the 100% directionless thread

[Jim37F]

20 new ambulances?????
I'm am jealous. We still have OLD boxes (like 2-3 left) with the OLD Ferno manual gurneys. It's ridiculous.

Oh and 2-3 months is a long time. Why is it like that

We have six ambulances in our department, bought three of the Dodges this year, with one a year coming the next three years...and they decided to go ahead and sell off most of our reserves so we only have 4 reserves, one of which was converted into the bariatric unit, two are in the shop for their own mechanical reasons, and the 4th is currently in service when the alternator of one of the frontlines decided to nearly catch fire while responding to a call. It's funny, one of the old old ones that's being donated to Armenia, in the meantime all the equipment has been stripped out and the patient compartment completely sealed off and lined with plastic, to serve as our "Ebola ambulance"

 

[Angel]

We have two FTO phases until we can clear. Its a busy and pretty complex department so they want to make sure you are good to go before chucked out into the wild. First four weeks are as a third rider. The rest is two man crew. Can't get OT until you are a cleared provider. Unless your FTO or Captain picks some up.

Oh gotcha. Yea that makes sense. I thought you were 3rd rider the entire time, which would be annoying.

Ugh I gotta just remind myself this is my first medic job and not where I wanna be for my career. If this company gets 1 new ambulance this year it'll be a major accomplishment. Almost all our equipment is super old with no outlook (that I know of) of changing. (Don't even use waveform cap, or have IO drills) It's exceptional experience so I guess there's that....

 

[Chewy20]

Really no IO's? @Angel California is killing yall!

 

[Angel]

Really no IO's? @Angel California is killing yall!

It's this cheap company! Trust me hearing about you guys in other areas makes me want to move. It's so hard to have a serious career as a medic (that's not in fire) here. I have one opportunity brewing and depending on that turns out will likely determine me relocating out of state or not.

 

[STXmedic]

It's this cheap company! Trust me hearing about you guys in other areas makes me want to move. It's so hard to have a serious career as a medic (that's not in fire) here. I have one opportunity brewing and depending on that turns out will likely determine me relocating out of state or not.

Texas.............

 

[Chewy20]

It's this cheap company! Trust me hearing about you guys in other areas makes me want to move. It's so hard to have a serious career as a medic (that's not in fire) here. I have one opportunity brewing and depending on that turns out will likely determine me relocating out of state or not.

What @STXmedic said haha. Treated rather nicely down here.

 

[DesertMedic66]

So, give with the details already....

Sorry, thought I already did. Called out at 1000 for SOB. We arrive first on scene and walk back to a bedroom and find this patient (49 male) laying supine GCS of 3 and agonal respirations and slow heart rate. Pulses not present at radial site. Start bagging him with an OPA and hook him up to the monitor. He had a rate in the 20-30s with a BP of like 50/20. I read the rhythm as IVR and decided to go straight to pacing at 60ppm. I got what myself and my preceptor felt as mechanical capture and electrical capture at 120mA. Get him loaded on the gurney to get going (transport time of ~20 minutes).

Start going code to the ED. Get a line started and his sugar read "low". D50% got his sugar up to 175. I attempt to intubate and he starts gagging and bitting the blade so I just go with an NPA and assist his breathing (started breathing after we paced him).

Decide to turn off the pacer to see if he can maintain a rhythm and he can. I called the rhythm junctional with a wide QRS. He was able to maintain a pressure in the 100s/60s.

Dropped him off at the ED and he was RSIed within 2 minutes, an additiona D50% and glucagon was given. Last I checked the ED was having a hard time maintaining a good pressure and SpO2 above 88%.

 

[Angel]

Texas.............

I actually submitted an app to Montgomery county a while back. I need to figure out reciprocity but Texas is at/near the top of my list. It is just daunting because its so far away and I know absolutely nothing about ems there besides what I read here.

@DesertEMT66 that sounds like a great call. I admit the rhythm gave me some trouble, just curious why you paced at 60bpm? (I'm assuming protocol)

 

[CodeBru1984]

It's this cheap company! Trust me hearing about you guys in other areas makes me want to move. It's so hard to have a serious career as a medic (that's not in fire) here. I have one opportunity brewing and depending on that turns out will likely determine me relocating out of state or not.

Apply in Kern County...

 

[Angel]

Hall didn't want me :/
Probably my fault though, I took greyhound there and had too much on my person

 

[CodeBru1984]

Hall didn't want me :/
Probably my fault though, I took greyhound there and had too much on my person

Re-apply. It took me three applications before I ended up at Hall. I'm still in FTO at the moment, but love it here!

