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I know a satellite program for our agency is dealing with this right now, although it's with 911 jobs. For this agency (100 miles away from our main operation), the closest trauma center by far is just across the state line. There are people (mostly employees who are lazy and would rather dump...

Isn't that what we were doing all on our own?

This is absolutely appropriate use of HEMS. Agreed. From my personal experience, HEMS is actually concentrated in areas that are population dense, rather than very rural areas (which are the ones that really need it). I live in a rural area, but within 40 miles of 2 metropolitan centers...

You're right. Before going back to the original topic, I will tell a story that one of my favorite ED nurses uses: "Sir, what is your pain, on a 1-10 scale? Bear in mind, 5 is being hit by a car." What would be some other reasonable choices? PO agents, like acetaminophen, aspirin...

You guys have got to be kidding me. If a patient has ANY kind of pain, they get pain meds? Good lord, we must work in vastly different systems. So if I call 911 and tell you I stubbed my toe and it's "10/10", I'm getting a narcotic? That's like swatting a fly with a buick. I'm a...

I think some people may be blurring the line of substance abuser vs. system abuser. They're not the same thing. (You've hit the nail on the head in your post.) Just this week, I had a heroin abuser from the local shelter. IV track marks, abcess growing on his AC. Walked (limped) up to the...

I don't get auras or much warning. I get sudden onset, and within half an hour, it's as bad as it gets. Usually, ASA/APAP/caffeine helps, so I don't use it much (usually less than half a dozen times a year). But, I've tried it both ways, and it seems to work best when the headache is worst...

Do what you do for your dog: rub their nose in it.

I've taken the PO form for migraines. It's fantastic.

It sounds like a did a decent assessment. Why would you say that?

Just a brief story..... This is a situation I was involved in that highlights the ridiculousness of rigid standards. At a former agency where I worked, one of our paramedics took a non-AHA class offered by a local cardiologist. One of the scenarios he brought back was the patient in a very...

Perhaps classes targeted to each group of providers would be best. - A class for physicians and mid-levels that supervise resuscitation in hospital. - A class for nurses that work in the hot zones: ICU, ED, PACU. - A class for floor (and other non-critical areas) nurses. - A class...

Have everyone get together and refuse to pay huge sums of money to AHA for a cookie cutter class that really isn't appropriate to teach to everyone? I mean, someone else could start a class that was appropriate for providers that make decisions, but with AHA there, I'm guessing that few would...

Excellent post. Definately agree. I also was taught ACLS in the era that required real mastery of the content to get a card. I think that having some basic class to standardize the response to cardiac arrest (and other cardiac emergencies) is a good idea. But there also needs to be a...

Actually, it's Zoll that uses rectilinear and Phillips and LP use truncated exponential. Here's where those calculus classes actually apply to something real. Remember the integral? If you integrate an equation from a to b, you get the area under the curve, from a to b. On the graph...

I think everyone needs to realize that you guys are talking about 2 completely different job descriptions here. I agree, burn nurses (in general) are pretty damn good at managing pain. They "get" the big picture, and for the most part, aren't afraid to use a lot of meds to help their patient...

Yup, he's a whacker. So was I when I was that age (as were a lot of people), because I was 16 when I joined my volunteer FD in a small town. There wasn't much to do, other than feed the cows and go on our department's 200 or so calls a year. People grow up. His agency got all offended...

Getting to meet them later is absolutely one of the best things you will ever experience. 3 come to my mind: - A 19 year old college student whose long QT finally found him and tried to take him out. That was recognized at a banquet where I got to meet family. I keep in touch with him and...

Good advice. Remember also that vascular anatomy is specific to the patient. Some people have a dominant LAD, while others have a dominant RCA. Either one can cause a STEMI in the inferior wall, but with different consequenses. If an inferior MI is caused by an LAD lesion, you will be more...

http://www.sunyabem.org/ems_smart.html The Emergency Medicine program at the University of Buffalo (with Erie County Department of Health) runs the smart car. The only way I've seen them used was for MCIs, like a school bus accident, and it was greatly appreciated. They triage, clear...