the 100% directionless thread

[CALEMT]

The two tillers for county fire in our area are BLS and will respond to medical aids when the engine is already on a call. Palm Spings Fire Dept. has a station that is truck only. The truck will respond to every call in its area.

 

[Jim37F]

Seattle sends a tiller truck on Medicals.

That's nothing. One of the districts nearby has a tillered Quint and ALS squad....they both go to all EMS calls in their district (or neighboring districts when those engines are busy).

Heck another nearby district is a Light Force...5 person crew staffing a tillered ladder Truck + Engine (dispatched as a single unit)

And that's not even touch LA City, where nearly all their trucks are Light Force companies like that (although at least City runs their own BLS and ALS ambulances, not a squad +private BLS ambulance like County does)

 

[Chris07]

Def doesn't happen in my area, we got engines, quints, the odd light force...

Ah the good ol' light force....the biggest waste of parking space ever.

 

[Jim37F]

I suppose a Light Force makes sense with a truck and pumper running actual FD calls (fires, fire alarms, downed power lines, traffic collisions (extra apparatus blocking traffic)) though a quint with a pumper makes less sense....and much less routine forst up for medical calls... (though the LF makes more sense than a friggen HazMat or USAR big rig haha)

 

[SandpitMedic]

We carry cardizem and have standing orders for it.


I'm bored. Only wheel we've turned all day was to go to a fire standby then were cancelled since they were just doing mop up and had no need for the second medic unit. Then we stopped at subway on the way home.

Now I'm watching Man on Fire. Gotta love Denzel!


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Denzel is my favorite.
Also, wish I had cardizem... What's the deal with the disparity?

 

[SandpitMedic]

I had to google light force. You LA boys have your own lingo.

 

[Jim37F]

^just wait until I start talking about Task Forces! (Fancy name for the engine company and light force company running together on a call...though City does seem to reserve that for things like fires and Rescue assignments haha)

 

[chaz90]

Denzel is my favorite.
Also, wish I had cardizem... What's the deal with the disparity?

I somehow missed the earlier conversation about Cardizem. I honestly don't know how I functioned without it. Most places I saw in Colorado didn't carry it (with a few exceptions), and now I use it all the freaking time. Are places without it just not treating a-fib RVR, or are they using something else? I mean, besides a fluid bolus and crossed fingers.

 

[STXmedic]

I probably only use it twice a year, but it's never failed to provide relief when I needed it to.

My last service preferred you to use amio first line, and if you wanted to bypass to cardizem you would have to call.

 

[NomadicMedic]

We have Metoprolol for Afib with RVR, but NOBODY here has ever used it, except me. Honest.

 

[STXmedic]

I've used metoprolol once for it, but it's not officially in our protocols. She was just normally on metoprolol for AF, and had ran out of her meds.

 

[RocketMedic]

We only have metoprolol, and anecdotally, it's nowhere near as effective as diltiazem.

 

[chaz90]

I've actually never carried metoprolol, but I guess I have used amiodarone for a-fib a couple times. Diltiazem just seems to me to be much more effective at predictable responses with fewer side effects. Plus, we carry an effective antidote in case of iatrogenic OD. Win win!

 

[chaz90]

Fun fact about Cardizem: Hearing people pronounce it as "Cardi-A-zem" like some sort of weird portmanteau of the generic and brand name is one of my pet peeves. Not as bad as "O2 stats," but I still grit my teeth every time. The dental damage increases as they repeat the word multiple times in a conversation.

 

[ViolynEMT]

Fun fact about Cardizem: Hearing people pronounce it as "Cardi-A-zem" like some sort of weird portmanteau of the generic and brand name is one of my pet peeves. Not as bad as "O2 stats," but I still grit my teeth every time. The dental damage increases as they repeat the word multiple times in a conversation.

What about diffib-U-lator?

 

[SandpitMedic]

I somehow missed the earlier conversation about Cardizem. I honestly don't know how I functioned without it. Most places I saw in Colorado didn't carry it (with a few exceptions), and now I use it all the freaking time. Are places without it just not treating a-fib RVR, or are they using something else? I mean, besides a fluid bolus and crossed fingers.

We either
a.) don't treat in the field.
Or
b.) hang Amio
Or
c.) cardioversion if unstable.

Personally I've only just hurried to the ER, as Amio is not a preferred intervention because clearly it's not Cardizem.

 

[DesertMedic66]

None of our doctors will ever authorize orders for amio for A-Fib out here. They would rather us just transport and they will deal with it when we get there.

 

[CodeBru1984]

Working a brush fire standby tonight and we're posted in the middle of nowhere with the nearest base camp at least 8 miles from our current location.


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[MrJones]

Fun fact about Cardizem: Hearing people pronounce it as "Cardi-A-zem" like some sort of weird portmanteau of the generic and brand name is one of my pet peeves. Not as bad as "O2 stats," but I still grit my teeth every time. The dental damage increases as they repeat the word multiple times in a conversation.

We don't carry cardiazem, but we do have amniodarone....

(hope you have a good dentist )

 

[STXmedic]

2.5hr nap to start this July 4th shift?