comical115

I don't want to rain on the parade here, but the Lucas device hasn't been shown to improve outcomes... http://roguemedic.com/2014/03/the-failure-of-lucas-to-improve-outcomes-in-the-linc-trial/ How about spending (a lot of) money on something that actually can improve outcomes, like more medics? Just my 2 cents.

Having responded to jobs in the projects before, it is no where near out of the realm of possibility (and I would speculate rather likely) that this job was communicated to the housing officers as an EDP, DI or other any other disturbance that they routinely handle. Unless you have specific and well informed knowledge about *THIS* specific incident I wouldn't dive straight to a soap box...

"There was a time where we took a guy like you in the back and beat you with a hose, now you've got your goddamned unions..." If you're as annoying in person as you are on this thread, a North Castle brother might just get an MTA officer to 85 with him and find out how Armonk's tazer policy really works... Out of your league junior, keep moving.

According to who? I'm all for the expansion of scope of care but there are times where a patient needs to be monitored more intensively than what a CFR and EMT can provide. The fire service talks about the right tool for the right job, a potential OD of narcotics with respiratory compromise is an ALS job. Period.

Scenario: 45 year old female found on the street, called in by passer-bys. It's Friday evening, patient is responsive to pain with a GCS of 11 (2/4/5). Patient wakes up to sternal rub and quickly nods off. She is unable to provide any information as to her present condition or history. Resp: 12. HR: 66, Regular. BP: 94/50. SPO2: 97% room air. BGL: 118 mg/dl. Skin: Cool, pink, dry. Eyes: Pinpoint, reactive. Patient has x3 empty methadone bottles in her pocket. Narcan or not? Keep in mind that ED's are using 1/10th of what we are in the field as the first line dosage now-a-days (that's 0.04 mg for those keeping score) and I've seen my share of crews bringing in patients who are either actively seizing due to narcan mediated withdrawal or some other acute stress response that ensures the patient's stay in the ICU... No medication administration is without it's potential adverse reaction and unless you're equipped/trained to deal with it, you have no business administering the drug to begin with. *Especially* if the condition can be mitigated with a BVM and some O2...

New Jersey requires an RN on board for ALS transports. Paramedics can transport patients on pumps, vents, nitrous, ECMO (usually with a fellow), balloon pumps, etc in New York State without an RN. ...Back to topic. Good luck with the DOH. I'm curious as to what they say.

You're going to have to contact NYS-DOH. Doesn't count the fact that you still need regional authorization to "work" as a medic (REMAC).

Because arm bands and labels on jackets fix 100% of ICS problems, 100% of the time.

The most interesting part of the new system, now we (the units) can see the time the call originated with the UCT where before we only saw the time it entered the EMS system. Over the last 16 hours, on average, there was a 4 minute delay between the UTC and the unit being assigned the job. Hint: all high priority jobs. Extra hint: EMD still doesn't pick up the transfer on quite a few and PD sends it out on their own.

I work regularly in a Frazer ambulance and in the winter, the condensation in the air lines would freeze the dump valves open. You had to wait for the valves to thaw before moving the bus or run the risk of cracking the frame. Ask me how I know... The most recent order of Frazers we received management forwent the air suspension to reduce out of service time and to save money.

Exactly... How many times did you hear the story of a crew working up a guy who was shot (*insert number of gun shot wounds here*) in the back of the bus when the perp comes back and asks if the patient is going to make it? *Spoiler Alert* The perp proceeds to unload whatever he didn't use the first time around into the patient in the back of the bus and he walks away, leaving the crew to ponder which protocol this exact situation falls under... Well NOW the perp assumes that the two Paramedics and the two EMT's who are crammed in the back fo the bus are armed, so now he has four *more* targets before he "finishes the job"... Bottom line, the list of disadvantages for having a firearm on my person while working as a paramedic is *far* longer then the list of advantages.

Don't bother with 5.11's EMS pant, like Goose said the pockets suck and they are way too baggy. However, 5.11's Taclite Pro's are awesome.

Maimo's ALS buses sit quite a distance from their ED, the extra space really helps on those 16 hour tours. This doesn't look any larger then their other ALS buses... FDNY EMS and St. Luke's Roosevelt EMS also runs extended cabs and its been working just fine for them. I can also vouch for the fact that working up an ALS job in the back of a sprinter *sucks*. Keep them for transport or BLS.

Unlike an Epi-Pen where there is no alternative, a BLS ambulance already has a tool to prevent anoxic injury secondary to hypoventilation. It's called a BVM. I'm all for it as long as the agency provides the proper training and support and equipment to monitor the patient after administration.

This is a retrospective study that looked at in hospital cardiac arrests. The researchers correlated an increased chance at survival with a longer duration of CPR. This study doesn't say anything about the presenting rythym the patient was found to be in, whether hypothermia was induced, whether it was used during the arrest or on ROSC (return of sponteanous circulation), which rounds of cardiac medications were repeated, etc. If a physican is willing to take another 20 minutes to try and correct the situation, I'm fairly certain the patient is getting a few more medications or treatments within that 20 minutes which could very well be the cause in the increase of survival rates.