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Rate control is a great way to provide symptoms relief. I suspect this patient will feel much better post CCB, which is a big reason why I give them.

If a 12 lead has not been obtained, that would be first. Assuming nothing is pointing towards a latent infection or volume loss, I’d hang some fluids and give some fentanyl. If a 250 NS challenge has no effect on the rate, I would give diltiazem. I’d continue the fluids. If the diltiazem was...

Haven’t taken the keys out of the ignition in 11 years. Fire me.

90 degrees and our ambulance has no air conditioning. Our reserves are broken. Asked if we might borrow another service’s rig. Told no. This place can well… Even at AMR if our air goes out it’s immediately back to base for a new rig. No questions asked. Unclear how a fire department with a 19...

Spent nine months in a big FD’s hiring process. Got dropped in the medical for what I assume is a preexisting injury. Fitted for gear, ready to start the academy (bummer no laterals), and this was the last box. Used lots of time off to make it to all the events, postponed my wedding when I got...

I feel like it has limited utility. Generally, I can find a PIV, it might be a 22 in a weird vein but it usually will do for my purposes. Is delaying transport to get a larger gauge of access useful? I don’t know. Seems unlikely? If it’s not a critical need the hospital can have at it, even with...

I think it would be unwise to base any of the refusal process on the monitor’s interpretation, which is not known for its steadfast accuracy. Not that paramedics and doctors are either. The EKG is just one piece of a refusal. I would not want an EMT using the monitor at all to obtain a BLS...

An ALS provider took a hypoglycemic patient back emergent and did nothing but have them drink tea? Am I missing something?

Out old guidelines said any ALS med needed to given 30 minutes prior to transport if the EMT was going to attend. This wording has disappeared lately…. Zofran and albuterol are BLS here and EMTs can also assist with OTC medications in Colorado so the above scenario would not really apply...

I am no fan of the printer or the paper changing. I prefer the bigger paper and the “format” the MRx and LP15 print 12 leads. I can get over it, I’ll just say bad words when the paper runs out mid call. The transmitting works fine for us.

I’m pleased that Colorado is moving to state licensure. Doesn’t seem necessary to restrict licensed ambulances from transporting patients to appropriate destinations. Also would be nice to get one sticker, instead of the four counties some services in my area must get because of the geography.

If there’s a company that can catch hate, it’s Zoll. Was like pulling teeth at my last job to get the Zoll vent (best features and price for our needs), just because the name started with Z. Not sure what the M series did to people but that’s what I hear as to why Zoll “isn’t allowed in the...

Someone said this thing was still heavy. I feel like a vitals monitor +/- AED depending on situation is better for wilderness/SAR.

Will they entertain buying your Lifepak stock to entice a sale or is that only for larger agencies?

I find racemic epi much easier to use than scrounging up five single dose vials. We already have fridges so can keep them at that right temp.

EMS is a lot of translating and navigating. Take their story (and other cues from their environment) and whatever objective findings you have and synthesize that into something that the busy ED can quickly and easily understand. Also finding the right the destination for your patient is IMO a...

We have it in our guidelines for use after three consecutive unsuccessful shocks. We are supposed to do AP pad placement on the first set but that has been difficult to get buy in on. Agencies that use the Zoll X have really struggled as you have to remove the CPR puck and people don’t do that...

The update: "They are too expensive to replace, so we won't." Not sure how we are going to get away with that.

But why?

Our budget is outrageous. I would blame it on fire-based EMS, but our EMS admin are not firefighters.