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I know of ambulances frequently going on scene for ODs without PD in a couple of the "most dangerous" cities on the east coast. For one service, there is usually an engine company already on scene and the other will usually be accompanied by a supervisor and followed up with medics (this could...

Kinda funny. Probably a great partner to work with. Don't like that it was filmed while actually driving, but we all know that plenty of EMSers at times drive no less distracted than him. I am certainly guilty of having rocked out too hard while driving my personal vehicle. Many years ago...

NO ONE has said TXA is meant to replace direct pressure or wound packing (as if that were something frequently done in EMS). How many times have you ever seen aspirin work? The benefit is realized over time when used on a large number of patients for whom it is indicated. At a certain...

Look up Nadine Levick and her site: http://www.objectivesafety.net/

Prove that there is a need for ALS.

Depending on the the comments, someone could have reason to make an example of what is said. The reality is that people do come by and read posts here and some folks use this site as a source of information about EMS. This is evidenced by folks that sign up and ask questions because they're...

Truth. Not that I can't get down with sharing stories one on one as a release or a form of bonding with someone else. But, in a public forum such as this, it is essentially gloating and is thus unnecessary and unprofessional.

Heh, "ALS = 'ain't lifting ****"

I admit that I sometimes miss the old manual stretchers due to their light weight, but now that the place I'm at has the stryker power-LOAD system plus power pro XTs, there's no going back.

There is little triage of calls and dispatches are frequently sent according to proximity or order of availability, not need. So, plenty of ALS jobs are sent to BLS medic units while the ALS trucks are sent to BLS jobs. I don't usually argue for "all-ALS", but considering how much it would...

Was she really posturing?

Or, nurses need to stop throwing any dumb certification abbreviation behind their names.

I'm still skeptical about all the IO hype, especially in cardiac arrest. Not trying to say it has no use or should not be used, but I do think it is far over used. I facepalm a little bit whenever I hear of "IO first" protocols for cardiac arrest. It hasn't been shown to increase rate of ROSC...

If he is actually using NEXUS, then conversation over. The criteria he stated is alarmingly narrow, so I hope it's actually a (unintended) deception or partial truth. I'd imagine that they were not at all OSCE style and probably quite rudimentary (I'll have to go track down the studies to...

My new job is pretty awesome and all, but my condescending tone predates it. Of course not, but I think you should be using a validated method to determining the need for immobilization (whether just a c-collar or full spine board). If you're going to use MOI and neuro exam findings alone...

Yikes. Your medical director should know that neuro deficits can be much more varied than what you have cited. Changes in reflexes, proprioception, vibratory sense, strength, tone, etc. all can be just as worrisome. With many patients, numbness and tingling is status quo (e.g. those with...

How are you checking for neuro defecit? The good ol' grips and plantar/dorsal flexion? I would hope you're using one of the validated screening tools such as the canadian c-spine rule or NEXUS.

I don't think anyone is disputing short scene times for trauma or surgical or other time sensitive emergencies (e.g. CVA in 3 hour window or STEMI). The topic is general medical patients.

At lower doses, epinephrine can actually LOWER mean arterial pressure and systemic vascular resistance through its beta-2 effects on the peripheral arterioles. However, its beta-1 effects of increased inotropy and chronotropy are present, thus you don't actually see much of a change in systolic...

I'll second that it's dogma. Depending on the situation, I think it's more prudent to spend time stabilizing than extricating the patient and running to the ambulance.