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.
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.
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. 👍
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
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!
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.
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.
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.
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.
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.
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!!!
#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.
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
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.
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!
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
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.
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.
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
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 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.
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’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
@PrepMedic, I'm really new to the channel and I personally love your stuff and I would wish to learn more of the things you do. Which is why I ask, how can you find out in a effective way of what these meds are for? And when and what these medications are, because I only got about a quarter of what these medications are.
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!
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
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.
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 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.
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? 🤔
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.
Great videos! Thanks! I wonder if you could advise me on the following: I am about to be taking off on a 1+ yr sailing trip on a sailboat that will probably include at least 1 month off the coast of Southern Newfoundland where there is very sparse population and even more sparse medial facilities, as well as a transatlantic crossing of roughly 3.5 weeks. I did animal surgery (mostly rodents) many years ago, and have had advanced emergency medical training (both as a Girl Scout leader and more recently). I am planning on taking a refresher course and would love to extend that training if I could. However, I'm also in charge of the first aid kid and need your guidance. What medications should I carry in our medial kit? And what other equipment would be useful (e.g., bandages, stethoscope, ,tourniquet, etc)? I want to make sure I am prepared - but not carrying anything that could be harmful in unskilled hands. Thanks so much!
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?
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.
Well done. I love the idea you are goi g to start using Ketamine for pain control. It's a drug that I gave a nickname to..... it's called .... perfect forgiveness!!!!! Because if you have a 10 year old male that comes into the emergency department with a supracondylar humerus fracture (foosh injury) you can give them Ketamine..... reduce the fracture and when the
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 😬
Must be a pretty Quiet day for you to be able to film :P out of curiosity which meds are standing orders and which do you have to contact med control for?
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?
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.
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
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.
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
That red bag is a gold mine
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
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. 👍
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.
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
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
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!
I would love to see a video explaining what every medication is for. Just like a refresher. That would be superb!!!
Thanks for all you guys do. Y'all are heros.
You carry what a CCT nurse carries here in Nevada!!! your medical director is awesome
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.
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.
You guys are awesome !
We Americans are blessed to have such level of care readily available to us practically everywhere anytime, day or night.
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 like the sealed boxes for the narcs, this makes handing over and replacement very time saving
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.
Informative video and GREAT Q&A!
It’s so beautifully organized! I wish everyone’s med bags were designed like that.
You channel is helping me learn so much thank you!
I just went through ACLS in my medic course, I was going through algorithms as you read off the medications!
Very informative video. You explained what they were for better then some doctors do. .
Awesome video with great information. Thank you for that!
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...
Love your videos! (From a French prehosp EMS)
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?
Subscribed. Glad I found your channel!
Really interesting to see how other countries work! Thanks for the 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.
Hey thanks. This is good knowledge. I subbed and liked. Keep em coming. Be safe, God Bless.
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 am 10 years old and I love your channel you are so awesome
My scrotum is 21 years old
#4 gonna start sharing some of these.. great Vid
#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.
Great Video. Clear and to the point.
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 the video! I think doing profiles on a the meds would be really beneficial t us all! Thanks!
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 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!
So interesting hearing about the protocols in different EMS systems! Medics push ketamine for pain management all the time here.
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
Very useful information. I apply some of this knowledge to when I instruct battle first aid at my squadron
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.
Cedar Rapids Iowa here, great video
I love your vids, greetings from Germany :3
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.
You are awesome best wishes from iraq
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
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.
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
You have it a lot better than us in Michigan. We don’t care carry a few of those. Lucky dogs!
Great video Thank you.
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.
Great and awesome video really loved it thanks for taking the time to show us this how long how you been a emt
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’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
Wow, your intro is *intense*
What camera do you use? The autofocus is ridiculously good!!
@PrepMedic, I'm really new to the channel and I personally love your stuff and I would wish to learn more of the things you do. Which is why I ask, how can you find out in a effective way of what these meds are for? And when and what these medications are, because I only got about a quarter of what these medications are.
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!
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 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 😬
I Carried Drugs Like this when I Was a Paramedic for the City of Portland Maine Medical Crisis Unit!!!
Are you guys using mag sulfate for resp, associated with copd? Also, are you using Levophed for sepsis?
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
Hey man I’m a fresh EMT and I’m looking to learn as much as possible so thanks man. Stay safe brother
Best autofocus camera i seen
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
That's awsome you guys have true RSI
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.
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
Really awesome video bud, you make me excited for P school lol
@@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.
This is great!!
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? 🤔
My Uncle who is an firefighter paramedic mentioned something about having carried Demerol in the med box, Did it get replaced?
Another fellow Iowan, you should see the things the paramedics have to go through in Ottumwa, IA.
Nice simple fast overview
Thanks for video!
Heros and life savers !
for research purposes...where do you keep that transfer bag at on your rig??
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.
Great videos! Thanks! I wonder if you could advise me on the following: I am about to be taking off on a 1+ yr sailing trip on a sailboat that will probably include at least 1 month off the coast of Southern Newfoundland where there is very sparse population and even more sparse medial facilities, as well as a transatlantic crossing of roughly 3.5 weeks. I did animal surgery (mostly rodents) many years ago, and have had advanced emergency medical training (both as a Girl Scout leader and more recently). I am planning on taking a refresher course and would love to extend that training if I could. However, I'm also in charge of the first aid kid and need your guidance. What medications should I carry in our medial kit? And what other equipment would be useful (e.g., bandages, stethoscope, ,tourniquet, etc)? I want to make sure I am prepared - but not carrying anything that could be harmful in unskilled hands. Thanks so much!
Hey Susan, shoot me an email at prepmedic@yahoo.com and I can see what I can do.
i was fully expecting him to get called out during his intro
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?
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?
Well done. I love the idea you are goi g to start using Ketamine for pain control. It's a drug that I gave a nickname to..... it's called .... perfect forgiveness!!!!! Because if you have a 10 year old male that comes into the emergency department with a supracondylar humerus fracture (foosh injury) you can give them Ketamine..... reduce the fracture and when the
Where did you get those clear cases in the pelican case?
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 😬
Do you carry the green whistle (Methoxyflurane)
Im in love with him XO
With that many “drip” meds and long transports, do you carry an infusion pump on your ambulance?
Must be a pretty Quiet day for you to be able to film :P
out of curiosity which meds are standing orders and which do you have to contact med control for?
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?
Have you heard of IV levocarnitine for acute MI? And/or, ascorbate, hydrocortisone, and riboflavin (all IV) for suspected sepsis?
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
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
Do you need to apply ketamin in addition with midazolam in your protocols?
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".