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?
I’m a nurse an this was a amazing educational video. I can assure patients that when y’all pick them up y’all are prepared to care for them in any circumstance.
This is really an awesome video. I've often wondered what EMS Carrie's when they're at work. I was in the Army and the best I can say is that I am certified to start and IV and administer a saline drip. Our medics were the ones with the meds as well as being the ones that can make the difference between life and death from the location where the soldier was wounded to a field hospital where the soldier can get the appropriate treatment for their injury. Regardless, I have a lot of respect for every EMT because in a critical situation, EMT's kick ass at keeping a patient alive until the patient can be placed in a hospital setting. Thank you for the work you do and thank you for the video. Keep up the good work!
In England we have " Ambulance Fleet Assistants..AFA" who make sure Every Ambulance is Made ready for the next crew to go straight out!Turn around between shifts 10 mins max.
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.
Ketamine is actually a very good medication that more EMS should be trained and equipped to use. Especially for things like severe fractures where you need to move a patient who has a broken back etc that can really help with the pain.
@@PrepMedic I agree with you Sam, I would rather see them trained in antiarrhythmics, and still need online medical control permission to administer...Kind of like the ole TV show Emergency. Just my two cents there.
I was always curious and glad to find a video explaining everything. I found it very interesting. I’d also like to thank you for your gift of saving lives. Very noble work medics have. 👍
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.
that’s not fair at all as an argument i think they both should be paid more. Sure paramedics keep them alive to the hospital but the dying doesn’t stop because your in a hospital the nurses are in there too keeping you alive which is also hard. Nurses and paramedics should both be paid more but unfortunately it just doesn’t work that wsy
My teacher told me on the first day of school that the 1st person that sees you in an emergency gets paid the least while the last person you see gets paid the most.
In Germany we are: emergency paramedics(in German: Notfallsanitäter) and they do all things that not a doctor have to do and they are allowed to give well tolerated and successful medications
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
Great video I'm from south Africa and its nice to see what u guys carry but also the different names you got for some of your things as well as drug names keep going respect
Awesome video. Really appreciate all the meds being briefly explained because the paramedic talk is still like a foreign language to me. Once I’m out of college and start towards the SWAT Medic track all these videos will prove invaluable. Thanks for taking your time to do this Sam. Stay safe out there.
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.
Fellow medic. Love what you bring to the table with these videos. I am currently a TCCC/TAC Medic. I would love to show what we do on our side of things. Keep it up, watch your 6 and stay safe brother...to you and your crews.
I really like how your meds are set up and how they are grouped together. One suggestion that I would make is to encourage your medical director to approve the use of TXA. It does wonders for trauma patients with severe internal or external hemorrhaging. Thank you for the video!!
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.
Love that stuff we used originally in the 70’s-80’s is now 40 years later primary again. Army discovered that Ringers works better than saline. Thru a PE and from the time 911 was called had 4 GRAMS of aspirin given to me. Then the FNP asked me why I tried to suicide by ASA they never charted that they had given me that much. You need to cover that every service and state has different protocols for meds. We have a number of near drownings so we still use a bit of bicarb
Medication has changed dramatically since I went to paramedic school in Los Angeles in 1974. You would probably be horrified as to what ACLS protocols were then (2 amps bicarb automatically on arrests,epi and calcium chloride intracardiac if unable to get IV. Hope you current medics appreciate all the patients we probably killed to get it right for you guys 😬
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!
Great video, here in South Florida American ambulance carries the same medications you have for critical care paramedics and the normal ACLS for ALS units.
For critical care life flight, the med backpack was 65 lbs, which included several liters NS. You had to be self-sufficient over 12-24 hour missions as there is no resupply when you're over the Atlantic.
Whats your preference over IN vs IM narcan? Also would love to see a video covering patient interaction: >De escaltion techniques >Getting through to people stuck in an anxiety attack that won't listen to you properly >Dealing with suicidal/self harming individuals Not very tacticool but useful for some newer EMS providers
Love that pelicase! You guys are just stacked. Over here in Germany we have to call a doctor to even apply most of the meds... Great video and very interesting topic as always!
