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The process may be easier and more flexible now 10+ years later, but maintaining the required CE was prohibitive for me at the time for reasons that I don't specifically remember. I think the requirement at the time was to take specifically accredited CE's which simply weren't available to me...

PIV's are probably the easiest application of US to learn but as you say, it still takes quite a bit of practice to get to where you can do it quickly and efficiently. I can definitely see agencies struggling with that as well as seeing it delay transport times.

Your situation is not unlike mine, other than the fact that my hiatus from EMS was due to pursing higher education in another (arguably related) clinical field. It is really unfortunate that the NREMT makes it so difficult to maintain certification, especially considering the nationwide demand...

A person can experience increased work of breathing and the associated anxiety and offer the subjective complaint of "I feel like I can't breathe" while having a normal or near-normal Sp02. An otherwise healthy and fit person can have a pneumothorax or a PE, for instance, but compensate quite...

It's common practice to avoid benzos in older folks. In that population their effects tend to be less predictable and last longer, but more importantly they are associated with an increased risk of postoperative cognitive dysfunction, which is already a much higher risk than in younger populations.

Re-watched Terminator and Terminator 2 this past weekend. Boring, I know. Just seemed timely given current events. Not nearly as good as I remembered, unfortunately.

That's a good question. It is true that most patient complaints and problems encountered in EMS are not something that you as an EMS provider can do much about. You aren't going to do anything in the prehospital phase about an obstructing tumor in the colon, a low fiber diet, chronic opioid use...

If someone took a HEMS job knowing that they would be expected to work elsewhere on their downtime, then of course that’s totally fair. But assuming that working in the unit or ED is something that a flight nurse is being made to do that wasn’t part of the original understanding of their job...

I'm sorry for your loss. "Esophageal rupture" can mean several things. A description of large amounts of blood could indicate rupture of swollen veins in the esophagus, called varices. This is usually the result of long-standing chronic health problems that might not be outwardly visible. The...

Using the best available evidence is important when developing protocols and procedures and system elements, but not everything of value can be objectively measured in a way that results in what we call "evidence". We can't directly measure the impact of increasing professional skills such as...

We did that for a while at one of the HEMS programs I worked with quite a few years ago. We were salaried so our paychecks were the same every time. It was pretty awesome. They eventually tired of paying us for hours not worked and we went to a more complicated schedule that included both 24's...

Come on, really? This take is only ever used to argue that an individual or group of individuals shouldn't be held accountable for their actions. Sorry, but in this day of body cams and cell phone cameras and Youtube channels where attorneys and former cops break these videos down, you have to...

I don't know that I would call this a medication error per se. Technically, I'm sure it could be classified as such, but the term "error" implies that an unintentional mistake was made in the process of selecting, calculating, and administering the medication. I don't think that is what happened...

No they did not, and that was a completely inappropriate action for which the paramedics deserve to be punished. However, the ketamine administration never would have happened had the cops not unnecessarily escalated an interaction with a citizen who was harming no one and breaking no laws. It...

What an unfortunate and interesting case. Nothing like deploying a perfect storm of callous, overly aggressive, poorly trained, and poorly disciplined public safety "professionals" to protect their city from an unarmed 140# young man from dancing as he walked home. At least someone involved in...

That's interesting. This is my original CFP certificate. No mention of the BCCTPC. I'm pretty sure that none of us had ever heard of the BCCTPC until they changed the name of the credential from CFP to FPC, which IIRC was a year or two after I was first certified.

I don't think it's fair to say that a person is bigoted just because they take a side or view a conflict from a certain perspective, and I don't think anyone has indicated in any way that they think Palestinian lives are worth less than Israeli lives. Peace hasn't existed in that region for...

Is the Ruger Mini 14 legal in NYS? Personally, that would be my first choice for a dedicated home-defense firearm if I couldn't have an AR. Uses the same cartridge as most AR's (5.56 NATO / .223, though you can also get it in 7.62x39 or .300BLK) and even if limited to a 10-round magazine, you'll...

AR-15 hands down. They are surprisingly easy to learn to shoot well and very versatile and very effective. Shotguns are great, but an AR gives you much more ammo capacity and much less recoil and arguably takes less training to learn to shoot well. Handguns clearly have their place but require...

That is a really nice example. The nice ones have gotten really hard to find, at least for a decent price.