Looking for a little input about what happened.

incorrect sir. what he meant(i have to assume) was medical control, meaning the doc at the hospital. you call the doc, say the pt is having cp sob diaphoresis left arm pain with a pressure over 100 etc and the doc say ok give him ntg sl q5m x3. the problem here is if his pressure bottoms out, you cant do anything about it except the super effective trendelenburg. you also cant do an ekg to determine the location of the mi which is *****HUGE***** in determining whether or not to give them the nitro.

You know, I've never understood this.

Millions of people are walking around out there with little bottles of nitro tabs to take when they're having chest pain... yet they don't have BP cuffs, much less 12 leads in their pockets. If it was really so incredibly important to rule out an inferior MI first, would nitro rx's be handed out so freely to cardiac patients?
 
First off, the truck should have been checked first thing before pulling out of the station. My trainees always were shown where everything was, quantity required on the truck (i.e.: how many NRB's, nasal cannulas, etc), where to get equipment to restock, etc.

Next, anyone I've ever trained in the past ALWAYS got lessons in documentation, such as a format on how to write a PCR. I even wrote out a sample PCR for them so they can refer to it until they got comfortable with their own documentation. I would also read theirs and offer critiques as needed.

If you did not recieve any similar training, then you should not work for them. I sure wouldn't.

As for the BLS crew that had their pt. with chest pains while doing a take-home run: they did the right thing, just as everyone here said. If transport time back to the hospital is less than that of an ALS intercept, then by all means go back. High-flow O2, monitor B/P as well as monitoring your pt's symptoms is the best (and, alas, only) way to go as BLS.
 
I am a basic in Pa we are able to admin nitro subling under medic command. But I also run with a ALS crew at all times..at least 1 medic on board. That does not mean I cannot read some of what is going on, on the LifePack, and place a 4 and a 12 lead, but monitoring a sinus rhythm is out of my scope of practice. Good job on leaving that place, seems very like a very badly run systemll!
sorry about my spelling its late and I just got off a 16 hour shift:P
Bird... I hope you are talking about giving the Patient's prescribed nitro. Not the nitro carried on the ALS rig.

PA protocols: (http://www.dsf.health.state.pa.us/health/lib/health/ems/pa_bls_protocols_effective_11-01-08.pdf) say that you can administer the Pt's prescribed nitro x1 prior to contacting command... as long as systolic B/P is ^100 and they haven't been taking Viagra or other "uppers" recently.

If the medic is there... the medic can give nitro per the ALS protocols. That isn't in the BLS scope.

PS... BTW - for the PA folks - the above link is for new statewide BLS protocols coming out in November... looks pretty cool.
 
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Let me start from the beginning. I have a friend who was an EMT-B for a local ambulance service. He told me they were hiring so I showed up and applied. I filled out the application and talked to the guy and he said I was hired as long as I didn’t have anything on my driving record, no formal interview or entrance test or anything. So I showed up my first day and the field training officer wasn’t there so I went along with the most seasoned medic at the time… which was one month. We transported a pt. from a retirement home to the hospital by strencher and backboard. He was slow to start an IV because everything was tagged in the back and things weren’t where he expected them to be [ex. Alcohol pads were under all the syringes]. We dropped off the pt. and departed from the hospital. As we posted up, we realized we had no back up straps for the backboard [plan was to pick a backboard up later]. The EMT-B [driver] was on his phone almost every time we were enroute or departing from a facuility[no pt. tho although we almost were the way he drove]. Documentation was poor and no one could give me a set way to write a report. Once I got back to base, the FTO went over a few things with me but stopped because he had a call to run. He wrote on my paper that the medic I was with probably went over everything but didn’t sign it. I quit the next day because honestly, I didn’t want to be apart of a company that ran this way. I hate feeling like a “QUITTER” but I have mixed emotions for it. I heard a story previous about a cardic pt. that was on a BLS truck enroute back home when they had a heart attack. All the EMT-B could do was put the pt. on oxygen and head back to the hospital. If that was my mom in the back, I’d want them to do a lot more than that.

What would you have done in my shoes? Should I have stayed hoping things would get better? Are all places ran this way?

one thing i was always taught in my EMT class.....ALWAYS trust your gut! 99% of the time, its the right thing to do! i think you made the right decision.
 
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