liking the new protocols. It's nice to see research driving EMS care. As far as the ALS and BLS interface. I completely agree with it. If you have an EMT and Paramedic on the same unit, the the higher level provider should be the one making initial contact and performing the patient assessment irregardless of the patients complaint. If the Medic feels the EMT can handle then fine. But then again, if the Paramedic has to type a PCR for their assessment they may as well just ride with the patient. I'm not sure how this will work with billing if an ALS assessment is performed but patient is then accompanied by EMT on same unit. Another reason I agree with it is I have the belief that an EMT level provider is too minimal to be a primary care provider on an ambulance. And I am not saying that to be condescending. How can 140hrs be sufficient to address a patients needs? I was a career EMT for commercial and 911 FD EMS for about 16yrs prior to becoming a Paramedic. And late into those years I really started to question my benefit as an EMT to the patient which is why I became a Paramedic. With the exception of rare, life-threatening calls all an EMT can do is an assessment and O2. And for those keeping up to date with the latest in O2 therapy, even that has fallen out of favor as it has shown to be harmful in many cases and is reflected in the new PA protocol as titration of oxygen to SpO2> 94%. Just my opinion.
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