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He may not exhibit signs while at rest. I would bet once he gets up and starts moving he may due to decreased cardiac output during exertion. It's not a respiratory problem.....it appears cardiac. My suspicion due to varied blood pressures with bradycardia. To know for sure you really need more...

We are getting ready to go back for union negotiations for the first time. What kinds of things have you been successful at negotiating into your contract? What problems have you been running into during negotiations?

Unfortunately EMS is used as a stepping stone for a lot of people. The average life span of EMS is 5 years...heck it may be less by now. The new bridge course to RN being offered to paramedics is a big hit in my hometown. Then there are those who get into it for the lights and sirens. They...

I have used this technique before but it's few and far between. Depending on this every time isn't advisable. If you have to do this then you need retrained. I know on anterior patients or patients with a lot of bodily fluids that would cause you to miss easily it works great. I truly miss the...

Seeing the age of the patient would make me think there is something more underlying going on. If the patient is senile then he is not dependable to give accurate information. Asking a few questions you should be able to see if he can be reliable. O2 can never hurt with just a couple of liters...

Unions Unions have to be started for the correct reasons. I know we self unionized due to unfair working practices. I have seen a huge change in management since we went union. Then again the union is only as strong as the employees make it, along with the eboard having the right people in...

I know here in TN we have EMT-IV class that is 2 semesters starting in the fall and goes until spring. You get healthcard provider CPR (through AHA) in the class. This is only provided by community colleges. Several years ago they use to require 2 years in a busy service to go to medic...

I've cheated death more than one time. The worse one was a car pulling in front of me when driving Code 3 (in a van) tried to avoid her which didn't work...and crossed a 4' wide 3' deep ditch without rolling the truck nearly going into a building. Followed by....ABD bleed post surgery 10 hours...

Good point Nitro is used for angina and CHF but also an adjunct treatment in AMI. Nitro increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic areas. Thus, reduces myocardical oxygen consumption and reduction of damage to the heart. Then again...

Always remember there is no right way or wrong way to do things. Everyone works different. It's a learning process for the new people. It's good to have a base pattern and direct from there with each situation. You know what I mean when there are medic's that are all over the place and the calls...

Becoming a Paramedic Let me tell you, don't be afraid to apply. I am also a girl and have worked in EMS for 15 years. It wasn't always easy though. You do have to prove yourself capable. If you can find a busy service with short shifts 8, 10 or 12 hours you can work around your school...

Seizure vs panic Well, there are different types of seizures. Sudo-Seizure, Petite Mal and Grand Mal. The Grand mal's patients usually have a phase called postical. They're confuses and sometime extremely combative. The do not breath when they have these types of seizures and will have snoring...

It's not just the blood pressure its self but how much of a change happens. A blood pressure drop of 30mmHg can make anyone dizzy/near syncope when getting up from laying. I promise you will have a difficult time establishing an IV then. Other times it's not a problem but you can never really...

SIDS Calls I found every situation is different. Most of the time it is possible to explain to the parents it's too late. When your life is in grave danger you bls to the truck and call it there. I haven't had to do the bls thing. I usually explain that even if we did everything medically there...

Well, if you drip it too fast you can cause bradycardia and/or hypotension. Besides, the med bag has up to 2 hours. We don't have protocols to use it for WPW...just a finding that cardiologist are using it for in my investigation. I'd rather have lido...short half life thus the reason for...

Keep on truckin' You do not have to stop when an advanced airway is in place...only when the airway isn't secured. The compression ratio is 100 faster there's no time for ventricle to refill...slower not good priming. Resp rate 10-12....much faster will cause resp acidosis which in return can...

Think before change Our medical director did away with lidocaine and carry only amiodarone. I think this a big mistake for any service to pick one or the other. Come on lido is CHEAP! Amiodarone is more expensive, you can hang it in IV bags but must be used within 2 hours due to it absorbes to...