# private vehicles



## jbrooksEMTangel (Nov 14, 2007)

i live in new york state and we have alot of different rules and regs in our volunteer fire dept.
my question,do you think its a good idea for an EMT-b to carry his own bag in his private vehicle? he wants to beable to carry 02,glucose,asprin,epi pen,. i myseld dont feel comfortable with it,we are having a meeting tonight about this and maybe im wrong but what if the patient is allergic to asprin? what if something goes wrong while he is administring anything on his own before the squad gets there? what if he gets in a car wreck with an O2 tank in his car? does all this come back to the fire dept? we are a volunteer dept and we do not transport, we are thinking about getting back into transporting as the private ambulance service pulled out. just need your opinions on this. thanks


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## jbrooksEMTangel (Nov 14, 2007)

*myspace*

i just started a myspace..please take a look and join.   http://www.myspace.com/emtjackie


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## skyemt (Nov 14, 2007)

also in ny state... we carry jump kits in our private vehicles... collars, bandages, bleeding control, airways, steth. and cuff to take vitals, oral glucose, etc... basically what would make sense to use to stabilize a pt before the rig arrives...

but no meds that could possible cause adverse reactions...

hope that helps.


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## firecoins (Nov 14, 2007)

I am baffaled that you would be carrying most of that stuff in your personal vehicle.
You need gloves, a cpr mask, some 4x4, 5x9s, tape  and thats it. I have found several MVAs off duty and I all I used were gloves and my cell phone. Responding units supplied everything else. You want to get kinky? Get a bp cuff and take vital signs. 

you don't give meds unless you ask if they are allergic.  There's no reason to be giving aspirin off duty.  You can recommend that to a person having a MI but don't push anything.  

Diabetes?  can of coke if conscious.  Nothing else you can do. Your not going to start an IV and push D50. 

MVA?  hold c-spine or have other bystanders do so and assess all the patients.  Tell 911 what they need.  All collars, backboards etc will be brought by an ambulance. 

broken limb? hold it stabile.  use a couple of triangular bandages.  The responding ambulance will do the rest.


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## skyemt (Nov 14, 2007)

Firecoins, why so negative?

first off, we are a volunteer agency, so there is no "off duty"...
secondly, in a somewhat rural area, it can be a little time before the rig gets there...

i agree with you about the meds... but a can of coke? oral glucose is preferred for many reasons, why would you have a problem with that?

and i have been on scene when having an airway was very helpful, as was being able control bleeding and bandage before the rig arrives...

or would you just have us sit there for 10 minutes and let him bleed?

really, i don't see why you are so judgemental... it takes nothing to have a jump kit in the car, and i don't think you can say it's not helpful.


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## medic001918 (Nov 14, 2007)

A couple of things, the first is you're listed as a "student."  I wouldn't recommend stopping and rendering anything more than first aid until you have a certification.  And certainly don't ever introduce yourself as an EMT-B or any other kind of certified responder unless are are certified/licensed in your state as one.

Next, you really don't need to have a large jump kit for these scenarios.  Personal vehicles needlessly tie up scene's.  If you come across an accident, simply call it in so the proper services can be sent and provide a decent scene size up to make sure they know what to send.

I'm just really not an advocate of people responding in their personal vehicles.  It causes a large liability and risk that people often don't understand the scope of (legally, insurance, traffic, etc.).

As far as volunteer's never being "off duty," if you're not on the scheduled shift then you would be considered off duty.  You're on duty when you're in uniform and on an actual response vehicle within your services guidelines.  I'm a paramedic at work.  Off duty, I'm nothing more than a first responder.  Most of the time though, I'm not even that.  I simply call things in if I see them and let the appropriate services handle their calls.  I don't want to interject myself into a liability needlessly.

Shane
NREMT-P


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## medicdan (Nov 14, 2007)

We have had a whole bunch of long, involved discussions about personal vehicles responding to scenes, personal jump kits, liability at these scenes, the role of students at these scenes, the most recent being about a month ago. I suggest you search for topics from the past-- they are very informative. 

Good Luck!

DES


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## skyemt (Nov 14, 2007)

listen, you guys are too much...

firstly, i am not a student, i'm an EMT.

we don't have shifts... whoever can respond the fastest does... we only have shifts between 8p and 6a...

so you would rather a pt sit alone for an extra ten minutes because my personal car on a non-busy road bothers you?

you are clearly not familiar with our type of setup, which is fine...

but please don't preach when you don't know... you can always ask, you know... even paramedics aren't familiar with everything...  

but, i accept your apology.


