explenture

Our service is having difficulties with whether our EMT B's are taking enough calls and if when they take the calls it is appropriate for them to attend. We also struggle with transfers when hospitals seemingly randomly check the ALS/BLS box. I think in both cases part of the problem is nobody actually knows what ALS or BLS means. To some its billing, to others level of care, some see it as ACLS/BLS which covers cardiac but not trauma and finally some see it as just a unit designation. So, I am asking you to help a brother out and provide your definition of ALS and BLS.

So, if one choses to re-cert their NREMT paramedic by examination A. Is it the same computer based test as the initial paramedic test? b. IF not is it harder, easier or how is it different? C. If anyone has done this what has your experience been? D. After several years on the street what is the recommended study plan?

You are such a positive person.....due to an admittedly irrational phobia I don't wear things with pins...so I am looking for this alternative. Cheer up!

Looking for collar brass that say EMT, EMTP etc. that attach with a magnetic backer rather than pins. I have a name tag like this can't find brass...

SP02 92-95 ETCO2 we don;t have

We have CPAP, but this guy was not close to CPAP per our protocol.

Did not treat the tachycardia. 1. BP 150/90 2. Patient not on diuretic. 3. bGL 120. 4. No steroids. 5. Crackles were in all lung fields. 6. Had albuterol and atrovent inhalers 7. As to CHF no diagnosis and no lower extremity edeme. 8. Don't know about BNP or lactate level So far I think I have learned that giving a breathing treatment would have been in effect treating the tachycardia.

Patient's chief complaint is difficulty breathing. Dib the same evening we saw him. Fire had him on 10L o2 pt. said breathing was better. Pt. had pneumonia in February. Hear rales and crackles thru scope gurling audible aurally. Pt. has emphysemea, not on home 02, only meds are an inhaler. He has been eating normally but urination frequency has increased, stated every half hour the nite before. A: Besides DIB he has no chest pain, regular but tachycardic pulse, no other complaints except fluid on lungs. RX: Did a 12 lead which was benign, pt. is tachycardic @ 120 to 130. Decreased o2 to 4 lpm on NC, still breathing good with normal effort, rate 16-18. Did a saline lock. Here's the rub....did not do breathing treatment. Senior partner says I should have. Rationale for not doing it was A. breathing improvement on 02 B. Fluid on lungs and increased urination would not seem to be helped by breathing treatment C. Tachycardia....yes perhaps caused by breathing, but also did not want to risk an increase in HR with an 81 year old. At ER a 12 lead was ordered but no breathing treatment was done. What is the correct call treatment or no?

Curently an EMT-P looking to take a Wilderness EMT class. Probably one where you 'upgrade' your regular skills with wilderness ones. Which provider do you think is best? Seems SOLO and NOLS are leaders? What others have you used, or do you recommend? If I take one of these classes do the credits count for CE's at NREMT-P level?

A co-worker of mine writes questions for this site.

If you have a Palm, I Phone, 'smart phone' etc. you can get a reference guide to put on that.

Michigan based so in state or say within the Big 10.

I'd like to make it but ah....I am working that days, ah there is no direct flight, I have nothing camo or military to wear etc.

Under the following general headings : Trauma, Diabetics, Pysch patients and Operations what are topics that you would like to see in a CE class. Examples: Diabetics: Diabetic Meds Pysch: The Mental Health System in yr. community etc.

Anyone have a lead on an upcoming PHTLS instructor course?

I don't know if counts as a right but one of my rules is: each patient has worth and dignity and we don't judge them we treat them. See Rules Post for my full thought on this.

How about this....Patient has a right to evidence based treatment that is least invasive...

You can say they should be appropriately transferred to ambulance.....the best way might be a stair chair, or a lbb. The cot might not fit into a space. Do you really want to be carried down flights of stairs on a stretcher? If it is for say abnormal lab values why must they ride on the stretcher, why can't they ride on the bench seat? For some folks it is a matter of pride to walk to the cot. Yes sometimes we must life heavy people on stretchers, we must maneuver cots into tight spaces to appropriately taken to the ambulance...

