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It may be my old dude (39 next month) ears or it may be diesel, but I've had better luck with a decent stethoscope than I have the $20 specials at the uniform store. Doesn't have to be a Littmann. I know you're paying a premium for that name. Probably my favorite set of ears is my MDF ER...

What's apparently not being taught are assessment skills and critical thinking.

Respectfully beg to differ. Assessment is assessment. And lung sounds are a part of any assessment that a competent EMT should be doing.

What risks are you concerned about? And I'd look at this link regarding Trendelenburg: http://www.ems1.com/ems-products/education/articles/384771-The-Current-Slant-on-the-Trendelenburg-Position

The only difference between Trendelenburg position and shock position is that, in Trendelenburg, the head is also lowered. So, nope, I don't think the results will be any different. Just for the sake of discussion, may I ask where you practice and what level you're at? :)

I'm not a flight junkie, but in this case, I'd agree with Mariemt if you're a ways out from a hospital with ICU beds. Also, another question on assessment of the patient.... How's his mental status? I've seen several septic patients who are extremely altered, as in hallucinating.

Agreed. In this case, oxygen saturation would be just another vital sign to add to the chart. It's not going to help you with a differential or in treating this patient at this point. And, assuming the respiratory rate is in the 50s, but the sats are, say, 97%, would you withhold oxygen?

What would O2 saturation tell you that the patient's respiratory rate wouldn't tell you? I'd be more inclined to get an EtCO2 on the patient. And hasn't the science pretty much shown that Trendelenburg is meaningless?

Metroscare (I meant MetroCare) was always an "interesting" operation when they were in Austin. However, I'll always be grateful to them for having EMT-B and EMT-P classes at night in Austin when no one else was offering them. You can thank (or curse) them for my paramedic patch. One year of...

If allowed, I'd seriously consider RSI for this patient. As an added benefit, we use Ketamine for our induction agent. Ketamine's hypertensive and bronchodilatory effects would be ideal for this patient.

I know of several services that use volunteers to supplement the paid staff. Most of the vollies ride as third crew members.

At the EMT level without ALS support, PUHA (Pick Up Haul A**) comes to mind. Get a good assessment in. What are lung sounds like? Is pneumonia with sepsis your differential? I'd think about assisting ventilations with a BVM. Paramedic level, this guy needs to be on a monitor and...

Take a deep breath. Settle. And realize that, regardless of where you end up, whether or not you remain in medicine, life is a constant educational process. EMT is but the first step in learning. My advice, start learning medical terminology and maybe see if your local EMS service will...

If you're about to start medic school next month, I'd hold off on an EMPACT or AMLS course. Get about a year's experience functioning as a paramedic and then you'll have had some calls under your belt where you can really fine-tune your assessment skills.

I've never taken it. It's a competitor to the AMLS class. When NAEMT changed publishers and authors for the AMLS course, the original publishers and authors developed EMPACT to compete with AMLS.

As for me, I'm an attorney.

Fascinating call! We were all a bit off. Thanks for sharing it.

Texas. Almost every variety of EMS you can find -- private, third service, fire department, hospital-based, etc. No state protocols or state scope of practice. And some of the most progressive medical direction you'll find.

Agreed. Paramedic school isn't all that difficult. IF you have a solid foundation of education and experience. However, many of us coming into EMS have never been exposed to higher education prior to our EMS education. Taking an accelerated paramedic program might be the rough...

If I remember correctly, there are multiple studies debunking MOI as an indicator for spinal precautions. And I'm not seeing any need to subject this patient to an unnecessary backboard and collar.