If you know, you know...

Fr

NurseMurse keep doing a great job bro

As Critical care and FLight medic, thank you for your respect-feeling is very mutual

john moyers currently working as emt and on a plan to go to paramedic school, just got an interest in flight medic do you have any tips or anything that might help with that?

john moyers thank you for your service

Nature’s milk

Propofol takes all your worries away for a bit or forever depending on the dosage lmao

Jacob Ramone Bennett-Watkins im going to hell for laughing at that lol

Damian Schultz we dont carry it in AZ :(

"more milk." Some sad last words.

It’s because it’s takes a lot less schooling to become a paramedic and the experience it takes to pucker an asshole outweighs that

Unfortunately it's because when traditional EMS started in the 60s, the federal government funded the start of systems country wide, but then a few years later declared it as only "seed money", and stopped funding EMS. This left municipalities to fund their own EMS systems, and it's very hard.

Amen to that

I want to be a nurse like you can you teach me

@@minarbidi1416go to nursing school

It was actually an american system to begin with and we've just adopted it over the past 5 years

That's a great idea. Generally when we arrive at hospital, the second officer starts getting the ambulance back together after the patient is off the stretcher and while the patient care officer does handover. I could grab a coffee while an AFA mops up the blood, vomit and restocks!

@@PrepMedic The "AFA" (regardless of where it began) seems like a great way to re-stock quickly and keep each ambulance set up the same. That's got to make everything much simpler if someone is working for an EMS system that may or may not put them in the same truck each shift! I'm pretty sure that it's England that puts up ads a variety of places, including ON their ambulances with not so gentle reminders that ambulances are not taxis but to be used for actual emergencies! I'd love to be allowed to do that here! I'm sure they still have some frequent fliers but.... Anyway, if I find the pics/article I'll post a link!

Well it still doesn't work! They generally just have a big ad on the side that tells you where to go if you have difficulties, so directs people away from the emergency number.

We just re-stock after every call. We are a station based EMS system. We have 5 stations and keep our stocks at our main station we’re we go re-stock. Works for me, I don’t mind it. Great job with the video btw.

68w??

@dayRman 25B

@@lima-uniform-indiasierra9548 25B

PrepMedic I will find out. Just got a call out. Stay safe

Thank you Sam. I too believe that all the knowledge will sink in as it should and I am very excited to start working towards this new career and life achievement. I am working out rigorously when I am not working of studying and your videos help see me through.

How’d you go with the medic track?

so you can give fentanyl, morphine ketamine ? No thought not. A few basic meds like NaCL, IM adrenaline, nebs etc. Your colleague pro gamer from germany even says that below

Best of luck to you. I recently finished my degree and licensing as an LP. Since you asked... 1) Depending on where you go to school, you may be doing a lot of ride-outs with 911 ambulance services. My best advice for that is GET IN THERE. Most won't make a great effort to include you as part of the team; that's your job. The whole purpose of ride-outs is to get you real-world, hands-on experience. 2) In the classroom, don't focus so much on memorizing the little details. Instead, learn how the body works, why it responds a certain way to this intervention or that drug. You will gain an intuitive understanding, which makes it MUCH easier to recall when you need that information. (This is not just my own viewpoint; John Puryear teaches the same technique for learning.) 3) Finally, remember you're a Basic first. If you can ease the pain of a patient's broken arm by splinting it properly, that's far preferable to drugging them up. I had a grade-school patient whose arm was visibly broken. My partner splinted it, and the kid stopped screaming. No meds needed. Always go to your basic interventions first. You're getting into a very noble profession, and not everyone can do what you're looking to do. Again, good luck, and God bless!

My scrotum is 21 years old

*In Europe many critical care ambulances have nurses and physicians on board, so EMTs or paramedics don't give drugs to patients.* *Fast response vehicules staffed with physicians and nurses are also common in Europe, they can come quickly to the scene and jump in the back of the ambulance to give meds.* *Most European EMTs can only give sugar and oxygen to a patient and only nurses can start an IV.*

JoeDurobot In the UK we've got a EMT and Paramedic ambulance and if need so BASICS will be called out if Doctor or Nurse is needed or call HEMS which will mostly have a Doctors, Critical Care Paramedic and a Critical Care Practitioner.

Amazing how different countries operate. In my home state in Australia we crew our ambulances with 2 Advanced Care Paramedics. Critical Care paramedics assist when necessary, and in Brisbane we also have High Acuity Response Paramedics who can perform surgical procedures on scene.

