Arbrow06

Hey Guys, Just wanted to put this here for consideration. Are there any EMT-I CIC's that can teach the new curriculum in Central New York? Just wondering. Best, Andrew Brown

Can you guys tell me more about the CME option to maintain your certification rather than a refresher course. Also are there any agency offering these CMEs in the Westchester/NYC area.

I love all the input. I would love to make this a weekly thing just regular old calls that make you ponder. I figured the pt. was crashing being he is usually hypertensive also suffering from dehydration. His SPO2 as per NIBP was borderline hypoxic and with no history of like COPD or any sort of respiratory disease. His breathing was shallow a a bit rapid for my liking but i decided against being rough on him to BVM him which could do more bad than good. So just went with high flow oxygen. I also treated for shock which with the new protocol isn't much more than O2 and a warm blanket considering hypovolemic shock possibly. Was really puzzled and it's good that I did the best I could.

So Blood Glucose at the hospital was 160. Very frail. PTA said they tried a IV but it went right through the vein. Pt. BP dropped about 5 systolic and diastolic by the time you get to the hospital (about 15 minutes). Unable to take manual BP over palp or pulse. No BP or pulse detected via NIBP at ER triage. Call was for failure to thrive ( no eating via spoon feeding for past couple days). Also note shallow breathiing.

Here's the scenario: Age: 80-95 Medical History: Pancreatic Cancer, Diabetes Symptoms: Hypotension, Pursed Lip Breathing, Accessory muscle use, Shallow Breaths, Unable to speak, Verbal on avpu BP: 90/40 HR: 95 Resp: 20 O2SAT: 95% If you need additional info please ask away. I want you guys to respond with a level of care(EMT-B, EMT-I, EMT-P) and what would you do for the pt. at scene and enroute. NO DIAGNOSIS but feel free to explain your suspicions and your actions to improve the pt condition.

I know it was a pretty stupid question but I just feel like literally anyone in Emergency Services can operate them. Sucks that its only limited to the FDNY. In a situation like hurricane sandy having a list of disaster volunteers to assist with logistics and moving of vehicles and operations would be very useful since they basically the OEM of NYC.

Who drives these FDNY trucks I want in!

The other issue is there is always an issue of flu shot shortages. There may be an extra burden on the flu resources during the season when the strain mutates and if they make HCP first up that may be an issue. I also just feel that the flu shot isn't a vaccine because there's no guarantee it will prevent you from getting the flu or carrying a strain of the flu. It just lessens your chances. I wonder how my employer will deal with this as I am not getting the shot. Also I want to see what the checks are to make sure those who don't have shots wear mask and the repercussions if you don't wear mask. What if I don't wear a mask will I lose my EMT cert or what? This is just a really interesting mandate because there's options and due to HIPAA isn't there some privacy amongst what vaccinations I have etc.

Agreed and as a result I will happily don a surgical mask during instances of patient care and if I develop symptoms I will take my sick but off the road until it passes. Patient care is very important to me and I will have have both hand sanitizer and hand cream to make sure that I am keeping my hands as clean as possible this season.

I think its a personal choice because the flu is avoidable and as the strains morph faster and faster who wants to be getting multiple shots all season long because the strain changes. I rather get sick and actually have the immunity to it rather than get an inactive virus injected into me. Not a huge fan of medicine I guess

Think I found a pretty good solution that will work for me. The Meret PPE EMS ProPack so I will be buying that. Just to keep things neat and not buy another pair of pants.

My main concern is patient care so if we put the ambulance behind and it gets taken out because it does take LEOs and Fire a bit to respond sometimes and I wonder if there have been any studies about which is better when you are first on scene. Parking behind the scene to block or in front for the best visibility and safety, especially with the new move over rule in NYS. At the end of the day I just feel comfortable putting my "bubble" in danger of being destroyed so that I end up stranded. What do people usually do when they park in front? Make someone spot?

Maybe I am just being more worrisome than anything of losing things so that probably is my biggest problem. New hire jitters.

No no not like that. I have been in EMS for 2 years and I love it. Also, being an EMT will not be a profession for me. Just what if I get the old lady who took a fall hit her head and is crapping out. Of course that shift is going to make me cry. Emotional tears not stressful ones. We can't save everyone.

Remember always uphill and upwind of any scene both for hazmat related issues also just get in front of the accident. If your ambulance goes out because its rammed thats one less resources to save a life. On the scene the ambulance and ALS fly car are paramount because theres plenty of RMPs and fire trucks can take a decent beating but a ambulance isn't made for it. I would 100% park ahead of the scene and set up safety precautions behind the scene and if a truck hits the car with the pin I would feel bad but my safety is paramount.