Evening adult EMS thread

Have you Used one of those SWAT-T's before?
So when we give medical advice you know it's coming from someone who knows tbth

You aren't doctors and no ones immediately dying

No, I only say that because the only two recomennded by the CoTCCC are the CAT and SOFT-T, and more data is showing the SOFTT-W.

Also, do not use improvised tourniquets. They can actually make bleeding worse.

I don't see a Doctor thread on here. And there's more EMS personnel than doctors. Plus, I'd rather have a paramedic tell me what they'd do in a situation than some neckbeard that has only looked at infographics

Ah, we've been trying out these SWAT-Ts that's basically a piece of rubber with ink on them. But we still carry CATs and Quikclot

Everyone I have met in the EMT/EMS community is a miserable person. They hate their patients, they hate firefighters because they get paid a fuckload more for doing a fuckload less, and they especially hate anyone in their workplace that is more educated or has the chance of moving on in life. I totally understand that it's hard, necessary work to help those who need help, and you aren't compensated adequately, but none of that justifies your piss-poor attitudes and crab-bucket mentalities. Fuck AMR in particular.

Was unaware of that case. I'd say it's why I'm a proponent for highly educated, qualified and ultimately paid professional services. I've never seen something as bad as that, but I can tell you there is a difference in my coworker cohort where I work now and where I cut my teeth. The fly by night privates got anyone with a pulse. They paid shit and got shit. Those communities either chose to utilize those for profit services or couldn't afford a third service or fire based transport service.

I've jumped around, 5 agencies so far in my career, 2 states, 4 counties. The third service and fire based services ran extensive background checks, had multiple interviews, had psych exams, 12+ month precautions. You figure people out through all of that and anything negative gets you kicked out that day.

I dont believe he should be on the box, nor do I believe anyone in this industry who talks about the industry in such a cavalier tone. There is a fine line between war stories and venting and being questionable as a professional.

This comment may be snarky, but it's TRUE. Even if you dont tell someone directly if it comes up in convo everyone gets in your business. We are held to a higher standard and need to take that responsibility. We to into homes without warrants, we see people at their most vulnerable. I dont want a dirt bag cutting the clothes off my mother to render aid in the room next to her family heirlooms.

>but none of that justifies your piss-poor attitudes and crab-bucket mentalities.
I'm curious if you work in EMS? Because just about anyone I know who does understands exactly why people turn salty.

Considering a Paramedic is considered the same as an RN (in Texas at least) there's no reason someone in EMS has no way of moving up the ladder to something greater. The only thing holding you back is yourself.

>We are held to a higher standard and need to take that responsibility. We to into homes without warrants, we see people at their most vulnerable.
Exactly. More and more people are learning this by posting dumb shit on social media. NEVER post, or hell even say anything can will make the public question your professionalism/integrity. Making racial comments calls in to question whether you can provide unbiased care.

A lot of people would rather die before they would work in an ER. Many people choose to stay in EMS because they love it. EMS seems to be like that crazy girlfriend. You love her, but you also simultaneously hate her, and staying slowly is damaging you, but you choose to stay anyways and your attitude changes overtime because of it.

I've worked with EMS personnel closely for a couple years. Yeah, I understand why 'people turn salty'. Doesn't justify the hazing and abusive behavior that takes place in stations.
You're absolutely right, there's nothing holding them back from doing bigger and better things - people simply refuse to try and do anything better because they are too lazy to push for higher education or too jaded to think they're capable of doing anything else.

Also, firefighters can suck themselves off all day - still won't change the fact that they're overpaid and have even more highly inflated egos than cops.

True true, I assumed he meant that most Medics and EMTs were salty because they can't or won't move up. However, even with an RN there's some places that do RN or even physicians on ambulances. I'm just saying that if you want, you can climb the ladder.

That ship has sailed for me at least
In RI they let just about any dumb bitch on
I knew this one chick who was a cutter, alcoholic, and suicidal attention seeker that managed to squeak through. One month Id see her crying with puke stains on her shirt, now she decked out in 5.11 / other mallcop shit spouting off about how "people's lives are in her hands"
It honestly just seems like a job for college grads looking for experience or people without degrees

H-hey, some fireman aren't that bad. But yeah, alot of large paid department guys have an ego so inflated you could take it around the world. But always remind them, there's a reason the phrase "it's fireman proof" exists.

