akroeze

Just to clarify, you're going to make the supine pt uncomfortable by putting them on a metal scoop or a wood board because you don't feel like carrying the stretcher in?

I guess I don't see the stretcher as as much of a hinderance as you folks make it out to be. Around here (service of ~60 FT and about 20-30 PT) I have yet to see someone who does not bring the stretcher to the pt when we're ready to transport unless it can't fit or the pt is ambulatory. Majority of the time, it is brought in with you.

No you bring the Stair Chair in with you along with the other equip., kindly REREAD THE PREVIOUS POSTS UP THREAD!!!!

out here,

ACE844

Good sir, kindly take your own advice. I will bold it to make it clear:

If you don't bring the stretcher in and you need it, what do you do?

Question:

If you don't bring the stretcher in and you need it, what do you do? Do both you and your partner leave the person alone while you go get it? Does just your partner go? What if there are several stairs to get up to the door?

This is assuming it's just the two of you and no fire.

Will someone answer my question(s)? What if there are several stairs to go up? Do you leave the pt alone?

Question:

If you don't bring the stretcher in and you need it, what do you do? Do both you and your partner leave the person alone while you go get it? Does just your partner go? What if there are several stairs to get up to the door?

This is assuming it's just the two of you and no fire.

Everyone backs into the driveway here... it's the exception, not the rule, to park on the road.

Pretty common but...

The other day we were sent to a poss hip # from a fall at a party. Elderly lady and she was the only sober one there. Of course one of the first things I did was start to assess her C-spine when one of the drunks behind me says "Hey buddy, she didn't hit her head at all... it's just her hip, how many times do I have to tell you? How about you do something for her??" I explained it to him and like two seconds later when I start palpating her C-spine he says something like "Look man, how many times do I have to tell you, it's her hip!"

Drunks...

Oldie but goody....must have been a slow night...

R/R 911

Is that a recruitment video.... ?

Hey everybody,

I just got accepted into college for the paramedic program and i was just wondering if anybody knows how good these colleges are for the program. Here is a list of the schools i got into

Durham

Georgian

Centenial

if you have been there id love to know how it was

thanks Jeremie,

I know that Centennial has a very high reputation.... can't speak to the others or even that one beyond that.

Sorry.

Something to consider though is to possibly go to school where you plan on eventually working.

Source?

Sounds like George Carlin to me...

I actually met someone this weekend who had a toshiba toughbook mounted in his car (just like we keep in our ambulances) complete with an AVL system loaded on it. (Automatic vehicle locator)...anyone in the metro area will know what I'm talking about....I gave him directions to my friend's place and he actually ARGUED with me...as he was driving past the street he was watching the blip on the computer...telling me we weren't there yet. WANKER!

Brat :wink:

...

There are no words for that

Dispatch: 5430 proceed priority 4 (our lights and siren) to 123 somewhere st for a 40 year old female complaining of shortness of breath, be advised patient is also complaining of pain to one of her tooth.

- Had me giggling as we were going up the stairs. Turns out the patients only problem is a broken tooth that's been broken for TWO MONTHS.

Not my call -->

Dispatch: 5421 proceed priority 4 to 321 whatever st for a 90 year old, unconscious.

5421 10-4

Dispatch: 5421 Be advised patient VSA, CPR in progress..

Maybe I'm tired but I truly can't see anythign wrong with that second one...

Nearest ALS is >1hr away other than a chopper which is ~30mins...

Let's just say that ALS (ACPs) are almost impossible around here.

So assuming that there is no hope of ALS, I would figure it would atleast be reasonable to contact a base hospital physician before removing to get direction?

So as a BLS service, would this be something to consider having a medical director attend the scene since we have no ALS back up?

I was out on an engine conducting hydrant tests one day and smoke started billowing up from under the dashboard. I radioed dispatch and told them to put us out of service because we had a fire on our apparatus. The dispatcher keyed up the radio, remained silent for about five seconds, then finally said, "uhhh.... do you need the fire department?"

Sorta like the page out for a volunteer station I heard about a year ago:

"Central dispatch to Station xyz, respond to.... your fire hall.... there is a truck in your firehall driveway that is on fire. Repeat, respond to... your fire hall... there is a truck in your firehall driveway that is on fire."

Why wasn't the FD even putting it out? :shock:

Well I just completed my 17th exam to end our first semester didactic element of our program. Tomorrow I have my orientation for our introductory ALS ambulance practicum. It is to be 360 hours or 8 tours in duration.

This practicum is to critique my assessment skills and reinforce the learning we did in the didactic portion. Although I will be able to assist on ALS level calls, they will be run by my preceptor. I will be expected to apply and begin to interpret 12 leads, calculate, draw and administer meds as directed by the attending medic. Also it will be expected to advance my learning via studying and doing a paper or two on a case study of a Pt chosen by the preceptor.

