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    SF Bay Area, CA
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    EMS, Guns, Motorcycles, Music.

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  1. I think it's much more cost effective and reasonable to have police respond to most if not all EMS calls for provider safety than it would to train all EMS personnel to a proficient level of firearm use as well as insure against the inevitable use of those firearms. Just a bad idea. There's a whole "tactical EMS" group at my work that wants to be armed and I think it's extremely silly (and I'm very pro gun in general).
  2. I also would hope it would increase the demand for more extensive paramedic education. If not for all, than as a certification for community paramedic licensure as required. Anything that raises our education level would benefit the profession as a whole. Working in the SF Bay Area though, most of what I have seen is negative and reactionary actions by medical direction when it comes to the lack of paramedic education. Notably in my county they removed the needle cricothyrotomy from our scope due to one call where it was performed improperly by a medic. With an ever-shrinking scope in
  3. I know this is an old thread, but it caught my eye. Rings a bell with me since I am also a firearms instructor. First off, if that was the actual question, than it is a very poor one. Picking it up by the trigger guard is a BAD idea because the trigger guard is small and often polished and it would be very easy for a finger to slip and land on the trigger. The grip falls in the same category as it feels natural to put your finger on the trigger especially if you haven't trained with handguns to keep your trigger finger away from the trigger until ready to fire. Safest answer to the que
  4. This is like the "guns don't kill people, people kill people" slogan. It's not the taking of the pictures that is such a bad thing. As has already been said, it's intent and use. Where I work, our resources are plentiful. I'll often arrive on major trauma scenes to find 6 people already working on extricating the pt from the scene. My job is really just oversight and assessing the MOI while the pt is extricated. I'll often snap a photo for the trauma center. Every trauma doctor I have given report to has appreciated a picture of the scene to help them build an idea of the MOI. We take
  5. Including this call, I've seen lidocaine appear to reduce ventricular ectopy a few times. I keep hearing the general consensus is that it doesn't help, but my county still uses it both in the ambulance and in the hospitals. I had another patient whose AICD had shocked them some 17 times before arrival for what appeared to be a recurring v-tach (was really hard to see because the AICD shocked so quickly). I gave lido and the patient went from getting shocked ever 30 seconds or so to once every 5-10 minutes (for a total of once during transport). At the hospital the MD tried to switch to ami
  6. In that article above, is it in reference to a stretcher in a moving ambulance, or a stretcher being moved on the ground? It refers to "riding the rails" such as when a person stands on the carriage of the stretcher while attempting to do compressions. Obviously this does not work well, but as with most extrication times, there is no chance of having effective CPR done without a device. In the back of an ambulance, I'll contend that quality CPR is quite possible. The article also didn't mention if the patient was on a long board or CPR board which is an absolute must if doing compressions
  7. I agree with your statement Bushy, hence why I did not administer any NTG on this call. Just curious as our protocol as would dictate to give it, and it's our discretion to not administer as appropriate. As Paramagic said as well, the risks outweighed the benefit in this case. However, I did read a while back about some testing done that came to a conclusion that administering NTG increased the v-fib threshold, which is why I have posed the question. I haven't put defib pads on every STEMI patient in the past and I'd say I transport around 30-40 a year. This is the first STEMI patient I
  8. So I'll give a quick recap of the funny parts of this call first, without trying to be too hard. So I respond from about 15 minutes away to a call for a 50y/o male patient with "Chest Pain." Upon arrival at the scene, there are already two Sheriff's Deputies there, I hear angry voices upon walking in and the first thing the fire captain says to me upon walking in is "Just hang back, it looks like this is going to be an AMA." So I peak in to see a very agitated man sitting on his bed with his shirt off reluctantly letting fire do a 12 lead on him and constantly trying to get up and saying "I
  9. What an entertaining post. I think the issue with the original medics was that they left the dog on the street and didn't accommodate it or the patient. I have transported a service dog with a patient once and it did end up giving me terrible allergies. Not a big deal as it wasn't an emergent transport, but my response to someone asking for a dog to come with us in the ambulance on a code 3 or trauma call would be a swift no. I would however notify my supervisor who would make arrangements to have the dog transported (we have done this several times in the past) including coming to pick it
  10. Don't generate transports if they are truly unnecessary, but also don't write off patients that look fine just because they look fine. Think of all the medical emergencies that we don't have the ability to confirm or deny with the tools we are given. I'm glad you are encouraging them to go in their own vehicle if their needs don't require an ambulance. This is one of those things though that can really come back and bite you in the worst ways. Always think of the patient's condition and possible outcomes. Forget thinking of wasting people's time, "cheating the ems system" or money issue
  11. Big congrats. We always need good EMTs. Good luck with collecting your experience and always be proud of your accomplishment. Keep your skills sharp
  12. RSI is one of many things on a list of skills that have been removed from our scope here in California. The county I work in has also taken away the needle cric due to a single case of it being used inappropriately (on a traumatic code no less) and now we will never have the chance to use it again. RSI was taken away years ago due to that "San Diego Study" that basically showed we couldn't be trusted to make the right decision on when to RSI. The general attitude of the fire medics where I work is one of apathy and laziness. Many don't want to run medical calls and when they do their att
  13. I'm considering taking an intern for the next bid I have coming up. Send me a message and we can talk. I work for AMR in San Mateo.
  14. Having preset notions that fire can't handle the job only adds to the animosity and detracts from a real solution. Who's to say fire run EMS is worse than private ambulance service? One angle of this is that the FD is created to help the public vs private ambulance which exists to take money from the public. Fire could run EMS well if the right people were in place. Personally I constantly talk with fire-medics about their continuing education and modern EMS practices. I also have been giving some of their interns some ambulance time as well. If any given FD staffed ambulances and ha
  15. Unfortunately, dealing with psych patients is an integral part of our job in most places. I don't know about you guys, but we did not cover too much about psych in medic school. I've learned most of what I know from extra reading and experience. Where I work, the ambulance transports all psych holds. This is due to the fact that our health department doesn't feel that PD can differentiate between an altered patient and a suicidal one (though it still gives them the authority to place them on a hold). If they are larger than me or I feel they can seriously hurt me, I will either have PD
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