cross-posted from: https://lemm.ee/post/60439802

A video, discovered on the cellphone of a paramedic who was found along with 14 other aid workers in a mass grave in Gaza in late March, shows that the ambulances and fire truck that they were traveling in were clearly marked and had their emergency signal lights on when Israeli troops hit them with a barrage of gunfire.

I'm just wrapping up my last shift in fifteen years on the job. What I'm about to say is coming from the perspective of someone who operated almost entirely within private ems. I've moved on outside the healthcare sector completely because:

• Medics in decades two and three of experience get their asses kicked just as hard as medics in decade zero of experience. I've seen too many medics that were in their fifties and just miserable because the job never really gets any easier. If you get injured such that the doctor tells you you can't do the work anymore, there's precious little else you can pivot to; seems like you usually either get a TYFYS on the way out the door or everyone collectively turns a blind eye to the fact that you really shouldn't still be on the ambulance.
• It feels like there are few options for naturally growing your career in EMS with your experience. In law enforcement, fire, and healthcare, there are more opportunities to naturally pivot out of the front lines

My local EMSA has approved IV Tylenol for pre hospital pain management in trauma patients. Supposedly, studies show that there's little clinical difference in the efficacy of acetaminophen and opioids in acute pain management. I've attempted to find this alleged research, and the link above is what I found. I can't quote it exactly because I'm on mobile and it's being weird, but the relevant section is towards the end and compares the efficacy of IV Tylenol to IV opiates. It leads with saying that the relevant evidence is considered low quality before indicating that (this is a VERY rough summary) IV tylenol seems to have a very similar though slightly less effective/durable analgesic effect. I recommend you read it for yourself. The study also doesn't seem to be limited to trauma patients, and seems to make no distinction between visceral and somatic pain, both things I was hoping to see.

Overall, I can see the benefits: it's cheaper, not addictive, less strictly regulated, doesn't a

EMS Expo 2024 is taking place in Las Vegas, September 9-13th.

I haven't been to an EMS Expo since 2010, and that one was pretty okay. Has anyone been recently / planning to go? Is it any good?

So, I wanted to have a level-headed discussion about this case. I've been loosely following it since it happened, and I'm curious to see what others think of it, perhaps hear from folks who followed it more closely.

For those out of the loop, here's the JEMS article on it: https://www.jems.com/patient-care/two-co-paramedics-found-guilty-in-death-of-elijah-mcclain/

The tl;Dr is this: Aurora fire medics are dispatched to assist Aurora PD with a combative patient they believe is in an altered mental state. Aurora FD EMS crews identify this patient as qualifying for their excited delirium protocol based on PD and patient presentation, and administer the maximum dose of ketamine allowed under their weight-based dosing (which was well over what Elijah weighed). Now, there's other details (this IS a tldr), but after the ketamine, the patient goes into respiratory and cardiac arrest and is eventually declared. The paramedics involved were found guilty of negligent homicide. The FD has stood

I was wondering how many of you have experience using pre-hospital ultrasound. I've heard for a long time that it's the "next big thing", and I can see it for rural systems or maybe even community paramedicine, but I've not seen much in the way of it actually getting adopted. Do you find it to be a meaningfully useful addition to your skillset and protocols? If you were around when it was introduced, how do you feel about the introduction? What were some lessons learned by you or the system along the way?

Visited this icon the other day. An off duty FF was leaving shift and noticed we were taking photos. He made sure the on duty crew let us in for a tour. They're very used to visitors and have it all set up for guests.

Army medic '86-'93. BLS: '89-'00, ALS: '00-Current with NREMT.

During Army drills in Germany & Belgium I transported one patient in Belgium and 2 in Germany. Then in 2017, I was friendly with a Medic in Hammerfest, Norway and rode 3rd on their rig. That gives me 3 foreign countries of ambulance transport.

I've worked EMS in MA, RI, NH, FL with total state transports of 11 states.

I am still NRP, but, currently running "Uber" ambulance at BLS level (At Medic pay due to credential level). Woot!

I love & respect everyone that's still hustling the streets.

I wonder if I can keep it up doing the easy work for 13 more years. Giving me a grand total of 50 years on an ambulance.

Lift smart, protect your back! I strongly suggest good massage therapy!

One thing I've recently seen be a point of contention is whether it's appropriate to disrupt sleep hours of 24 hour units for non-urgent transfers. That is, should 24 hour units have a time in which they're protected from being sent on non-urgent transfers? When this came up in the past, the consensus of "no" seemed to be coming from people whose systems weren't mixed 911/transfer systems and didn't do 24s. On the other hand, most of my 13 years in EMS has been with mixed-service 24 hour systems, one system of which was also a system-status deployment model (yes, I know that system status and 24 hour shifts are supposed to be mutually exclusive, but that fact never bothered company leadership). So, suffice it to say, I've had my fair share of riding 2 hours at 0300 on 30 hours without sleep for what could be an outpatient consult or because the local ED doc really wanted some other doc to take the liability for the discharge. A small company that I work for (mixed service, consecutive

Coming to you live from San Diego

Everyone's got a favorite "war story" to bust out when it's story time. What's your go-to?

One of mine is the time I picked up some dude who slammed a brand new bottle of hydrocodone to try and keep from going to jail. They'd just picked up the bottle when he popped the lid off and just downed the whole thing in front of his family, who (rightly) freaked out and drove straight to the nearest fire station. By the time we got there, dude was on the dark side of the moon. We get the story, do an initial, take over bagging, drop 2 of narcan in his nose, load and go. I know this guy, he's going to be a jerk about it, and I don't to allow him the lattitude that he'll have at the scene. So, five minutes pass, IV's in, re-assess to find no change. Shocker. I dump another 2 in the line. Nothing. Well, shit. Re-assess to make sure I didn't miss anything, and opiates are still the best explanation. tl;dr we have a long transport time, so I end up making base contact a couple of times and fina

Those of you who left EMS, what are you doing now, and are you happy about your choices?

I left full time paramedicine after 12 years. I've been in software development for a little over a year now, and I still do some part time for shits and giggles. I don't regret my choice, especially seeing how hard the full time folks at my company get ran. It's fun to do this job again now that I'm not dependent on it for finances. I will say, though, programmer stories make a much smaller impact with friends and family.