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Why the heck were they having you turn the dials? Did they also ask you to get the tube and the IV for them?! It is possible that they just couldn't get capture with this patient's dying heart, but yeah, pretty sad that they weren't totally familiar with their equipment. I will say that the LA county FF in my medic class were all good guys. They seemed to really want to be good medics, and in fact our class valedictorian was a county FF.

Geez, the exact same thing happened at King/Drew here in LA last year. Yesterday there was a story in the LA Times saying that the video from the security camera had just been released. Just as with the Brooklyn case, nobody attended to the woman after she collapsed. It's totally ridiculous that this could happen.

Yup, there are medics on all the engines, but no fire ambulances. PM me if you like.

If you work as a medic for SD Fire, you won't really be a medic.

From what I understand, 20% of anaphylaxis patients will present WITHOUT the typical skin signs (hives, redness, edema, itching.) (I don't remember the source for this statistic; otherwise I'd include it.)

It shouldn't be hard getting hired as a medic. They have as hard a time keeping medics as all other privates in CA.

Should we be giving a fluid bolus to patients with kidney stones? I got a liter of fluid from the ER when I had my kidney stone a few years ago. Most medics I know give fluids to "flush" the stone out, but does it really work? From what I understand, that treatment is controversial.

You do mostly (probably 90%) emergency calls. It probably won't be easy to get hired by them since nearly everyone graduating from EMT class will want to work for them.

And one more.... http://www.sfgate.com/cgi-bin/article.cgi?...=020&sc=210

This is a several-part article that appeared in April... Part 1 http://www.sfgate.com/cgi-bin/article.cgi?...=002&sc=857 Part 2 http://www.sfgate.com/cgi-bin/article.cgi?...001&sc=1000 Part 3 http://www.sfgate.com/cgi-bin/article.cgi?...=003&sc=394 Related story http://www.sfgate.com/cgi-bin/article.cgi?...=009&sc=298 Related story http://www.sfgate.com/cgi-bin/article.cgi?...=019&sc=210 Editorial http://www.sfgate.com/cgi-bin/article.cgi?...=007&sc=301

StCommodore wrote "Ya'll are missing the point. Dynamic deployment means that units are out at specific posts and not tied down at a station during the shift. Having those units out on the road, ideally closer to expected call demand cuts down response time...." With all due respect, I think you're missing the point. You've been brainwashed by your company! The point of "dynamic deployment" (never heard that before! love it! ) is to save your company from renting stations for you guys. It's great that now their having to pay lots more for gas.

What are the correct dosages for calcium given to 1) hyperkalemia 2) calcium-channel blocker OD's. I've looked at several sources, some saying 1 to 4 grams, another saying 500 mg, another 1 - 4 mg/kg.... Also, why are the pediatric dosages so high?

Thanks for all your responses! I understand that Valium is not a first-line treatment for vertigo, but would it be appropriate to give it pre-hospital to reduce the patient's discomfort? More about Valium...what are your thoughts on treating agitated or delirious meth/coke OD's with Valium? How about Versed? I know this is done in the ER, but what about prehospital? Most Southern California counties have no protocols about using benzos for sedation, and I think most docs around here would be reluctant to allow such an order.

I was reading through another county's protocols, and they had one for vertigo. They suggest the use of valium. Anyone out there familiar with this? I suppose it makes sense. They also suggest the use of Benadryl as an adjunct for anti-emetics, or by itself if anti-emetics are contraindicated.

That was brilliant!

In the case of a beta-blocker OD, you could consider an epi drip after you've gone through your other treatments.

I've never worked for Rural-Metro, but I've gone down to check out their operation and had a chance to talk to some of their medics. My impression is that they have a very good operation, much better than AMR Riverside where I used to work. Most of the units are stationed at fire stations, and you run calls with the engine, which has a fire medic. Some years ago the FD got rid of all their medic ambulances, and now Rural-Metro does all their transports for them. Pay is a little better than AMR, but not much. I talked to a guy who worked for AMR in Chula Vista, and he said the pay was horrible. The only positive thing was that they worked dual medic and that fire was BLS only. Protocols for San Diego and Riverside are similar (much better than LA), but in San Diego you are required to make a very lengthy radio report to the base.

I misread the original post...I've never tried using the regularprobe off the Lifepak or some other pulse ox. Rather, I used disposable type designed to be taped around a finger. Many times when I was unable to get a reading with the normal probe on a finger, I was able to get one with the disposable probe taped to the patient's ear.

Works great!

Anthony, I think you're reading too much into how people use the word "tight." It doesn't describe a particular lung sounds; rather, like others have said, it describes reduced airflow (reduced tidal volume) and wheezing due to constricted bronchioles. If, as you say, you can't hear wheezing in half of your asthma patients, try listened very carefully to some other parts of the lung. Also, junk that $5 scope that Care gives you.

Cardiac arrest save after drowning.... http://www.emstube.com/view_video.php?view...94d42f4ef36764f

I would treat his obvious injury and give morphine before I moved him, but I would also be sure to do a very thorough physical exam with a high index of suspicion for other injuries, especially abdominal injury. We can't be sure that there isn't more to the story than we were told regarding the mechanism of injury. Maybe the horse stepped on him after he fell. Perhaps he was knocked out for a moment. Witnesses are unreliable. I suppose all this is obvious, but it's easy to get distracted by a nasty extremity fracture.

Judging by how well her article is written, I'd guess that she did in fact get a higher education...and has probably moved on to bigger and better things beyond EMS.

This article is wonderful. Although it's about a terrible mistake, I believe that people reading this article in The New York Times will come away having a better appreciation for people who work in EMS. The author acknowledges her mistake, and she obviously still feels terrible about it all these years later. One stereotype of EMS workers is that they are cynical and that they have little compassion. Obviously this person is not any of that. I hope she is still working in healthcare.

Hmmm...maybe I should've gotten a job with Kern County Sheriff instead. If you're gonna work in the dreaded 909 (Inland Empire), your best bet may be Hemet. I met some of the Hemet crews last year during the big fires, and I was surprised to hear that they really liked working in that division. I later met the division boss, and he was really a nice guy. You may also want to look into the division that coves Apple Valley (I forget the name) because I've heard good things about them too.