*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.
I love these vids, very educational. When I was in high school, my career program-Law and Public Safety-the other seniors and I took a one and a half First Responder training and CPR... I know really basic trauma stuff... I know how to use the stethoscope, BP Cuff, splints, and all the other BLS stuff. I also know how to do triage.
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.
You don't seem to carry too many drugs in your pelican case. We use softpacks (made by Ferno) which are our primary kit. Can be carried over the shoulder and has the 60 odd drugs we have, plus IV/IM gear and consumables. You'll love the LifePak 15. We've had them since we introduced administering tenecteplase for STEMIs in the field. The biggest differences I guess between Australian EMS and US is that we focus on clinical judgement rather than protocols, paramedics here have a degree in paramedicine (we don't have BLS level staff) and in Queensland ambulance service is free for state residents. We only have one service per state, most are owned by the respective state government.
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.
Solid work! You are very fortunate that your service allows you to use their facilities, equipment, and let you shoot videos while on duty! If I did that, I'd get fired. LOL! Stay Safe!!!
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.
I saw you break a seal on that transfer bag, does that mean you have paperwork for pharmacy? Do you get in trouble for breaking the seals when you end up no administering treatment, or does pharmacy need to simply reverify the contents of the box and ensure none of the medications are unaccounted for? Sort of a medication question, but do ambulances carry nitrous? I know you carry oxygen, but do you carry any other gasses in the field? Not a medication question, but does EMS servicing a college carry activated charcoal for alcohol poisoning, or do you save that to be started by the ER?
I work in Kern county, Ca. We don’t carry any other gas aside from oxygen but we do carry Activated Charcoal but we don’t administer it for alcohol poisoning.
looked up random emt video and it happens to be my local hospital. That's crazy, the next in line was a new york ambulance but the top result is the middle of the middle of Iowa
I’m getting ready too start medic school in Pennsylvania, I really wish PA would update with the times like other states. We really can’t do anything here
#Awesome as always - A few different meds then approved for use California protocol (insane laws / restrictions); Bugs many AEMS and myself, when there are plenty of useful & effective preferential treatment options, and seems in Wisconsin you have any options at your disposal. Politicians have no idea what Pt treatment in the field is like.
Very well done you make me proud to live in Ames. If you ever want help to make videos or expand on this channel let me know. That is my background Thanks for your service
Cool video and interesting to see what's carried. I work in the UK and what I found really unique is the mix of generic and brand names in your drugs pack. Is that every brought up at your agency? Is there any reason behind it?
@@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.
I’m wondering why your RSI kit is tagged? Perhaps it’s different in some states or based on protocols, but rocuronium, etomidate, succinylcholine, etc. aren’t controlled substances, correct?
Love how lucky we got in the video! There was a 0.01% chance this would go all the way and we did boiz 😎 Jokes aside, great content! I’m gonna def sub to this channel now.
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 may of missed something, but why are the narcotics in the big pack sealed with the tag, but they're laying around in the red pouch. It seems really easy to steal the morphine/ fentynal out of the red pouch.
I think it's crazy that the red bag is not tagged. What happens if an employee is a suspect of narcotic theft. No accountability and the DEA could get involved and that would be bad
I worked at a private company where a very trusted senior employee was stealing fentyenal. The DEA got involved and even confiscated an ambulance. It was ALS and they didn't get it back for over a month
Interesting to read the different ways narcotics are kept. We keep ours in a drug safe in our store room. At change of shift you've got 8 to 10 paramedics signing drugs in and out! Pretty hectic. They're then kept on the person they're issued to in special pouches (my pouch is marked "Spare gloves").
Nicholas Whitcraft It is tagged, he opened it in the video... Everything in the red pouch is high risk so the pouch being tagged is plenty. There is plenty of paperwork done for all meds given. Y’all playing checkers and we’re playing chess.
So interesting! A progressive system like yours with roc, propofol, RSI, etc and no cardizem? It's been a first line a-fib drug for a long time. Very surprising, but thank you for sharing this. Reminds me how stone age the system I am currently in is!
