1EMT-P

Personally I don't like to use narcotics for kidney stone pain. I like to use IM or IV Toradol with Phenergan.

If the patient is alert & oriented & stable then YES they can request to be transported to XYZ hospital, but if the patient is in Police Custody or if they are altered or if they are a minor of if they are unstable then no you do not have to honor their request. Most EMS agencies have Standard Operating Procedures and Protocols in place that deal with issues like this, I would urge you to ask your employer for a copy of your SOP's and review them, If your agency does not have SOP's then I would start looking for a new job ASAP... GOOD LUCK, 1EMT-P

I was always taught that you should use Saline Locks for stable medical patients & patients at risk for APE or CHF & that you should use IV fluids for trauma patients or for patients at risk of becoming unstable.

Do any of you use the Littman Lightweight II SE Stethoscope in the field?

If I were you, I would document everything that happened and then I would contact the EMS Agencies Director and/or Medical Director in writing outlining your concerns. If the EMS Agencies Director and/or Medical Director do not respond in a timely fashion then I would contact your State EMS Office.

I would encourage you to do the following 1. Find a good mentor who can give you advice and help you. 2. Review your A&P & then draw & label the veins. 3. Take a deep breath before start your IV's. & 4. Try feeling & looking at the veins before you start your IV's. GOOD LUCK!

If you were going to buy a new stethoscope what kind would you buy & why?

I agree that ETI is the standard of care when it comes to airway management, but what about EMS providers who live and/or work in communities where their call volume is low or where they primarily do transports? There are some places here in the US where providers simply do not have access to an OR. For these folks the ECT, King or LMA maybe the best option available.

The purpose of CERT as I understand it, is to assist in communities in the event of a disaster. CERT members are trained to perform basic first responder functions until EMS, Fire or Police can arrive.

The first thing that I would do if I were you would be to write to the local and/or state office of EMS and ask them. The second thing that I would do would be to ask your agency if their insurance covers ALS providers. The third thing that I would do would be to ask your Medical Director for written authorization to perform advanced skills in an emergency. PS: Remember to dot all your I's & cross all your T's.

We shouldn't throw the baby ( Phenergan ) out with the bath water just because a few providers did not know how to properly administer the medication, instead we should educate providers on the medication and on the proper administration of the medication. Zofran is a good medication, but is it going to work at preventing and/or treating motion sickness?

I have been using the Combitube since 1994 and I have not had any problems with it. I think it is a good alternative airway device. The LMA is a good device if your patient has been NPO, but lets face it most of our patients have not been NPO and are at high risk for vomiting. If I had to rate the alternative airways I would say: 1. King, 2. Combitube, 3. LMA & 4. PTL.

I recently attended an ACLS provider course and to be honest with you I was shocked at just how much content the AHA had left out. The AHA basically deleted the advanced airway and pharmacology sections of the book...

Do any of you work with RRT's who are not EMT's or Medics, but have advanced scopes of practice and who work in the critical care/pre-hospital emergency care environment. Examples: Flight RRT or Ground CCT RT or Pre-Hopital EMS RT... Not Home Care RT...

Do any of you work with Pre-Hospital Respiratory Care Practitioners/Therapists?

Do any of you know if there any alternatives to AHA ACLS?

The device implies that it reduces the risk of injury, but without research data it's hard to say...

What medications do you use for PAI/RSI in the field? Diazepam & Morphine.

Does your agency offer critical care training? Does your agency offer a stipend for becoming CCT certified?

I agree with your treatment given the patient's history & physical exam. If she had CHF I would expect her to have some edema. Plus given the fact that her sputum is a greenish or yellowish color. I don't think the nurse was right to question your assessment or treatment... What made her think that it was CHF? Did she do a Basic Metabolic Panel, Chest X-Ray, Ecg or Pro-BNP?

I think it all depends on the patient's condition. If you have a critical patient ( AMI, CVA or Trauma ), then yes lights & siren maybe indicated.

I would have given the patient a 500 ML bolus of NS first and then re-assessed the patient. If the lung sounds were clear after the first bolus then I would have given a second 500 ML bolus.

Sorry about that, but my pc crashed in the middle of my post. The patient's vitals were as follows: BP 140/100, P 78, RR 20, Spo2 94% on RA, SR/Paced 78. The patient states that her Dr. recently increased her Lasix to 80 mg and that her labs showed that her cholesterol and liver function tests were elevated. The pt's Dr. scheduled her to have an echo along with a stress test. Allergies: Bumex, HCTZ, IVP Contrast, Motrin & Sulfa.

You respond to a 59 y/o female patient complaining of fatigue, swelling of the abdomen & legs & shortness of breath. The patient states that she has not been feeling well and that she has gained 20 plus pounds in the last 10 days. history of Anxiety, Depresion, Gerd, HTN, Sick Sinus Syndrome & Restrictive Airway Disease. The patient was on ASA, Albuterol, Lasix, Lopressor, Protonix, Xanax & Vitamin E.

I think you did a good job under the circumstances. I probably would have given this patient Cardizem and/or Lopressor instead of the Amio.