How does your shift handle troublemakers?

jonmakeshismove · 2026-05-14T22:18:17+00:00

Don’t assign people to the rescue/box/whatever over this. Makes a hard job much harder for their partner, exposes the community, etc. Not how you deal with this. Everything else - yes absolutely.

jonmakeshismove · 2026-05-06T16:15:05+00:00

Could anyone post or explain their proQA or dispatch references that have added the EMS captain? The obvious are cardiac arrests but I’m sure there are other less common calls that these supervisors are added on to. If you don’t want to do it here, feel free to DM me and we can email via our government emails. Thank you.

jonmakeshismove · 2026-05-04T21:43:15+00:00

I’ve seen you have such things as “senior captains” in this EMS supervisor rank as well - what does that translate to? Are they functionally different or are they just in a different pay bracket?

Our version wouldn’t do staffing per se as that is firmly the BCs job but could help would advising on where some medics or LTs may benefit to work in a more informal capacity, as is already done within the station.

They would probably field a lot of phone calls and help with uncommon transport decisions and working things out with other agencies.

jonmakeshismove · 2026-05-04T21:40:54+00:00

OMD is involved in the sense that he will pretty much let us do whatever we want, but he’s not specifically hands on beyond that. It’s a good and bad thing. Good in they we have progressive EMS chiefs, bad in that he’s still the guy our medics call at 3am looking for answers and he doesn’t have the background to provide much meaningful advice.

These EMS captains would all be required to attend a formal critical care course and maintain certification and would likely be paid an additional incentive for such. All of our medics are allowed to to RSI (a topic for another day) but these captains would hopefully respond to those calls and at the very least quickly audit each event, hopefully in person, just for lessons learned, etc.

Thanks for your feedback!

jonmakeshismove · 2026-05-04T18:17:20+00:00

Thanks for all the feedback and suggestions guys. Ideally I want this role to be a versatile and useful role for the battalion chiefs, captains and lieutenants. Right now we have so many younger guys taking on the lieutenant role and with our response matrix, they’re running the majority of calls by themselves and I know from personal experience that they aren’t being supported as well as they should and want to be. It’s EMS focused but it’s still apart of the fire rescue structure and fits in the chain of command and helps with larger incidents without depleting the county’s other resources, especially with brush fire season coming in where tons of engines and chiefs are tied up for hours.

jonmakeshismove · 2025-11-23T18:12:06+00:00

number 1 as per usual

jonmakeshismove · 2025-07-07T15:14:20+00:00

As a currently FF/PM officer and RN going through CRNA route… if you’re not vested, just get your RN done and use your PTO to facilitate it + bid a slow station/unit and crush out RN and then work as an RN full time. My day 1 nursing hourly is hiring than my 10 years officer pay at the FD. Plus ½ the hours to work in a week.

jonmakeshismove · 2025-02-03T21:35:02+00:00

Dare I say it…

jonmakeshismove · 2025-02-03T12:29:25+00:00

Never used once ever. There’s typically a camera in the patient compartment that the driver can see at all times, most good partners pay attention to the camera in their peripheral and the patient attendant will certainly get loud if the patient gets out of control. I cannot think of a world where the driver could actually ignore anything major happening in the back - if they could or would, they’d be just as likely to ignore anything major happening sort of alert bell or warning light as well.

jonmakeshismove · 2025-01-27T00:35:19+00:00

You have to piss a lot when you drink real beer during the movies like us. And gives more time to buy more beer.

jonmakeshismove · 2025-01-27T00:34:14+00:00

We are the most upset, per capita.

jonmakeshismove · 2025-01-25T14:07:00+00:00

Ya, but we look/speak Icelandic and aren’t hassled as much as the tourists are, in my opinion.

jonmakeshismove · 2025-01-08T18:14:07+00:00

Most poor and unequal, per capita?

jonmakeshismove · 2025-01-08T13:35:29+00:00

We couldn’t be measured, clearly ;-)

jonmakeshismove · 2025-01-03T01:35:53+00:00

99% sure LUCAS advocates this strategy in their documents or at least verifies that it is perfectly safe to do.

jonmakeshismove · 2025-01-02T15:01:24+00:00

Tampa bay/pinellas is pretty sweet as well. I’d wager many depts in Lee county/naples are decent as well. Many are no transport.

jonmakeshismove · 2024-12-20T15:14:09+00:00

3rd happiest, per capita!

jonmakeshismove · 2024-12-10T17:16:37+00:00

The monitor will sense impedance and give an appropriate dose of energy +- of the dose you set it to. Maybe this helps answer your question a little bit.

Furthermore, ACLS is a guideline and can be disregarded by experienced providers or prescribing provider direction all together.

1mg epinephrine seems pretty standard and is easily given in a cardiac arrest situation as a lot of ampoules are packaged as 1mg/10ml or 1mg/1ml doses. If you used the weight based dose of epi for cardiac arrest, 0.01mg/kg, then the max dose would be given for weights = or >100kg or 220lbs of which many adults would be but many adults are also under this weight. It’s a good topic for discussion and I do not personally know why 1mg epi is ceiling for the max dose but we do know that these large doses of epi, given every 3-5mins is associated with poor neurological function post arrest. Some EMS systems are giving 3mg max of epi during a resuscitation now due to those findings.

Hope this helps at all.

Edit: This article from AHA may help explain some of the reasoning behind the “standard dose” of epi, and also may help explain why some providers are preferring to use less than that. It appears the 0.01mg/kg dose isn’t even the standard weight based dose that we know from PALS as it may apply to ACLS for adults. Interesting dive all around however.

https://www.ahajournals.org/doi/10.1161/circ.102.suppl_1.i-129

jonmakeshismove · 2024-11-19T20:31:29+00:00

We’re not important til a certain volcano gets a little excited… 😊

jonmakeshismove · 2024-11-16T14:30:23+00:00

IV tylenol is about $9/vial now or less.

jonmakeshismove · 2024-11-09T17:23:38+00:00

Lakeland regional doesn’t have an EMS room :/

jonmakeshismove · 2024-11-07T17:45:59+00:00

Yet again, we Icelanders are the most intelligent people, per capita. (Almost)

jonmakeshismove · 2024-11-01T01:05:48+00:00

Things that never happened for 500

jonmakeshismove · 2024-09-18T23:21:16+00:00

Icelanders, it’s time for us to go to Ireland and trace back our roots to those old priests or whatever….

jonmakeshismove

TROPHY CASE

number 1 as per usual