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  1. Tigger

    Privatized EMS in Placentia CA

    How much money is this Lynch company going to get from the city to provide this service? They are going to have a hard time billing patients for their services. Perhaps in some places, it is on standing orders for every Colorado EMT.
  2. Tigger

    Daily overtime or highly hourly?

    My AMR op pays OT for anything over your scheduled shift. So any late call or hold over is paid time and a half, which is great. Hourly rates are based on your shift with lower hours getting a higher rate (ie an 8 hour car gets more per hour than the 12 hour car). Full timers make essentially...
  3. Tigger

    How has being in EMS changed you?

    I've removed the off topic posts. If you'd like have a conversation with another member you can do that in a private message. I'll also add that healthcare relies on effective, professional communication to make sure the right things are done for the patient. This was a really awful example of...
  4. Tigger

    the 100% directionless thread

    Second "MCI" in as many shifts. My ambulance goes mutual aid as the second due, arrives first, discovers that the first due engine and ambulance won't be making it as all lanes are blocked and there are no shoulders and the lanes are super narrow. The most lonely feeling being on the highway...
  5. Tigger

    Paramedic under investigation for death of schizophrenic patient

    Why would the state EMS office, the one responsible for the certification/licensure of providers not have the authority to investigate providers accused of patient abandonment? This is a standard function of state EMS offices.
  6. Tigger

    Airway Management and Intubating without Drugs

    That was a huge part of our RSI/DSI update this year, I think it's going to make a big difference. That along with the new but not new adage of "resuscitate before you intubate" which mostly just re-emphasized the utility of push dose pressors and a really solid pre-ox regimen.
  7. Tigger

    Airway Management and Intubating without Drugs

    It’s not above loving or hating the system, it’s about doing what’s right for the patient. C/BiPAP prevents intubation in a variety of settings, both in and out of the hospital. I’d rather be intubated in an ED than an ambulance but most of all I’d like to avoid intubation unless there isn’t...
  8. Tigger

    the 100% directionless thread

    I'm familiar with CalFire's predilection for mandatory OT, but 115 miles away? Hope you get compensated for that, such BS. Apparently my new employer mandatoried people like crazy for the past two years, but since they've hired a bunch (I was the last one to get hired to get us all the way to...
  9. Tigger

    Airway Management and Intubating without Drugs

    What do you need to study? Pretty sure that Washington state is not a vortex in which evidence based practice does not apply somehow.
  10. Tigger

    the 100% directionless thread

    I'm sorry, wut.
  11. Tigger

    Airway Management and Intubating without Drugs

    Wait, so you guys RSI and intubate a high number of patients...and then BVM them to the hospital? Is there at least a PEEP valve?
  12. Tigger

    the 100% directionless thread

    Pretty good, I think around 60 to start with a 2.5% stipend for a bachelors and 5% for a masters. Very very high cost of living and quite isolated however. Great service though.
  13. Tigger

    To Degree or Not to Degree. That is The Question.

    If there is a credit transfer agreement from the college conferring the degree it should not matter. Even if you never got a degree, many institutions will let you transfer at least some credits earned at another institution. We have far from a paramedic shortage here, but there aren't five...
  14. Tigger

    Airway Management and Intubating without Drugs

    That also have a pulse? Probably not often, but I'm not sure that "if they have a pulse they get RSIed" is good practice either.
  15. Tigger

    Airway Management and Intubating without Drugs

    Which is I suppose conceivable (and likely makes for more difficult intubating conditions due to potential residual muscle tone), but does the near-apneic, peri-arrest patient with a GCS of three need sedation?
  16. Tigger

    Airway Management and Intubating without Drugs

    I have no idea what the state numbers are. Our system (which is the largest "combined" in the state) probably only does at most five per year over 650k total population.
  17. Tigger

    Airway Management and Intubating without Drugs

    Could you post? I'd be interested in reading that. A good primer regarding RSI in shocked patients: https://litfl.com/intubation-hypotension-and-shock/ More specific to Ketamine: https://rebelem.com/dosing-sedatives-low-and-paralytics-high-in-shock-patients-requiring-rsi/
  18. Tigger

    Question on Paramedic schools

    Was not aware of the price. That's a solid 5k more than I paid to go to a CC in Colorado. But also, is getting a better education worth some money? Probably. How much? I have no idea. I am not entirely sure what the cost of medic school is in MA these days. When I worked at Brewster before...
  19. Tigger

    Airway Management and Intubating without Drugs

    If the patient has not intact gag reflex, why the RSI medications? Hopefully the dosing was at least lessened for the difficult to resuscitate patients.
  20. Tigger

    Question on Paramedic schools

    Never heard a bad thing about ProEMS Center for Medics in Cambridge.
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