Ask A Medic

Precisely!!! BLS before ALS. Sometimes people forget that.

 

And CPR. All those put together can save a life.

 

When I worked in Illinois, we were allowed to use Versed to consciously sedate people.

 

rules to live by
paramedics save lives and basics save paramedics
a paramedic with no bag or monitor is a basic.
the KISS method is my motto. Keep It Simple Stupid. some people make things so complicated and it completely works against everthing your trying to do.
slow is fast and fast is slow
as far as helicopters go, most services have a nurse and a paramedic. most nurses ride and the medic does all the work. some flight nurses are also medics so they aren't snotty. having a nurse onboard makes a lot of hospital staff feel better about "the same level of care" between hospitals, since we are so inferior to them lol. RSI is on helicopters and not many ground trucks because of the advanced training and responsibilty. Believe me it can be pretty nerve racking when your in a field a good ways from a hosp and your doing an rsi that could easily have a complication or someones anatomy is not exactly ideal. nurses have nothing to do with rsi since in a lot of states they cannot push paralytics. the doctor always has to document that he did it in the hospital.
i work on a helicopter and my wife on an ambulance for same company. we don't have a nurse on our birds, just one medic. i work overtime on the ambulance whenever i can. i still love the lights and sirens through traffic and the calls with psycho nutjobs among other calls we don't go on on the aircraft.

 

you know i can think of a few calls where we didn't get past "A" and no als care done. its ok. some medics believe they can't walk into er without an iv. if i can't get it done then so be it.

 

Exactly. Sometimes people become a paramedic and get the "ParaGod" syndrome. I hate that. I used to teach medic and basic up north, down here I am teaching EMT-I and I am enjoying teaching the basics to people much more.

 

At my company we also can do sedation facilitated intubation with versed on the ground ambulances. the biggest thing with any of these procedures is being at least 15 min from hosp. you don't wanna burn an assload of time on scene dicking around when you could be in the er down the road with a full staff ready to help stabilize pt.

 

I agree. I'm about 30 minutes from the hospital. I love rural EMS.

 

I rode a couple times with EMS out in Alaska. They'd fly an hour (in a plane!) to the scene, and transport an hour back. IF the weather cooperated - sometimes snow blocked them in. We'd land on these dinky air strips and ride a sno-mobile in to town. Some medics said they'd been pulled in by dogsled.

Now that's rural EMS!

 

Yup yup. We just got the king tube and those should be a bls skill too.

Hospitals don't like them though. Makes more work for them.

 

I am sooooooo jealous!!!! That would be awesome. I used to work a busy metro EMS that was mostly 5 minutes from the hospital - and I did not like that one bit.

 

True dat! That would be pretty awesome.

 

Could not agree more!!! With a few exceptions nothing I do will help more than good BLS.

For Chris4x4:
I always wanted to be a firefighter to help people and fight fires. I became a Paramedic to be able to apply for all FF jobs and have never regretted it. There really are few bad days and they usually have nothing to do with the calls or patients. Its all about attitude and not taking anything personally although patience is hard to find on call #4 after midnight for an ailment that has been going on for several days or when the hospital advice nurse tells someone to call 911 for tricep pain after a day of moving boxes.

On my first day of ER time for paramedic school I had a CHP officer ask me "Whats the difference between God and a Paramedic?... God does not think he's a paramedic!". I've never forgotten that joke and try not to take myself too seriously. Everyone stay safe out there!

 

Sounds like us. We end up working in the "back hallway" which has now been coined ER 3 for a while after we arrive. We usually take over for the crew that's already there, so we have two or more patients. It really sucks when you're short on crews on the street and you're stuck in the back hallway. Crews out on the streets get pounded. The fulltimers come in and hand their patients off to the part timers even if the part timers have been there for 4 hours already. They don't care.

True this. I just did a call with an RN in the small town I work in. She lives across from the patient and is a nurse at our hospital. She was in the back of the car and was like "WTF!!! WHERE IS MY MONITOR!!! HOW DO YOU MOVE IN HERE!" It was hilarious.

The rural area I live in has a small hospital with a 5 bed ER (one bed being the "trauma" bed). There are only three doctors that work it, and everyone needs time off. The ER is often down, which means we have a 1 hour routine drive to the closest hospital, or a 45 minute code 3. It's frustrating when you know what your patient needs, but you can't give it, and the hospital is closed. Thankfully we can get an ALS or Critical Care meet, en-route.


Stay safe out there, all.

Cheers

 

Sorry I missed this. They legislated us to have it, but then took it away before it was ever given to us.


The idea was that if someone was on a heroin/coke mix, if we give them narcan, now we have a pissed off drugged hopped up on coke that we can't "Put to sleep".

I've had a few calls out in the sticks that required us to respond on Skidoos before.

 

That is CRAZY!!! Talk about being in the sticks!!!

 

Well we didn't ride them like that, but I did have a spine board and monitor on the skidoo, while my partner was driving and I was trying to shine light with my Surefire cause the skidoos light was busted.

Ah good times.

 

I bet that was an adventure.

 

Sounds fun - don't drop your light! A skidoo is a LOT warmer than a towed sled...

Alaska was pretty fun. I was there only for a month, but got 4 ride-alongs. The pay was pretty damned good for a paramedic, but obviously there are some drawbacks. Then again, they have a really nice expanded scope of practice.

I got a paramedic looking at me funny last week - we had a patient in the clinic that we sent to the hospital. She was like "I've never had a doc load the gurney before." I just said "well the guy's like 250lbs.... besides, I did this for 9 years."

 

Makes sense. But our PCPs are allowed to give a lesser dose by "treatment guidelines", and they usually do. Just enough to take the edge off so they aren't so damn high maintenance. I finally got to see a good OD a couple blocks ago. Lady took a ton of Morphine pills, didn't remember how many. RR 4, sats 80%.