 

[irishboxer384]

So. My bike breaks down this morning. My girlfriend breaks up with me. Fix the bike and my brand new Note 4 falls out of my pocket on a ride and gets demolished. Anything else?

Your bike is fixed- time for road trip with no chick on the back...perfect!

 

[chaz90]

Sorry, thought I already did. Called out at 1000 for SOB. We arrive first on scene and walk back to a bedroom and find this patient (49 male) laying supine GCS of 3 and agonal respirations and slow heart rate. Pulses not present at radial site. Start bagging him with an OPA and hook him up to the monitor. He had a rate in the 20-30s with a BP of like 50/20. I read the rhythm as IVR and decided to go straight to pacing at 60ppm. I got what myself and my preceptor felt as mechanical capture and electrical capture at 120mA. Get him loaded on the gurney to get going (transport time of ~20 minutes).

Start going code to the ED. Get a line started and his sugar read "low". D50% got his sugar up to 175. I attempt to intubate and he starts gagging and bitting the blade so I just go with an NPA and assist his breathing (started breathing after we paced him).

Decide to turn off the pacer to see if he can maintain a rhythm and he can. I called the rhythm junctional with a wide QRS. He was able to maintain a pressure in the 100s/60s.

Dropped him off at the ED and he was RSIed within 2 minutes, an additiona D50% and glucagon was given. Last I checked the ED was having a hard time maintaining a good pressure and SpO2 above 88%.

You're a braver man than me. Once I start pacing someone and achieve good mechanical capture with corresponding increase in BP, I continue to pace for the rest of the time I'm with that patient. Sounds like a good call though!

 

[DesertMedic66]

You're a braver man than me. Once I start pacing someone and achieve good mechanical capture with corresponding increase in BP, I continue to pace for the rest of the time I'm with that patient. Sounds like a good call though!

It was a really good call. The more I look at the EKG/12-lead and talk to other providers I think it was a sine wave instead of IVR however with how he was presenting I still would have went straight to pacing the guy.

What's even more weird is that I taught his daughter.

 

[DesertMedic66]

I actually submitted an app to Montgomery county a while back. I need to figure out reciprocity but Texas is at/near the top of my list. It is just daunting because its so far away and I know absolutely nothing about ems there besides what I read here.

@DesertEMT66 that sounds like a great call. I admit the rhythm gave me some trouble, just curious why you paced at 60bpm? (I'm assuming protocol)

Yeah. Protocol is to start at 60ppm and start at the lowest setting of mA. Once we have good capture we can adjust the PPM to maintain a good pressure.

 

[Chewy20]

I actually submitted an app to Montgomery county a while back. I need to figure out reciprocity but Texas is at/near the top of my list. It is just daunting because its so far away and I know absolutely nothing about ems there besides what I read here.

If you are nationally registered all you have to do is submit the paperwork and fee. Nothing else to it. If not all you have to do is take and pass the National written part. Pretty sure yall in CA have to be registered anyways.

 

[Angel]

well thats super easy. yea we have to have NR here. as much of a headache it is to get im never letting it lapse.

If you are nationally registered all you have to do is submit the paperwork and fee. Nothing else to it. If not all you have to do is take and pass the National written part. Pretty sure yall in CA have to be registered anyways.

 

[Handsome Robb]

You're a braver man than me. Once I start pacing someone and achieve good mechanical capture with corresponding increase in BP, I continue to pace for the rest of the time I'm with that patient. Sounds like a good call though!

I was thinking the exact same thing.

Only paced a couple of people though. Last one got dope as well. Talk about getting deep into the protocol. Next step was OLMD and an Epi drip.

In other news applied for an FTO spot and also for TEMS. Gotta start running with a light weight vest to get my *** in shape. Plenty strong after coming back from surgery but I hate cardio with a passion...

 

[TransportJockey]

I was thinking the exact same thing.

Only paced a couple of people though. Last one got dope as well. Talk about getting deep into the protocol. Next step was OLMD and an Epi drip.

In other news applied for an FTO spot and also for TEMS. Gotta start running with a light weight vest to get my *** in shape. Plenty strong after coming back from surgery but I hate cardio with a passion...

Brother I know the feeling about getting in shape. Any recs on a weight vest anyone?

 

[9D4]

I was thinking the exact same thing.

Only paced a couple of people though. Last one got dope as well. Talk about getting deep into the protocol. Next step was OLMD and an Epi drip.

In other news applied for an FTO spot and also for TEMS. Gotta start running with a light weight vest to get my *** in shape. Plenty strong after coming back from surgery but I hate cardio with a passion...

I'm still upset about my broken leg. I was finally down to a 9:35 mile and a half. God only knows what I'm at now. Plus side, the cast is now off as of last week, so at least there's that.