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The problem is we are responding to a vast majority of non emergency calls while trying to still act like a emergency system. The issue is one that I could write pages on and it filters down to everything from response times to pain management and everything between. As far as the current...

To comment on your bold statement, I have never withheld LIFE OR LIMB SAVING TREATMENT. I don't think it's fair to group all treatments we have available to us into the same group. I am surely not going to judge you for not medicating a patient that was having legitimate pain. Frankly if we...

You asked if it is ethical to withhold from those that are not in "life threatening need". I say no it is not ethical. However I think it is perfectly ethical to withhold from those not having an "emergency" From an ethics standpoint it is absolutely okay to withhold ALL treatment from patients...

And to address this, doesn't the patient convey their wishes all the time about whether they want to be transported or want meds or etc..etc.. In this situation if I heard the patient verbally say to me he didn't want anything done then I don't care if I have a DNR or not...The patient stated...

What more is a DNR then a legally binding way for a patient to communicate what he or she wants. If they lack a DNR then you use family, what you know about the patient and history, and make a judgement decision on what you think the patient would have wanted. You do not have to have a DNR to...

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I think a great part of this is the lack of time to "Decompress". A full time ER nurse works 36 hours a week and that is what most ER nurses work. A full time paramedic works somewhere between 40-60 and many Paramedics have to work 60+ a week to make ends meet. Its harder on family life, its...

If we were talking 30 minutes + transport time I might be tempted to give an atropine possibly to give me a couple minutes to get some more fluids in and see what the atropine did in terms of sustained higher HR or BP, kind of kick start the system while we try and warm him and get some fluids...

Honestly with a hospital a mile away that has a level 2 trauma center (and I would assume a semi capable ICU) I am putting this guy on a stretcher and going, not bothering to try an IV, not bothering with an EKG, certainly not bothering to try and take a medical history, whoever knows him best...

In my experience I have never seen a patient extubated in the ER even if it was probably the right thing to do. Once a tube is placed its automatically the ICU's problem...It's really a poor way to do things in some cases and results in extended intubation times for some patients that clearly...

Not to say it has never happened, but in years working within a hospital system I have never heard of or seen a head bleed with a BP that low unless they are an imminent cardiac arrest. I don't really see any information or vitals or patient presentation in this case that point be towards a...

I wouldn't use more Benzo's in a suspected benzo overdose. If Benzo overdose is #1 on my suspect list then I am probably just assisting with ventilations via BVM and not intubating either. Once you intubate you kind of tie the ER doc's hands about using flumazenil and the patient might end up...

Maybe an all or nothing protocol for him. I would have just used a paralytic and intubated without further sedation of any kind.

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I'm glad someone else agrees here. I think the "all or nothing" mentality is one of the worst things left in EMS. I don't give every single trouble breathing patient a steroid...it's in the protocols but I choose to withhold it for various reasons...I use critical thinking and make a decision...

Quite frankly, because there are not enough paramedics to put two on every truck. In progressive states I think there is a role for the EMT-I but I think EMT-B is a dying breed. For practical purposes EMT basics don't (can't) do anything that I can't talk a calm lay person through doing...

It does matter, we are supposed to be patient advocates and doing what the patient wants or would want done to and for them. This all or nothing approach in EMS is absurd and really shows a lack of critical thinking and ability to make judgement calls. I am treating a treating a 45 year old...

You should be fine depending on how long ago the charges were. Most public service offices (and private companies that contract them) are fine with the marijuana charge. Prescription drug abuse and harder drugs like cocaine are an absolute no no for getting hired though.

Depends on your hospital and EMS system setup. Yes we declare after the patient is dead...most of the time....but our hospital also calls "code blues" and our EMS crews do as well (we use triage colors for general impression on the radio) for patients in respiratory arrest with a high...

Ah, well in that case I wouldn't bother using a BvM. The amount of oxygen you are going to deliver (while higher in theory) will make no practical difference in a patient that needs more O2 than a NRB can supply. It's kind of like saying a 12 gauge needle would deliver more fluid faster in a...