It should be an interesting experiance and I am so looking forward to it. I will try and keep you all posted on my progress.

EMT-P? I could have sworn they had started to adopt the PCP/ACP designations in Alberta?

Regardless, good luck! I'm half way done mine and it's amazing what you will learn...

Theres alot of equipment on the rig you rarely use,or do you use it all?Come on,be real!

Yes, it is used very frequently here in my experience as it tends to keep the pt more stable than the "twist 'em and lay 'em down" method.

I personally think the KED does more harm than good,if you need to be self rightgeous,use it!It's rarely used here because this equipment is a joke.Next I"ll here that you guys use mast pants alot too!Come on ! Yeah if you get an occasional legitimate c-spine injury you might dust the dirt off but thats not very often, most crashes are BS and you guys know that!

Because you have a portable X-ray/CT scanner in your pocket right? I wish I had one...

If you can't spell the drug you're administering...

Just courious what your folks opinions on volunteer FDs is? As in ones who don't do EMS but are first responders that go to "major" calls where EMS will be delayed?

Is that a worthwhile EMS element?

No, this sounds more like Algoma DSSAb actually ...

Don't get me started on the PCPs doing ACP skills though. Same argument has been presented in other threads about being able to provide ALS services at BLS prices.

Yes, I'm aware that some services *cough*HastingsQuinte*cough* allows their PCPs to do tubes and push ACLS meds (Epi, Lidocaine, Atropine ...), but atleast they're smart enough to state that it's only for VSAs and they must be working with an ACP.

If services want ALS provision, then they should pay for ALS providers. EMS is not a 'per-diem' industry.

Zach

Just wondering where you draw the line on ALS services? 12-lead and IV are becoming standard BLS skills and those that don't do them will become the exception, not the rule. Do you disagree with BLS doing these?

Not trying to sound confrontational... just curious.

Ive been offered a job (pending completion of the pcp course that is) at the service I rode with during my highschool co-op. Call volume at the base I worked at was 1300 calls/year. There was one base with a higher call volume Im guessing around 1800 calls/yr. Yes, this is in the sticks. My base was a 7-7 day shift then on call from 7-7. There was the odd day that we just sat around but being on a very accident-proned hwy with no ALS backup, just you and your partner- FD was volly and only came to MVCs- we got some amazing calls. It isnt a huge call volume but enough to keep busy (obviuosly its rural so some of the transport/response times were quite long).

During the down time- the crews worked on their 'upgrading' material- they are adding IVs and Intubations etc. One of the medics was the base hospital coordinator so he would do mini-lectures and one of the guys was an EMA so he had plenty of time to do homework and all that fun stuff. Lots of good suggestions for the down time in previous posts!! Even as a new medic, Id still consider a slower service- still get to use the skills but not stuck at a hospital with a 3 hr offload delay

What area was that?

I'm going to guess it probably was with Hasting-Quinte right?

Here folks:

1. Despite plans to dissect them one by one, SEMAC gave wholesale approval to the new CPR Guidelines 2005. You might have seen the February memo from State EMS Bureau Director Ed Wronski (www.health.state.ny.us/nysdoh/ems/bemsupdates.htm) warning that State written exams will continue using the 2000 AHA Guidelines until such time as SEMAC and SEMSCO review the new material. All that stands in the way now is the process of changing exam questions to incorporate the new material. The Bureau projects this could be completed by the fall. Gasp!

2. If you’ve reviewed the new CPR Guidelines, you no doubt saw recommendations that Emergency Medical Dispatchers and EMS providers give aspirin to patients with suspected acute coronary syndromes. Whadda you know, the SEMAC approved CFR and all levels of EMT to administer 162 milligrams of chewable aspirin to any patient with suspected acute coronary syndrome provided there is no history of aspirin allergy and no recent history of GI bleeding. The Education and Training Committee is working on a classroom component, so don’t rush over to CVS and stock your ambulance with baby aspirin just yet. A revised version of the BLS protocol for Adult Cardiac Related Problem should hit the streets once all the i's and dotted and t’s crossed.

3. Just in from the department of no surprises: not all AED manufacturers have updates available for users to upgrade their machines to the new CPR Guidelines. The Bureau plans to write each AED manufacturer inquiring about availability of upgrades. They’ll share responses with the EMS community. Hard to believe that an electronic medical device can’t be upgraded to keep with the times, but at least the Bureau’s findings will tell us which vendors we might want to do business with in the future.

