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I wonder if the reason the guy panicked was because he woke up to 8 people holding him down? I would say I average between 1-2 narcan administrations per 24 hour shift at work. Our protocol for ALS or BLS is to give 2mg IM/IN for the unconscious heroin user regardless of respiratory effort...

I deal with GSWs quite frequently. I can't say I've had extensive trauma training, but the general consensus I've gathered from thoughtful discussion with trauma docs and surgeons has been "if you can't tourniquet, then pack". I've had success in packing quite small entrance wounds. One midline...

How often is behavior like this happening? I've read a few anecdotes like this on the forum, but never seen any similar behavior aside from the pt defecating, vomiting, or shivering. I've never seen violent behavior. And I run a LOT of heroin calls. What adds more to my surprise is the fact...

I transport to 6+ hospitals. Every one of them rolls their eyes if a heroin overdose ends up transported to their facility. They will immediately give narcan aggressively until the patient signs out AMA. They will generally draw labs on them as well in case there is more to the case, but little...

Seems like it would be very unusual for both meters to be out of calibration at the same time, especially since you go on to imply that they are routinely calibrated. Without further information, it does read like an equipment error. I can't think of any conditions where loss of consciousness...

I can't recall the exact wording, but I seem to remember both ACLS and PALS having language in them that emphasizes this. Had a discussion with some physicians recently about overdoses/poisonings that result in arrest, and some of the unusual treatments available.

In my system there is about a 5% chance a patient with no categorically ALS conditions receives zofran for their nausea/vomiting. We have the drug and a protocol for it of course, but those patients always end up triaged to BLS.

Narcan requires an ALS transport for your agency? What about albuterol by the BLS crew?

You just summarized our system, the standards are unclear. Though this is arguably the most important aspect of our operations, it doesn't seem to be a focus of the OMD for protocol or training. When I was hired and oriented, what I was taught depended on who was "training" me that day. It is...

My agency has had several OMDs within the past decade. We operate under a mixture of protocols and orders. The protocols haven't been updated in SEVERAL years. We are a large agency and dont have much direct contact with our OMD. He seems more interested in a public health type role than EMS...

Personally I am not made uncomfortable by those patients. I've only been in this system for a few years. I came from a place without triage, where ALS rode almost everything. I'm getting into training new medics in this department and hope from this discussion to enhance my ability to articulate...

For the purposes of my agency, about 99% of the patients who are downgraded are done so by ALS. If ALS is dispatched, it is incredibly unlikely for them to be cancelled en route under any circumstances. In fact, EMTs will also request ALS to come perform an assessment even if they weren't...

I'd be interested to discuss different providers' barometers on different cases. In my agency ALS is definitely a limited resource. You won't be singled out for occasionally transporting a BLS call, but if your charts are reviewed and many BLS transports are found, they will have a discussion...

I don't have access to this study. What's the outcome?

I'm referring to systems where an ALS first responder or ALS transport unit triages down to a solely BLS transport unit.

I'd be interested in seeing what was outlined as requiring ALS. Would you mind sharing some of those details?

At the risk of starting a tangent, this is how my previous department was. I thought it was a great system for developing EMTs, especially those who were looking to become paramedics. If something goes wrong you can always pull over and swap out if an ALS intervention becomes necessary. That...

I'd like to start a discussion regarding systems where both ALS and BLS transport are available, particularly ones where ALS can triage calls down to BLS for transport. For those of you who work in systems like this, do you have a clear and specific protocol for what requires ALS intervention...

In general, if I'm called for a seizure and arrive to find the patient still seizing, they are probably getting versed after an ABC check. The less desirable effects of giving versed to a seizure secondary to hypoglycemia seem less significant to the problems caused by allowing a person to...

I've worked a few large events and in general it requires dealing with my least favorite patient populations. Intoxicated people with minor scrapes who slur their words at you, meanwhile their significant other drunkenly screams "please help my girlfriend bro", with everyone having a high...