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  1. U

    Septal infarct > Flash Pulmonary edema > Code

    In my EMS system we only have NS and an epi drip to treat hypotension (and nitro tablets and CPAP for pulmonary edema). How would you recommend managing the patient in the given scenario using just those tools? Granted, we're in a city with a PCI-capable hospital never more than 15 minutes away.
  2. U

    "Must Be Diluted"

    Went back and checked and it's actually 300mg of amiodarone in 20-30 ml of D5w.
  3. U

    "Must Be Diluted"

    According to my pharm textbook, an amiodarone push dose is supposed to be diluted in 50ml of NS. But I've never heard of anyone doing this in real life, and certainly not prehospital.
  4. U

    Refusal after Narcan administration

    If I may, since this is my protocol as well: we explain to them that since they OD'd and are only awake because of the Narcan, our doc would have our asses if we don't take them to the hospital. Once there, they can leave AMA if they want. I never get sent to an OD without a 4-man engine/tower...
  5. U

    Refusal after Narcan administration

    Again, this doesn't necessarily align with my opinion. I just quoted it straight out of my protocol in my first post in this thread. The rationale was explained, even if many here do not agree with it.
  6. U

    Refusal after Narcan administration

    Of course I record their LOC and mentation before and after the Narcan. But as the protocol states, someone who is only responsive due to Narcan is considered to be lacking capacity. So any liability would fall to our medical director. Florida gives first responders a good amount of protection...
  7. U

    Refusal after Narcan administration

    I would probably be fired for taking that refusal, especially without consulting med control. Our protocols specifically state that "patients presenting with AMS, who respond to narcan, are not candidates for informed refusal. Due to the relatively short half-life of Narcan, these patients are...
  8. U

    GRBS Assessment for Seizures

    Did you respond for a seizure, or does she just have a Hx of seizures?
  9. U

    Orlando Fire is hiring for EMS-only

    I don't want to go into too much detail about the hiring process (they're kind of secretive about it, so I don't want to throw it all out there without permission), but I will say that it is psychologically gruelling. And there is a polygraph or two. I basically felt like I was applying for the...
  10. U

    Orlando Fire is hiring for EMS-only

    Yes, all 12 hour shifts. We currently have trucks starting at 0700, 0800, 0900, 1100, and 1500. It's intended to a peak truck system, but we still usually aren't all that busy (I average 4-5 transports in 12 hours, with short transport times). The benefits are awesome by EMS standards (they list...
  11. U

    Orlando Fire "Civilian" Paramedics

  12. U

    Orlando Fire is hiring for EMS-only Come work with me, people. I'll answer any questions that I can.
  13. U

    Reliable Street Names for narcotics

    Yes, and so should you. Some of them will try to deny they took anything, but if you firmly (but still respectfully) call them on their ********, they will all fess up after a few minutes. It helps to remind them that you aren't the cops, being high isn't illegal in the US (possession is), and...
  14. U

    Experience with Bone Marrow Transplant patients.....

    Huh? Is your partner the patient? Or are you asking about some sort of long-term care gig?
  15. U

    Pain Score and Analgesia

    I only carry fentanyl for pain. If I gave it to everyone who tells me they have significant pain, I'd be out of fentanyl by noon most days. So I mainly reserve it for patients with obviously painful traumatic injuries or those who are screaming/writing in pain and cannot be properly assessed...
  16. U

    ER physician in EMS Break room

    Wait, what?
  17. U

    Best way to prevent injury?

    Get hired by a company that uses the Stryker Powerload system. It has been wonderful for my back :)
  18. U

    CPAP for flail segment

    We're specifically contraindicated from using CPAP on chest trauma patients.
  19. U

    CBD Oil

    Get a home drug kit and test your own urine for THC. If it doesn't pop, you should be fine.