Recent content by jbiedebach

I guess I don't understand the difference between a standing order and a protocol entry in EMS. We have standing orders (not for PDP) in the ER (because as a medic I am not allowed to order anything in the hospital). But on the ambulance, our protocols are, in essence, standing orders...

You likely passed. I passed with 80 questions.

I failed the KED station when I took my medic because I allowed my EMT partner to take his hands off the patient’s head before I got everything secured.

I am a firefighter and a medic and an ER tech/nursing student so I have seen all sides of it. I would say the primary challenge is money. Large fire departments spend less per capita than midsize departments. Example: Dallas spends about $190 per resident on FD/EMS. Plano spends about $226...

One thought might be to call your local Red Cross in CA and volunteer there. I am sure they have sent crews to FL and TX and are likely short staffed. It is not 911 EMS but if they are operating shelters you can get plenty of hands on patient care helping people change dressings, work their O2...

I had a chance to go but I work too many different jobs and could not get time off from them all. I am picking up shifts to backfill others though Sent from my iPhone using Tapatalk

I took the NOLS Wilderness first aid class and I now teach a class for a Wilderness group here in TX. My class focuses on decision-making more than hands-on skills. I have seen a lot of Boy Scout classes like "put an onion on a burn" or "make a litter out of tree branches and duct tape". That...

I get the point of the article, but I think it is a little off base. The principle is that delayed care = worse patient outcome and marathons delay care. Point taken. But lots of things delay care. Calls in the middle of the night have a slower response times because crews are usually...

I am always trying to learn and I accept the coaching to learn more about STEMI mimics, good advice. But I also think it matters what kind of system you work in. I have 6 cath labs in my immediate response area and they are all staffed during the day (3 are staffed 24/7). So I never "activate...

I am a medic. And I do know about BER. It is not something we spend a lot of time working on. The biggest STEMI mimics I see are elevation from bundle branch block. We do activations all the time for strokes, STEMIs, trauma, etc, but those activations are always subject to override by the...

It would be interesting to get a follow up from the ED. I would have transmitted the EKG for sure. If the Pt was not symptomatic I would have given ASA and let the doc decide. There are medics here with more experience than me and I trust them if they see BER. But is see elevation in 2 or more...

I work in TX. We don't have any AEMTs in our system (it is actually just as easy and costs the same to get Medic). When I went through medic school you could test for EMT-I halfway through and many people did but several years back they changed the internship requirement to match the medic...

We had a lady come into the ER with an INR over 6 and she was bleeding from her eyes. Her tongue was normal and her airway was not affected. Treated with Vit K and admitted. Only time I have seen it. Sent from my iPhone using Tapatalk

There is a lot of evidence for the additive effects of ketamine + fentanyl. We used to dose it like you described (typically ketamine first, followed by fentanyl). However we had some suboptimal experiences with patients reporting a "heavy" or "drunk" feeling after Ketamine slow IV push...