BlueLifeSaver

Combitubes have no place in the hands of anyone under the education level of a paramedic? Are you kidding me? I'm not sure how you guys do things where you're from, but it sounds like you're allowing a "Para-God" complex to take over your thoughts! A combitube is FAR better thans simple BVM ventilations. When placed and inflated correctly (not the full cc amount, but until resistance is felt) the combitube DOES prevent aspiration and DOES protect the patient's airway. In "my neck of the woods", EMT-Intermediates are allowed to intubate with an ET tube... only EMT-Bs can use combitubes. Endotracheal intubation in an artform, definitely, but so it the placement of a combitube. If you were the Code Blue patient, would you rather be "worked on" with a simple BVM, or a combitube that was properly placed with skilled hands. Tough choice...

First of all, there are several sizes of c-collars available. My service carries six different sizes. If one doesn't fit, go for the next biggest or next smallest. However, if you measure properly, you shouldn't have to worry about changing sizes. If your service doesn't provide the luxury of choosing from several different sizes, then a rolled-up towel placed around the patient's neck, foam blocks, and 2" tape should work just fine. Do what you have to do to make sure the patient's neck doesn't move. Period. Stay Safe

I have been called "Ambulance Driver" on several occassions. The state in which I'm certified has five different levels of certification for EMS personnel. They include First Responder, EMT-Basic, EMT-Intermediate, EMT-Defibrillator, and EMT-Paramedic (known as Mobile Intensive Care Technician (MICT)). I will agree that the general public has absolutely NO idea how many titles are available for an EMS professional, and even if they did they wouldn't know the definition of each title. From what I've heard, we're either ALL ambulance drivers, ALL EMTs, or ALL paramedics. The differentiation of titles means nothing to the public, only to those of us in the EMS profession. Hell, even most doctors and nurses don't even know what each level of EMT can and can not do. It's all about public education. We need to step up and make the public we serve aware of what we do. Though we all drive the ambulance from time to time, we are all much more capable of providing patient care then what was offered back when EMS was born. Stay Safe

I think every patient that has been involved in ANY trauma where c-spine injury can NOT be SPECIFICALLY ruled out, should be treated with full spinal immobilization precautions. Depending on the age and health of each patient, it may take more force in some patients to fracture a cervical vertebrae. If the trauma is unwitnessed, c-spine precautions should be taken regardless of the incident. These are just my opinions, but it's better safe than sorry. You can't HURT a patient by protecting their c-spine, but you CAN if you don't treat them based on a "broken branch" theory. Stay Safe

Our service allows blood draws in the field, and, as far as I know, the lab accepts tubes that are filled with enough blood. As long as a service holds a Labratory License issued by the state, everything is fine. 9 times out of 10, every time we start an IV in the field, we draw the rainbow as well. It's very rare that we don't draw blood when we start an IV. Also, I think it's far better to draw blood in the field then to have the patient be "stuck" again in the hospital. It's less trauma for the patient, and a better use of resources.