HALL AMBULANCE

NPO said:
Want stranger? The EMTs go on flights, too.
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What kind of extra training (flight-wise, in-hospital, or both) do these EMT’s get? This seems sort of counterproductive otherwise.
 
VentMonkey said:
What kind of extra training (flight-wise, in-hospital, or both) do these EMT’s get? This seems sort of counterproductive otherwise.
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Officially? None. Nothing required for applying for the position. But I'm sure they get a lot of on the job training. I could easily see them building a relationship with their partners where the RN/RT become comfortable with the EMT setting up the isolet, pumps, vent, etc.

When I worked in LA on CCT that's how it was. The RN just came by after getting report and verified settings and hooked up the patient.
 
NPO said:
Officially? None. Nothing required for applying for the position. But I'm sure they get a lot of on the job training. I could easily see them building a relationship with their partners where the RN/RT become comfortable with the EMT setting up the isolet, pumps, vent, etc.

When I worked in LA on CCT that's how it was. The RN just came by after getting report and verified settings and hooked up the patient.
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Yes, I’m well aware of how it’s done down south. “When I worked in LA” might not be the comparison to reference, just sayin’.

With that, any of us can punch numbers into a machine, but what happens when they’re unaware of trends, and normal parameters? What, and where these “numbers” should be? Not to mention the physiology behind all of it...

RN/ RT, RN/ RN, MD/ RN/ RT, or RN/ P isn’t “just cuz”. I’m not saying it can’t be done (clearly it is, lol), but it shouldn’t be done with merely OTJ training. You and I know that’s all sorts of wrong, plus you know like liability n’ stuff??...

Is it RN/ RT/ EMT, or RN/ RN/ EMT, etc.?
 
VentMonkey said:
Yes, I’m well aware of how it’s done down south. “When I worked in LA” might not be the comparison to reference, just sayin’.

With that, any of us can punch numbers into a machine, but what happens when they’re unaware of trends, and normal parameters? What, and where these “numbers” should be? Not to mention the physiology behind all of it...

RN/ RT, RN/ RN, MD/ RN/ RT, or RN/ P isn’t “just cuz”. I’m not saying it can’t be done (clearly it is, lol), but it shouldn’t be done with merely OTJ training. You and I know that’s all sorts of wrong, plus you know like liability n’ stuff??...

Is it RN/ RT/ EMT, or RN/ RN/ EMT, etc.?
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I know. All I did was copy and paste the settings from the facility. The RN would confirm everything, and hook up the patient. He may or may not have changed things after that in transport.

In retrospect, working with that nurse helped me out a lot. At my new job we do a lot more critical care transport from our small hospital to better hospitals up north.
 
NPO said:
At my new job we do a lot more critical care transport from our small hospital to better hospitals up north.
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That’s what’s up. I can dig on a setup like this. What’s your guy’s IFT to 911 ratio? Is it P/P, or P/B trucks?
 
VentMonkey said:
That’s what’s up. I can dig on a setup like this. What’s your guy’s IFT to 911 ratio? Is it P/P, or P/B trucks?
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We run probably 80:20 911 to IFT.
I am on a dual medic truck, because my partner is a very new medic who still needs some supervision. Everyone else is P/B, but they are interested in staffing more dual medic trucks.

About half of our critical care IFTs are patients that we being in. Usually the crew that brings in the patient sticks around for an emergent transfer out. When patients need immediate stabilization we will stop at our local ER, but they can't so a whole lot. These patients usually get an emergent transfer an hour up north.

The other half of our critical care patients go 3+ hours to St Louis. These come off the floor.

We're allowed to take anything on a transfer. I do my due diligence and make sure I know about the meds I'm transporting. I can only hope everyone does the same...
 
Qulevrius said:
How are the ALS protocols, compared to what you’re used to ?
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Better, but not the best. The hospital service my girlfriend works for that I mentioned has the best protocols around, as well as a VERY pro-ems medical director.

The only thing I really wish I could help my medical director on board with is TXA. He's not a fan. Otherwise, we have decent protocols.

Like last night I couldn't give nitro to my STEMI patient with a systolic blood pressure of 230 because we still have it listed as a contraindication for inferior MI.

https://drive.google.com/open?id=0B6KcfTe0DJSDaVNQU05RcUtFR1k
 
Oh you added the County protocols after I posted. I’ll browse later, thanks
 
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gonefishing said:
What's the issue? I hear the cost isn't that much.
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Retail, about $100/vial. But I'm told you can find it much cheaper.

Idk, he's not sold on it. We truthfully don't run much trauma, and it's benefit on bleeding outside the initial 3 hours is minimal, ruling out things like GI bleed.

But he's a former military doc, so it's interesting that he doesn't like it.
 
NPO said:
Retail, about $100/vial. But I'm told you can find it much cheaper.

Idk, he's not sold on it. We truthfully don't run much trauma, and it's benefit on bleeding outside the initial 3 hours is minimal, ruling out things like GI bleed.

But he's a former military doc, so it's interesting that he doesn't like it.
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Per a relative in KY ive spoken to some places have been doing $35 a vial but that's outside the ems realm and inside hospital settings such as the OR. Amazing a military doc is anti military medicine.
 
gonefishing said:
Per a relative in KY ive spoken to some places have been doing $35 a vial but that's outside the ems realm and inside hospital settings such as the OR. Amazing a military doc is anti military medicine.
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The price I quoted was from a medical supplier. But it's their retail price. I'm sure many places have agreements, discounts, or bulk discounts.
 
Probably seen it being misused too often. You know military medicine, breaking an ASA tablet in 2, ‘this half is for your head, the other is for your stomach, make a mistake and you’re ****ing dead’ sort of thing...
 
EpiEMS said:
That's pretty funny...
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On my last inferior I just gave it anyway. No RVI in V4R so I just used that as an excuse in the documentation. I would've last night too, but my supervisor was there.
 
Qulevrius said:
Probably seen it being misused too often. You know military medicine, breaking an ASA tablet in 2, ‘this half is for your head, the other is for your stomach, make a mistake and you’re ****ing dead’ sort of thing...
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The adverse effects of txa are pretty minimal. And the NNT is 67....
 
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