Hey prepmedic, I had listened to a talk given on IO administration that cuationed against the use of the cardiac lidocaine for local anesthetic due to the mixture being slightly different. Maybe the preservative was different from the regular lido the hospital uses for say, wound care. Heard of this?
@@PrepMedic hey man I'm also working on the ambulance in Iowa, over by Harlan. How would you go about getting some tactical/swat medic experience, as there isn't too much around here.
It varies, depends how the manufacturer wants to send it. Two bottles of prop, which is more than enough for our transport times, even though no one likes to use it.
Found your video while viewing various med kit bags. When you broke into the propofal side of the transfer bag, what are those four red items under where you are holding the Diprivan? Thanks for the video.
Thank you for this video!! 😁Very informative. I was wondering…some fire dept ambulances do not carry epinephrine because they “aren’t allowed to.” Do you know why that was decided? 🤔
I know this may be a dumb question, but can people who don't necessarily want to become medics/ENTs take your level of training and have access to your medications and other life saving stuff? For example while I don't want to become a medic I'd like the level of training, the medications, etc.. so if I come across someone who needs help I can give it to them as well as say a SHTF scenario I have what's necessary to sustain life.
I probably can’t speak for every state but generally speaking, the medications are only on your person when your on duty so you wouldn’t have any of these in your personal vehicle. Especially controlled narcotics like fentanyl; those are usually kept double locked and picked up from the hospital before a shift and dropped off after a shift if unused. If you’re looking to be a help, spontaneously, like say at an accident, you’d probably manage with just BLS training as an EMT; knowing how to triage, take demographics, maybe even control bleeding.
@@peterwc101 Alrighty, I figured something like that, just figured I'd ask so I could get advice on how best to help. THanks for the reply and I will definetly keep what you said in mind and once I can get that training. :) I asked, because I do wanna help people, but I think in the world where I would be best to help wouldn't be an EMT, but have as much life saving training as possible. I feel "destined" for other things if that makes since, but again wanna have as much life saving training, gear, etc.. as possible. Again thanks for reply and knowledge you gave.
Damn. Thats a lot a medic needs to memorize… all the indications, contraindications, side effects, doses, etc. how long does it take to know that by heart?
Hey your scope looks good, have you noticed an increase in your hourly remuneration amount as your scope of practice grows? and i not why do you think EMS gets takin advantage of?
Very nice. I'm always surprised about the amount of cardiac drugs that a carried in the states like diltiazem etc etc. Here in the UK, for years, we used to carry tenecteplase and heparin for STEMIs but now go direct to cath labs (however critical care paramedics still carry it for special circumstances such as Cardiac arrest caused by suspected PE, had some good outcomes albeit rare). I'd like to see ketamine (analgesic dose) as a standard drug for ALL paramedics here in the uk- at the mo it's critical care/Hazardous Area Response paramedics/HEMS. Non specialist paramedics are restricted to morphine/IV Paracetamol only. Would.also.like to see fentanyl but our dept of health is notoriously slow at changing anything. Paramedics carry, amongst other things, IV/IM/IO antibiotics for meningococcal septicemia, IV Paracetamol, IV TXA for trauma and IV co-amoxiclav for open fractures. In critical care we have rocuronium, phenytoin infusion, hypertonic saline, Mag sulfate, ketamine, calcium, midazolam etc. Primary care we carry a variety of oral antibiotics, analgesia, can suture and glue wounds - primary focus is to avoid unnecessary hospital admissions by assessing via the medical model and treating more in the home. Saves a fortune in the long run. In primary care if a patient needs admission but not via A&E or ER we can admit directly to either the medical DRs, via the surgeons or orthopaedics etc.
