chazEMT

Hey EMSWhiteCloud, glad to hear you got the pump, too!! Good for you!! The pump is an AMAZING little gadget....I call my wife's pump her "bionic pancreas!" The pump my wife is on does not automatically check her BS...her glucometer is "linked" with her pump, and readings from the glucometer transmit automatically to the pump. The pump then "suggests" a bolus amount based upon her preprogrammed "insulin sensitivity" number. The pump will not, however, deliver the bolus without being told to do so. Insulin pumps give a constant "basal rate" flow of insulin, which would counteract glucose administered. We teach the students in our EMT class about the insulin pump. How to disconnect it, how to suspend the operation of it, and most importantly, how to RECOGNIZE IT. We also show some of the places the pump might be hidden (in a pocket, clipped to an undergarment, or that pager your patient is wearing.) Another thing to be aware of--Medic ID "jewelry." My wifes pretty silver bracelet on her wrist, with all the lovely colored stones....it's her Medic ID bracelet, and you'd never know it from a glance! The Medic ID stuff is getting more and more inconspicuous. They have watches, necklaces, etc...and most of it looks like "everyday jewelry!" Anyhoo....this may be a little off the topic of EMT-B's using glucometers...but it is important. More and more diabetics are wearing the insulin pump...it's important we know how to recognize it and deal with it if necessary!

There's an EMT-Basic original AND refresher challenge course starting up the second week of September-AFTER Labor Day, so you can finish out your summer before starting class!! Refresher starts on Monday, Sept. 12, Original on Thursday, September 15. Class will be held at Somers VFD, Lincolndale Firehouse, Monday & Thursday evenings, 7PM-10PM-with 5 Saturday sessions (9AM-5PM) scattered throughout the class. Anyone interested, contact Phelps Hospital Emergency Life Support Program at (914)366-ELSP (366-3755); or you can visit the Phelps ELSP website at http://phelpshealth.org for enrollment info.

HAPPY BIRTHDAY JIMMYBOY!!!!!!!!!!!!!!! :angry: GOD BLESS YOU!!

Jimboy and the entire Arena family are in my thoughts and prayers. God bless you all.

I must admit that when I first started reading this thread, I thought "Great!!" I was all for teaching EMT-B's glucometry. My wife is a diabetic, and I learned quite easily how to check her sugar using her glucometer. Then I started thinking: "WHEN does it become necessary for me to check her sugar--something she can do in her sleep, with both hands tied behind her back....??" The answer: "When her sugar goes LOW!!" And when that happens, I recognize the signs & symptoms and TREAT HER FIRST!!! Then, as the symptoms begin to alleviate, I check her sugar. But AFTER FIRST TREATING HER!!! EMT's must recognize the signs and symptoms of possible hypoglycemia, and TREAT IMMEDIATELY!! NOT monkey around with a machine (as simple and user-friendly as the machine may be), trying to confirm what the patient's presentation and history are already SCREAMING at us. NYS Protocol tells us - AMS + hx of diabetes = GLUCOSE (provided pt is conscious, able to swallow & maintain their own airway.) And when the patient is hypoglycemic, prompt treatment is key. Yes, the EMT cirriculum needs to be expanded. But not to teach EMT-B's how to use more TOYS. EMT's should be taught good, thorough, and EFFICIENT assessment skills-and the proper emergency care steps based upon their assessment findings! Now (and here's where my ignorance will shine through) is there any way a more effective treatment for hypoglycemia (at the BLS level) could be developed (or maybe it already exists??) It was mentioned earlier that oral glucose is less effective and much slower acting than IV dextrose. Would dextrose administered IM (via autoinjector) be more effective than oral glucose (kinda like an Epi-pen??) For all I know, such a thing already exists-and if so, I haven't heard of it. Anyhoo, just a thought.

AMEN WAS!!!!! I can't put it any better than you did there!! =D> Have SOGs in place regarding rehab that will be ADHERED to & ENFORCED ("I don't care if you wanna play with the pretty orange fire...your pulse & BP are both way up--so you're gonna have to sit out!!") Have your BLS crews TRAINED to do good, thorough, rapid assessments on the firefighters, and able to make an informed decision on whether a firefighter should sit out, or be transported! (And this all comes back to the basic EMT training they receive in the first place!) And finally - ALS should be nearby (ideally on scene - NOT COMMITTED) and able to respond in quickly if needed! I strongly believe we should provide the BEST care possible for our brothers & sisters!! With this in mind, EMT-Bs--TRAIN, DRILL, PRACTICE--keep your skills sharp, so you can provide effective BLS to your brothers & sisters!!! And, most importantly, recognize when ALS is necessary, and call for 'em ASAP!!

I know that is NOT taught in my class....quite the opposite!! We teach the students to recognize when ALS is needed on a call, and to call for ALS as early as possible... But EMT students in my classs (and hopefully every EMT class) are NOT taught to rely on medics for "anything major!" EMTs are taught to assess and treat/stabilize life-threats using BLS skills-and none of those skills include "hiding behind a clipboard" or depending on a medic!