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## medicdan (Nov 14, 2007)

skyemt said:


> listen, you guys are too much...
> 
> firstly, i am not a student, i'm an EMT.
> we don't have shifts... whoever can respond the fastest does... we only have shifts between 8p and 6a...
> ...



Let me flesh out my thought a little more.....
I admire questions, heck, I am still new to the game, and ask more questions every day then my partners appreciate...
From what i understand, I think medic001918 was referring to jbrooksEMTangel being a student, not skyemt. 
Personally, I support personal jump kits, but think that contents and scope of practise should be much limited. 
I dont see a need for anything other then:
--Common Sense
--Cell Phone
--Gloves
--CPR mask
--bandages, etc to control severe bleeding,
--cravats
--bp cuff/stethoscope for baseline vitals.  

I still encourage all interested parties to do a search, it seems this has been discussed to death elsewhere. 

Good Luck...


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## firecoins (Nov 14, 2007)

skyemt said:


> Firecoins, why so negative?
> .




Its not a matter of being negative.  Its a matter of experience and common sense.

I am a volunteer in NY state.  The never being off call isn't true.   If I am not scheduled, I am off call. I can pick up calls when not scheduled.  I can take calls when the first rig is out on a call but I am technically off duty. 

I have come across medical emergencies outside of being "on call". I am telling you from experience, less is more.  The most helpful thing you can do is prepare for incoming ambulances is take yourself first and give them as much information before hand. This way they are prepared to handle the situation. They will have all the equipment necessary.  Vital signs, airway breathing and circulation are all thats needed at best.  

- For airway and breathing, all you need is a CPR mask. Want to throw in some OPA's? okay you are rarely going to use them. The opportunity you get to do so, you won't have them.  Just how it works. Less is more.  They have CPR masks you can put on your key chain.  Its great cause you will always have it. 

- BSI scene safety.  As usual protective yourself first. Make sure you don't become a patient. Than have gloves to prevent disease.  

- you want carry bandages. Not a problem.You will occasionally use them if available and necessary Most situations where bleeding was occuring it was miner and I don't stop to give out bandages.  I only stop at apparent life threatening situations. 

If the sitation permits, do a full assessment, take vitals (pulse and respirations are good) and stop major bleeding.  Hold C-Spins or stabalize broken bones as necessary.  You don't need to have the patient on a backboard prior to the ambulance arriving. 

O2, aspiring, glucose , they aren't necessary.


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## skyemt (Nov 14, 2007)

i don't carry aspirin and O2...
basically what you said would be usefull was what i said i carried in my bag...

so, you are essentially agreeing with me, when you started out disagreeing.

glad i shed some light!

about the "on call", that is just semantics... no one is scheduled between 6am and 8pm... so then, i guess everyone in the agency is "off duty". what you are saying here is really irrelevant.

it is simple SOP's we have... if going to the scene in personal vehicles will cut response time by more than a few minutes we do it... if what we carry will help the pt before the rig arrives, we use it (and yes, i have used OPA's)...

it is about as common sense as you can get, not sure how or why you would want to disagree with that based on your "experience".

no reason to be contrary for contrary's sake...


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## jbrooksEMTangel (Nov 14, 2007)

sorry,i havent changed mmy profile..i am not a student EMT anymore..that was awhile ago..i am now the LT emt..anyway,thanks for all the responses,the case is,,we have someone that lives about 15 minutes from the station,he wants to have all this stuff in his private vehicle in case there is a call closer to where he is. where i live we have a population of maybe 500,,small community and in the winter the roads here are horrible.alot of back roads.he wants to have oxygen in his private vehicle,and a bag with the other stuff that he will purchase on his own.my question is ,if something goes wrong while he is taking care of the patient before the rigs gets there when he administers asprin,epi pen,? or if in route to the scene,he gets in a car wreck, who does this all go back on? himself,the dept?..thanks again..i will change my profile..did anyone join my myspace?


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## bstone (Nov 14, 2007)

The few times which I have stopped to help I was very glad to have gloves, a few 4x4s and a BVM. Steth and BP as well. I think that's all you really need.


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## Lisa (Nov 14, 2007)

*I understand where you are coming from...*

I too live in a very rural area where response time for the ambulance can be as much as 25 minuntes. I work full time at our County service and am involved in Vol Fire Dept as  well. I carry a lg bag of supplies in my POV, including 02 and OPA's. I also have a complete IV set up and a few bags of fluids. I can count on one hand that I have used anything more than a BP cuff, steth, and maybe some 4x4's. On the occasions I have had to use anything else, our Ambulance was transpotring another pt.  I do not run to every single "I need help" call. I do however go if I know that my help is really needed. I guess it's a catch 22...... If you don't have it, you might need it...If you have it, you will never need it!! 
Just thought I would put my .02 worth out there. I do understand small communities.....Our First Responder program has worked really well here.
Good luck whatever you decide to do!