If anyone in a family is a diabetic EVERY home FAK and the diabetics IFAK should include Glucose Jell and other sources of sugar for emergency use. Additionally both kits should include a Blood Glucose (BG) Test Kit. If the diabetic is a young kid the parent and older siblings need these items in their own IFAK Signed A Type 2 Diabetic for 15+ yrs
Things are a bit different here in South Africa , Our system is a mess. However we have Standard fixed guidelines and drugs to different levels of care, no exception. We also Have diffrent Paramedic qualifications , As well as Shorter courses similar to EMT but we have a bigger drug allowance as I have found. To Give a brief example of the levels of care. Shorter courses: BAA (Basic), AEA (Intermediate), CCA (Advanced), ECA (New and Unclear) these are all normal certificates. ACLS and ITLS and PALS are also presented to these qualifications except BAA. But even the new skills and drugs can't be incorporated so it sucks. Then Diploma and Degree courses: ECT (Diploma), NDIP(National Diploma) , DIP(New Diploma) , ECP (Degree) these are All advanced Life support. All of these are Registered as Paramedics with our Health Profession Council. Except ECT. And the drugs for these are Numerous and Limited to each , no matter what Province or as you'd say "state".
I feel that spiritually when he said Surgeons can tell pretty loud
If you know, you know...
This autofocus is crazy amazing !
Fr
As a nurse working in the ER with paramedics this was very helpful. Thanks!
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
By-far the best medical channel I've found. I'm a senior nursing student, and I love critical care/trauma pharmacology. This video was great.
Amen to that
I’m a nurse an this was a amazing educational video. I can assure patients that when y’all pick them up y’all are prepared to care for them in any circumstance.
I want to be a nurse like you can you teach me
@@minarbidi1416go to nursing school
@@minarbidi1416I'm studying medicine so I can help :)
This is really an awesome video. I've often wondered what EMS Carrie's when they're at work. I was in the Army and the best I can say is that I am certified to start and IV and administer a saline drip. Our medics were the ones with the meds as well as being the ones that can make the difference between life and death from the location where the soldier was wounded to a field hospital where the soldier can get the appropriate treatment for their injury.
Regardless, I have a lot of respect for every EMT because in a critical situation, EMT's kick ass at keeping a patient alive until the patient can be placed in a hospital setting.
Thank you for the work you do and thank you for the video. Keep up the good work!
68w??
@dayRman 25B
@@lima-uniform-indiasierra9548 25B
That red bag is a gold mine
In England we have " Ambulance Fleet Assistants..AFA" who make sure Every Ambulance is Made ready for the next crew to go straight out!Turn around between shifts 10 mins max.
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.
I would love to see a video explaining what every medication is for. Just like a refresher. That would be superb!!!
You carry what a CCT nurse carries here in Nevada!!! your medical director is awesome
Ketamine is actually a very good medication that more EMS should be trained and equipped to use. Especially for things like severe fractures where you need to move a patient who has a broken back etc that can really help with the pain.
In the Commonwealth of Kentucky, Ketamine is now a medication that can be given at the AEMT level. It is a great medication though.
@dillonlexington it’s insane to me that an AEMT would be authorized to give any narcotic or sedative
@@PrepMedic I agree with you Sam, I would rather see them trained in antiarrhythmics, and still need online medical control permission to administer...Kind of like the ole TV show Emergency. Just my two cents there.
Ahh, propofol. Milk of Amnesia.
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.
I was always curious and glad to find a video explaining everything. I found it very interesting. I’d also like to thank you for your gift of saving lives. Very noble work medics have. 👍
I’m 6 weeks into my 19week program and I’m happy I was following along this video and know all drugs shown here. Dosages and MOAs.
Why is it that paramedics are paid less than nurses??? These people literally keep you alive from point A to get to point B...smh I don't get it
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.
Much less training as well.
that’s not fair at all as an argument i think they both should be paid more. Sure paramedics keep them alive to the hospital but the dying doesn’t stop because your in a hospital the nurses are in there too keeping you alive which is also hard. Nurses and paramedics should both be paid more but unfortunately it just doesn’t work that wsy
My teacher told me on the first day of school that the 1st person that sees you in an emergency gets paid the least while the last person you see gets paid the most.
It’s so beautifully organized! I wish everyone’s med bags were designed like that.
