paramedicmike

2.5mg albuterol. Solu-medrol. We carry mag, too. I've talked to a few of the docs about it and could probably justify myself if I brought in a patient on mag for asthma. However, it's not covered in our guidelines. -be safe.

Michael! Shhhhh! You're giving away all of our adult secrets! And you remember what the penalty is for spreading classified information, right? We send you to Robert Novak and he writes an article and it's all downhill from there. Special prosecutors, congressional hearings...messy, messy stuff. You don't really want that now, do you?

All the cool people are from Alaska. Did you know that if you cut Alaska in half, made each half a state, Texas would become the *third* largest state in the Union? It may get cold. It may snow. But if you want to think big, Alaska's the place to be. Everything else, starting with Texas, is just small potatoes. -be safe.

Yeah...you get more sleep out of the in person class because they're so frickin' boring! Obviously, go with what the employer wants. But if you can do it online I highly suggest doing so. I did IS 100 in a classroom setting. It was a huge waste of time. The online versions were much better and didn't take nearly as long! These are now required classes. Doesn't matter where in the States you live and work. If your department wants access to federal funding then you *need* to have these classes. So, take them and get them done. Good luck with it all. -be safe.

I thought those active noise reduction headsets reduced constant, regular noise like engine noise or siren noise. So, at least in theory, you would still hear your partner talking or the horn of the oncoming car. I tried on a pair of the Bose headsets but only once. And I didn't have the opportunity for a long drawn out test. But when I had them on they were really nice. I'd like to get a set of the ANR for my helmet at work. Just a tad pricey. -be safe.

Two come to mind: 1. We went out to the residence of a frequent flier. Only this time we were there for the wife and not the husband. As we were getting her settled on the stretcher I asked if Mr. XXXXXX would be ok by himself for a bit. She paused, looked at me as her tears welled up, and screamed, "He died last week!" They'd been married almost 60 years. 2. Trouble breathing on a lung CA patient. The wife grabs me on the way out of the residence and wants to know how bad it is. I told her that she knows he's sick but he should be ok for the ride to the ER. Don't you know the bugger up and codes on me half way there? And that I didn't get him back? It was not fun informing the wife at the hospital. If looks could kill I'd be long dead. Now I will not tell anyone that their loved one, my patient, will be ok for whatever the question may be. And dude, if you're looking for gory stories, there are tons of other places to look. Have you read the site rules? Have you searched the forums? I'm sure you could find what you're looking for in other places here. -be safe.

We used to have a set up with all the peds gear stuffed in a bag. It was a pain in the ass trying to find anything...especially when you had a sick kid. We convinced our boss to buy a couple Broselow bags. Within a month I had worked a padi code using one of our new bags. What a HUGE difference it made in our ability to find not just the equipment we needed but the right sized equipment. Just roll out the bag, match the colors and you're set with all the equipment you'll need. It took less than five seconds to have what we needed at our fingertips (compared to much longer trying to dig it all out of our previous 'stuff everything into here' peds 'bag'). I would definitely recommend getting one for each ALS vehicle you need equipped. Don't be put off by the cost. These things are worth their weight in gold. Good luck. -be safe.

You missed the point of what I was saying. The point is you are not entirely capable of determining what you are mature enough/ready to handle. That needs to come from someone else who is, preferably, non-biased in the assessment. Age needs to be a requirement in that consideration. It's part of the larger picture. But the younger you are, the larger a role it plays in that determination. UMStudent: I knew Maryland allowed it. I used to live and work in MD. I've seen dozens of 16 year old wanna be EMTs come through. All of them argued they could handle it. None of them could. Maryland isn't a bad place to work in EMS. But it has it's problems just like every other system out there. And one of their big ones is allowing minors to hold such a large position of responsibility. -be safe.

The post I quoted said nothing about the parents signing the confidentiality waiver. It mentioned maintaining patient privacy, yes. But not who was ultimately responsible. And if the parent is the one ultimately responsible, where is the protection for patient privacy? The person legally responsible won't even be on the call. The minor could care less as there will be no legal action taken against him/her. Would you want to be the patient in a situation where the people walking through your door aren't legally responsible for maintaining your privacy? Why not? Do you not feel comfortable sharing because none of what you've said is true? Are you afraid they're going to find out what you've said here? Are you afraid someone will find out and take legal action against the department effectively ending the program? You're here raving about this program. The least you should do is identify the department. There is no privacy standard in this case because the person responsible for maintaining the privacy (the parent as you insist) isn't even there. Further, as has been discussed, there is no legal action taken against the minor as s/he isn't the one ultimately responsible. And minors are the only one who will argue that they are capable. Just as they'll argue that they're capable of driving a car at 16. Just as they'll argue they should be allowed to consume alcohol. Just as they'll argue they should be allowed to do all sorts of things they shouldn't be doing because they're not mature enough. It's not up to you to say you're mature enough. You can't say that. It's up to those around you who are mature enough to judge whether or not your actions up to that point warrant any extra trust be given. The trust and responsiblity for something like this is something earned. It's not handed out like candy. And a minor is not in a position where they've had the experience to have earned that much trust. -be safe.

