DFIB

Diddos to all the prior posters. I would also encourage you to consider instructor insurance.

Because we do not have the luxury of an ECG. If the patient is having a Right Sided Ventricular Infarction and we administer Nitro we will drop the preload due to the vasodilation. This can induce severe hypotension resulting in immediate hypoperfusion. In essence we could contribute to the patients ultimate demise. Here is a link that explains it in detail. http://www.emsworld.com/article/10321209/recognition-and-treatment-of-right-ventricular-myocardial-infarction?page=2

Good for you Biebs! Please congratulate your honey for me.

Good idea and great point.

I am the boss when I am not at home. Odd how that works out.

Thanks guys for all of the input. I did omit AMS and head trauma but it was not on purpose. I was posting the idea while on break from having a linguistic interchange with the monsters in the toilet. Amazing, I thought I had forgotten that language! I think the primary considerations for less immobilization are first that many patients don't need it and prolonged immobilization can cause more harm, especially in the elderly and folks with spinal pathological. Another reason that I have not seen anyone address is that immobilization ties up valuable human and time resources that would be more efficiently used attending other injuries or aspects of the call and patient care. Thanks everyone for posting your protocols.

I agree with not administering most meds but (in my opinion)basics can and should administer O2, activated charcoal to say the least, but I can see your point although it seems extreme. I think Nitro should be banned from EMT level administration but don't see any reason why they could not do a D-stick. This is in no way intended to bash you but I would be mire concerned about students splinting than checking BGLs.

There have been many reports of abuse of authority, human rights violations and just plain stupidity since Katrina. Oh, I just noticed he was a civilian and has been fired. I had no idea that civilians could put a boot on a vehicle. http://www.ems1.com/...ce-fired-cited/

Firemen come here?

Just an additional thought. I am trying to move our department toward less immobilization under a pretty simple guideline. No pain + no deformity + no distracting injury = no immobilization I have a fight ahead, but what the heck, I have nothing better to do!

I let students lay hands on the patients and encourage them to perform all of the skills that are appropriate to their level of training. I observe, correct, modify and improve their technique. That is how they learn. The patient is never at risk because I am there, directing and supervising their actions. Even doctors learn this way, "See one, do one, teach one" I have heard many a resident say while learning a new technique from the nurse, PA other medical personnel that are way below their educational level. When I get green students that are timid and shy I get them to talk to the patient, interact, and begin exercising the skills that have learned in school. Just because they they do not have a cert does not mean they are not competent. Moving back to the OP, you might try to volunteer for other things that are not necessarily EMT related; take out the trash, tidy the living areas in the station. Make sure you do these things well and expeditiously. This gives your preceptor an opportunity to watch you move, observe your level of confidence, see your hand to eye coordination and begin to form an opinion on how you will move in the confined spaces of an ambulance. It also lets them see that you are eager to get at the task at hand. Good fortune to you.

Your awareness of your reluctance to post subjects that usual or old is generally profound, new and somewhat different. It is almost Shakespearean "To post or not to post, that is the question".

Isn't that a self defeating post? I guess we can talk about posting in order to ask a question about not posting.

Dwayne is pretty much spot on. In a MCI if I am the only provider on the scene I recruit any bystanders I can and pass out gloves as needed. I treat the patients where they are so C-spine immobilization is usually a non issue at this point. Our police are pretty much useless in helping in patient care so I rarely recur to them for help. I instruct the bystanders to help me watch patents breathing, mental status and help stop bleeding. I don't get hung up on a single patient because when I finish the triage round I revisit the patients to monitor for changes and if additional quick interventions are needed. Also I go back to give the newly recruited team a pep talk and make sure they know that they are not on their own and I am available for help. I tell police where I need my ambulance staging area. I continue to make the rounds and prepare my patient priority list. Here, I usually have to exert some authority with LE to keep them from loading patients in the back of their pick up trucks for transport. This part really stinks. I know I used the pronoun I a lot but then I am alone right? I do hope this helps organize your thoughts. I like to use start triage. It is simple and fast.

Stayin' Alive, Stayin' Alive, ah,ah,ah,ah stain' aliiiivvvveeee ..... where is that darn Lucas?!?

You been hitting the gym Bro? You look like you are getting fit.

It is good to have you. You are one of the most informative new posters I have ever seen, I think. Jump in to every discussion that tickles your fancy. I simply could not resist pitching in an idiom. I am not familiar with Paris, France but have beet through Paris. Texas. Our Proteccion Civil Logo from the other side of the world is very similar to yours. Welcome!

Hello inquisimedic, I am a Medic student as well. I would love to interact with you on a student to student level. Welcome!

Ask away William. Los paramedicos de este foro trataremos de responder.

Welcome, it is always nice to chat with folks that have duel nationalities. You guys have an entirely unique perspective on a lot of things. Feel free to share.

Welcome back. Hang around and make some new friends.

The last flat I had on the ambulance the kid I was precepting stood by while my partner and I changed the tire. When we were done I asked the student "Have you ever changed a tire before?" to which he answered "no". "Well son, you still haven't" Welcome Jacki and Caleb!

I bought an A/C for 600 usd below retail price. The best part is that I didn't even have to go to the store to get it.

In a very real sense the United Nations is for the most part an impotent organization without the United States participation. Texas is so cool.

As you mentioned you have sparked my interest. Your post always make me think, that is why enjoy reading your comments so much. It is a little disheartening though. Until now I just thought I was AWESOME! Bummer.