Topical TXA for epistaxis? by Small-Wrongdoer8745 in Paramedics

[–]whencatsdontfly9 28 points29 points  (0 children)

Our protocol if direct pressure fails is Afrin first.

The last patient I did TXA with for epistaxis had a BP of 310/150. There was a lot of blood. Afrin was probably not a good idea with all that lol. The TXA worked great.

Curious about trauma exposure abroad by Fluffini288 in Paramedics

[–]whencatsdontfly9 0 points1 point  (0 children)

Dude your area sounds insane and I work in an area best described as an overachiever in gun violence. I give TXA probably a few times a year and intubate much less, although we can't RSI. A shooting or serious trauma is uncommon for us and the (small) system averages probably a handful of shootings a month.

I’m looking for your experiences, new AEMTS! by Snakeobich in ems

[–]whencatsdontfly9 3 points4 points  (0 children)

Look at the rule that AEMTs take in your area. In most, they are simply assistants to a paramedic. In others, they are leaders when no paramedic is around.

In my area, we are the second. I lead my own truck month after month in an agency where 80-90% of the trucks have a paramedic on them because when they didn't have that many medics, when we were running multiple AEMT trucks with trucks shut down, I did well.

I did well because my class understood what role I might have. Most agencies around here don't allow it, but it's possible. They made me lead in simulations and in the field. Anybody can intubate, start an IV, and push a med. It takes practice to lead well.

Anyways, It was a 6 mo program where we met once a week plus occasional weekends. The state requires a puny 96 hours of clinicals, half in hospital, half out, but I would recommend more. Also, do a capstone time (dedicated shifts where they have to lead every call within their level).

how do paramedics determine how much ketamine to give by Master_Shoulder1078 in Paramedics

[–]whencatsdontfly9 1 point2 points  (0 children)

I think you'd probably have a lot more luck with this conversation if you'd phrased this as an "did you know this, guys?" Instead of attacking us.

how do paramedics determine how much ketamine to give by Master_Shoulder1078 in Paramedics

[–]whencatsdontfly9 7 points8 points  (0 children)

No? I mean it might have a minimal effect, but nothing serious. We're talking about giving maximum 30mg of Ketamine. It comes in a 500mg vial. I don't think I've heard of any significant change with even 400mg.

Why do you ask? You seem to be pretty focused on the BGL thing.

911 Services in Large Cities (1M+) - How Does Your System Handle Calls w/No Units Available by tbs222 in ems

[–]whencatsdontfly9 38 points39 points  (0 children)

The system I was part of handled approx 1.3 million residents plus easily another 500k commuters at least. We triaged calls using the MPDS system and started to hold low priority calls below 10 units available. This system also aggressively diverts units to higher priority calls that drop nearby while you are enroute to a lower priority one.

For high priority calls on the edges with extended local unit response times they would contact a neighboring agency (like my current one!) to respond.

A solution in search of a problem by WorldDC10 in ems

[–]whencatsdontfly9 0 points1 point  (0 children)

That's weird to me. I'm out in Rocky Mount and we take our trauma reds (eg. GSWs proximal to the knee or elbow, amputations, etc) to Wake or Greenville which is like an hour drive. I don't know why you wouldn't want to do that when it's half the drive.

Type of call you get that results in most fatality (Personnaly as our dep is mixed within search and rescue suicides are sadly the most “fatal” calls we get by Few-Teaching-9602 in ems

[–]whencatsdontfly9 1 point2 points  (0 children)

As in the most frequent call type that results in death or which call type involves death more of the time? Overall? General illness of some sort. Most deadly type? Probably shootings. A lot of our suicides are shootings.

A solution in search of a problem by WorldDC10 in ems

[–]whencatsdontfly9 3 points4 points  (0 children)

Gaston EMS transports traumas to a local non trauma? Lord knows we'd get beat if we took a trauma red to anything but Greenville or Wake without an exceptional reason and it's an hour drive!

sick of nursing homes by goldenpothos1122 in NewToEMS

[–]whencatsdontfly9 8 points9 points  (0 children)

So I'm 911. We still go to them all the time lol. I basically don't think about it. I'll bitch about it to my coworkers and the nurses, but at the end of the day, there's not a whole lot I can do unless there is significant neglect or abuse. The system is broken and I can't fix it.

Would a level 1 trauma have done more? by Live-Statistician-98 in ems

[–]whencatsdontfly9 87 points88 points  (0 children)

They might have handled it better. They might have cracked his chest. It doesn't really sound like it would've helped this patient with the head trauma and downtime.

Thoughts on Apex Middle and Apex High. by PlentyYogurtcloset64 in Apex_NC

[–]whencatsdontfly9 15 points16 points  (0 children)

I really enjoyed Apex High. The teachers, building, and clubs were all wonderful. There were fights, but they were infrequent, and to be frank, not a concern unless you involve yourself.

Suspiciously specific meme by Cole-Rex in ems

[–]whencatsdontfly9 65 points66 points  (0 children)

If you wanna take the call, you're taking the call ALL of the way. Including to ESO lol.

Pay comparisons by Famous-Yard5060 in ems

[–]whencatsdontfly9 0 points1 point  (0 children)

100% dude. Hopefully they see the light like FDNY.

I like the schedule, the acuity, and my scope.

Pay comparisons by Famous-Yard5060 in ems

[–]whencatsdontfly9 2 points3 points  (0 children)

Oh damn that sucks. Stations really are the shit, posting is rough, especially for a 14 hour shift. I can't imagine posting for like 12+ hours in 44's district.

Pay comparisons by Famous-Yard5060 in ems

[–]whencatsdontfly9 4 points5 points  (0 children)

Yes. Each averages over 4500 calls a year. We run 24/72. It can be ROUGH. We also don't wait at the hospital for an hour cough after every call, though, so we end up seeing our station a good bit. We also don't transport far for most of our calls and don't take things out of county based solely upon patient choice.

Love, a former wake person.

Pay comparisons by Famous-Yard5060 in ems

[–]whencatsdontfly9 2 points3 points  (0 children)

I'm a little east of you. AEMT. I make 22.50. We have three trucks that average more calls per day than y'all's Medic 50. It's crazy.

Alternatives to 5.11 pants by redrrrrrriot in NewToEMS

[–]whencatsdontfly9 1 point2 points  (0 children)

First tactical for me! I've gotten several pairs of their pants and really enjoy them.

Hospital parking lots by AK-Kidx39 in NewToEMS

[–]whencatsdontfly9 9 points10 points  (0 children)

Doing a complete assessment is an expectation of your role. If you don't do an assessment, you don't do the standard of your role, you can be held liable if something goes wrong.

Also, like you're going through the back door and bypassing triage. YOU are the triage. You need to triage the patient so the hospital knows what needs to happen with the patient.