In Germany we are: emergency paramedics(in German: Notfallsanitäter) and they do all things that not a doctor have to do and they are allowed to give well tolerated and successful medications
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
@@danielebrahim8057 We do in fact give fentanyl, morphine and ketamine as well as many other meds.
Great video I'm from south Africa and its nice to see what u guys carry but also the different names you got for some of your things as well as drug names keep going respect
Awesome video. Really appreciate all the meds being briefly explained because the paramedic talk is still like a foreign language to me. Once I’m out of college and start towards the SWAT Medic track all these videos will prove invaluable. Thanks for taking your time to do this Sam. Stay safe out there.
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 interesting hearing about the protocols in different EMS systems! Medics push ketamine for pain management all the time here.
Wow, your intro is *intense*
Fellow medic. Love what you bring to the table with these videos. I am currently a TCCC/TAC Medic. I would love to show what we do on our side of things. Keep it up, watch your 6 and stay safe brother...to you and your crews.
PrepMedic I will find out. Just got a call out. Stay safe
I am 10 years old and I love your channel you are so awesome
My scrotum is 21 years old
I really like how your meds are set up and how they are grouped together. One suggestion that I would make is to encourage your medical director to approve the use of TXA. It does wonders for trauma patients with severe internal or external hemorrhaging. Thank you for the video!!
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.
Just found your channel, awesome stuff, very interesting to learn some of the tools you use in your job. Thank you for being out there for all of us!
The neurosurgical community appreciates you holding the succs! Could you please let Trauma in on that little secret. Thank you.
Succ has lots of contraindictions (TBI included), that's why trauma likes Roc. :P
Love that stuff we used originally in the 70’s-80’s is now 40 years later primary again. Army discovered that Ringers works better than saline. Thru a PE and from the time 911 was called had 4 GRAMS of aspirin given to me. Then the FNP asked me why I tried to suicide by ASA they never charted that they had given me that much.
You need to cover that every service and state has different protocols for meds. We have a number of near drownings so we still use a bit of bicarb
Thanks for all you guys do. Y'all are heros.
Medication has changed dramatically since I went to paramedic school in Los Angeles in 1974. You would probably be horrified as to what ACLS protocols were then (2 amps bicarb automatically on arrests,epi and calcium chloride intracardiac if unable to get IV. Hope you current medics appreciate all the patients we probably killed to get it right for you guys 😬
I liked this video alot. I'm going into a paramedic program soon and would like to know more about what I'm going to be encountering in the future.
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!
I worked as a medic fireman in so cal......we didn't have many of these meds...maybe because we were so close to so many hospitals...good video...
Great video, here in South Florida American ambulance carries the same medications you have for critical care paramedics and the normal ACLS for ALS units.
For critical care life flight, the med backpack was 65 lbs, which included several liters NS.
You had to be self-sufficient over 12-24 hour missions as there is no resupply when you're over the Atlantic.
Going to point out that Med Bag 2 was not tagged, but it contained the same controlled substances found in the other tagged boxes.
It was tagged he ripped it off.
You channel is helping me learn so much thank you!
Whats your preference over IN vs IM narcan?
Also would love to see a video covering patient interaction:
>De escaltion techniques
>Getting through to people stuck in an anxiety attack that won't listen to you properly
>Dealing with suicidal/self harming individuals
Not very tacticool but useful for some newer EMS providers
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
What camera do you use? The autofocus is ridiculously good!!
Love that pelicase! You guys are just stacked. Over here in Germany we have to call a doctor to even apply most of the meds...
Great video and very interesting topic as always!
*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.
You guys are awesome !
We Americans are blessed to have such level of care readily available to us practically everywhere anytime, day or night.
I love these vids, very educational. When I was in high school, my career program-Law and Public Safety-the other seniors and I took a one and a half First Responder training and CPR... I know really basic trauma stuff... I know how to use the stethoscope, BP Cuff, splints, and all the other BLS stuff. I also know how to do triage.
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.
I like the sealed boxes for the narcs, this makes handing over and replacement very time saving
You don't seem to carry too many drugs in your pelican case. We use softpacks (made by Ferno) which are our primary kit. Can be carried over the shoulder and has the 60 odd drugs we have, plus IV/IM gear and consumables.