Andreas Hasselmann Firstly, I love Ortenaukreis. We stayed a night in Offenburg as we toured the Schwarzwald for a week. Do you think the Notfallsanitäter training programs will allow for them rather than doctors to perform more procedures in the future? Doing so would free up doctors (and be cheaper). Years ago the Paramedics Australasia (the professional body representing members of each Australian ambulance service) approached the federal and state governments with a desire to create world class services throughout Australia. We looked at how EMS systems operated in the US, Canada, the UK and Europe and took the best ideas from each. It's a dynamic process, and Queensland, NSW, the ACT and Victoria have as good a EMS system as you'll find anywhere. Funding for equipment and training wasn't an issue, and we're always introducing new drugs and procedures. Once we had about 20 drugs at our disposal and was very BLS. Now we can sedate violent patients, administer tenecteplase for STEMI patients, perform roadside surgical procedures, and every rescue helicopter has a paramedic as part of the rotary wing crew. Seeing what EMS services do around the world is a passion of mine.

PrepMedic We have carried it for a couple of years. It has to be given BEFORE the 3 hour mark. In my opinion this is an even bigger reason TO carry it on your ambulance. I took a course from a special forces medic that said “our protocol is BSI, scene safety, TXA.” It just stops the body from breaking down the clots that it has already built. Obviously very good for trauma situations. I encourage you to have your medical director look up the CoTCCC guidelines. They are pretty much THE authority on trauma care.

PrepMedic Why not consider writing a case study on the benefits of TXA in the field? Refer to stats from services that already use it. A well researched and written thesis could sway your MDs decision. I don't know how it works where you work, but here in Queensland, Australia we have what's called Continuous Quality Improvement (CQI). You have to get 200 points every 2 years (some clinical, some non clinical) before you can reapply for your Certificate of Clinical Practice. Writing a thesis, writing about a patient follow up, presenting an argument on pros/cons of a certain drug/procedure as well as annual skills validation all give you points. One of my most involved studies was on spinal immobilization. I quoted stats on patients with potential spinal injuries (based on MOI but in absence of symptoms) comparing places that use collars, spineboards etc. (like most first world nations) vs. nations where no spinal immobilization is used (India, Malaysia and many third world nations). Surprisingly, the number of patients cleared of spinal injuries was no different. I found no evidence worldwide that spinal immobilization in the absence of field examination findings was value added. Surprised myself actually.

Sean Barnette TXA is awesome, we just don’t have long enough transport times to justify it, plus we will be carrying blood very soon.

Succ has lots of contraindictions (TBI included), that's why trauma likes Roc. :P

I got my EMT-D for NYS back in college, but that was a long time ago. I was with an ALS crew and we had quite a few paramedics (street doctors) and would sometimes go out with them on an ALS assist call. I'd get glimpses inside their drug bags when out on call and shake my head, that required a lot more training than I had. Mas respect for you. One thing that frustrated me, was despite the volume of calls we would get we never really did find out if a patient made it or not once we handed them off to the next level of care. Aside from the frequent flyers that is (retirement homes, troubled homes, etc). And then the only time I did find out was through word of mouth and in those cases it was always how long did the patient last before they passed. Did the time we buy them give them enough time to say goodbye to their family? My one complaint about working in EMS.

That's awesome. Imo, everyone should learn CPR, first aid, and basic first responder training. If something happens to me out in public, I'd be comforted to know Joe Dude standing 10ft away has some clue about how to help, instead of having to wait 5+ minutes for EMS to arrive. Longer, if people are using their phones to video instead of actually calling for help.

717EMS8846 Guy I agree but curious as to why succ is still used pre-hospital. I guess if no other choice...

Killer Inst1ncz Because it’s short acting, very effective, and w/ a relatively low complication rate. For those hyperkalemic or renal failure Pt’s, or the rare malignant hyperthermia or penetrating eye injury Pt., they have Rocuronium, but I’d say succinylcholine is still the go to...

@@jnl477 Short-acting is the key, if a medic fails intubation in the field they can bag for a short time and the patient will regain spontaneous effort. Overall, intubation success rates among medics nationwide are pretty shoddy, so much so they were at one point considering removing that intervention from the scope of practice. However, I would say the contraindications to succ outweigh its benefit in more cases than roc in my experience.

