Search results

I agree with DrParasite. EMS organizations just care that you have a degree, not what it's in. You don't want to limit yourself with some super specific bachelors in case you ever want to switch careers or go to graduate school or whatever. I don't know a single supervisor who had an emergency...

Anecdotally, I've never actually met anyone who actually caused a dangerous hypotension with nitroglycerin, though I've been warned about it my whole career. This study suggests that the risk of hypotension with RV involvement is basically the same as non-RV MI...

We've been starting with 2mg IV in PA and going up from there. Lots of fentanyl around. Like CANMAN said, if we take them to the ED still unconscious they'll just get 2-4mg as soon as they get a bed (and usually immediately leave AMA). Honestly I've never seen any super bad combativeness that...

It was just agency policy. If an ALS "intervention" was performed then it required an ALS level chart. I believe it was a combination of so it could be billed ALS 1 instead of BLS, and that the PA protocols were unclear on the ability of ALS to hand over care once an ALS intervention was performed.

The only reason we wouldn't BLS chest pain in a young person with a (-) EKG and normal vitals is since the medic on the truck already needs to write a report anyway, now you're just making the EMT write a report as well. I think especially in suburban/urban systems we overestimate the amount of...

How long are your transport times? If they're not that long and you're not expected to hold the wall for hours while a bed clears up then it probably doesn't make sense to wait on scene for ALS, have them do an assessment, and then transport when you could already be at the hospital. This goes...

All of Hampton Roads EMS is done by fire, except for VA Beach which is volunteer EMS + paid fire first response for some ridiculous reason.

If you can't get hired at a well paying job in NJ, the Philly suburban services (in Montgomery, Bucks, and Delaware County in PA) pay $15-19/hr + bennies for EMTs. I know some of them are hiring right now/always hiring. We had a couple people from Jersey commute over. They all left once they got...

There's one of these in Manhattan too, an island that has a giant academic hospital/stroke center every couple blocks, which I always thought was the most ridiculous idea I've ever heard of. Apparently there's a lot of debate in the emergency medicine physician world about whether or not tPA...

Other than opioids and maybe IV fluids for a SCD patient (who are hilariously under treated in EMS), I can't think of a hematological issue that should be definitively handled prehospitally. How are you going to diagnose a thyroid crisis without lab work? Insulin for DKA can be dangerous if you...

Haha I didn't even see the old dates. I had just passed my EMT-B practical and probably didn't even know what a STEMI was when this went up.

All the different names and types of chest pain always confused me, so here's a detailed breakdown: Stable angina is exertional chest pain/pressure that would classically present with ST depression during the attack but a normal EKG in between attacks. Like others have said, it would...

Lets also not forget, there are plenty of stab wounds or shootings that will only require a shot of antibiotics and a bandage, but you'll never see people try and leave them on scene. In my experience, the same medics who would want to BLS an asthma "anxiety attack" are the first to try and fly...

Technically, the guidelines for asthma suggest patients try 4-8 puffs every twenty minutes for one hour during an acute attack--4 MDI puffs is approximately 1 neb treatment (though the actual dosing is not identical--which is confusing) before seeking medical attention, unless they have no...

My EMT class was adamant about a lot of things that were 100% wrong haha. It's unfortunately part of the joys of EMS education. There are definitely 911 systems that have few or no ALS resources though, so it's a good question to ask.

First off, the backboard is on its way out--it has no evidence of benefit to patients and, as you can clearly see with your example, lots of ways it can harm a patient. So hopefully you never actually have to use on in the field. However, if you're in a system where you still have to backboard...

I think the evidence is at best wishy washy, yeah(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5209309/), though there is a study in the works: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576288/ Either way, no one I worked with was giving close to the (controversial but current "best...

While EMS providers may be comfortable bolusing fluid, I wonder if the improvements seen in that JEMS article (as an example) are less due to prehospital antibiotics and more to early recognition of sepsis and therefore aggressive management with fluids. Anecdotally, many of the medics I worked...

You would give empiric broad spectrum abx (in this study ceftriaxone, but in the US I think that's rarely given alone due to resistance) depending on your suspicion of where the infection originated. It takes time--more than 48 hours--to culture bacteria, which is obviously too long to wait for...

Hypothetically, one could google a Kazakhstani scientist who got fed up with the payment requirements for research papers and made a website storing millions of free papers. I would of course never encourage this kind of behavior.