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The fire vs EMS debate doesn't even belong here, though. Remember when firefighters used to be in the newspaper for saving puppies and kittens? Helping little old ladies off of the street? When I worked in an urban department, I used to mock the suburban departments who were effectively "boy...

Yep. I don't think I heard all of the call, but I heard no repetitive persistence, no action with a reason, no use of her calm to control the situation. We were not allowed to disconnect the call before the caller. I pretty much agree with that policy.

We use ASHI exclusively. The ease of use from the training center perspective is awesome. I teach ACLS and PALS 3 times a year, and CPR monthly. The big hospital system nearby doesn't accept it though.

I agree with usalsfyre, but not so much your "easy" argument. It's easy to do anything in a mediocre way. STEMI? Meh, if the machine calls it, great, if not, oh well. I just sat in a class with craigalanevans for 8 hours today. I'm 20 years into my career, and he gave me at least a...

Oh yes. You feel all badass as a medic, knowing it's just you and your partner against the world, with help 15 minutes away *if* it's coming. And then sometimes you have someone to help schlepp all your stuff and carry the patient to the truck while you ponder your plan of care and discuss...

I'm like dr parasite, but on the rare occasion I need to write on paper (usually a train wreck situation) I write on monitor paper. My partners joke that that's how they know I'm giving out my phone number or email address or the bomb has gone off. If I'm writing on paper, it's on.

There is a certain amount of suck it up involved in the level of working together that we do, but it doesn't extend to safety issues. Seriously, just never transport with lights again. It doesn't really save time, and it's not worth it. Look for a better agency. If you're willing to...

I guess as a BLS provider you have to bring in to play the risk/benefit analysis of calling ALS, waiting for them to arrive, turning the patient over to them, etc, vs how quickly you can arrive at the hospital by just driving the patient in. In my rural system, if I choose not to "comfort"...

So what's the line they need to cross to qualify for non-luxury pain meds in your mind?

Blankets are not a luxury. They are BLS care, and one of the key parts of taking good care of sick people. Fluids are often just the first step in making people feel better. Are we here to save lives? I would say no. We are here to make people feel better on their worst days. Very rarely do...

I can usually get access, but this is one of those times that calls for intranasal fentanyl.

As much as the ideal position for a woman in labor is to be upright, it's simply not possible in an ambulance. Seatbelts, and all 5 of them, are needed for the transport. Most of the time women have spent so much time lying on their left sides and drinking a glass of water as directed by the...

The other thing is that our primary helicopter service is very, very, very conservative for weather. So if it might storm this afternoon, and it's closing in on lunchtime, they're not coming. Or if there's a cloud in the sky between here and Singapore. Or something.

If it's only 30 minutes to the hospital, it's important to have worked out well beforehand what the real-time dispatcher to dispatcher, dispatcher to pilot, pilot to weather check, crew to helo, helo to scene (approx.) time is. Those times can really mean that it's a lot faster for the patient...

Agreed. One thing I notice is that while I might only transport 4-5 people in a 24 hour shift, when I change out my drug box, people from my agency take up more than half the slots in the log. For all the other surrounding counties, we are changing out 1/3 to 1/2 of the ALS boxes. Acuity...

Yep. We have an hour to get to the hospital. Temp less than 90? Warming and airway win. It's important to remember to lay these people on a couple of thermal blankets too. The cot mattress sucks heat out of them also.

I like that schedule. I worked it for 2 years in a comm center job where I was pretty sure to get off on time. It's nice to sleep at home every day and have rotating days off. In my experience, the shift is like this: MTWTFSS MTWTFSS AABBAAA BBAABBB I like that shift.

Wow. 79. Dang.

In these mystical altered mental status cases, it's a challenge (especially in the nicer neighborhoods) to go to overdose, but I've found that people with normal skin, altered mental status, and depressed respiratory drive are usually not neuro issues. Warm, dry skin, AMS, I'm thinking...

Further evidence of the impact of her non-effective ventilatory status. Does she accept an oral airway?