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We do not suture them in. To secure we use 2 sterile towel clamps, one over and one under the tube, both just into the skin. Both clamps and the tube are taped together to hold the tube until we arrive and the docs can suture it in.

Same here, we keep the 5" catheters on hand just in case, but don't use anything else special.

Bumping an old one, I know... We are allowed to place chest tubes in the field. The Turkel devices have been successful cut down on our need for a chest tube in the field, but we still keep them and use them when necessary. Indications are pretty standard for suspected tension pneumothorax. On...

Our normal crew for ground and flight is medic/RN. For NICU calls, the RN usually stays behind and we pick up an RN and RT from the NICU. On the ground, they sometimes send an NP or MD as well. Us medics are more for safety, but are expected to back up the crew as requested.

I would also defer to your medical director for educating the ED staff. That said, we are also encouraged to use NC during intubation as Chase describes. I can't say I have always checked ETCO2 prior to intubation, but I do often slip a NC ETCO2 under the BiPAP mask when someone is still...

BP HR SpO2 Respiratory Rate Patient Temperature Cabin Temperature (CAMTS req.) Blood Glucose in all patients with GCS <15. Intubated patients add ETCO2, PIP Pplat when applicable.

I do more peds in my CCT role than I did on a 911 truck, but it is still a small percentage of ours runs. We do NICU transports as well, but usually have their team with us as well. We still have to maintain NRP in addition to PALS.

I worked at an amusement park for a few summers in college before entering EMS. They had a number of seasonal EMTs and paramedics, but also expected around 50-60 hours a week of work during the season.

We use the Revel vents and have the LTV1200 as a backup unit. They consume less oxygen than the disposable CPAP masks, but some patients still drain a portable tank quick. I doubt a service that is unwilling to invest in disposable CPAP masks will outfit units with ventilators.

In addition to the above, offer to help the crew with their chores, washing the rig, etc... It will go a long way to building friendship and trust for future shifts.

SpecialK, could this crew have felt bound by protocols preventing them from transporting a pulseless patient? I know many services are preferring not to transport until we get ROSC or call them on scene. To me, this would be an easy exception since the patient needs blood products and surgery to...

You could look in to industrial EMS / safety. You might need to learn more about OSHA regulations, but large factories employ personel to oversee fire, EMS, safety and security. Theme parks do employ EMTs and Paramedics, but most would be seasonal unless you are in the South.

I just spoke with an intensivist about this last week. Fluids are desired in large amounts, 1 liter is probably not enough. Our protocols call for a goal of 30 ml/kg actual body weight with pressors added as needed to keep MAP >65. We carry Levo then add Epi for sepsis.

1. We rarely make scene calls. When we do, it is usually a mutual aid call or an intercept request. If we were to witness an accident, I will provide care and attempt to contact the local agency as well. We would probably need at least PD and Fire on scene anyway. I don't want to jump a call or...

The bougie is a great tool, I wish I would have given it more consideration when I was first a medic. My medical director now really likes to see us us them and has shown us tips like the kiwi grip to make managing them a little easier.

I would want a potassium level as well.The chest pain, nausea, bradycardia, 12 lead with peaked T waves suggest hyperkalmia. It looks like a sine wave might be forming which would raise concern that this patient is close to arrest.I would go to the closest 6 bed facility. D50, insulin...

Glad to hear there were no injuries. Stay safe out there on the roads and skies.

This patient needs blood as quickly as possible. We carry 2 units of O- PRBCs on our rig as well as TXA. These will help, but they will also need more blood, FFP ready as well. Remember the lethal triad of hypothermia, coagulapathy and acidosis. NS is acidic, so you don't want to go overboard...

Last call was a car / motorcycle MVC.

I agree with the others and don't have anything else to add. Working critical care transports has greatly increased my clinical knowledge and I am able to apply that when I work on scenes as well. On the ground, skills like intubations and IVs can be more difficult because there is usually a...