To say we are equal is untrue. They can't work where we work and we can't work where they work. We are both professionals delivering care. A paramedic is technically part or the allied healthcare field but not at the same time. More and more we are directly providing primary care or assisting.

We have a non emergency social services division at my department. AKA this catch phrase community-paramedic. Most of that job is RN case management. It's just RNs don't work for a service that has a fleet of quarter million dollar mobile medical facilities and the staffing system to respond at 2am. So there is some cross over, just as some RNs work critical care transport but not 911.

The bigger issue is barrier to access. RNs nationwide are going BSN. Texas does not require even an associates degree to my knowledge for Paramedic, it's just cert based. Until EMS culls the lowest common denominator, outside of my system where majority of the medics have bachelor degrees in paramedicine/EMS and many have enough additional course work to qualify for a masters, we will all be known as ambulance drivers.

>Considering a Paramedic is considered the same as an RN (in Texas at least)
Do Paramedics have to do a college degree? In Canada, RNs have to do a 4 year degree, Paramedics have to do a 2 year diploma. There's also a 2 year nursing diploma, you're considered what's called a "registered practical nurse", and there's bridging programs for these diplomas to get to RN. Overall, I'd say the RN has more utility; once you've got the RN degree, you now have NP open, and in the US you guys also have the Nurse Anesthetist position that makes a bundle of money.

Give them a break. They're the guys who have to scrape people off of highways and pull mouldering bodies out of decrepit apartments. I've worked in an ER; it's stressful, and a lot of the people are fucked up pretty badly, but even the most fucked up people coming into the ER are the cleaned up version of what the paramedics have to deal with. They're entitled to a modicum of respect

>Weapons related

Not related you fucking med school drop outs

PhD chads coming in hot

The only time I've ever posted about my career was in a way to encourage others to join. Other than that, what goes on in the station/ambulance with the crew, stays there. And what goes on outside, stays outside. There's no reason to have anyone fear about their health or safety in your presence.

>Doesn't justify the hazing and abusive behavior that takes place in stations.
Definitely agree. Worked with quite of few people like that, who should have just got out years ago rather than stay and be miserable and take it out on the world.

Part of the problem is the fact that standards are kept low due to the high number of volunteers, and high turnover rates. If we increased standards, and education requirements you would see more quality people.

I think the reason, in Texas at least, they're considered the same, is their skills. The RN just has a few more in hospital skills than a paramedic does prehospital. But then again I work at a hospital and I and the paramedics are always helping in the E.R, since it's a rural regional center. But most of our medics have taken the 2 year college course to go to medic.

Regional dependent. Where I work the fire service is EMS. From transport to training to community outreach and assisting the hospital.

>PhD chads
PhD in what exactly?

>Not working your way up and gaining experience in medicine from highschool to med school
>Ok

Ah, I work in a hospital based EMS and then volunteer at a city fire department. Two totally different areas here. But seriously half of the fire department works at the hospital for EMS. So we stand on equal ground.

>They're the guys who have to scrape people off of highways and pull mouldering bodies out of decrepit apartments.

Im an ICU nurse, but when I was going through school I worked for a transporter company that ferried bodies. Firemen and policemen shied away from those and let us handle the nitty gritty. Ive picked pieces of body off the freeway, Ive spent a night with an ME collecting the pieces of multiple people who died in a housing explosion. Firemen did fuck all and Im glad im done with that job.

I don't disagree that it's hard, dangerous, and depressing work. To that point - nobody who isn't wholly invested in the best care of their patients and saving lives should work in that field. In my (admittedly limited) experience, the vast majority of people who work in EMS do it because it's economically sensical to them, not because it is a passion-fueled experience or a training job for more advanced healthcare roles.

I get you dude. I just see that EMS people never want to do anything with their careers. They start out thinking that it's a chance to see and do some cool shit, and realized that it's about human tragedy and suffering, and get disenfranchised, and give up on trying.