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## bstone (Nov 14, 2007)

You might want to change out the fluids you keep in your car as they might go bad quickly after sitting in a hot car for a while.


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## skyemt (Nov 14, 2007)

Lisa,

thank you for your post...

a voice of reason...

i don't think too many emt's really understand how different it can be in a rurual area.


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## Lisa (Nov 14, 2007)

*Thanks*

Thanks Bstone.... Good point on the fluids.... I try to change them out when we do monthly check offs for exp drugs!!


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## Arkymedic (Nov 14, 2007)

jbrooksEMTangel said:


> i live in new york state and we have alot of different rules and regs in our volunteer fire dept.
> my question,do you think its a good idea for an EMT-b to carry his own bag in his private vehicle? he wants to beable to carry 02,glucose,asprin,epi pen,. i myseld dont feel comfortable with it,we are having a meeting tonight about this and maybe im wrong but what if the patient is allergic to asprin? what if something goes wrong while he is administring anything on his own before the squad gets there? what if he gets in a car wreck with an O2 tank in his car? does all this come back to the fire dept? we are a volunteer dept and we do not transport, we are thinking about getting back into transporting as the private ambulance service pulled out. just need your opinions on this. thanks



I live in Arkansas and we are quite a bit rural as you would guess. Before I truly got started in EMS I was a FR for a district that averaged 10 FR a day with EMS over 15 minutes out so I have some experience with this. When I first started I had a full size BLS jump bag loaded to the gills and I replaced more supplies out of it due to expiration then I did using them. As I continued on my journey in EMS I become an EMT and Paramedic. Off duty I was a FR only. I did not introduce myself as an EMT or Paramedic I simply said Hi I am Jaison with the FD and I am here to help.  I also made a smaller bag and all I carried was gloves, CPR shield, 4x4s, 5x9s, bandages or maxi pads (they soak up 20 x as much so don’t laugh), red bag, BP cuff, stethoscope, and a tube of cake icing. I personally have always been against individuals carrying oxygen as it is dangerous and potentially deadly. In most areas FRs and EMTs cannot administer inhalers, NTG, EpiPen, ASA; they can only assist a pt to take them. Administering meds without prescriptions and without ALS there to intervene is a stupid idea that only ends up in losing a license. Hell, if you really want to get technical oxygen is a drug requiring a prescription as well. 

As for the department it is best to do some serious research. Transporting pts also opens up a huge legal can of worms for your department.


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## medic001918 (Nov 14, 2007)

skyemt said:


> listen, you guys are too much...
> 
> firstly, i am not a student, i'm an EMT.
> 
> ...



The student wasn't referring to you.  Your profile didn't state that you were one.

Your car on the road doesn't bother me.  It does present a safety hazard on the roadway though.  Personal vehicles do not have the proper lighting to clearly mark a scene.  A simply strobe light doesn't count.  The biggest threat to us as EMS providers is traffic accidents.  Responding to calls, and on the roadway while at a scene.  The fewer vehicles there, the better.  The ones that are there should be properly marked.

I am familiar.  I got my start in EMS volunteering in a small town where people would respond to the scene in private cars, and people would respond to the station to get the ambulance.  It's a broken system at best.  If a service is going to provide EMS, it should have a staffed ambulance 24 hours a day, 7 days a week & 365 days a year.  Small towns are usually bordered by other small towns.  Combining resources is a good way to justify call volume.  County services tend to have a decent set up to model after.  All the towns could receive care in a timely manner (including transport instead of waiting), and it could probably be provided for less expense since those expenses are shared.

Please don't assume that I'm not familiar with how different systems work.  I've worked small town to big city.  Most EMS systems are broken in some form or another, including those in which I work.  This has nothing to with paramedics "not knowing everything."  It's not a paramedic level discussion at all.  Thanks for bringing it up though.

No need to accept an apology as one wasn't offered, nor will one be.  It's simply not warranted.  Thanks though.

Shane
NREMT-P


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## ffemt8978 (Nov 14, 2007)

skyemt said:


> Lisa,
> 
> thank you for your post...
> 
> ...



Considering a large majority of us on this forum live/work in rural areas, you may want to reconsider your "Nobody understands what I go through" mentality.  

I've been doing this for several years, always in a rural area.  (My nearest stoplight is an hour away, the nearest McDonald's is also an hour.)  Out my my jumpkit, the only thing I have ever used is the gloves and my BP cuff/stethoscope.  