I agree with the first part of your post Mike...especially in a two-tiered system, it makes no sense to tie up a medic on BLS jobs when the need for ALS may arise on another job! As for your last statement--bear in mind that EMD, as with most things, is "garbage in-garbage out!" EMDs can only process and act upon the info they're given during the brief duration of the call. It's often impossible to make a definite determination of ALS vs BLS from the info a caller gives. And when one of those "grey areas" arises, the judgement is usually to send ALS, with the understanding that the medic can either "BLS" the call, or be cancelled by the BLS crew en route. (Of course, this leads us to a whole other can of worms regarding response times of the BLS crews, and the competence of the EMTs....but that's a whole different bottle of tylenol!!) Sorry I've rambled on....AGAIN!

EMD is a great system from the standpoint of getting care to the patient early! But as EJS mentioned in the above quote, the system has to be set up properly for it to work (sufficient personnel, etc.) Dispatchers also need to be TRAINED to the point where they feel comfortable and competent working the cards...trust me, it AIN'T like you see on TV, where the dispatcher is giving a calm, compliant caller instructions on how to revive their 6 year-old! And if there isn't a comfort level on the part of the EMD, the system encounters a glitch at the "get-go!" Well, as always, I've rambled on...in a nutshell, EMD WORKS-but make sure you have your system adapted for it at the dispatch level!!

THAT garbage scow?! C'mon, the best thing we could do with 71 is cut it's mic wire!! Sorry, Mikey, had to post it!!! :twisted: And Seth, just a quick correction....79 is now one of the backup Ambulances....78 is the town Ambulance, staffed by a civilian medic-and second due ALS for the Villages.

Hey all -- EMT-Basic Original & Refresher Challenge courses, beginning Jan 31st, 2005 at Goldens Bridge FD. Contact Phelps Emergency Life Support Services (914-366-3577) for registration info.

7pm-10pm Mon/Thu, 9am-4pm 5 Saturdays

EMT Basic Original, hosted by Goldens Bridge Fire Dept, start date Jan 31, 2005. Classes meet Mondays/Thursdays 7PM-10PM, and 5 Saturdays 9AM-5PM. EMT Basic Refresher Challenge will run concurrent with the Original. Contact Phelps Hospital ELSP (914-366-3577) for registration info.

Phelps Hospital will be sponsoring an EMT Class at Somers FD beginning the end of this month (Refresher starts 8/23, Original starts 8/30.) Head over to Phelps' website (www.phelpshealth.org) for info.

Yes, I will be runnng a EMT Refresher challenge course, as well as an EMT Original, beginning around the latter part of January, 2005. However, the location is still being worked out...it will likely NOT be offered at Somers, but somewhere in the northern part of Westchester County. I'll update ya all when the starting date and location are finalized. As I mentioned, I'll probably start somewhere in the Jan 24th-Jan 31st -ish timeframe. Classes will be Monday & Thursday evenings, 7pm-10pm. Details coming in the next few weeks.

As a 911 Dispatcher for a PD here in Westchester County, I can see the potential probs with 911 going to a central point in the county...TRAINING TRAINING TRAINING first of all!! The PD I work for is the PSAP for the town...we handle all incoming E911 calls...police, fire, EMS. We're EMD trained, and we dispatch PD and EMS. Fire calls are transferred to the appropriate agency. The big problem with one agency taking the 911 call, then gathering the info, and passing it along to the appropriate agency is it turns into a game of "telephone," and info gets lost or changed in the process. I've unfortunately gotten calls from other agencies quite often telling me of an emergency in my jurisdiction called into their agency, and the only thing they can tell me is where it is, and the only sketchy details of what the emergency is...no callback number for the complainant, or whether there are weapons involved, or if the patient is conscious, etc. Direct E911 transfers work for the most part, however, the callers want their call answered NOW, not to be told "hang on, I'm transferring you to the Fire Dept." Also, two other problems that arise: the original operator who answered the call must stay on the line while the operator to whom the call was transferred gets the info until the call is terminated...which does not always happen; and I can't tell you how many times I've transferred out a 911 call, only to have the receiving point ring on and on! Should all areas have access to E911, with trained, COMPETENT, Emergency Medical Dispatchers?? DEFINITELY! Would I feel comfortable with 60 Control handling Police emergency calls? NO. And not because I doubt the comptency of 60 Control's personnel...quite the opposite, my hat's off to all of 'em. But their purpose and expertise lies in Fire/EMS dispatch, and they've got quite a workload as it is! Sorry I've rambled on...just wanted to throw my 2cents in.

Condolences, Chief, to you and the family.

There are no plans on the part of the State to discontinue the CFR course that I've heard. They've actually recently updated the CFR cirriculum, and should be coming out with CFR protocols shortly (aaaaany day now!) Anyhoooo...I actually teach EMT class, and I'm looking into running a CFR class. Unfortunately, it probably won't happen until January.