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Does this patient pose a danger to themselves or others? They stated their plan was to walk into a traffic in an attempt at self harm and now, hours later, they want to walk out of the hospital and out of YOUR care. I believe they have demonstrated themselves to be a risk to themselves due to...

We don't transmit our EKGs either and I don't hear too much about false activations coming from field crews.. Here is a copy of our Cardiac Alert protocol (cath lab activation). If you note the inclusion and exclusion criteria they both have associated ACS symptoms as part of the criteria. So...

So we ended up transporting the patient non emergently, did NOT call a cardiac alert or activate the cath lab, but did treat for ACS. My partner and I had a good discussion with the attending physician in the ED about the event, patient presentation, and the EKG changes we noted. The physician...

My partner and I both noted the BER pattern (especially in the inferior leads + V5/6) but what got me was V3 and V4 (in both 12 leads above). V3 looks like it has 1-2mm ST elevation and lead V4 has 2-3 mm ST elevation, both these leads don't have the BER notch at the end of the QRS complex. Also...

Called to a crowded arena after a public speaking event for a 65y/o male with a "seizure." When you arrive you find the patient sitting on the ground outside of the building against a wall in the shade. The patient is awake and alert and denies any current complaints (A&O x 4 with a GCS of 15)...

He points the bat towards the left field fence and is calling his shot! ... Codeine overdose.

Overall I thought it was a pretty good read and not a bad sales pitch for Ketamine as an analgesic. The initial pain management protocols seemed very limited, I guess different places can have different standing orders for pain management but if somewhere has a such a limited opioid analgesic...

I love it. Great place to work and I truly enjoy it. Yep still got the good ol' prams. Supposedly we are upgrading our ambulance fleet (including the stretchers :) but I haven't heard any updates about that in about 6 months.

We do 4 10hr shifts a week at Denver Health ("DG"). A shift "pick" last 4 months and then another round of shift picks before the next 4 month block begins, all seniority based (time with the division). Earliest start times are 0500 and the latest start time is 2130.

I think this is this ^^^ is the key to the equation. I am not sure about the culture of the department or how seriously they take EMS but in my experience non-transport fire services usually serve a basic first responder most of the time. With 90K calls a year there will be something like 900 -...

Students of Denver Health EMS education do all of their internship rides on our ambulances. We also get riders from DFD (new hires do one or two rides I think), Denver Cadets (https://www.denvergov.org/content/denvergov/en/department-of-safety/jobs-opportunities/cadet-program.html) and riders...

I worked as an EMT for AMR in Colorado Springs and had a great experience. It's a busy system and a good place to get 911 experience. The commute is brutal but if you can swing it, that's where I would go. That's the only system I worked in as EMT and don't much about the other privates up here...

@Claire Vrooman Don't consider this ^^^ a bad thing. Being new in the field is overwhelming and a few months on a wheelchair can be good exposure to hospitals and interacting with both patients and staff. Take what ever experience you can get and continue to build on it. There seems like there...

Great find! We get to listen to "biophone" calls every so often for training/continuing education purposes, but I have never actually seen this page before. I have even requested to listen to my own biophone calls for more interesting cases and its always a learning experience to hear yourself...

So it seems like you are really getting hung up on this "not asking for permission" statement. When I say I am not "asking for permission," i'm not saying I call and act like an a**hole or tell the Doc what to do. I simply relaying my situation in the field, assessment and exam findings, the...

Sorry maybe I'm missing something here too, what point are you trying to make exactly? That we shouldn't be making base contact to document higher risk refusals? My whole point was that refusals require good and thorough documentation to protect ourselves and documenting the refusal with the...

I have noticed a few different folks in this thread mention something along the lines of "what if medical control says they have to go? What are you going to do, kidnap them?" If the pt is sober, competent, has decision making capacity and is making an informed decision than there is nothing the...

@WyMedic Passing on the liability football is exactly what we are doing and thats the whole point. I work under my medical directors license and have an approved scope of practice/protocols. When I get to the edge of those protocols or scope of practice I call medical control to document it and...

Well, honestly, all of it. Refusals are one of our biggest liabilities and they need to be rock solid and able to be defended. "I'll make a reasonable effort..." does not sound like a good way to defend the above point ^^^ "I rarely will call med control because..." again, IMO, not a good...

Sketchy.