4. While we’re on the subject of acute coronary syndromes, here’s a ditty that might give you angina. A SEMSCO tabled SEMAC motion that EMT-Basics be trained to acquire 12-lead EKGs (if approved by their Region and Service Medical Director) went out to various committees for consideration of potential impact and implementation concerns. Members of the Council’s Finance committee calculated fiscal impact of the decision would range from $90 to $150 million dollars initially, followed by some $10 million annual upkeep costs for statewide implementation. More concerning (if you’re still conscious) is an estimated $6 million cost to equip the remaining hospitals in the state to receive 12 leads from the field. Without that little drop in the bucket, the whole program would be for naught. I guess you might say, “further study is needed” on this motion. If you’re still clutching your chest, you’d better go ahead and pop 2 baby aspirin.

5. Stumbled into a meth lab lately? If so, you hopefully had a copy of the Bureau’s recently distributed brochure tucked in your pocket. A 2005 NYS law requires EMS services to educate their personnel on recognition of illegal meth labs. The educational brochure distributed by the Bureau can be downloaded at www.oasas.state.ny.us/meth/index.htm.

6. The Pilot recert program will not expire this June, if the legislature passes a proposed extension. Current bills call for an extension through 2011, although the Bureau had intended to recommend the program be made permanent. Given that nearly one quarter of New York’s EMS providers participate in the Pilot Recertification program, it certainly is not going away.

7. The Easter Bunny may be delivering burn kits for every NYS ambulance courtesy of the State Hospital Preparedness folks. The Bureau notified County EMS Coordinators last month to expect shipments shortly. Here’s what’s in the snazzy, soft, water resistant carry case: 1 thin thermal reflective blanket, 4 pair uni-sized gloves, 4 surgical face masks, 2 clean (not sterile) burn sheets, 6 assorted nonstick, multilayer gauze burn towels, 4 rolls assorted sterile roller gauze, and 2 rolls 1 inch tape. Before you get on the blower to invite your County EMS Coordinator out for lunch, note that there are only enough kits to equip ambulances. The Bureau is hoping to include an educational module and PowerPoint with the shipments.

8. Plans for Vital Signs 2006 this October 20 through 22 in Syracuse are moving along. Scope it out at www.vitalsignsconference.com. While you’re there, check out the NYS EMS Council Awards link for information on Annual Awards presented at the Conference Banquet. Consider nominating a deserving colleague for their exceptional EMS contributions.

9. Gad zooks. We may be done rebuilding Iraq before a revised spinal immobilization protocol appears. The ball is now back in the physicians court after it became apparent that there’d be a dramatic increase in field immobilizations under the proposed revision. Consider yourself lucky to be getting a new burn kit and leave it at that.

10. The NTSB (National Transportation Safety Board) issued a report on air medical operations in January, revising it on March 6, 2006. You need only look to your EMS brothers and sisters killed in the line of duty during 2005 (www.nemsms.org) to know that urgent safety changes are needed for aeromedical transport. While the industry has work to do, users (yup, that means you) share responsibility for crashes by participating in or allowing a practice of “helicopter shopping” and inappropriate use. Surf to www.ntsb.gov/publictn/2006/SIR0601.htm for a summary or full copy of the NTSB report. On the same subject, the SEMAC Air Medical Services TAG proposed a series of standards be issued as a Bureau Policy Statement for Air Medical Services in NY. Suggestions to tighten the recommendations were offered along with the possibility of developing Air Medical Services Regulations in NY (based on the proposed policy statement). Further discussion and possible approval is expected in May.

11. Seen a bunch of Hare Traction splints and Thomas Half Rings up for auction on eBay? All for naught, says the Bureau. A Fall 2005 memo from Director Wronski regarding approval of the Sager traction splint for immobilization of proximal third femur fractures has resulted in a brouhaha of sorts, despite a second memo clarifying the first. Note that current protocol allows traction devices only for mid-shaft femur breaks. SEMAC did not change this. What they did was add approval for straight in-line traction splints to immobilize proximal third femur breaks. SAGER is the only such device presently on the US market. Keep your Hare, your Thomas Half Ring, and whatever other traction gizmo you might have. Just don’t use ‘em on anything other than mid-shaft femur fractures!

12. Interested in getting your hot little hands on a copy of the revised QI manual? You’ll have to wait until Christmas, most likely. The Evaluations Committee projects having the revised manual and a PowerPoint presentation ready by year end. Hey, at least you won’t have to rack your brain for stocking stuffer ideas.

13. Next time you see a bus or taxi bearing down on you, it’s unlikely you’ll be field resuscitated with PolyHeme®, the red blood cell substitute manufactured from human blood by Northfield Labs in Illinois (www.northfieldlabs.com). A February 22 Wall Street Journal article blasted Northfield for hiding results of a 2000 study where 10 of 81 cardiac surgery patients given PolyHeme® suffered heart attacks versus none of 71 patients given blood. Northfield Labs disputes the Wall Street Journal claims, and while some prehospital studies using PolyHeme® continue, the Albany Medical College trial previously approved by SEMAC appears to be on hold for the moment.