You'll love the LifePak 15. We've had them since we introduced administering tenecteplase for STEMIs in the field.
The biggest differences I guess between Australian EMS and US is that we focus on clinical judgement rather than protocols, paramedics here have a degree in paramedicine (we don't have BLS level staff) and in Queensland ambulance service is free for state residents. We only have one service per state, most are owned by the respective state government.
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.
Solid work! You are very fortunate that your service allows you to use their facilities, equipment, and let you shoot videos while on duty! If I did that, I'd get fired. LOL! Stay Safe!!!
I just went through ACLS in my medic course, I was going through algorithms as you read off the medications!
Subscribed. Glad I found your channel!
Do you use D50, and Glucagon for diabetics or Glucagon for Beta blocker ODs and calcium channel blocker ODs
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.
Informative video and GREAT Q&A!
I saw you break a seal on that transfer bag, does that mean you have paperwork for pharmacy? Do you get in trouble for breaking the seals when you end up no administering treatment, or does pharmacy need to simply reverify the contents of the box and ensure none of the medications are unaccounted for?
Sort of a medication question, but do ambulances carry nitrous? I know you carry oxygen, but do you carry any other gasses in the field?
Not a medication question, but does EMS servicing a college carry activated charcoal for alcohol poisoning, or do you save that to be started by the ER?
I work in Kern county, Ca. We don’t carry any other gas aside from oxygen but we do carry Activated Charcoal but we don’t administer it for alcohol poisoning.
Love your videos! (From a French prehosp EMS)
Awesome video with great information. Thank you for that!
Are you guys using mag sulfate for resp, associated with copd? Also, are you using Levophed for sepsis?
Baby aspirin and nitro tablets are standard when they suspect heart trouble.
looked up random emt video and it happens to be my local hospital. That's crazy, the next in line was a new york ambulance but the top result is the middle of the middle of Iowa
Very informative video. You explained what they were for better then some doctors do. .
Really interesting to see how other countries work! Thanks for the video
Great Video. Clear and to the point.
I’m getting ready too start medic school in Pennsylvania, I really wish PA would update with the times like other states. We really can’t do anything here
#Awesome as always - A few different meds then approved for use California protocol (insane laws / restrictions); Bugs many AEMS and myself, when there are plenty of useful & effective preferential treatment options, and seems in Wisconsin you have any options at your disposal. Politicians have no idea what Pt treatment in the field is like.
Very well done you make me proud to live in Ames. If you ever want help to make videos or expand on this channel let me know. That is my background Thanks for your service
Cool video and interesting to see what's carried. I work in the UK and what I found really unique is the mix of generic and brand names in your drugs pack. Is that every brought up at your agency? Is there any reason behind it?
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.
I’m wondering why your RSI kit is tagged? Perhaps it’s different in some states or based on protocols, but rocuronium, etomidate, succinylcholine, etc. aren’t controlled substances, correct?
Etomidate and ketamine are controlled.
Hey thanks. This is good knowledge. I subbed and liked. Keep em coming. Be safe, God Bless.
Love how lucky we got in the video! There was a 0.01% chance this would go all the way and we did boiz 😎
Jokes aside, great content! I’m gonna def sub to this channel now.
Sam, In the IFT bag. Is the black device in the background one of the wonderful temp monitors. Almost looks like cigarette plug device otherwise
i was fully expecting him to get called out during his intro
In Poland paramedic can use 47 medicaments it's a lot, but we can't use e.g. oxytocine, haloperidol etc. Interesting to see for me
ABLABLABLA100 good deal!
As a Corpsman kedimine is my go to pain med in the field. Great multi use medication.
@@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"
I just wanted to know if you use benzos to treat anxiety attack or panic attack when you are on duty?
We can. I don’t do it often though.
#4 gonna start sharing some of these.. great Vid
I Carried Drugs Like this when I Was a Paramedic for the City of Portland Maine Medical Crisis Unit!!!
In NY you cannot take most of the meds out of the ambulance. AND they are in a lock box in a locked away cabinet.
