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TBI might be the exception for prehospital which was the group studied. But that is not true for all medical patients.

True. Using an AED might be one. But I have also seen albuterol given to a "wheezing" patient with a HR over 200 just because it is "only albuterol" or someone took a number off the pulse ox as true. Or, a wrong path taken when the BP was way under the correct number.

I doubt if it is fair to compare Australia to the US. Why would the US Paramedic want to spend more time on education when most of them can do every skill the ICP can in Australia and with less than 1/4 the education and a lot less than 1/4 the training in clinical hours?

Where do you chart the vitals? Do you chart them on the Paramedic's PCR? Since you are arriving at different times, how well do you and the Paramedic know each other? Your set of vitals is great to get the ball rolling but from that, if a Paramedic is to start an intervention he should...

No Paramedic should ever start an intervention, especially medications, unless they have confirmed or witnessed the vital signs. This is not only true for EMS but also for other health care professionals like RNs. Even doctors have been known to confirm a BP and other vital signs themselves. No...

Intubation with only paralytics is bad. Sedation only is what many emergency situations need and can be successfully intubated without paralytics. Paralytics now are used only when needed and in the OR for obvious reasons with surgery. In the ICU the use of paralytics for intubated patients...

Yet if a hospital worker is caught with gloves on outside of a patient room they are disciplined. This is just one example of not wanting to make waves with the EMS agencies or some have just given up telling them why they should not walk around a hospital with gloves on. When picking up a...

That does not make you immune from getting another strain which will make you contagious or another disease which will weaken your or your son's immune system which could become a very serious and even deadly event.

But now we know despite the hospitals' efforts to stop infections, they can not stop the infections from being transferred by the ambulances and EMS providers. When there is a weak link in the patient care system as it now appears ambulances are, no matter how much the hospitals try, infections...

Copy and paste make quotes like that easier.

I have to ask again why you would want an EMT to drain their oxygen tanks blasting a NRB mask at 40 liters. If a hospital has to resort to that by not having the appropriate equipment or KNOWLEDGE then that is a sad place to take any patient. Also with the suspicion this pt is septic and a NRB...

It makes you wonder how many Paramedics already have a diagnosis based on opinion or attitude long before they arrive on scene if they know the call is initiated by the Police. This could explain some of the EMS news articles which are not favorable.

Flow does not necessarily equal FiO2. It seems in EMS a "high flow" device means giving an FiO2 of 1.0. The FiO2 is dependent upon the minute volume or tidal volume demand. A high flow device is designed to meet that demand. If you actually know the limitations of the oxygen device or how...

If someone requires 60 L/m via mask, time to move on to adjusting their toleration for something on their face through pharmacological means. I doubt if any hospital can have someone hold "blowby" for several hours. Blowby O2 is an ineffective way to deliver the appropriate FiO2. Room air is...

Using a device for a way it was not intended will probably not achieve the results you are desiring. Anyone can turn up the NC to blast but then have you look at the way a true hi-flow NC or mask is designed. Adding PEEP is not going to do anything to meet flow demand. I believe the ARDSnet...

Were the police detaining her to find out if she broke the arm? If it was a true act of violence which results in a broken bone then it is preferable to allow the police to take action and get the kids away from her. The woman with the alcohol intoxication could still possibly be salvaged but...

This may sound rude but, whether it is ALS or BLS you are still giving the patient a provider with just a year or less of training. I could see this argument in the UK, Canada, Australia or any other country besides the US. The AEMT needs to be the minimum so at least a few things can be...

While the cop is giving the woman a break by not having an arrest record, child endangerment and abuse are no jokes either. If the hospital doesn't follow through, the kids are screwed. I hope you did write a good PCR and talk to the nurses and doctor about what you witnessed. A note by you left...

In this situation, it is a form of child abuse. The health care professionals at the hospital will probably follow through with their obligation to report this. Social Services will definitely be involved. We have a special group of professionals which deal with situations like this since it is...

The cop was correct here. This woman did not need jail. There was more than patient here. She and her unborn child needed to be examined in a hospital. I doubt if you can assure anyone that the fetus is okay even if the mother had no complaints. No Police Officer wants to be hit with the...