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  1. M

    First Responder - Handoff Reports

    "Those bags look heavy. I'll carry them."
  2. M

    Hallucinations... play along?

    This was not covered in your basic class? Or in your book? Really?
  3. M

    Driving Emergency

    1) Don't hit anything. 2) Keep the shiny side up. 3) Don't drive like an A-hole.
  4. M

    Epipen when Pt is child

    I'd probably freak out and call for the Paramedics!
  5. M

    7 yo SOB

    It's February. He has the croup. Give him humidified oxygen. Take him to an EMERGENCY ROOM!!! If he has a PMHx of asthma give him a "nebby". If he has a Hx in ambulances he'll be fine with it, if he fights it it's not worth it. If it's not croup it's acute bronchospasm and the sympathometic will...
  6. M

    Fentanyl in Pennsylvania's heroin

    IN narcan is cute and useful in traditional ODs, however the strength of this heroin cut with fentanyl is killing people with preexisting drug problems. These are people with tolerances and habits. ERs have been giving as much as 6mgs of narcan to regain the respiratory drive. Not consciousness.
  7. M

    Fentanyl in Pennsylvania's heroin

    While it's not mentioned in the article, this is most likely acetyl fentanyl and not fentanyl citrate, which we have on the trucks. Acetyl fentanyl is a Schedule I controlled substance and has been labelled as having no medical properties and is 15 LESS potent than fentanyl citrate. Rhode...
  8. M

    Transporting a patient against their will to Trauma Center

    While we like to think that we generally know where the best transport destination is for a patient, we are not doctors. Sometimes people are in dire straights and will still refuse to go to what WE think is the appropriate place but will want to go thee preferred ED. We can try until our...
  9. M

    Just passed the Registry

    Be nice. This is a customer service job. Your "patients" are customers. These customers are normal people, presumably, just like you. Talk to them like you would want to be spoken to. You are no better than them. Most likely your first private ambo job will be mostly dialysis runs and hospital...
  10. M

    Seizures and 12 lead

    OP, is this a state/county/local protocol or an employer protocol? This SMACKS of billing purposes to me.
  11. M

    WHat was the BEST thing you ever said to a patient?

    "Looks like your humorous. It's not that funny" Pretty much every time.
  12. M

    Seizures and 12 lead

    I do what I want.
  13. M

    Is EMT/PHEMS Seen As "Low Hanging Fruit"?

    That means that about 60% actually need help. That is pretty significant. Out of the couple of dozen I do a week, I'm happy if I genuinely help just one.
  14. M

    How do your shifts/ work rotations worK?

    Mind. Explosion.
  15. M

    Morphine vs fentanyl myocardial o2 demand

    The RI protocol update came out while the belief that morphine's reduction in preload was beneficial for an acute CHF exacerbation. Shortly afterwards the general consensus became that the administration was an overall bad idea and borderline negligent as there is a good chance you're going to...
  16. M

    Intranasal Narcan for BLS

    Nightmare. The last thing I want to do is wake these jamokes up. I just want them to breathe independently (professionally, not personally). So yes. 0.4 IM. If I'm REALLY concerned and they're small they get 0.2 IV. Narcan is for respiratory issues related to opioid overdose. Not "fixing" them.
  17. M

    Esophageal Airway

    It's very rare to find a BLS trick on the road. Even for BLS transport. Our OEMS is just a little slow to act...
  18. M

    Esophageal Airway

    EOAs are required on every ambulance in my state. Frontline BLS "advanced" airway. Add that they don't have expiry dates on them and you can imagine how old some of these suckers are.
  19. M

    Intranasal Narcan for BLS

    I'm not going to lie; I haven't read all 90 posts in this thread so I don't know if this has come up. BUT: My state has had nasal narcan for BLS for a couple of years. The same amount of time ALS has had both IN narcan and Versed. I've done both IN and IM with both narcan and versed and feel...
  20. M

    How do you keep up your energy?

    I find that complaining and telling those damn kids to stay out if my yard gets me pretty jazzed up.
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