I dig - when it's handled by people who are passionate about it, and paid accordingly, it's a different story. The others are just SOUR COCKS

Oh yeah, I've seen people in our EMT-Basic class give up at clinicals because they couldn't handle the death and stress. It's just a matter of time before you burn out and just want to find something else. So I don't blame them for not wanting to waste time and money moving up, however, I don't get them bitching if they don't. Either move along or don't, but it's your choice so.

Regional dependent. We will let the service borrow equipment if they need it (occasionally they need breathing aparatus). Its not our job to do body recovery unless it's in a hazardous environment or requires extrication.

My doctor is perfectly capable of making a cup of coffee, but I go to him to get fixed up and leave the coffee making to a barista. At upwards of a few hundred maybe even thousand an hour in maintenance and labor costs having the fire department unavailable for their intended job is not efficient or managing public funds well.

>SWAT-T
I've heard SWAT-Ts referred to as the "multitool of EMS" and that's honestly a decent comparison.

A SWAT-T can work as both a pressure dressing and as a TQ.
Just like you CAN fix a car with a Leatherman.

It's still not as good as a dedicated tool.

True, I just love the fact that the instructions say "you may need to use another Tourniquet to adequately stop circulation to the limb." Like
"I spent forever putting one on, why would I do two?" But I've figured. A SWAT-T, then a CAT?, It could work, and might cause less tissue damage.

As an ER nurse in a level 1 trauma center, I want to thank the EMTs and Paramedics that bring people in. Even when the patients are absolute trash people and/or are dying you guys still got them there and usually at least got a line going for me. Always appreciate it. Still debating if I want to get my paramedic license/work as a flight nurse or go for NP.

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Damn near everything you said is total anecdotal. except.
>Fuck AMR
What a sucking fucking soul-grinding time vampire of a coorporation. They don't give a fuck about you, they don't give a fuck about patients, they don't give a fuck about communities. All they give a fuck about is securing those sweet ass transfer contracts and finding ways to gatekeep competitors. They'd rather pay off labor fines and keep burning people out to the point that it becomes known as a stepping stone to Flight, FD or PD rather than improve their services and invest in their employees and education to retain people to better serve their communities. They want bare minimum, will just follow a shitty protocol book and upgrade everything to ALS because "THA HOSPITAL WILL START ONE" EMTs/Medics who have no ambition in life.

I used to work for a service that back in 2015 was considered one of the best EMS agencies to work for in the entire US. We led the fucking way in CCR research, mechanical CPR devices, Blood Packet delivery in field, FAST Exams in field etc. Then AMR bought us out because the owner wanted to retire and no one had the business connections to step up and take over. So in slides AMR with it's promises that "nothing will change, just a name rebrand". Now it's just another notch on AMRs belt of "cities we turned into a hell hole". I left before it got too bad but from what I've seen everytime we take a flight to their area, the equipment is pure shit, the trucks are ran to hell and shit, crews are burnt the fuck out from taking back to back transfers out 100s of miles away because again that sweet ass transfer money, everyone who's still there is either salty as fuck and stuck in the area due to child support and working ungodly amounts of overtime to make up for lack of personnel and pay cuts, or brand new about to get churned the fuck out.

I hope Cunt Van John Dyke or whatever his name is gets systematically raped by a gorilla gang. Smarmy fucking piece of shit.

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As an EMT. sorry for bringing in those 3 AM 4 day long tow pains that only get worse with meth usage

Well that's one way to fix yourself

AMR is horrible. I did clinicals for a few days with them and just. I would rather die than work for such a company.

I should have worded my original post to just target AMR EMS. I got done working today and dealt with one of their b2b 24 crews. Idk. Everything you said is correct. Sorry if I shit on anyone else without warrant. Just angry.

Kek, those and the drunkicidal patients are pretty shitty. Had one patient come in for """SI""" and being high as a kite, we gave them some xanax and shit the first night to help them calm down and sleep. The second night, the doc would only give them atarax so they got mad and immediately said, "I'm not suicidal, let me talk to the doctor." Got them out the door about 15 minutes later. You gotta do what you gotta do.