Royal Air Force Air Cadets. Its for ages 12 - 18 years old. It helps people in civilian life and benefits people joining the forces. Once I've done this I will be going to the RAF (UK) to do my service. Currently I am a cadet NCO at the rank of Flight Sergeant. I am more than happy to tell you all the stuff we do.

@@PrepMedic and thank you for what you do as well. Do you mind if I us your videos in the training of my marines?

Gotta love that ketamine stare in patients. "Hey buddy, your leg was ripped off" "Oh......OK....I think I'm floating"

PrepMedic wonderful, look forward to it! I feel you man, we're dealing quite a bit with the freshman crowd on our nightclub district at the moment

Both. D50 is on the way out in some areas for hypoglycemia, most are switching to D10 infusions. They still have it for hyperkalemia along with insulin in some services in addition to D10. Glucagon can be used when a line can't be established as well. Some protocols utilize glucagon for beta-blocker overdose as well as esophageal foreign body obstruction. In the case of calcium channel blocker overdose, things can be a little more complicated.

It's Actually pretty scary. Not saying those guys aren't good but I wouldn't want a medic to do a wrong rsi on mr

They can't afford luxuries, like gloves.

April Richards I get a skin reaction to nitrile gloves too, but I think it could be the powder. If you get a reaction using gloves, try using non powdered gloves.

I am so sorry but I actually moved to Colorado 😬

@@PrepMedic how do you feel about medics working in the ER or somewhere else in the hospital? I ask because with my military experience all I did was work in the trauma bay and our sick call/urgent care area. While I know the ambulance is required for school hours and a vital service, im.not completely sold on it just yet lol.

Cost

@@MrUldrick oh I think you’ve misunderstood me. I mean in the U.K. regardless of the brand of medicine carried we only refer to generic names. Naloxone instead of Narcan, Paracetamol instead of Tylenol, etc. But you guys don’t seem to have a set standard. Sometimes using generic names and sometimes brand names.

Why giving a lysis in STEMI? Recommended first line therapy is a Percutanous coronary intervention. Are your ways to long and no helicopter available?

PCI may be first line intervention in the hospital setting, but putting an X-Ray machine in an ambulance to do a coronary angiogram is not possible. We administer a fibrinolytic for STEMI patients who meet the criteria in the field (either on scene at the patient's home etc. or en route to hospital). A 20 minute plus road trip from the suburbs to hospital is not uncommon, and by the time a crew on scene identifies a STEMI, and calls for a helicopter you're looking at a minimum 40 minutes (chopper departing base to arriving at hospital with patient). With an onset time of 15 minutes, a fibrinolytic can assist managing a STEMI far quicker. Patients treated for a STEMI get taken straight to the hospital catheter lab for angiogram and ongoing management. This treatment is being performed by more and more paramedics around the world (Australia, UK, Canada to name a few). Progressive services look at bringing the emergency department to the patient, with paramedics performing procedures that would generally be done by doctors and nurses within the first half hour of arriving at hospital. It's contraindicated in patients with a left BBB.

Coover Hmm, here in Germany it's very uncommon and mainly administered in cardiac arrest or pre-arrest pulmonary embolism. Actual studies suggest, that it's the best treatment to admit the patient to a hospital with a cath lab within two hours. (Call-to-balloon-time should be under two hours) That's in the most cases possible, even in rural areas often by road. If not, in Germany we have a great HEMS systrm where the next helicopter is maximum 15 minutes flying time away (at day).

w W Germany has a great HEMS system. One advantage most Germans have that we often don't have is close proximity to a cath lab (some people in our state alone are 1000km plus from a cath lab). Patients treated in the main cities still make it to the nearest cath. lab well within the two hours. Towns that are the equivalent distance of Belgrade to Berlin from a major hospital are what we call rural! Some patients who live in the outback of our state and do need urgent medical treatment at a major trauma hospital/burns unit etc. often have a 5 hour journey, including 3 hours by RFDS aircraft.

@@coover65 That may explain why you have so much more leeway in using clinical judgement to perform advanced interventions; because you have to way out there in the middle of no-where. In countries and/counties with closer available services, there is less risk in simply transporting the patient to make pci. I may be mistaken but I don't think anywhere in the US are pre-hospital services allowed to administer any tPA products, even though they would most likely be better suited for paramedic administration if indicated.

Hey Susan, shoot me an email at prepmedic@yahoo.com and I can see what I can do.

they are glass ampule holders, with elastic on them. made by statpacks

We can. I don’t do it often though.