No insults were made. You sound young. You sound immature. The idea that minors can participate in a ride along is idtiotic. These are merely observations. If you're insulted by this there's nothing I can do about it. I don't think you're understanding what any of us are saying in response to your proposal. A minor cannot enter into a legal agreement. The patient confidentiality waiver that any ride along should be signing is legally binding. Since minors can't enter into legal agreements they can't sign the waiver. Since this should be required prior to riding, they can't be on the ambulance simply for legal liability reasons. This on top of the other clearly written responses as to why this is a bad idea. What county in which state is running a program like this? Does this program have a web site advertising itself? Care to post a link so we can see just what, exactly, is going on? -be safe.

Well, for starters, minors can't sign the patient privacy/confidentiality agreement. Why? Because they're underage. And as such, they cannot enter into a legal agreement (which is what most of these agreements are). And since they can't legally agree to keep their mouth shut about what they see, they are violating that patient's right to privacy. So, at the very least, there's a legal reason as to why kids don't belong on ambulances. Ummm...no riders period. If you're not in school for EMT or Paramedic then you have no business being on an ambulance. Then what are you talking about? Minors as ride alongs is the same thing as minors as EMTs. Neither belongs in the back of an ambulance. I suggest you do a perusal of the forums to see the previous threads where this has been discussed. Unfortunately, I think you're too young and immature to understand where everyone else is coming from. But at least you'll see more indepth discussion and reasoning as to why what you're proposing is simply idiotic. -be safe

Interesting. A few questions though. It will be able to accommodate two litters in the back. What about a provider to take care of them en route to the hospital? Will any provider be willing to climb in the back of a pilotless aircraft for a flight into or out of a combat zone? Rotor of fixed wing? I guess we'll have to wait and see what happens with it. -be safe.

I'm with Rid. I don't think it's WPW either. Was the doc looking at the PVCs to determine a D wave? I bet he was wondering himself after this patient coded! :shock: Interesting strips, though. If you get more follow up let us know! I know I'd be interested to hear. -be safe.

So next time, be a little more efficient in your use of words. Why take two paragraphs to describe what can be said in two sentences? You must write some pretty long charts! :roll: -be safe.

Why not just save all the typing and say... PCP: You're best bet it to contact the state office of EMS (OEMS) for the state in which you're interested in working. They will be the ultimate authority in telling you what you will or won't need for certification/licensure in their state. Links to each state's OEMS website can be found by looking at the NREMT website. Good luck to you. But I have to agree with Dust and say, why NJ? Of all the places you could go....why NJ? Trust me, the novelty of glowing in the dark as a result of the proximity to all the hazardous waste dumps gets old pretty quickly. -be safe.

Rid was right to mention the IDEAL body weight. You don't want to be using 10cc/kg based on a 120 kg patient. But if you use 10cc/kg of the ideal body weight for patient gender and age, regardless of what s/he weights, you're on the right track. My service uses 8-10 cc/kg. Unless, that is, we're bagging. Then it's like AZCEP mentioned and just enough to get the chest to rise. -be safe.

Slow down VS. I read this like he used the blade as a tongue depressor and then reached in with the magills. I didn't take it to mean that he had the patient lay flat while trying to visualize vocal cords. I agree that there may have been other ways to address this. But I don't think this was nearly as bad as you're thinking it might be. Slow deep breaths, my man. -be safe.

The video he bought was the "Star Wars" holiday episode. Back in November 1978 they did a TV special that aired for one time and one time only. No one has seen anything about it since. I actually remember seeing it on TV but I don't remember much of it. If I remember right, Lucas realized after the fact that it wasn't really something to have floating out there and pulled everything. Also, if I remember right, it was really, really bad. There's some Google-able info out there about it. But you probably have better things to do with your time. And in case the mere fact that I noticed what the video jacket cover said, and knew all this info about it, didn't convince you I'll tell you straight up in my best Weird Al gangsta' rap, yo! I'm white. And I'm nerdy. Yo yo yo...be safe, yo!.

I saw this today and laughed. http://www.break.com/index/weird_al_white_and_nerdy.html -be safe. Hope you don't mind, I added the YouTube code for it - Admin

THANK YOU!!! Hard to keep in stock, eh? That's ok. I can wait for it to get here. Maybe I'll order a couple just so I have them. -be safe

Do a search on interviewing here in these forums as this has been discussed many times before. You will find a ton of information. Probably nothing agency specific, but EMS interview related none the less. -be safe.

Check this out. I saw this linked in another forum: http://www.cnn.com/2006/US/09/15/er.homicide.ap/index.html What do you think? -be safe.

Asy: A Camelback is a backpack like device with a bladder inside for holding fluids...preferably drinkable fluids in the form of water. They're pretty popular in certain outdoor circles. If you're going to wet a sheet and wrap a patient in it, make sure you keep them out of the sun. A wet sheet will allow all sorts of UV rays through. If the patient's not wearing sunscreen they'll burn. Glad to see you back! Hope all is better and improving in your area. -be safe.

