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Shameless bump! I'm in town now, if any friendly LAS types are on here and would like to show me their shop I'd be really grateful. DPM

If you don't mind, I'm going to jump on this bandwagon too. I've been looking into this recently too.

Hello EMT life! I'm sure we have members from London Ambulance on here, and I would like to meet you! For those who don't know, I'm actually English, former RAMC medic, and I work as a Paramedic in California. I'll be back in blighty from the 16th to the 31st, and I'd love to get down to an...

I understand that, I was merely point out that a ground ambulances safety isn't inherently linked to the ability of its engine to stop it crashing. I don't really think that a redundant engine and the extra power it affords you is quite as necessary in a road vehicle... but I might be wrong

Yessss.... but an ambulance won't fall out of the sky if it breaks down.

I was just thinking about AMR, which envision has recently said is up for sale... could this signal the end of profit driven pre-hospital healthcare?

My main reason for posting was the A-star, which seems like the most common aircraft out there. I work two places, and one is a police helicopter with a secondary medical mission. I trust to pilots, and they know the response area intimately, but it looks like cost has led to single engine IFR...

I found an interesting article about single engine HEMS operations and human factors. Worth a read. http://helicopterems.blogspot.co.uk/2015/12/hoisted-on-my-own-petard.html?m=1

Absolutely. I don't really care how you pre-oxygenate, but you have to do it!

My problem was the lack of awareness that things were going south, and then a lack of insight or even open mindedness when a problem was highlighted. It's incredibly frustrating for me to see other professionals not following best practice.

To an extent, but I've seen it work very well, and also much quicker than a NRB alone. It's not really the NC that I have a problem with, just the general intubation. They allowed the PT to desat, and then blew air into her stomach with a BVM while not doing much to increase her SPO2 and...

The NRB alone doesn't really deliver 100% fiO2, so adding the NC bumps it up significantly. This also means your NC is in place for apneic oxygenation when the time comes. I would use a NC with the ETCO2 bits on it too, which is my practice for respiratory emergencies.

Good evening all! I work in California, where we have no RSI, but that is not the debate. Frequently I will have a Pt who you can predict is going to be getting an RSI upon arrival to the ER. To best prepare these patients, and to generally protect them the best I can, I will usually begin...

I'm interested to hear what it is about Boston that you like so much, If you don't mind.

This was my concern too. I know that I'm in Cali, which is bad already, but I'm having a really hard time finding any systems that I would consider great. You might get OK protocols and OK equipment, but the pay will be bad, with no room for promotion. Or you can get paid well to do glorified...

Do you know of any systems that fulfil those criteria that you listed?

Specifically it was the reciprocity for me. I'm hoping to expand my scope, at it looks that a move to LAS would limit it further. I think I'm correct in thinking I wouldn't be able to start IV's or give any IV meds, intubate etc until I was an Advanced or Specialty Care paramedic.

Do you have first hand experience with LAS? I've heard some not so great things from people going from the US to London, particularly in regards to the scope / level that a US paramedic will be accredited at.

Mind if I DM you?

Thanks! I'm leaving the fire based systems in just to hear if there is an outlier that works well, but I agree with you about the issues that these systems present.