medic25

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Posts posted by medic25

  1. Posted

    Generally the reason for the ALS assessment/transport is not so much the actual tasing, but the reason why they were tased in the first place. The vast majority of deaths associated with taser patients have been due to agitated delirium; the patient is in a medical condition (drugs, psychiatric, etc) that caused the actions leading to them being tased. We teach our medics that it is not the shock we are concerned about; it's the big dose of cocaine (or hypoglycemia, or acute psychosis, or half a dozen other causes) that led to their agitation in the first place.

  2. Posted

    Now this I would call distressing. CPAP is great, and decreases intubation rates and hospital stays. I haven't seen anything where it makes a major impact on fatalities. ETT drug administration results in a zero save rate in cardiac arrest.

    A quick comment about using etomidate. Why not use etomidate in the presence of trismus? I've heard of it causing trismus, but haven't seen anything in the last 10 years telling you not to use etomidate in the presence of trismus. If your agency does not use paralytics and the trismus is not as a result of an injury to the cranial nerve there is a reasonable chance that the etomidate will facilitate an otherwise impossible intubation.

    Actually the most recent study out of Canada showed at 21% reduction in mortality after the introduction of CPAP in the field to EMS (Annals of Emergency Medicine last year, don't remember which issue).

    I'm a little surprised to see etomidate-only intubation being done. The research on that is far less favorable; for the most part you either need to go all in and give the paralytic as well, or don't give anything. The problem with just sedating the patient is that you can frequently go from a bad SOB'er who can't be intubated to an unconscious bad SOB'er who's jaw is still clenched. Not really what you want, especially if they start vomiting.

  3. Posted

    Do you think the Governor will sign off on it or will he feel too much backlash?

    Hopefully he will do the right thing and pass it. The amount of service replication in New York is mind-blowing. I thought that the Hudson Valley was bad enough, but after living on Long Island for 2 years and seeing the excesses of their departments I was converted to the concept of consolidation. For the amount of tax money New Yorker's are paying they deserve much, much more from their municipal services. If the governor has the courage to sign this into law, perhaps it will be the first step in bringing some of the systems into the 21st century.

  12. Posted

    New Haven Sponsor Hospital Program is now accepting applications for a full-time day paramedic program, beginning September 1, 2009. This will be a rigorous program, and will meet all of the classroom and clinical requirements of a traditional part-time program in less than a year. Upon graduation, students will be eligible to sit for the NREMT Paramedic Examination.

    The class will run from September 1st 2009, until July 1st 2010 (assuming completion of clinical requirements). The classroom portion will be Tuesday, Wednesday and Friday 0800-1700 until May 1st 2010. Clinicals will be on Mondays and Thursdays until completion of the didactic component, at which point they will be full time.

    Certifications embedded in the course include ACLS, PALS, PEPP, PHTLS, AMLS and GEMS.

    Please call (203) 562-3320 or visit www.sponsorhospital.org for more information.

  13. Posted

    Medic 25 You guys covered the South Central system correctly. Back in the day FOX used to be Woodbridge until they disbanded thier ambulance service, Novembers were the old New England Ambulance Service out of Shelton, and Gulfs were both Milford Fire and Chamberlain Ambulance (now AMR). Also I thought the Serria designation is no longer being used again? It wasn't in use when I "left" again in 2007.

    You don't hear Sierra on the air too often, but Yale Student EMS does sign on with CMED while doing athletic standbys (at least for varsity games; not sure about intramurals). I believe they generally utilize 1-Sierra-1.

  14. Posted

    So would SHARPS be 10-Romeo-1?

    Yes, 10-Romeo-1 would be the SHARP team. The SHARP team is structured differently from other agencies in that the individual members are assigned a CMED ID number, rather than assigning it to a vehicle. Since SHARP team members may be responding in personal vehicles or onboard another agency's vehicle, this is an easier way of keeping track of who is responding.

  15. Posted

    The way South Central CMED's ID's are structured, the first number represents the level of care, the letter designates the agency, and the second number is a unique vehicle identifier.

    1= Non-transport first responder

    2= Transporting BLS ambulance

    3/4= Rescue/Intermediate (no longer really used)

    5= Transporting ALS ambulance

    10= Physician

    So as an example New Haven FD Engine 11 (BLS first response) would be 1-A-11; if AMR ambulance 20 is staffed by a paramedic, they would be 5-C-20.

  16. Posted

    i was wondering if there was like a web site or something with the assignments of all Connecticut ambulance names. kinds worded that strangely but something like this:

    Shelton: Victors

    Derby: Kilo

    Ansonia: Bravo

    Seymour: Tango

    Oxford: Juliet

    VEMS: Zulu

    (guess you can tell i'm from the valley :blink: )

    AMR NH: Charlie

    ???: Lima

    ???: Mike

    ???: November

    etc...

    thanks in advance

    Since you've got the Valley down:

    Alpha: New Haven FD

    Charlie: AMR NH

    Delta: Hamden

    Echo: West Haven (includes Allingtown and West Shore)

    Fox: Nelson

    Gulf: Milford

    Hotel: Branford

    India: North Branford

    Lima: Bethany

    Mike: North Haven

    November: AMR Valley/Bridgeport

    Papa: Hunter's

    Quebec: East Haven

    Romeo: SHARP Team

    Sierra: Yale Student EMS

    Whiskey: Wallingford

    X-ray: Madison

    Yankee: Guilford

    I'm sure I might of missed someone, but that covers most of the New Haven area at least.

  17. Posted

    Norwalk EMS is holding a 10-13 for him on March 28-30 at O'Niels Pub and Restaurant 93 N. Main St Norwalk, CT

    Really glad you are doing this; Grady is a great guy. Could you just clarify the time? I'm assuming it's March 28th, but only the -30 showed up on the first notice.

  18. Posted

    Not that uncommon once you get out into rural America. I've talked to colleagues who work in Northern Maine, and they have volunteer ambulances who have to "relay" their patients from service to service because the hospital is well over a hundred miles from town. They'll meet up half way with an ambulance service that is located closer to the hospital and transfer care; this sometimes happens 2-3 times on a transport depending on the distance. Funny to think back in the old days I used to have BLS crews get mad about going from Putnam county to Danbury with a trauma......

  21. Posted · Edited by medic25

    Have any attempts been made to have the non-profits pay a PILOT/PILT (Payment in Lieu of Taxes)? This is done by a fair amount of universities, government institutions, etc that take up a big chunk of the tax base. Yale University and Yale New Haven Hospital both contribute several million dollars/year to the city of New Haven, a percentage of which is based upon how many fire calls the university generates.

  24. Posted · Edited by medic25

    If you are interested in running a first response service, you could try talking to the EMS service at SUNY Geneseo (Geneseo First Response). It's where I got my start in EMS, and since I left (all the way back in the mid 90's) I believe they are now fully integrated into the county 911 system, providing BLS first response with an SUV. You can check out their website at http://www.geneseo.edu/~esquad/index.html