A couple of questions for you... Where are you? What river? Commercial raft trip? Private raft trip? Private kayaker? Class of river (I-VI)? Description of area in which this particular boater was pinned? Was the pin completely underwater? Who were the providers of CPR? Professional guides? Other boaters on the water? Random commercial raft customers? These may sound like stupid questions. But the answers will potentially affect the answers and reasoning you're looking for. First, you never know if it was a waste of resources before hand. You, and it sounds like others, went with gut feeling and called for the helicopter. If you had called to stand down the flight team and then decided you really needed them you'd have been so far behind you never would have caught up. It is much too easy to Monday morning quarterback a call like this. Don't let your 20/20 hindsight affect your interpretation of the events as they were unfolding. Second, don't ever hesitate to call for an aircraft if you think you'll need it. We love to fly. If we get canceled en route we're just as happy...if not happier because now we don't have any paperwork to fill out! For this part, I don't know your experience so please forgive me if I say things you already know. I don't know if you're a paddler, either. It doesn't sound like it from your post. Again, please bear with me if you know this. Third, white water rescues (which is what this sounds like) are crazy, hectic affairs. They're even more so in a wilderness setting (which, again, is what this sounds like). There is little time to think, act or do. Things need to be done and they need to be done now! What's worse is that while you're busy trying to affect a rescue you're panicked, your adrenaline is working overtime, and, this is probably the biggest part, for the rescuer (and the pinned boater if still awake) time flies by. They probably thought it only took two minutes to get this boater out of the water when in reality it took 5, 7 or 8 minutes. Now, you know he hit his head. Helmet or not, if he's got a facial laceration you've got something to worry about. Plus, you don't know what or how he hit or the forces involved. If there was a recipe for a head injury this was it. If they said he was blue, he was blue. If they said he wasn't breathing, he wasn't breathing. If they said they didn't check a pulse then chances are pretty good you didn't talk to the right person...especially if this was a commercial trip. Commercial raft guides, especially those on big water rivers are pretty good with this sort of thing. They get routine training in rescue, CPR and first aid. Many are EMTs or paramedics with extensive experience. They know what they're doing and how to do it well. What's more, regular boaters (I'm thinking more kayakers) are just as knowledgeable and experienced as commercial guides, if not more so. This is simply because kayakers tend to travel in smaller groups. They have to rely on themselves and their paddling partners to save them should something bad happen. With a patient like this I'd have preferred to send them by air to a trauma center, too. I would not have trusted something like this to a local community hospital. Again, it comes down to clarity in your reflection on events. It's easy to say after the fact that "they only kept him over night". It would be much harder to say "if we had sent him to the trauma center he might not have died". River rescues, especially in wilderness situations get really hairy, really quick. The more resources you have the better. The soonest you can have them there is never soon enough. Call for help early, call often. How, you ask, do I know all this? Glad you asked! I have worked as a commercial whitewater raft guide for more than 10 years. I have been a whitewater kayaker for about that same length of time. I have been involved in both rescue situations and have been rescued myself. Some of my comments above about guides/boaters are generalizations...many are good, many are not. The same can be said for anything. The ones who are good tend to be the ones who take charge but the ones who aren't tend to be the ones you always manage to talk to (because they like to look/feel important...a form of a whitewater "whacker", if you will). To give an example of how quickly time can seem to move I'll relate a story about a pin I had. I got stuck upside down, in my kayak, with the edge of my boat under the lip of an exposed undercut right on the eddy line in the middle of a class III/IV rapid. I couldn't reach the rock underwater to push off (not that I could push against the current anyway). Because I was on the eddy I couldn't get enough purchase with my paddle to try and roll up and off or even paddle forward or backwards. I couldn't get out of my boat because if I did the current would push me under the undercut rock and I didn't know where the current would take me (and I really had no inclination to find out). I tried all sorts of things to get myself unstuck (save getting out of the boat because, as we discussed, I didn't know where I'd end up). Nothing was working. Now, my buddies were scrambling out of their boats trying to figure out a way to get to the rock against which I was pinned. I was rapidly running out of air and in desperate need of a breath. Somehow, and to this day I still don't know how, I washed off the rock and was able to roll up and breathe. I swore I was only stuck for 30 seconds or so. One of my buddies on shore was watching the time so they'd have an idea of just how long I was with out air when my limp lifeless body finally came out. He said it was almost two full minutes. (I don't know how I held my breath that long. But stranger things have happened I guess.) Every one else thought it was only 30 seconds to a minutes worth of time that I was stuck. Just an example of how their reported "2 minutes" could've been much longer. Sorry for the long post. I think you were right to summon all the resources possible. I think you were right to fly the patient out. I don't think you should've done anything differently. If you have any other questions (but don't want another long post), let me know. I'll be happy to discuss the finer details of the joys of whitewater! edit: I can't believe I forgot this part... -be safe

Given a recent post by Timmy I'm wondering if this has anything to do with local drug use in his area. Some excellent questions have been raised, though. Is "battery acid" a street name for something else? Car battery acid or from some other battery source? So Timmy! What's the deal? -be safe.