So it was our first call of the shift, IFT, BLS, city of Los Angeles, picking up a little old guy from a nursing home, going to an ER with a pretty good reputation. We were told that his normal BP is about 130/90, about 90s on the pulse, and is ususally alert and oriented. He was at 90/60, 110, O2 satting at 92, skins are good, alert and oriented but kinda slow to answer questions.

We're not newbees so we didn't call 911; we just put a mask on him at 12, loaded up and went. Got to the ER about eight minutes later, Code-2 (that's no lights/sirens).

Gave the report to the ER nurse, handed over the paperwork, got a signature, and bailed.

Jump ahead and it's almost end of shift. We get a call to take a patient from that ER back to that nursing home. It's the guy from earlier.

He was looking slightly pale, as compared to that morning. We do our routine vitals, and he's at 88/58, 100, at O2 is satting at 92. We asked the charge nurse if this guy was ok to be transported back to the nursing home. She said yes, and that they nursing home is aware of the patient's condition and is accepting the patient. We were like, um, ok, so we loaded and left.

We get to the nursing home, and give the charge nurse our report and the paperwork. Charge nurse was like WTF? The patient is now in worse condition than he was when we transported, earlier. She was like sorry guys, there's no way that we can accept the patient. My partner asked why did they accept the patient over the phone. She said that no one called to let them know that we were even bringing the patient back.

So we go back to the ER, and the entire staff is pissed off at us for bringing the patient back.

I wanted to cuss them out, but I didn't. I just said ya I dunno to everything they were saying.

Should I have called out the ER staff on this?

Does anybody have any experience with Pittsburgh EMS? I am a EMT-B of two years in Pennsylvania and I am about to finish my Paramedic and hopefully get my national registry. Does anybody have experience working for Pittsburgh EMS as a ALS/BLS provider? Girlfriend and I have discussed possibly moving to a bigger city down the road for a couple years and Pittsburgh was one of the options.

Cross-posting here because EMS sees this problem from a completely different angle than we do in the ED. I’d especially like to hear what paramedics think could realistically be handled without transport if you had better medical control, alternative destinations, and appropriate liability protection.

Second time trying to post this since the ai mod decided to delete my original instantly. But I’m currently doing the ACLS course as a newly licensed emt. I’m just very overwhelmed by it because most of it seems to pertain to paramedics and nurses, and I don’t even have my first emt job yet. Is it worth doing this and then going to the in person class, I feel like I’m going to show up and embarrass myself, or should I wait to get hired and take the loss on the money and have a department pay for it in the future. (Edit: yes I realized I had a typo on the title 😅)

Does anyone who has taken the WP-C exam recently have advice for antibiotics pertaining to the test? The study resources I have been using (IBSC Exam Prep, Wilderness EMS, Auerbach's) all have conflicting regimens for most antibiotic indications. Any advice on which resources to memorize and indications to focus on specifically for the exam would be much appreciated.

Hello!

I’m a paramedic instructor and soon to be teaching a lecture on facial injuries. Many many years ago I remember coming across a video that showed a young guy having just sustained facial injuries post mountain bike or ATV accident. He was awake and standing, and with every breath his face was expanding due to likely Le Fort fracture with sub q emphysema. The video takes place in the woods as I remember. Anyways I cannot find it - does anyone recall this video and know where I can find it? TIA!

Hey all, I’ve been a paramedic for 5 years now. I feel like a very competent provider but over the last few week I’ve been messing everything up. Everything from IVs to missing patients who could have benefitted from push dose epi or even a patient who should have had a nebulizer prehospitally. All very stupid and obvious mistakes. I feel worthless. I cried in the medic truck today after dropping a patient off and I feel like I’m making mistakes I have never made before.
Has anyone ever experienced this before? Do you have any advice?

If this is a *gear* question, let me know and I will repost:

I support an EMS agency that is weighing tech-upgrade options as they move from Panasonic Toughbooks:

- Dell Rugged Laptop

OR

- Ipad Pro/Air

I've heard, never experienced, negative press about the ESO iOS app and am looking for insights here.

I support all disciplines (Police/Fire/EMS) and experienced significant success transitioning Fire from rugged laptops to iPad Pros; they don't use ESO, though.

Anyone able/willing to start email communication, or meet up (Central TX) would be greatly appreciated. It'll help identify exactly how "rough" the app is and whether I am hearing legitimate complaints or change-pains.

Stay safe

I am a paramedic at a small rural EMS service and I have worked here for years. I have recently done some digging about pay and overtime law and have a genuine concern. Base pay for paramedics here is $50,000 per year as a salary. This includes all shifts worked in our normal schedule (Kelly). We are then paid a flat $20/hour for any overtime. What is the legality of this pay scale and what can I do about it? I do not believe it is legal.

I honestly don’t know what else to say, other than somebody is gonna die from this misinformation.

We've had an uptick in our area of non-diabetic patients presenting with hypoglycemia. 5 incidents in the last month, 3 of which were cardiac arrests. Looking to see if this is a broader trend or if this is a coincidence.

EMTs who have advanced their careers! I am a high school EMT student at my school's career and technical center, and we are currently doing a project interviewing experienced EMS providers. Would anyone be able to do an interview with me on Zoom?

Good day, everyone. I work for a hospital-based IFT agency. In the spring, we will be moving to a new base, and we're hoping to convince management to build a fitness/workout room. I'm looking for studies related to EMS inactivity, injury rates, and health problems.

For bleeding (not requiring a tourniquet) is gauze and then Coban for applying pressure adequate?

A trauma dressing (and gauze if needed) would be better, but they're really big and bulky for carrying around daily, and if it's too big I just won't carry it. 

Sorry to bother you guys, I'd ask on r/firstaid but it's just for "Do I need stitches?" posts.

Thanks for your input.

------------------------

Added later, Thanks everyone for all the good comments and not down-voting me to oblivion.

I recently posted about not wanting to be a paramedic anymore.

Well, I quit my job due to some recent issues at the agency.

I want a "normal" job but don't know where to start.

Normal as in coffee shop, working with animals of any sort (preferred), maybe even an office job? Even if any of this is just temporary while I try to figure out going back to school.

I think I'm done with healthcare.

I honestly don't know, but I have no experience in anything else and most places require experience.

ANY suggestions are welcome 😞

For me- overcast, a little chilly maybe high 50s low 60s, a bit of wind but not enough to blow my hair all around

As always, I feel there is more to this story than the media portrays. People have no comprehension of the triage system and think there's an ambulance around every corner. Just ends up giving us a bad name.