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If someone took a HEMS job knowing that they would be expected to work elsewhere on their downtime, then of course that’s totally fair. But assuming that working in the unit or ED is something that a flight nurse is being made to do that wasn’t part of the original understanding of their job...

I'm sorry for your loss. "Esophageal rupture" can mean several things. A description of large amounts of blood could indicate rupture of swollen veins in the esophagus, called varices. This is usually the result of long-standing chronic health problems that might not be outwardly visible. The...

Using the best available evidence is important when developing protocols and procedures and system elements, but not everything of value can be objectively measured in a way that results in what we call "evidence". We can't directly measure the impact of increasing professional skills such as...

We did that for a while at one of the HEMS programs I worked with quite a few years ago. We were salaried so our paychecks were the same every time. It was pretty awesome. They eventually tired of paying us for hours not worked and we went to a more complicated schedule that included both 24's...

Come on, really? This take is only ever used to argue that an individual or group of individuals shouldn't be held accountable for their actions. Sorry, but in this day of body cams and cell phone cameras and Youtube channels where attorneys and former cops break these videos down, you have to...

I don't know that I would call this a medication error per se. Technically, I'm sure it could be classified as such, but the term "error" implies that an unintentional mistake was made in the process of selecting, calculating, and administering the medication. I don't think that is what happened...

No they did not, and that was a completely inappropriate action for which the paramedics deserve to be punished. However, the ketamine administration never would have happened had the cops not unnecessarily escalated an interaction with a citizen who was harming no one and breaking no laws. It...

What an unfortunate and interesting case. Nothing like deploying a perfect storm of callous, overly aggressive, poorly trained, and poorly disciplined public safety "professionals" to protect their city from an unarmed 140# young man from dancing as he walked home. At least someone involved in...

That's interesting. This is my original CFP certificate. No mention of the BCCTPC. I'm pretty sure that none of us had ever heard of the BCCTPC until they changed the name of the credential from CFP to FPC, which IIRC was a year or two after I was first certified.

I don't think it's fair to say that a person is bigoted just because they take a side or view a conflict from a certain perspective, and I don't think anyone has indicated in any way that they think Palestinian lives are worth less than Israeli lives. Peace hasn't existed in that region for...

Is the Ruger Mini 14 legal in NYS? Personally, that would be my first choice for a dedicated home-defense firearm if I couldn't have an AR. Uses the same cartridge as most AR's (5.56 NATO / .223, though you can also get it in 7.62x39 or .300BLK) and even if limited to a 10-round magazine, you'll...

AR-15 hands down. They are surprisingly easy to learn to shoot well and very versatile and very effective. Shotguns are great, but an AR gives you much more ammo capacity and much less recoil and arguably takes less training to learn to shoot well. Handguns clearly have their place but require...

That is a really nice example. The nice ones have gotten really hard to find, at least for a decent price.

That is actually pretty awesome.

What do you give with the ketamine for RSI?

Are you using actual fitted N95's at work - the same one you wore when you had the fit test done? If not, the fit test is irrelevant, as the non-fitted masks are all different. I don't know if there is a really good, objective way to tell how good your seal is. My method for doing so is to...

As others have said, it depends largely on how many calls you get during those two shifts. Everyone has a certain amount of experience that they need to get in order to obtain the level of competence and comfort that they desire. That experience depends on how quickly you pick things up, how...

15 years......this has got to be a new record!

Are you sure they can't intubate in the hospital? "Not allowed to intubate per their scope of practice as defined by the state BON" and "can't intubate due to hospital policy" are different things. Scope of practice questions like this depend entirely on state BON and EMS regulations and they...

Again, you technically don't need any breaths to maintain a decent Sp02, especially when a high Fio2 is being delivered. As long as oxygen is flowing to the lungs (i.e. you have an open airway and 10 lpm of oxygen being administered), it will diffuse across the alveocappilary membranes into the...