Remember this...when you stop to render aid while off duty, all you are doing is providing first aid.  You are not the ambulance or even the emergency response crew.  As such, you should concern yourself with the basics of what needs to be done: Scene safety, ABC's, and SAMPLE Hx will keep you occupied for some time, especially if you have more than one patient.


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## Chimpie (Nov 14, 2007)

And let's all remember this:  Just because someone has a different opinion than you, that doesn't make them wrong.  It just means they have a different opinion.


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## skyemt (Nov 14, 2007)

really, these threads always go the same way... the paramedics out here promote this site as a place to exchange ideas and learn... well we all know that the education of emt-b's is not up to par... it's been said here a million times, and i agree with that...

but then when and emt asks a question, maybe is ignorant and wants to learn something, he is often greeted with the various forms of the following:
"you shouldn't be..."
"you don't..."
"why in the world would you.."
"i'm baffled that you would even..."
"if this doesn't prove how poor the emt-b curriculum is..."

not to mention all the comments about being "drivers", and the like...

so is it really a surprise that some emt's get a bit defensive, and the thread goes downhill...

i admit, i've been pulled into that mentality sometimes myself... but if a question is asked, an answer is wanted...

a discussion is wanted perhaps, but not about all the things you shouldn't be carrying, shouldn't be doing, don't know, etc etc...

granted, many people who post do not do this... but if you read enough, you will see that far too many do...

if you don't want the forum to be "paramedic only", maybe can we try to reserve all the judgements and judgemental comments?

those comments are not constructive, and usually turn the thread bad, and really that doesn't benefit anyone...


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## BossyCow (Nov 14, 2007)

skyemt said:


> first off, we are a volunteer agency, so there is no "off duty"...
> secondly, in a somewhat rural area, it can be a little time before the rig gets there...



I can relate.  I am also in a very rural area.  But, I've found that the more years I spend in EMS, the smaller my kit gets.  We do carry glucose, its small, its light and doesn't take up much space.  I've had a tube in my kit and have replaced it twice for outdating and haven't used one yet.  As for C-collars.  I had this same discussion with one of our volunteers who was advocating for us to carry at least one of each size 'just in case'.  I finally told her that we do carry our very own c-collars with us every where we go.  I wiggled my fingers at her and reached out and held c-spine on her.  There.. instant c-collar!  

While it would be wonderful to have absolutely every tool at my disposal on every call, I've found though that most of them don't get used.  

Go to the volunteer who has been with your agency the longest and see how many old, never used items are in their kit.


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## Anomalous (Nov 14, 2007)

medic001918 said:


> Small towns are usually bordered by other small towns.  Combining resources is a good way to justify call volume.  County services tend to have a decent set up to model after.  All the towns could receive care in a timely manner (including transport instead of waiting), and it could probably be provided for less expense since those expenses are shared.



A good point.  I made just that offer to three towns close to us.  We have revenue to support a paid crew about half the day and have volunteers and paid on call the rest of the day.  The other towns are in about the same position financially but are all volunteer.  They all declined.  Their replies all sounded like the problem was ego related, not in the logistics.  Makes sense to me.


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## Gbro (Nov 15, 2007)

jbrooksEMTangel said:


> sorry,i havent changed mmy profile..i am not a student EMT anymore..that was awhile ago..i am now the LT emt..



I think there ar a lot of profiles on this forum that are out of date.


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## certguy (Nov 15, 2007)

There are good points to be made on both sides , but the point is , that card you carry doesn't say you're only an emt or medic while on duty . We can and do come across emergencies when not working . Unless the laws have changed , we do have a duty to act , so if you're licensed to give care , why not carry some gear ? I don't mean a whole rig , but at least a basic jump kit . You don't have to be in a rural area to realize this . God put me and others in the right place and time to save a woman whose car rolled over her . The first responders and medics were very delayed due to traffic . If she hadn't gotten the basic care we gave in a timely manner , most likely she would've died . For those who say you're carrying o2 , how are you getting around the FDA ? We're not supposed to be carrying it off duty . I think this was a very poor decision by them and a mistake that has most likely cost lives . Early o2 therapy = better chance of survival . I used to carry it before this law was passed and it did help save lives .