Omfg, those drunk and "suicidal" ones are fucking annoying, we had one that had called his brother in Dubai, then his cousin in England. And his Dubai brother called us. And it was a mess the involved at least 6mg narcan and some physical restraints

A long long time ago when I was cutting my teeth AMR was nearly the end of me and my career in EMS. It was a bad time to be a medic with the recession (guys at better services were not retiring based on uncertainty) and the post 9/11 flood had saturated the market.

I made it out alive and have had some very "high level" roles in an EMS world that was unthinkable back then. It's literally another planet once you find that career professional service and enter the big leagues.

So to all my AMR anons out there, stay strong, do the right thing even when no ones looking (because someone always is, this industry is tiny), network and get educated.

I still recommend AMR to the new guys. Around here AMR cover the shit areas, low socio-economic demographics, gun and knife club. I just remind them you cant start day 1 without a plan to get out. You should have your 2 week notice pre written with a date.

One time a friend and I were getting drunk (and embarrassing his GF) with stories we had about his obese neighbor (she's pretty evil and we've accumulated a lot of fat bitch stories which came pouring out for some reason). Anyway this EMT at the party waited until the very end and sniped us just before leaving by describing how a fat woman came in and when they lifted her folds a sock fell out.

I climbed with an EMT for a while, but the dude could NOT calm down. He was always amped on 12 cups of coffee and got ultra hyped on lead. I think being an EMT fried his ability to be calm.

Nah it's all good. I understand where you're coming from. I think it's largely an issue of big city areas where EMS and most FD are working in out of date structures and cities/counties are afraid to do a restructure because it might cost more than it's worth in the short term. And that's how you get people you describe. They're burnt out, they're angry, they feel stuck and lash out at others for having it better.

But yes, fuck AMR.

Had one patient come in high on every drug we test for. They had a heart rate of like 170 bpm and was flipping out, sobbing and being noncooperative. Kept ignoring the doc and the rest of us and constantly calling people on their shitty old cellphone. Doc finally got sick of it and ordered a B52 for them so we could actually get treatment started.

50mg Benadryl
5mg of Haldol
2mg of Ativan

Means a little extra paperwork on my end but goddamn does it make life easier. Really feel for you guys being limited on sedation options out in the field.

What "lack of options".

>haldol
>ativan
>verses
>valium
>ketamine

Damn, I understand that, we had a PT extremely combative, and on a BLS truck the only thing we could do was restrain him. He lit up like a Christmas tree on his drug screen. And the E.R ended up Sedating him.

>>Weapons Related
>Military grade asshole
>PhD Chad

It checks out, chief

maybe he should've been happier

This user speaks truths. The only EMTs I've seen fucked harder than the AMR boys are the local poorfag company that uses decades-old gurneys and rigs that break down every other call.

Oof. Three seperate booty shots or all in one?

>Evening adult
Are there child oriented EMS threads?
Or does "adult" imply we're going to be discussing naughty bits?

You haven't? Are you brand new to the internet?

There's no other real place on the chans for law/security/fire/ems stories and banter, I've found. Where are we going to go? /b/? /soc/? Hah.

He meant in real life you dip

Not sure if that's a by state thing but the only thing I recall my local EMS giving for sedation is versed and that not too often and mostly when intubation was necessary. I have seen them give it for combative patients though. You definitely have more experience than I do so you probably know a lot I don't about it.

Always a good time when we see someone come in in restraints.

Three separate. If they require sedation, then a couple extra pokes are probably the least of their concerns.

Our ER is actually split up into the adult and peds side. Peds emergency medicine has a lot of extra steps to it because shit can vary pretty wildly depending on age/size. I've got mad respect for the nurses and docs who work on that side. It can be hard enough starting an IV on a regular person let alone a screaming, struggling child that can't be reasoned with.

Some states do it state by state, others county, others agency.

Where I work we want something? We write a protocol that works for us and submit it for review. Our director signs off as he always does and as long as it is not outrageous and doesnt fit certain criteria he has sole authority and doesn't involve the state other than to say hey we are doing this and getting a pencil whip.

We got in trouble with the state for our "borrowing" of blood product. I guess raiding the pharmacy for FFP and O neg is frowned upon. The end result? If it makes sense do it and ask for forgiveness later.

