xselerate

thanks for all the quick replys.

No. . . not just plane webbing. look at this link. this is actually what I am demoing right now.

http://www.wildmed.com/Merchant2/merchant....ategory_Code=RG

All those straps seem kinda excessive. Here we keep two peice straps on our boards and just buckle people on; chest, hips and legs. It's secure and easy so why fix what's not broke?

I'm sending you an email with some info...

I am trained as a peer debriefer for CISD

This is how it should be... I don't mind talking about something that bothers me on the job (I havn't had to yet) but I'm not talking to some ass doctor. I would talk to a fellow member in the field.

NOBODY should be forced to go to a debrief

It's nice to have something there for those who want it... but I will admit that if you run off to talk to CISD every time you have a pediatric arrest.... I mean CISD has to be very very serious.... something would have to blow up big time for me to think about it.

Wouldn't it just be easier to consider what you can give.... albuterol. I know on a basic level it's all you can give. And on a medic level I would imangine you would gave the same unless their was some type of severe airway obstruction due to the asthma... maybe they would give epi or something. Either way albuterol should be all you really need to know.

(if they don't die due to complications)

It sounds like the second guy definitly will. I can't imangine him surviving. The first guy sounds like a long shot but he's got a better chance. Either way it's a rough situation.

I don't know what's available to you devine but here in NYC we have a counseling unit for EMTs / Paramedics. If the job upset you excessivly you should talk to someone about it. Either way... it sounds like you did a great job.

Question: What is the difference between a saline lock and a regular IV clamped down? Why could BLS transport with a lock but not an IV? I'm trying to read up on IVs but what I've seen so far doesn't address this.

I have recieved no formal training but from what Know for sure...

A saline lock is when there is some type of fluid lock on the iv and nothing is running into it. One would be able to inject meds through the port still, or attache a drip.

An IV clamped down.... I'm confused by what you mean. I think saline locks have a clamp on them, but it sounds like you may mean an iv with fluid that is clamped closed. I'm not sure. A search should give you some more info on the subject though. That and I'm sure one of the medics will correct anything I'm not sure of and tell you more...

My instructor told me that everybody gets oxygen.

Even if they break an arm, they get oxygen.

If his pulse ox was that low it certainly couldn't hurt.

Yes, I have heard of this before. It's called EMR, Emergency Medical Robot. Give everyone O2, don't bother to attempt an assessment of their perfusion...

Anyway...

Here are the people involved.My boss has the pulse ox on him waiting to see if he wants to give O2.

Respitory distress is one of those things you would give oxygen for though... but many people seem to be excessivly hung up on pulseox readings. I don't think it's really neccessary on a basic level. Sure it's nice but not really neccessary. If you got a reading of 98 on this patient would you with hold oxygen? I wouldn't. Let's not forget that pulseox devices are machines and on a basic level we're not even really taught the science behind it... and machines break and need calibration from time to time. I have a far better idea to replace a pulseox on a BLS level.

Look at your patient... feel them... how is their peripheal perfusion (fingertips), how is their central perfusion (lips), are they sweating or diaphoretic? If you follow your basic assessment (skin color, temperature and condition in the C step of your initial assessment) you will have all the information a pulseox will give you. You need to get that information through your assessment regardless of having a pulseox or not or being a medic or emt.

In a perfect world, you would have turned it over to ALS because of the ALS interventions already established. Just like a medic should not be turning ALS patients over to EMT's, neither should nurses or doctors. For that matter, you shouldn't be accepting them.

In NYS BLS can not take a patient who has any type of running IV, which you mentioned was wide open. We have to wait for ALS. We can take the patient if a saline or hep lock is in place but that's it. Is it the same for you in Conneticut neo? I'm just curious.

Here in NYC you've got volunteer services (they don't get dispatched to 911 calls, but if in the area of one they can pick it up) and you have voluntary services (hospitals that are part of the 911 system and respond to 911 calls with the city FD ambulances).

I wish I Had something to help you out but the only sleepwalking I see is some of the things people write on this site (sleeptyping?)... Good look with your project

You can't take the NYS exam after taking a non-NYS EMT class.

See.... that was an easy enough answer

I've always avocated working as a basic for a couple years first.... I personally feel the experience I have now will be invaluable when I go to medic school. But I know many other disagree....