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## medic001918 (Nov 15, 2007)

certguy said:


> There are good points to be made on both sides , but the point is , that card you carry doesn't say you're only an emt or medic while on duty . We can and do come across emergencies when not working . Unless the laws have changed , we do have a duty to act , so if you're licensed to give care , why not carry some gear ? I don't mean a whole rig , but at least a basic jump kit . You don't have to be in a rural area to realize this . God put me and others in the right place and time to save a woman whose car rolled over her . The first responders and medics were very delayed due to traffic . If she hadn't gotten the basic care we gave in a timely manner , most likely she would've died . For those who say you're carrying o2 , how are you getting around the FDA ? We're not supposed to be carrying it off duty . I think this was a very poor decision by them and a mistake that has most likely cost lives . Early o2 therapy = better chance of survival . I used to carry it before this law was passed and it did help save lives .



Different laws govern different regions.  My medical control only covers me as a paramedic while on duty.  If I were to perform a paramedic intervention outside of the job, I'm operating without medical control.  As far as duty to act, again that's location specific.  When I'm not on duty in the state of Connecticut, I have no duty to act.  My services haven't been requested and I haven't identified myself or been identified as a responder.  My only "duty to act" is to notify the proper resources through a 911 call.

When I'm not on duty, I don't have the tools to do my job properly.  I do have the ability to call the services with a good scene size up and leave the job to the people who are on duty, with the proper tools and resources.

Shane
NREMT-P


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## BossyCow (Nov 15, 2007)

It's so important to know what the protocols and rules are for your agency!  Can't be said enough!  Anything said on here or other forums may be true for the poster, but illegal and a fire-able offense in other systems.


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## skyemt (Nov 15, 2007)

different policies for different regions is right! we only have shifts between 8pm and 6am... inbetween those times, we are all free to respond to calls, and will be "on duty" everytime we do such...

i also think that just because a piece of equipment doesn't get used a whole lot doesn't mean it shouldn't be carried in a jump kit... the one time you need it, you'll be thankful you have it...

if we stocked our rig based on items rarely used, it would be half empty!


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## Flight-LP (Nov 15, 2007)

certguy said:


> There are good points to be made on both sides , but the point is , that card you carry doesn't say you're only an emt or medic while on duty . We can and do come across emergencies when not working . Unless the laws have changed , we do have a duty to act , so if you're licensed to give care , why not carry some gear ? I don't mean a whole rig , but at least a basic jump kit . You don't have to be in a rural area to realize this . God put me and others in the right place and time to save a woman whose car rolled over her . The first responders and medics were very delayed due to traffic . If she hadn't gotten the basic care we gave in a timely manner , most likely she would've died . For those who say you're carrying o2 , how are you getting around the FDA ? We're not supposed to be carrying it off duty . I think this was a very poor decision by them and a mistake that has most likely cost lives . Early o2 therapy = better chance of survival . I used to carry it before this law was passed and it did help save lives .



Very few states impose off duty requirements to act in your official capacity. I've said it once and I'll say it again, if I am off duty, I chose if I stop and render aid. There are a lot of variables involved. Where am I at? How far out is the unit? What type of call is it? Do I have my wife and kids with me? I very rarely stop and until recently did not carry equipment. I now, upon the request of my employer with a financial incentive involved, carry a full ALS kit. I choose to respond when I am on my way to work and on my way home. I occasionally choose to respond if the call is of a severe nature, I am close by (I do not run with any of that whacker lights and siren crap),  and I do not have any family with me. But the choice is mine. 

I may be able to provide emergent interventions on some medical calls as an ALS responder, but I'm sorry, there is little that can be done at the BLS level on the scene of a trauma. So please enlighten me as to how you "saved" this woman.  Trauma surgeons save lives, not EMT's......


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## BossyCow (Nov 15, 2007)

Flight-LP said:


> Trauma surgeons save lives, not EMT's......



Well, not entirely true.  I'm not up to speed on the specific incident you are arguing about, but I have been a part of several trauma saves.  Just being able to get the person to a hospital lying on a gurney with O2, bleeding control, splinting and c-spine precautions ups the viability of the patient considerably from being chucked into a friends car and driven the 50 miles or so to the local hospital. Basics generally have access to ambulances and all the stuff in them.  This by itself can make the difference between life and death for some.


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## Ridryder911 (Nov 15, 2007)

Bossy, I think you have to look at the whole picture. BLS & ALS can help prevent further injuries and deterioration of the patient. Even now, it is debated that even BLS procedures such as C-spine is worthy. Since most injuries and occurrences actually occur during impact. 

Trauma is defined medically as a * surgical disease* hence; yes it is only corrected by surgeons. 

That is why trauma is a mute point in the ED as well as why no one is resuscitated from an traumatic arrest. The only true treatment in a true trauma patient is surgical intervention. 

R/r 911


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## ffemt8978 (Nov 16, 2007)

This thread is closed for 24 hours to give everyone a chance to cool off and review our forum rules.


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