LonghornMedic
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What? Where'd you pull that BS stat from?
EMTs starting IV
- Thread starter lampnyter
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What? Where'd you pull that BS stat from?
the_negro_puppy
Forum Asst. Chief
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I think he is sayign that he starts IVs in 8/10 of his calls
Bullets
Forum Knucklehead
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Or, like in or system, medics do the blood draws en-route to the hospital. Every patient that comes in ALS is supposed to have a line started, even if drugs wer'nt pushed or fluids hung, labs go straight from the ER to pathology through one of those bank vacuum tube things
What's the rationale behind that?
Never been on scene and thought, I wish I could put a line in this guy. Its useless at the bls level unless you work with a paramedic even still the times are miniscule that the medic is going need the basic to start a line.
Back when I started medics were hard to come by,there was a need for expanded scopes today you can throw a rock and have it bounce off three medics. Leave the als skills to the paramedics.
Never been on scene and thought, I wish I could put a line in this guy. Its useless at the bls level unless you work with a paramedic even still the times are miniscule that the medic is going need the basic to start a line.
Back when I started medics were hard to come by,there was a need for expanded scopes today you can throw a rock and have it bounce off three medics. Leave the als skills to the paramedics.
Bullets
Forum Knucklehead
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Maybe where you work, but we always get, "FA1, respond to 410 bank street for chest pain, medics pending" or "medic 2 responding from XX station, eta 15 minutes" so we have to decide is it worth waiting or hoping an als unit frees up, or do we sh oot and scoot? If I could push d50 I could cx micu on a lot of calls, or if the patient is hypovolemic with no other complaint, I could hang fluids and go.
All I want is d50, nebulize, fluids, maybe a 3 lead. It would cut our dependancy on MICs and speed up calls
Cohn
Forum Lieutenant
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or when you have a dehydrated UDA just came from walking in the desert for 3 days with little to no fluids taken in and the next ALS unit is 45 minutes away... Yes, yes you need basics starting lines.
TransportJockey
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I'm still trying to figure out why oral rehydration wouldn't work on a patient like that. Now, granted I don't live in AZ, but I've treated my fair share of dehydration patients in the high deserts of NM (and the mountains for that matter too, mostly offroaders who got lost or mexicans wandering in illegally, which I'm assuming is what your UDA means), and I can think of maybe one or two that actually needed IV hydration instead of PO.
TransportJockey
Forum Chief
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Are you willing for the state/NR to increase mandatory education to gain those skills?
EDIT: Wait, nebs aren't in the basic scope there?
wyoskibum
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Bullets
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Nope, we don't get anything but o2 in NJ, just what's in the text book.
If they allowed us to start iv with fluids, d50, and neb, I would only want it if we got the appropriate pharmacology instruction along with the practical skills instruction as well. Otherwise its useless
And we don't need more ALS providers, if they expanded the basic scope, or eliminated basics from the 911 system in favor of intermediates, there would be less demand placed on ALS, and the increase in training would not be exceptional. Patients would get the same level of care, and ALS could do more calls that truly require them. Let basics handle simple diabetic calls that only lead to RMAs and stop tying up ALS while cardiac or respiratory calls are hanging
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Cohn
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We don't carry jugs of water and who ever find them, mostly BP does not carry water for them.
Oh damn it to the bowels of bloody hell Brown feels like throwing this one (and all the others like it) into the friggin tail rotor .... scurge of the earth man seriously!
You do not need more ALS (Advanced/Intensive Care/Paramedic) what you need is a base level of adequately educated and dexterious practitioners who do not need to run off to mummy [Advanced/Intensive Care/Para]medic everytime you need to put in a drip or give some salbutamol or adrenaline.
*Brown smashes his head on the desk repeatedly, stops and figures getting into his helicopter and flying far, far away is a better idea ....
City traffic, Medivac airborne, below 1,000 northbound
You do not need more ALS (Advanced/Intensive Care/Paramedic) what you need is a base level of adequately educated and dexterious practitioners who do not need to run off to mummy [Advanced/Intensive Care/Para]medic everytime you need to put in a drip or give some salbutamol or adrenaline.
*Brown smashes his head on the desk repeatedly, stops and figures getting into his helicopter and flying far, far away is a better idea ....
City traffic, Medivac airborne, below 1,000 northbound
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So then why not replace the bags of fluid with bottles of water?
Bullets
Forum Knucklehead
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What acts faster? IV saline or tap water absorbed though osmosis?
Look at what is lost via sweat in this particular case of dehydration. Now look at what your using to replace everything lost. The general rule of dehydration is baring an emergent issue, you should rehydrate only as fast as you dehydrate. Speed is not always a desirable trait (look up sodium replacement and central pontine mylinolysis, although not aplicable if your only using NS, it is an example of what happens when you start messing with fluid balance and electrolytes).
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Bullets
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The fact that we drive an ambulance out into the deserts of arizona indicates to me that this is an emergent issue, and wouldn't the saline replace sodium list during extensive perspiration better then an equal volume of tap water?
I think most would be absolutely willing if they had the chance. Nebs aren't basic here, either.
Whoa! There is only one working ALS medic for my county's EMS, and three total. One works BLS only and the other is a county commissioner and RARELY goes out on trucks.We used to have another active one, but he left due to travel time. Recieved Medic of the year, too, for giving O2 to a pt's dog after a house fire.
Emergent situation for "border patrol needs you"? Maybe. True emergent patient presentations? I doubt it.
Saline would replace sodium, and nothing else. There are better fluids for rehydration. Even better than pumping them full of fluid that will make their number look great for an hour or two before leaking out of the vascular space is gentle rehydration using something like gatorade and water half and half over several hours/days as well as a meal. It's realisticlly going to take a few days to rehydrate these people, not a matter of a liter or two. Learn how to calculate water defecit and you will see exactly how staggering of a loss it can be. Dumping fluid in the vascular space is sometimes the answer, but having uneducated EMTs with a merit badge (or for that matter, uneducated paramedics) doing it is asking for trouble.
If you had bothered to look up the condition I was speaking of, it's a warning as to why you don't replace sodium TOO FAST. There's a lot to consider when messing with these things.