bandaidpatrol

I suppose it's better than nothing.

I liked the old cots, you're six inches off the ground, just straddle the guy and continue with CPR. No chance the cot will hit a "doorway bump" and flip, and no hitting your head on hanging signs. I had four stitches after hitting my head on metal sign hanging off the ceiling. Needless to say, that "Ambulance Entrance" sign disappeared that night... I think I still have it in the garage.

There is a dye free benadryl available, in the children's liquid form. I use it for sleep occasionally, and I noticed my wife bought the wrong "color". Still works the same, but it has an awful taste, almost like they put bitrex in it.

As long as you don't faint, vomit or kill someone... You'll be fine!

JMAC,

What else does "Obvious signs of death" mean? If the three "Or's" are present; rigor, algor, and livor.. It's probably too late.

I'm not in NYC, so forget the store and it's address that I provided.

This was my first text book...

Key wording* obvious signs of death

Would I begin resuscitation?

My answer: No.

Would I consider it? If I determined my life or my partners life was in danger due to the parents anger or grief; or if I determined that the parent was a danger to themselves, i.e. threatening suicide.. Then I may take the kid and run, and call command in the rig/call the police.

But otherwise. No.

Unsure what you mean by this. A waiting list for Emergency Care & Transportation to an appropriate Medical Facility?

Not enough ambulances to cover emergency calls, some people have to wait till a unit clears. IMO, for every day operations, no disasters-natural or man made, placing people on waiting lists for ambulances is unacceptable. We called this "Dispatchers Diagnosis", or placing priority with minimal information. The most calls our service ever had "on hold" was 29. Those were the days when people began to use the ambulance as a Taxi.

Consider it's sedative effect also. On a patient that is getting exhausted from their asthmatic episode, sedation is not going to be on your side. May cause the need for intubation.

Perhaps we should also focus on the lack of EMS in many places.

Opinions please:

Given what we know, as far as how long it takes for emergencies to go from serious to critical to dead, heart attack, CVA's, cardio-pulmonary arrest, seizures, car accident victims, etc.

How long is too long to wait for an Ambulance?

How far is too far for populations to be from an Ambulance?

How far is too far for populations to be from a receiving hospital with a certified ER?

This is not a paid/volunteer question, it applies to every location in the United States. Obviously, in some cities, people wait a long time due to lack of units, caused by "bull shit" runs. I remember going through a list the whole shift, in a fairly large city, people were on there for hours... everyone. There was no specific order, except cardiac and pediatric patients held priority.

What can be done to free up units from BS calls?

What can be done to prevent patients from being put on waiting lists, excluding times of disaster?

Opinions only, please.

They have a degree for Basic EMT training? No offense, but if you're going to college for EMS training, why not take the next step to become a Paramedic? I've never heard of a degree for basic. Intermediate, critical care, and medic I've seen, but this is news to me. Maybe I'm just old? I remember the first EMT classes were only 64 hours long, I can't believe a 120-160 hour class would equate to a college course.

You'd think that would lead to a drop in interest, that is, if it became a requirement... I didn't even go to college for my Paramedic certification, it was a four month program at a hospital.

:arrow:

Just because you have paid professionals, will not mean you will develop more EMS calls ..

If you have more crews, there will be less calls to go around. Less calls per unit makes the big wigs think you don't need that extra rig. There goes three shifts worth of jobs.

Right. Money.

Less volunteers means more paid professionals. Which brings the need for more calls, which leads to someone getting the short end of the stick. Which leads to less money, that means pay cuts and lay offs.

It will never be perfect.

What did I do first?

Something I learned from working in the 70's. Look for guns, knives & drugs. Never sit down in a place that "looks" like a junky lives there.. Needles. Stay away from their drugs, and block their path to the weapon. If they go for it, oxygen cylinder to the abdomen, lunge the cot at them, and run.

Not that I recommend any of that, except the obvious.

No! It is NOT a BLS topic! It may well be an EMT topic, but it is NOT a BLS topic. If your MD lets EMT's perform brain surgery, then that becomes an EMT skill, but it does NOT become a BLS skill. There is a difference here that is more than mere semantics, and you need to understand that difference if you are going to practise responsibly and professionally.

BLS does not define a scope of practise. BLS is a very specific group of basic skills. The key term there is BASIC. Anything that is advanced is not basic. Anything invasive is advanced, not basic. And "Basic" is a term we are using to describe the skills being used, not the certification level of the provider. The inability to separate the two in your mind is frightening.

Down boy! Down!

Thirty plus years as a career man, and an instructor, I've seen an equal number of ignorant EMS personnel on either side.

I didn't become a paramedic till I was 33.

Of course, there were no paramedics before then... and EMT's were pretty new also. I've taught a lot of people who were in their 60's and wanted to become EMT's. Probably the oldest EMT I knew was 82, while he didn't run calls, he was a hell of an instructor. Taught the first attendant classes in 58.

The question should be, how long after taking the medication, is it safe to administer a nitrate.

Another question is; Is the patient just prescribed the medication, or when was the last time he took it.

It's not a medication one would take every day.. And no, I don't use it. Knock on wood, I don't require any medications.

Vein...

Should be able to do that with your fingers... I did it for 32+ years and in the army. It's not that hard, sometimes you miss, that's part of the job.

If you have a patient with crush syndrome, you should try and avoid a bolus of fluids. By all means gain IV access, and run fluid for shock and hypovolemia, but do not run it wide. Set up a large bore IV, titrate to BP, Bicarb, CaCl & Lasix IV. Insulin IV could also be used, but you probably won't see that pre-hospital. Leave the patient in a sitting position, if you have to tube them, just don't lay them down. Combitube them if you have to.

I'd go on, but the chances of renal failure happening in the rig is unlikely, the rest is up to the ER.

My hearse had an under-the-hood siren... Seems perfectly morbid that I can have one, but a physcian cannot...

I suppose if someone did disagree, that's their right...

But I would wonder why they are in this profession.

If he's getting cookies... I want some too.

Which reminds me of something I should blog about..

Surely I don't... My son began saying that in the 70's.. I don't know why, I think he was watching too much MASH.

and I only drink Guinness...