What kind of gloves do you use? I have a severe latex allergy (amoung others) and I worry about that.
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 may of missed something, but why are the narcotics in the big pack sealed with the tag, but they're laying around in the red pouch. It seems really easy to steal the morphine/ fentynal out of the red pouch.
I think it's crazy that the red bag is not tagged. What happens if an employee is a suspect of narcotic theft. No accountability and the DEA could get involved and that would be bad
Thats what i was thinking. It seems like there is a lot of rust with paramedics. It would be pretty easy to swipe a few morphine's.
I worked at a private company where a very trusted senior employee was stealing fentyenal. The DEA got involved and even confiscated an ambulance. It was ALS and they didn't get it back for over a month
Interesting to read the different ways narcotics are kept. We keep ours in a drug safe in our store room. At change of shift you've got 8 to 10 paramedics signing drugs in and out! Pretty hectic. They're then kept on the person they're issued to in special pouches (my pouch is marked "Spare gloves").
Nicholas Whitcraft It is tagged, he opened it in the video... Everything in the red pouch is high risk so the pouch being tagged is plenty. There is plenty of paperwork done for all meds given. Y’all playing checkers and we’re playing chess.
So interesting! A progressive system like yours with roc, propofol, RSI, etc and no cardizem? It's been a first line a-fib drug for a long time. Very surprising, but thank you for sharing this. Reminds me how stone age the system I am currently in is!
You have it a lot better than us in Michigan. We don’t care carry a few of those. Lucky dogs!
Hey prepmedic, I had listened to a talk given on IO administration that cuationed against the use of the cardiac lidocaine for local anesthetic due to the mixture being slightly different. Maybe the preservative was different from the regular lido the hospital uses for say, wound care. Heard of this?
Are the morphine and valium in pre-filled syringes? And how many bottles of propofol are there?
Ok thanks
@@PrepMedic hey man I'm also working on the ambulance in Iowa, over by Harlan. How would you go about getting some tactical/swat medic experience, as there isn't too much around here.
It varies, depends how the manufacturer wants to send it. Two bottles of prop, which is more than enough for our transport times, even though no one likes to use it.
Have you heard of IV levocarnitine for acute MI? And/or, ascorbate, hydrocortisone, and riboflavin (all IV) for suspected sepsis?
That's a lot of medication to remember. Does it come with experience to remember all those?
-EMT-b student
Somewhat, but you are expected to have your pharm memorized in paramedic school.
You work with it o ER and over and read the protocols until you have it down.
Nooooo absolutely not. They’re not gonna put you on an ambulance if you don’t know every medication you can give and what they do.
Are those all of the meds ems has to memorize
Most of them. You will probably need to learn a couple others in paramedic school.
My dude i hope you'll never have to pick up a pharmacology book
Do you not carry a green whistle? (Penthrox)
for research purposes...where do you keep that transfer bag at on your rig??
Found your video while viewing various med kit bags. When you broke into the propofal side of the transfer bag, what are those four red items under where you are holding the Diprivan? Thanks for the video.
they are glass ampule holders, with elastic on them. made by statpacks
i want to be a paramedic
Me too. Going to school to become one right now!
Good luck! I did it for 10 years
Ok
Thank you for this video!! 😁Very informative.
I was wondering…some fire dept ambulances do not carry epinephrine because they “aren’t allowed to.” Do you know why that was decided? 🤔
@PrepMedic is anything in a lock box or locked at all?
I know this may be a dumb question, but can people who don't necessarily want to become medics/ENTs take your level of training and have access to your medications and other life saving stuff? For example while I don't want to become a medic I'd like the level of training, the medications, etc.. so if I come across someone who needs help I can give it to them as well as say a SHTF scenario I have what's necessary to sustain life.
I probably can’t speak for every state but generally speaking, the medications are only on your person when your on duty so you wouldn’t have any of these in your personal vehicle. Especially controlled narcotics like fentanyl; those are usually kept double locked and picked up from the hospital before a shift and dropped off after a shift if unused. If you’re looking to be a help, spontaneously, like say at an accident, you’d probably manage with just BLS training as an EMT; knowing how to triage, take demographics, maybe even control bleeding.