When you go shopping for a department you should do research the health department, medical director, area hospitals, to get a true feeling as to what the flavor is.

Totally makes sense. I'm still a new grad nurse and have only been working about a year plus I don't have a previous background in EMS so I'm just not as familiar with it. Some of our EMS folks have been doing good stuff with sepsis protocols over the last couple years though. It's definitely a nice safety net for us in the ER to just be able to just walk over to a doc and ask if we can do something or get them updated on new developments immediately.

For real? I thought he was asking the medical personnel if they had seen a smashed in face on the internet. Thank you for enlightening me.

Sepsis is the new trauma (60s and start of modern EMS), STEMI (90s+ with new advances and eventually cath labs on every corner), Stroke (2000s+) advanced imaging in every podunk hospital.

What are they focusing on? We are focusing on early recognition and alerts in the basic life support level (EMTs) and public. At the ALS level just reiterating aggressive fluid, pressors and airway management (better pharmacological options for RSI) when warranted. Nothing we were not doing already. Curious if your EMS crews are doing anything cooler.

It's really nothing crazy, they're starting to include pre-hospital antibiotics in the protocols.

We have yet to start antibiotics in the field. Dont know how I feel on that. I'll wait till the studies come out. Here is my "uneducated" not backed up by anything opinion.

Some of the stuff makes sense. We start heparin in the field after nitro and ASA for STEMI. We carry plavix but I always consult and more often than not it's out of favor with the cardiologists on the off chance this isnt a straight cath. Starting Heparin makes sense, so does plavix. Getting that on early makes a difference.

It's almost totally out of favor now, but we used to administer steroids for respiratory as well as head trauma. The studies were inconclusive as to whether or not it made a difference in respiratory and as we all know now it's pointless in head trauma some studies say even contraindicated. When we gave it the dosage was also pitiful if I remember correctly 150mg? When at the time neuro was loading up grams.

I feel with TPA and Antibiotics there is just too much we dont know without imaging and labwork/cultures. So any administration in the field is going to be limited, probably ineffective in dosage and without that additional information available, we run the risk of complications.

Every system is different and that is why medicine is practiced and some really smart docs come up with studies
Basic stabilization comes first and doing something right the first time can wait for the hospital. I love new tools in the tool box, but I want peer reviewed studies and evidence. Which I am sure your system is enrolled in a study.

Whoops forgot my trip.

Yeah I get what you're saying. I can probably count on one hand the number of sepsis patients I've had that had gotten the pre-hospital antibiotics. It's a pretty strict criteria and definitely a work in progress. God damn, I can't imagine starting TPA in the field. I've seen it work perfectly and kind of miraculously but I've also seen it go really really bad. At least with broadspectrum antibiotics, there's really only so much that could go wrong but man, I would not want to mess with TPA.

It was an option we were presented and we declined. There are services that jumped on the bandwagon for a study.

One of my last partners knew a guy who had a 250+ abm on the way to some 5150 joint straight up bust out of four points in the back of his rig and almost chase him and his partner out of the ambulance on the middle of the freeway. What would all of you other anons do in such a situation?

do you ever start quizzing the victim on what they got shot by and if not will you please start so we can circle jerk the caliber wars?
>what gun
>what caliber
>what ammunition if they knew the person well or if they were a certain stereotype thats most likely to be using cheap fmj
Have phone pictures of each of the common handguns used today to help the victim identify what was used.
Really important stuff, thanks

We know what the answer to that is already. Hi-Point. 9mm. FMJ. Niggers.

Lot use fotties and fottyfive. sigma tier variants and stolen guns normally XDs here.
Self defense shootings Im sure are rare but cops might blast someone

Thoughts on the Alex McNabb drama?
> White Supremacist EMT Suspended After Neo-Nazi Podcast Surfaces
archive.is/z010E

> Patrick County meeting turns into all-out screaming match over EMT accused of white supremacy
archive.is/uMOIB
youtube.com/watch?v=ijFvu0wPhG4

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>they hate firefighters
fucking bigots!

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I like Alex, though it boggles me as to why he'd use his real name on the Shoah. Hopefully he'll be fine after all this blows over.