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mobey

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Everything posted by mobey

  1. My personal opinion is to wait a few more years. I don't think I'd allow a 15year old (male or female) to ride-along with us. Just a little too grown up..... No offence intended, but if you watch someone die right in front of you at your age, it may change who you are forever, and not necessarily for the good.
  2. Kat: Just gotta warn you against air suspension. A few companies here in Ab have it and HATE it! Freezes up all the time... air line antifreeze or not.
  3. Oh yes, but if you've ever felt the hood of an ambulance (or any other vehicle) that has a block heater plugged in, they are substantially warmer than room temp. They keep the engine closer to operating temp rather than ambiant room temp.
  4. Over the years I have worked in almost all the ambulances mentioned above. (not that I'm all that old) I have definitely found the old Ford 6.0lt to be the WORST engines for both maintenance costs as well as passing power. Best diesel I've ever operated was Duramax. But oh so expensive to repair! Loved the high end torque though, if you dropped a gear while passing it made it quick and safe without an expensive turbo to repair every 5 years! Overall I find the gas engines to be more comfortable in both station smell, as well as vehicle noise level. Gas has the added low end horsepower, which I actually dislike. Too often I find myself or my partner will be a little heavy footed around the urban streets, and end up potentially injuring the rear passenger. It a diesel you just don't get that 'snap' of responsiveness if your freezing cold foot hits the pedal harder than you'd like. It's almost worth iyt though for all that low end passing horsepower. We keep all our units plugged in with block heater on. Talk to any mechanic, it just makes sense since we don't warm up our engines at all. In my opinion though, switching to a chev cab is the best thing that has ever happened!
  5. Integraded shmintegraded. Remote 911 ALS care is where it is at brutha! I'm not really into the Globalmedic thing, these days I like my days off to be - days off. Shoot me a PM sometime, I'd love to have ya out for a ride along.
  6. Just don't try that here in the west! I also did it commonly in Sk.... glad to hear you all still use your heads. The monkeys are too dominant here for that.
  7. Yes, anyone over 65 does not qualify for the exclusion according to either NEXUS or Canadian C-Spine, I don't recall off the top of my head. That is the one time I will really push the limits though. I often contact OLMC to discuss a 'hybrid' type of SMR I enjoy using. I basically put on a collar and scoop them onto the cot. Keeping the cot flat, I use a blanket roll and tape to secure them to the frame of the cot. Then I move the straps on the cot to the criss-cross fasion, and bam...... Spinal motion restriction on a mattress!. One way I get away with this if I call OLMC, 9 times out of 10 they will say "Why don't you just pad the board with blankets?", my standard answer is "Thin flannels don't really add padding as you can imagine, How about if I put the backboard under my cot mattress and use the 3" foam as padding" By that time they get the point, and succumb to "Mobey's hybrid Selective Comfort Spinal Motion Restriction" (patent pending). Edit for spelling
  8. Yes, osteoporosis is a contraindication to IO. Contraindications are subjective though.....
  9. To be clear we actually use a bit of a hybrid Canadian C-spine that also takes into account distracting injury and intoxication factors found in NEXUS. I was just being simple in my post. This is a written EMS protocol and I think the CCSR was just too open for interpretation to give to EMS practitioners without proper education.
  10. If the pneumo is tension, then yes: Needle or Finger thoracotomy, followed by chest tube. If it is a small pneumo then it may resolve on its own and we are better off to let it be. When making the decision we should peek at her INR if she is anticoagulated. To make the decision can we get a current set of vitals? Do we know what meds she's on? We have her on Narcs & Benzo's for sedation right?
  11. Yes ERDoc, looking closely at the tubing as it exits the urethra it looked like a white "fog". Almost seemed like a thick white fog that was mixing with the urine. Island: that is the worst part of my job out here in remote Canada. People are boarded and can only be cleared via CT. The CT is 3hrs from my stn, add some scene time and delay at local hospital and people can easily spend 4-6hrs on a board. It is damaging to them and does no good at all..... But if I take them off the board I forfeit my registration # and get to start a new career. I am VERY selective about who gets boarded, and we use NEXUS to clear a lot of people. This is the system..... It sucks. Nice find J306. Rhabdo was definatly an issue whith this sedated (not moving) patient on a hard board. I do try to tip the board periodically and move padding around the body to allow circulation to pressure points, but I know it's probably crap.
  12. I am not a urine expert.... or even amateur. I was transporting a patient who had a fractured ankle, acute epigastric pain, and a minor head injury after a high speed collision. He was on a back board for approx. 4 hrs. He was aggressive and combative and ETOH, so I was using fentanyl for pain, with occasional 1mg IVP of midazolam to keep him in a deep sedation. He had good urine output (300ml/hr amber-clear) when suddenly, it turned super cloudy. I mean like freaking milk coming out of his bladder! At the time I assumed it was myoglobin from being sedated on a board for such an extended period. After some research, I see myoglobin turns the urine dark redish. So what you all think? Renal injury? Acute bladder infection? OK I'm reaching!
  13. I'll go with perforation causing hemothorax (though I think pneumo is more likely). As a side note, when this lady was in her excited state I would have been quite aggressive with benzo's. Elderly just can't handle this much stress.
  14. This only works in a urban setting. Police are 30min away. Nope: Actually there was a moment of silence and I started to chart. I do not put every patient on the cot. If they are not sick or injured, I usually put them on the bench with a seatbelt. This leaves me in the airway chair with rapid access to the side door.... if the unit is stopped.
  15. You win this round....
  16. Wait! Are you saying men are superior?
  17. I have worn jumpsuits and have had many partners/employees wear them. I like them as much as a regular 2 piece uniform as long as they fit, which usually means some custom altering. Nothing looks worse that a jumpsuit that is too big in the chest or crotch.
  18. I have had a few close calls lately with 'suddenly' aggressive patients. My most recent was a few days ago I had a slightly intoxicated 31 year old male who had been assaulted. he was seated on the bench and we were conversing happily enroute to the hospital. My transport time was 30min. Suddenly he says "look me in the f**king eyes!" I was like huh? Then he says "just like I thought... You have no soul" luckily I was able to talk him out of escalating the situation, but it was a pretty scary ride. Those of you who know me would know I am about 140lb soaking wet, and battling arthritis. I am a great lover (or at least I think I am) but a TERRIBLE fighter! I wear a vest at work already, and carry a combat pen which is kind of a joke, but I am considering purchasing a nice heavy flashlight or something of the sort. Any ideas? Here in Canada a collapsible baton is illegal as is pepper spray.
  19. Holy $hit man welcome back! What a treat for the nOobs here (and us not-so-nOobs) I have thought about you a lot over the last year but refrained from calling because I was afraid of stirring up some old stressors. I hope that does not happen here at the City! look forward to chatting it up again bro Take care Marc
  20. Can we get some more pics? It helps me think so I can answer your question better....
  21. These are not designed for long term use. They are designed as an adjunct or alternative to a tourniquet. Btw: There are no stupid questions.... only stupid answers
  22. You guys are old. I use 'Into the night' by Nickelback. In all seriousness.... I actually turn on a metronome on my Iphone.
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