@@peterwc101 Alrighty, I figured something like that, just figured I'd ask so I could get advice on how best to help. THanks for the reply and I will definetly keep what you said in mind and once I can get that training. :) I asked, because I do wanna help people, but I think in the world where I would be best to help wouldn't be an EMT, but have as much life saving training as possible. I feel "destined" for other things if that makes since, but again wanna have as much life saving training, gear, etc.. as possible. Again thanks for reply and knowledge you gave.
I love your vids, greetings from Germany :3
With that many “drip” meds and long transports, do you carry an infusion pump on your ambulance?
I wish i had ur pelican case in jersey, but we don't. all our meds are are stored in different containers and not as organized.
Damn. Thats a lot a medic needs to memorize… all the indications, contraindications, side effects, doses, etc. how long does it take to know that by heart?
I don't know what most of the meds are but still watching!
Hey your scope looks good, have you noticed an increase in your hourly remuneration amount as your scope of practice grows? and i not why do you think EMS gets takin advantage of?
Very nice. I'm always surprised about the amount of cardiac drugs that a carried in the states like diltiazem etc etc.
Here in the UK, for years, we used to carry tenecteplase and heparin for STEMIs but now go direct to cath labs (however critical care paramedics still carry it for special circumstances such as Cardiac arrest caused by suspected PE, had some good outcomes albeit rare).
I'd like to see ketamine (analgesic dose) as a standard drug for ALL paramedics here in the uk- at the mo it's critical care/Hazardous Area Response paramedics/HEMS. Non specialist paramedics are restricted to morphine/IV Paracetamol only. Would.also.like to see fentanyl but our dept of health is notoriously slow at changing anything.
Paramedics carry, amongst other things, IV/IM/IO antibiotics for meningococcal septicemia, IV Paracetamol, IV TXA for trauma and IV co-amoxiclav for open fractures. In critical care we have rocuronium, phenytoin infusion, hypertonic saline, Mag sulfate, ketamine, calcium, midazolam etc. Primary care we carry a variety of oral antibiotics, analgesia, can suture and glue wounds - primary focus is to avoid unnecessary hospital admissions by assessing via the medical model and treating more in the home. Saves a fortune in the long run. In primary care if a patient needs admission but not via A&E or ER we can admit directly to either the medical DRs, via the surgeons or orthopaedics etc.
Plus ultrasound......is that a thing in the US for rehospital care?
If anyone in a family is a diabetic EVERY home FAK and the diabetics IFAK should include Glucose Jell and other sources of sugar for emergency use. Additionally both kits should include a Blood Glucose (BG) Test Kit. If the diabetic is a young kid the parent and older siblings need these items in their own IFAK
Signed A Type 2 Diabetic for 15+ yrs
How come on the pelican case all the fentanyl and ketamine was tagged but in the long distance bag it was not?
Best autofocus camera i seen
i am now just learning that you're in the same location as I am and I'm actually really hyped about it LOL
I am so sorry but I actually moved to Colorado 😬
That’s pretty slick, you guys must have a wide scope. Right on.
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
Things are a bit different here in South Africa , Our system is a mess.
However we have Standard fixed guidelines and drugs to different levels of care, no exception. We also Have diffrent Paramedic qualifications , As well as Shorter courses similar to EMT but we have a bigger drug allowance as I have found.
To Give a brief example of the levels of care. Shorter courses: BAA (Basic), AEA (Intermediate), CCA (Advanced), ECA (New and Unclear) these are all normal certificates. ACLS and ITLS and PALS are also presented to these qualifications except BAA. But even the new skills and drugs can't be incorporated so it sucks.
Then Diploma and Degree courses: ECT (Diploma), NDIP(National Diploma) , DIP(New Diploma) , ECP (Degree) these are All advanced Life support. All of these are Registered as Paramedics with our Health Profession Council. Except ECT.
And the drugs for these are Numerous and Limited to each , no matter what Province or as you'd say "state".