Better luck with your ambulance rotation, and keep at it.

The pulse itself would be enough, in my humble opinion, for me to light it up. With the associated mental status changes your patient was describing I wouldn't have had to think twice. And something you hear me ask quite frequently.... central eta on the medics? 10-4, you can cancel them, were closer to the er.

done.... if i can't get medics there by the time im ready to go and i have less then a 5 minute trip to an er im moving.

Although I'll admit I would never ever be questioned for going straight to an er and using my own discression with lights/sirens.

Un-freaking-believable. Our guys have been kicked off the dept for much less...the powers that be recognize the danger and stop it before it gets to that point. Contrary to popular belief, you can still be fired from a vollie squad....

That video: natural selection at its finest!

Brat :wink:

Darwin would love to write a book on these guys...

I wish you could... treat up the AIDS patent's arterial bleed.

I wish you could... recognize meningitis after getting too close.

I wish you could... find out the patient with the bad cough had TB.

I wish you could... have a million different spots in your truck where HEP B may live for weeks.

I wish you could... train to recognize when it's chicken pox... and when it's smallpox.

I wish you could... see the bag full of atropine and 2pam and know it's there to save other EMT/Medics from nerve gas.

I wish you could... be mistaken for cops in the very worst projects in the city.

I wish you could... worry your bringing something you can't see home to your family.

Now this is an original by yours truly.... and something I think we can all relate too much more easily.

Not to break up the gender party here.... but has anyone else read about the baby found in Long Island? It was run over so many times that it's sex and race could not be identified. Not only did it make me grossly sick to my stomach when I heard it on the radio and again in the paper but it made me think of this discussion and about this law. This is the reason this law is good and is needed, but it's also proof that the law dosn't always help. Sometimes I think that there is no real answer.... sometimes things are just so horrable you can't find any answer that makes it feel better.

I volunteer for a local service when I'm not at my full time job. Our billable jobs don't add up so we have to do charity events and such. So the situation seems pretty average.

What may be of interest is increasing your billable jobs simple through your paperwork. I've read articles (why does JEMS ring a bell) about simple things that can increase your revenue like having every patient sign the billing portions of you patient care report (or a seperate billing form if you use one). You could always mail bills out to people who aren't billable through insurance, if they pay they pay and if not then it's no worse for you. Other things like proper documentation of necesity of services can vastly improve your billable jobs.

Either way good luck!

Yes Yes Yes I know you both got in.... along with 88 other people. And I guarentee you some of them cut ahead of the rest cause they knew someone. It's not even a good ol' boys club thing or anything like that it's just that they want good EMTs and if someone in the department happens to know a good EMT and also happens to know someone in human resources.... well....

Good luck on March 13 :wink:

I used the NR review to study for the NYS exam and I got high 90's both times I took the NYS exam. The major difference is the numbers (nitro for NR requires minimum of 100 systolic, for NYS it's 120). If you can get the numbers like that figured out you will do good on one if you did good on the other.

But...

Will your new New Jersey EMT card be accepted on the NY side of the state line?

NOPE As far as I remember NYS does not honor NJ EMT certs because the level of training (according to NYS) is too low.

Yeah seriously someone needs to kick third watch in the ass. I sat in an ambulance fo 8 hours tonight on my ass. It's not the greatest fun in the world. I've only heard of rural services actually having a "station" to sit in. And if I had a station.... S L E E P

I personally have been waiting for something like this in the field. I call medics on my bad trauma calls for two things... pneumothorax and unmanageble airway. I would love to be able to get medics to administer a blood substitute. I think it could save an aweful lot of lives.

But.... I understand the argument that the study should only be carried out in the hospital by consenting patients. In the field however, where the patient either gets the drug that will carry oxygen to their cells and help compensate for all the blood they lost or they die I would tend to say give them the damn treatment. They can decide about continuing it later once it has already gotten them to the hospital alive.

Put it in a 7/11 parking lot...everyone will be sure to find it

emmmmmm slurpies.... oh I'm sorry am I getting one tracked again? ummm how about if you put the command post..... emmmm slurpies....

Is it too much to think about or am i just being geeky

If anything you should learn that everyone is geeky here... aren't questions like yours half the point of a place like this?

Good luck in medic school!