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  1. V

    Ibuprofen vs APAP

    Our protocols will soon include a choice of Ibuprofen or APAP for fever reduction and pain management Assuming the agency will carry both which is your choice and why. I know there are hepato-tox issues with APAP. Would that rule it out
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    Which type of CPR

    So in the NYS Collabrative Protocols two types of CPR are authorized for cases without an advanced airway The first is the standard 30:2 and the second is continuous compressions with asynchronous ventilation. I double and triple checked and this can be done even without intubation Given the...
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    Updated peds CPR guidelines

    I was looking over the BLS algorithm and it says that for peds from 0 through puberty you are supposed to add compressions if the pulse rate falls below 60 and they are symptomatic of bradycardia Is this fairly new still? The last time I updated in CPR/BLS they were still saying compress for...
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    CPAP for flail segment

    So I heard some medics talking about, and found some articles regarding CPAP being used in flail segment patients to "splint from the inside" Has anyone done or seen it done? How concerned would you be about a pneumothorax, because I am having a hard time imagining an injury pattern where you...
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    Pupil changes in trauma

    So I've been doing some of my own reading on this topic and was wondering. In a closed head injury, would you expect to see a unilateral sluggish pupil before ALOC or loss of consciousness and Cushings triad? What about in a concussion ?
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    ETCO2 questions

    I have a hopefully quick question about ETCO2 values. If the person has ETCO2 values above the normal it is said that they are retaining CO2. But if a slip stream ETCO2 monitor tests exhaled air shouldn't retaining give a low number and someone who is acidotic have a high number?
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    Advanced training for an EMT B

    Currently I am volunteering in a busy system as an EMT Basic. As background I have been in the ambulance corps for 8 years total and have been an EMT for 3 years. I am at the point that I want to expand my knowledge, even if it doesn't mean an immediate change in my scope. I eventually want to...
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    NPS Liberty Island

    I know it's not exactly wilderness, but I figured this would be the best place to get an informed reply. Does anyone know about the EMTs for the National Park Service on Liberty and Ellis Islands? I remember reading something about them a while ago, and the work seemed fairly interesting as...
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    Community Paramedics

    Can someone explain what exactly community paramedics are and how what they do is different from what the existing public health nursing/community health nurses do now. Maybe it's not like this everywhere but where I live, the county health department has nurses who go check in on elderly...
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    EMS investigators

    I don't know how common, if at all, this happens, but I was wondering if anyone has heard of EMS personnel assigned to investigative agencies or task forces like a Child Fatality Review Team or a MAIT. (Multi disciplinary accident investigation team)
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    For Blood Pressure experts

    Quick question for those who are great with auscultation of blood pressures. Is there an average on how many mmHg the third phase Kortikoff sounds (when they get really loud) are below the first sounds. I'm trying to figure out if it is probable that a pt with a systolic blood pressure in the...
  12. V

    Prevention in EMS

    I know that community ems/paramedicine is now doing some of this, but why is prevention not emphasized in ems the way it is in the fire service and even law enforcement? For example, the same way the fire service does smoke detector installation and fire inspections and the way that law...
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    Helicopter Usage

    Just wanted to run this situation by everyone and get their opinions on it. Our local hospital had a patient with a partial thumb amputation. Replantation center is 45 min to 1 hour away by ground, so they called for a helicopter transfer. Now, the thing is this patient was completely...
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    EMS dispatch jobs

    Does anyone know of an EMS agency either municipal/fire based or hospital/private with heavy 911 work that has a good dispatch system?
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    National Standards

    I've noticed in some past threads that people have said that one way to make EMS better/more professional then now is to have some sort of national standard/training. Is this really the best option though? Some might even say a statewide standard is too broad. For example, the way you...
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    How much do your police officers know about EMS

    Just wondering, how much do your police officers know about EMS and how much are they able to help you on scene? In general ours are very good, all of them are first responder trained and respond to most medical calls. Occasionally though some do pretty off the wall things: for...
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    Should EMT-B be split

    I was just wondering if anyone thinks that what is currently EMT-B should be split into two positions. One which would be continued to be called EMT and would have a scope of practice similar to: CPR AED Oxygen BVM Pulse Oximetry Glucometry Oral Glucose Administration Epi-Pen...
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    EMD recertification

    I realize this is mostly for EMTs/Paramedics, but does anyone know if there is any IAED/NAED EMD recertification opportunities in the mid atlantic area? I will take anything in the NY, NJ, PA, MD, DE, DC, VA, CT, RI, MA, NH, VT areas
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    IFT transport for sexual behavior

    When I was dispatching we had one facility in particular who called us twice for transport because their patients were displaying sexual behavior towards staff members. This was at a regular nursing home, although I don't know if these patents were dementia patients or not. Bascially the...
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    Best "Skilled" Nursing Home stories

    I know we all have them. What are your best "skilled" nursing home stories. Some of mine when I was working dispatch: Wheelchair van driver called to report an aide was using a "green leafy substance with an odor consistent with marijuana" in the outside smoking area SNF calls for...
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