Are you comparing the response capability of a rural community of 2,800 people to that of an urban area of a million? Really? There is no comparison. If the resources in Boston were not staged, yes, it would have taken more than 18 minutes to transport all the victims, you have a firm grasp...
But they are set up for the 4th, 1st night and playoff games...So...if there were a ficticious large scale event that BEMS didn't prepare for, yes, it would not have gone as well. Good thing they prepare for large scale events.
I leave the vial attached to the needle (blunt tip). No question of what is in the syringe, once used, it goes in the sharps box. If I found a syringe w/o needle in the truck I would just toss it, whining to management isn't the best option.
All medic promotions are from within, you have to be on the job for at least a year (BLS) prior to taking the promotional exam. The exam is competitive, written, practical and oral boards, top 6-10 get into the internship. Internship consists of a month of clinicals in hospital, then 9 weeks...
We do our best to switch out every 2 minutes, the quality of CPR goes down rather quickly after that. Also, transport before ROSC, in most cases is a bad idea, if you can't leave them, do yourself and patient a favor and give it 20 minutes or so on scene.
I would argue that the asthma patient that is intubated would benefit from short term paralysis, let the vent do the work. This is not a substitute for inadequate sedation, more to rest the patients muscles.
Propofol is generally not available to EMS except in the IFT arena, for those patients a benzo/opiate combination is what you have to work with.
In my experience, analgesia is woefully under used during induction or the short term post intubation period, both in and out of the hospital. I'm...
I doubt I would cardiovert, a judicious fluid bolus, a little Fentanyl IN for pain management and and EJ or IO for access. An AF at that rate isn't that much of a concern and seems an unlikely cause for her hypotension in and of itself. Rate control with Cardizem after some fluid might be...
The last Academy class graduated last week, with a few exceptions. Its essentially a 6 month process, written, practical and oral for entry. Once in, there are numerous quizzes and tests along the way, the daily PT is nothing to worry about, stair climbs, calisthenics, etc...Class is both...