WAS967

And if pulses are not returneds? Then what? Also, protocol is to do CPR until the defib is attached. Do you skip the initial CPR and go right to the defib?

ALS article? Care to share? Or is that the one from FOOPS?

Money? Who knows. I think it looks like a great idea. Why strip the aparatus of it's flares when you can have a vehicle deicated to Fire Police use. For my information as well, what capabilities do Fire Police have on the fireground? Do they have the ability to arrest someone who violates the cordoned off area? Do they have any police powers at all? (I had heard something about this a while back but my knowledge of the subject is nill).

God bless this woman. Good to see a fighter like her back on the road.

Hehe. Sounds like the last time I delivered on in peekskill. Went something like this: Expose the necessary area, check for crowning....oh look....amneotic sack......oh look....it just burst.....hello there head....."drive faster!"....and in the words of Van Halen...."Hello Baby!".....:->

http://www.villagevoice.com/print/issues/0...25/robbins2.php

Perhps next time there should be a little more advertising. I think aside from your piosting, I haven't seen a single announcement or posting anywhere for a class in Peekskill.

DRD: The scedule may have changed, but I would call Steve Nardozzi at the college. When I was still regularly teaching labs over there, we had a Monday/Wednesday class and a Tuesday/Thursday class. I forget which cycle he teaches, but I highly recommend Marty Greenburg who teaches one of the classes there.

Sleepy Hollow as well.

And who is teaching the class? (The reason I keep asking folks is that the teacher makes the class and a crappy teacher can make a crappy EMT).

Please don't get me started about nursing homes..... :roll:

From http://www.msnbc.msn.com/id/5214850/ This article falls in the area of "well, duh!" for most of us. But interesting none the less.

The simple reason at it stands right now: Protocol. There is nothing that says we should go to the med for a patient in MI and no local. If you take the extra 10 to 15 minutes to go to WMC from lower CPA, and the patient codes, there could be potential for a huge liability. I personally would like to see patients go to a center equipped for cardiac care. But personally, right now the medical center is so swamped, I don't see them being capable of handling the extra load. If I had a heart attack right now, I'd demand to go to the city or Jersey. I hope things improve in the future (and I'm sure it will eventually) but right now the medical center is just in a state of chaos. I went to the medical center with a head injury patient and had to wait about 10 minutes before anyone really paid any attention to us. It was just too damn busy and the nurses are overworked as it is. Anyone who said that the 160 nurses cut doesn't affect patient care is full of you know what.

The good news is that several hospitals in our area have applied for the ability to do catherterizations. II know Northern Westchester is one, and I think White Plains was the other. So it will make things a little easier. But yes, in a lot of cases it will involve longer transports as it does in the cases of trauma. In the end it all comes down to what is good for the patient. If a patient in need of a cath doesn't get one because they have to wait at an incapable hospital for three days while a bed frees up at the med, there is no benefit to going to the hospital without the cath. The problem we have right now is that the medical center is overloaded with patients, does not have enough beds, and simply does not have the time in the day to schedule all the caths that are needed by people out there. I hope the state sees this and grants NWHC and WPHC the ability to perform this much needed procedure. (There is of course much more to the issue, but I'll spare you the gory details.)

It is scary the statistics. Pull out the latest issue of the local fire newspaper and take a look at the firefighters who were lost in the line of duty in the past several months. It is staggering how many are not from injury, but from sudden cardiac arrest.

From http://www.jems.com/jems/exclus03/e1203b.html

Oh most definatly. Look at blood sugars. Years ago you used paper that turned colors to get an idea of the person's blood sugar. Now you get a nice readout in a device smaller than your palm. Blood gases would be a good thing too. Blood gas machines return results within seconds. Why not have that capability in the field? One day, and with much more money than we have now. As for the Natricor issue at the med. They are short on a lot of drugs for obvious reasons. I've taken several patients to thier L&D and had to bring medications with me from the sending hospital because WMC doesn't carry it. I can only hope that they fix the problems soon or people are going to die. (And some would argue, that several already have.)

I like the pizza delivery analogy better than the cable one. After all, who wants to call 911 with a heart attack and be told, we'll be there within the next 4 hours? ;->

I was told that there was originally people reported trapped in the structure. Thankfully everyone was reported out and safe upon initial reposnders arrival.

And even in cases where ego does not get in the way, the locals are unwilling to pay for the much needed service. Go figure. ](*,) :roll:

I do not unfortunatly. I only regularly work with HVHC and NWHC and occasionally Putnam (I have no idea if they have the ability). Best way to check is to talk to the ER doctor at your local ER and ask. If they have the capability to the BNP assay, they would know or would be able to tell you when they plan to deploy it. It's a really easy test and results can be had in about 15 minutes. It's not as quick as a Blood Glucose, but for the value of the results, it's worth a litle wait.

I posted the previous article because I thought it was very informative both about CHF and BNP. A few comments first: I too am a big proponent of Tridil (IV NTG) and would love to see it used in the field. As Doctor Rodenburg mentioned, it does require titration and most in hospital workers would scoff at using it without a medication pump. But we shall see. My organization has been contemplating putting IV pumps on the flycars for a while. Perhaps this would be a good reason to do just that. Also, it will be interesting to see how Natrcor (Nesitiride) pans out. Don't be surprised if it ends up in our drug bags in a few years. You may poo-poo the idea now, but contemplate this. I said the same thing about Cardizem 5 years ago. ;-> Anyways, on to the meat and potatoes. BNP (b-type Natriuretic Peptides) are something that most advanced prehospital providers should be at least aware of, if not for your own knowledge, for the sake of your patient. Why you say? Well, many hospitals are working towards using BNP as a marker for CHF patients. Hudson Valley Hospital just recently started using it. Northern Westchester has been using it for about 8 months. Why do you care? Well, if you don't typically draw prehospital labs when you start an IV, then you shouldn't. But if you are like me, and a lot of other advanced providers who DO draw bloods when starting a line, you might want to take heed. BNP levels typically require an extra purple (lavender) top blood tube. Next time you have a CHF patient, keep the second blood tube in mind. It will potentially save the patient from another stick later on. The BNP level from the field can also be used to gauge the effecacy of your tratment for the ADCHF (Acutely Decompensated Congestive Heart Failure) patients. I personally have gotten into the habit of including two purple top tubes in my IV start sets just so it is there as a reminder. If I don't need it, I don't draw it. Your milage my vary.) Comments?

Just when you thought it was safe.....