1. The RIght to be transported regardless of illness/injury, or ability to pay. (Comment: Kind of like the signs you see in ER's....usually end with this hospital does/does not take medicare) 2. The right to have a supervisor or another ambulance respond if you do not like the crew you got. (Comment: Couldn't that be a can of worms based on certain calls.... 3. The right to have an interpreter if you do not speak english. (Comment: In person, or via phone or radio?) 4. THe right to be transported in fully functioning ambulance with no mechanical problems or equipment issues. (Comment: Is one scene light out a violation? How about we have no sam splints so are using a pillow?) 5. The right to be transported via stretcher instead of being asked to walk to the ambulance. (Comment: What if you are one of those folks that like to meet us at the door? 6. Patients have the right to be treated by competent personnel who have received regular training. (Comment: So training=competence? If I have say ACLS as required by my med control and you take a 12 lead class are automatically more competent? 7. Patients have the right to be transported to the most appropriate facility (in their area) for the condition that they have. Comment: Don't they have the right to chose their destination already? 8. Patients have the right to have a pillow and blanket. Comment: What about a sheet? 9. Patients have the right to not have their body parts exposed for the whole world to see. Ambulances will carry gowns to cover female patients while a 12-lead is being performed. Comment: What about males? Are your rights asexual?

From http://www.pharmacy-technician-certification.com/?p=23...... What are your thoughts on this? If you’ve ever seen an ambulance screaming past your vehicle on the roads and felt your heart beat faster, you’re one of those who know the true value of life; you realize that every second counts when a person is in danger and that the faster they can get medical help, the better their prospects of survival. For the loved ones of the patient in the ambulance, it’s a long ride, perhaps not literally, but in every other sense of the word. From the time they call emergency services, till the time the patient has been admitted to the hospital and attended to, they’re not able to function normally. Their hearts are in their mouths as they pray and hope that their loved one pulls through with no lasting damage. The situation is even more fraught with nervousness and uncertainty when you’re talking about developing countries where the infrastructure is not as good as it is in places like the UK and the USA. India, for example, is a country that’s doing well as far as software and the IT industry are concerned. But there are many areas in the country where they don’t have an emergency number like 999 to call in case of a medical emergency. The government does maintain EMS services in places like New Delhi, the capital of the country, but even this is bound in miles of red tape so that the benefits more often than not never reach the common man. Ambulance drivers and staff are more likely to ask for a bribe than concentrate on getting the patient to a hospital, the paramedics, if they are present, are usually untrained, the roads are unbelievably clogged with traffic, and every now and then, the country goes on a strike which paralyzes even essential services and sends traffic to a standstill. Under such circumstances, it’s a miracle that the patient gets to the hospital, let alone alive. There is a small ray of hope for the country in the private sector though – a band of self-styled do-gooders have come together to form a not-for-profit agency called Ambulance Access for All. This group of five people launched their venture Ziqitza with initial help from the London Ambulance Service, and introduced the congested city of Mumbai to an ambulance service that used a sliding scale of payment, a novelty both to the city and in the entire country. The patient would have to pay depending on the hospital he or she was being transferred to, and in case they were being taken to government-run clinics and hospitals, the service was entirely free of cost. With a single number, 1298, that could be called from any phone line, a team of trained paramedics, a fleet of state-of-the-art ambulances, and an efficient support staff in the control room, Ziqitza promised to deliver patients to their destinations within 15 minutes, irrespective of the location of the caller. The company has extended its operations to the southern state of Kerala too, having set up ambulances to serve three towns so far. Ziqitza is looking to cover the entire country with its network of ambulances, an ambitious project in deed, but one that will certainly make a world of difference.

Our system goes by the last day of the listed month

Driving thru a supposed blizzard got me to thinking. Others were told to stay home and off the roads. There I was tooling along because I had to work. Why did I have to work? Well as a paramedic in emergency medical services I suppose along with police, fire, utility crews, snow plows etc. we are considered essential. Theoretically the golden arches can close but we can't. Later I took a call for a person who had fallen in the snow. Knee pain was the chief complaint. The fall and pain were bad enough she met us on her feet outside her house. Was it essential she go to the ER? Not likely. Probably more essential she went inside and 'RICE'd it. More evidence that folks don't always know how to use EMS. So, I thought would it make a difference if EMS became Essential medical services. That is in the midst of a blizzard if it is essential you need medical services call us. If it is not don't..... Think such a change would make an impact?

Ah, the 'OP' says...they do not have the rear slash pockets. I think I may miss these but we shall see. As for the knee pads I do have surgically repaired arthritic knees so I hope they can help make things a little easier. Wow I'm not a company man nor do I desire to be a 'supe' just want comfortable useful pants.

Just got a pair of the new 5.11 EMS pants5.11 Pants Anyone else have them? Comments? I'll post here when they have a few shifts in.