14. The Bureau provided the Finance Committee with a template for use by Regional EMS Councils to request training funds not presently provided through Council, Program Agency, or Course Sponsor contracts. Award of monies (which come from unspent training dollars) is subject to availability of funds and DOH discretion.

15. Here’s a legal pearl for you troublemakers out there: REMACs have authority to limit the practice of BLS providers. In a recent downstate region dispute, parties argued that REMAC control over field provider practice is limited to ALS providers. Not so, said a State legal opinion. NYS laws and regulations make no differentiation between levels of care in the authority of a REMAC to limit a provider’s practice. That said, REMACs have no ability to revoke certifications, effectively limiting their influence over BLS providers to physician controlled local protocols like albuterol.

16. On February 7, 2006, the State Health Department issued a revised Pandemic Influenza Plan with EMS included. You might want to pop onto the DOH web site and take a peek before flu season arrives (surf to: www.health.state.ny.us/diseases/communicable/influenza/pandemic/index.htm). Specific prehospital care guidance is included. EMS agencies are advised to reinforce infection control practices, promote flu vaccination of EMS providers, and review proper use of PPE. Each EMS agency should also have plans in place to rapidly immunize workers and key ancillary staff as well as to distribute antiviral medications should DOH make them available. EMS also places high on the list of priority groups for immunization and antiviral meds. County Health Departments are urged to establish close communications with the EMS Coordinators and EMS services. Blah blah blah aptly summarizes the rest of the 406 page document.

17. The EMSC (EMS for Children) federal grant to New York was extended through February 2009. Under the approved extension, EMSC will become a permanent NYS program, expand the role of the EMSC Advisory committee, increase prehospital pediatric equipment, and (hopefully) begin designating pediatric receiving facilities. Hooray for kids!

18. The Systems Committee may be trying to usurp the Spinal Immobilization Protocol with their sixth redraft of a new CON (Certificate of Need) policy statement designed to replace 93-09 and 93-10. A few more terms need better definition and additional subgroups have been duly appointed. Discussion will likely continue at the May meetings.

19. As a result of a Bureau meeting with State Education officials, the Education and Training Committee appointed a TAG to investigate clinical skills performance issues. You may recall the State Ed notified hospitals last fall that certified EMS providers cannot perform ALS skills falling within the scope of practice of a licensed profession in a hospital setting unless those skills are carried out as part of an original or refresher EMS certification course. This could spell trouble for ALS provider skill retention programs, air medical hospital contracts, and other existing programs. It appears that a mechanism can be put in place to allow existing programs to continue – the TAG will flush out these details.

20. Instructors around the state remain hot under their collars about a relatively new DOH policy prohibiting them from taking a peek at their student’s state written exams. DOH is considering ways by which CICs could become more involved in the exam development and validation process. Stay tuned.

21. If you rank yourself as a trivia geek, here are some statewide stats to fill you up from 2005 year end: 1100 ambulance services, 115 ALS-FR services, and 721 BLS-FR services (that DOH knows of). Services by level of care: 405 BLS, 133 Intermediate, 188 Critical Care, and 484 Paramedic. Total Certified Vehicles = 5553 consisting of 4017 ambulances and 1536 other (which would include EASVs, helicopters, etc). Sweet.

22. Remaining 2006 SEMAC and SEMSCO meetings are schedules for May 23 and 24, September 14 and 15, and December 12 and 13.

These notes respectfully prepared by Mike McEvoy, PhD, RN, CCRN, REMT-P who was the 2005 Chair of the State EMS Council where he represents the NYS Association of Fire Chiefs. Mike remains on the Council as a wise old past-chair, kinda like an old Fire Chief. Mike is EMS Coordinator for Saratoga County, a paramedic for Clifton Park-Halfmoon Ambulance Corps, a firefighter and chief medical officer for West Crescent Fire Department. At Albany Medical Center, Mike works as a clinical specialist in the Cardiac Surgical ICUs, Chairs the Resuscitation Committee, and teaches pulmonary and critical care medicine at Albany Medical College. Contact Mike at McEvoyMike@aol.com. If you want a personal copy of these “unofficial” SEMSCO minutes delivered directly to your email account, surf to the Saratoga County EMS Council at www.saratogaems.org and click on the “NYS EMS News” tab (at the top of the page). There, you’ll find a list server dedicated exclusively to circulating these notes. Past copies of NYS EMS News are parked there as well.

8,

Just wondering, have you ever sent a student home that way? How was it received? Did it help?

Code 4 is an antiquated, yet widely used status code to describe how you are/should be going to the call or hospital.

Code 4 = presumed emergency call and/or you are going lights and sirens.

Code 3 = presumed non-emergency call and/or you are not going lights and sirens.

A little too black and white for emergency calls. Thankfully our service does not use it anymore.

10-90 is lunch by the way. At least here... :thumbright:

Antiquated? As in used in the entire province except the city of Toronto to the best of my knowledge?