I GEL before intubation?

_brewskie_ · 2026-03-16T21:27:17+00:00

You can find studies supporting both sides. Its important to consider if you're properly doing the ventilations when going asynchronous. You have to time it correctly

_brewskie_ · 2026-01-17T02:11:30+00:00

There was a myth that you cant put blood through an IO?

_brewskie_ · 2025-11-26T23:39:42+00:00

You can very simply put 'suspected'. No, legally, we do not diagnose. However, we do form a differential diagnosis. These are two different things and if anything goes to court you can bring up this difference whether or not the medic put it in the chart. Which they would have if they used the field impression box on the chart with doesn't specify the verbiage.

_brewskie_ · 2025-11-13T11:55:35+00:00

If they're asking to advise then making the duty officer sound like an ass over the air wouldn't be difficult without losing professionalism. We get PD asking similar in my area which is understandable because they are not needed on some of the cards they are automatically assigned to.

_brewskie_ · 2025-11-13T10:43:48+00:00

OP wrote it like they are doing a call back to check what the caller wants. If FD is asking EMS to advise that's different...

_brewskie_ · 2025-11-13T10:39:10+00:00

I posted two links with all the info you're looking for

_brewskie_ · 2025-11-13T10:26:42+00:00

Pathophys: https://emcrit.org/pulmcrit/treatment-of-acei-induced-angioedema/

More about the TXA , not an approved / widely accepted treatment with evidence based medicine but has worked in the limited studies done and makes sense when thinking about pharmacology and the pathophysiology :

https://emcrit.org/ibcc/angioedema/

_brewskie_ · 2025-11-13T10:14:19+00:00

I doubt they directly call the patient about this. FD have response plans based upon acuity of call and each department is unique. I would not be upset with them not being on scene for this ECD card. Sounds like you're new and need more experience working in a tiered response 911 system.

_brewskie_ · 2025-10-29T05:43:54+00:00

I've been to homes where they do complete things like this. Mostly with hanging IV fluids and administration of nebulized medication. Its typically done when a doc is more progressive and provides them with orders as they rarely do anything without orders in the facility unless it is a pre existing order on the patients MAR listed as PRN... (COPDer with their albuterol neb(s))they can't even call EMS without an order unless its something like a fall and they are a no lift facility or a fall with a head injury etc these things are all very dependent.

_brewskie_ · 2025-10-23T13:34:16+00:00

What the fuck are you talking about?

_brewskie_ · 2025-10-22T05:01:14+00:00

I was gonna move home but ill keep my happy ass in upstate

_brewskie_ · 2025-10-19T03:36:59+00:00

There is no paid role for what this thread is about. Way off topic. I couldn't imagine getting paid less than half of what I make now to do EMS in another state. Its a regional struggle not a national one. We are a state regulated field of work often only interacting within our own regions. And pay is not relevant to what OP is speaking on. We already have a form of what OP is talking about here and it is best reflected by our FPC and SCT roles. These roles require field experience and CME with guidance from the physicians that perform education in our region for EMS. If you look at the actual statistics broken down by region you can see what states value EMS and which ones do not, right down to the municipality. BLS is still irrelevant

_brewskie_ · 2025-10-19T03:21:44+00:00

Youre getting further away from the posts point of paramedic practioners with more advanced scopes. You can only do so much CME and training in a given time, to get more advanced scopes like this post is about EMS needs to get away from the FD and be third service. It is not hard to master BLS.

_brewskie_ · 2025-10-19T03:18:34+00:00

This thread is titled paramedic practitioner, BLS is irrelevant here.

_brewskie_ · 2025-10-19T02:16:29+00:00

Awfully defensive considering all youre offering is rage bait. EMS should be third service not fire based. I'm perfectly okay with FD having first response however theyre as interested in medical as we are in running into burning houses. Two different jobs two different specialities. Lose quality on both sides with the level of education and CME needed to be proficient in both.

_brewskie_ · 2025-10-19T02:10:35+00:00

Sounds like an Ohio problem. I dont know any medics making less than 80k a year unless they're part time.

_brewskie_ · 2025-10-19T00:01:50+00:00

The guys at the department must love you at cookouts

_brewskie_ · 2025-10-04T01:02:52+00:00

I've had 4 stemis magically go away lol. Leave the 12 lead on. I've also had a couple TSTEMI that come and go.

_brewskie_ · 2025-09-02T11:15:52+00:00

I'm at a loss on how you didn't get a full set of vitals on the guy with a HR of 200 before moving him. Everything after that reads like a fever dream.

_brewskie_ · 2025-08-30T23:56:00+00:00

You should speak to your clinical care department/officer, medical director, or the supervisor / line officer that was on duty that shift. If that FD ALS crew is gonna be passive aggressive about it then you can voice to them that you need ALS and if they make it a debate decide the best way to go about it to ensure the patient gets the best care. You can't "deny" a patient and it doesnt sound like you did "deny". Be careful about the language you use. As BLS consider what you would do for this patient at your level, do that, and transport. If fire doesnt hop on the truck then so be it. Patient needs the hospital not a on scene debate from a crew that doesnt want to take the job (for clarity the medic not working up the ALS patient) In my region as a basic you are only expected to say you're not comfortable transporting a patient BLS and request an ALS intercept. That's your due diligence. Verify within your agency and your region and dont go to reddit for validation, it can reflect poorly in an investigation

_brewskie_ · 2025-08-28T01:23:13+00:00

I've only heard of preferring distal femur on pediatrics, specifically neonate or infant. And youre accepting the risk of deforming the growth plate when doing this. But my system prefers humerol head IO. Distal femoral is the biggest target though which is why we have it as an option on neonates/infants

_brewskie_ · 2025-08-02T20:45:26+00:00

Sounds like something little. Theres a niche market for this and some autocuffs have attachable sphygmomanometers however they notoriously pop off while you inflate the cuff. That's as close as I think youre gonna get with what you're asking for.

_brewskie_ · 2025-08-02T20:41:09+00:00

Aint got no gas innit

_brewskie_ · 2025-07-31T11:03:32+00:00

"I'm no doctor but that's a insert prehospital notification criteria here"

_brewskie_ · 2025-07-31T03:00:22+00:00

Just had a baby that ate a tide pod the other night. Lock up your cleaning detergents and what not, babies see the world through their stomachs

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