EMT/Paramedic thread?

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>>34671690
Here have a (you) anon.

>>34671690
unofficial "medfag". have a strong interest in medicine and healthcare but am a neet. I have a wealth of knowledge but no formal education except a background in chemistry which helps a little bit with pharmacokinetics and some biology.

I can use all the supplies in a US Marine's medical kit and have most of the supplies myself in one form or another. More hemostatic agents/adjuncts and an occlusive dressing are on my list.

I have a genuine interest in medicine so I find it fascinating but if you force yourself to like it you won't in the end. If you're thinking about becoming an EMT then best of luck, you'll have to work hard for little pay and the opportunity to become a paramedic or a nurse / PA eventually, but it's worth it to people like me.

>>34671749
Neat shit anon, thanks.

>>34671884
Actually, why is it such a bad idea to allow a victim with a stomach wound to drink?

>>34671837
Yeah, I figured EMT, would be a good way to gauge my aptitude and see if I wanted to advance to PA or something.

>>34671893
Because adding fluids and stimulating the stomach to produce more fluids (ie: stomach acid) when you have a hole that's probably draining into their abdominal cavity is bad.

If you're in a situation where dehydration becomes a serious concern before you can get to definitive medical care, your best course of action is going to be to hydrate through alternative means.
This means, an IV if you know how to run one, or in the pooper if you don't.
Rectal rehydration is much harder to fuck up than IV rehydration, and doesn't need everything to be sterile, since you're literally shoving it up their ass anyway - useful skill for wilderness first aid.
> http://www.realfirstaid.co.uk/rectal/

Don't go fucking around with IVs unless you really know what you're doing.

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Any med-informed Anon willing to inform how to deal with nasty wounds, like bullet wounds, in a total SHTF situation?

I got basic first-aid training, watched several training videos on field medicine, but just about every single set of instructions seems to end with "Get patient to hospital, ASAP".
What do you do if that is literally not an option? Just keep the wounds clean, the guy on pain killers, and hope for the best? Bullet to the head?

>>34673211
Give a specific scenario and I'll tell you what might happen.

>>34673353
I'm really mostly interested in two likely situations:
A ballistic projectile (bullet or fragment) to the torso and limbs, while living and operating in a complete "innawoods" scenario; with access only to typical, personal first-aid equipment, and some "real" medicine + raw nature's cure stuff of the area.

I'm well aware that a shot in the guts out in the sticks may just as well be considered a one-way ticket with very little you can do, but would it really be that pessimistic situation?

>>34673393
>to the torso
Pretty dead, man.
>limbs
Tourniquet or pressure bandage, then drag him to a real doctor. Your job is not to heal, you cannot heal. Only real doctors that studied this shit for more than seven years or so can even attempt to heal. You're nothing but a life preserver, like those floatation rings on a ship, to keep the guy alive for long enough to get real medical attention. Tie the holes off so he doesn't bleed to death immediately, then get him to a doc.
Alao, do not pull anything out, do not stuff anything back in and do not cut anything off. NOTHING. You're not qualified.

>>34671690
The reality of it is you'll mostly be dealing with old people with nasty ass infections (literally, the first call I ever went on was an 80 year old lady with an ass infection that decided we needed to see it), filthy homeless people, and heroin junkies. There will be very little saving drowning children from pools. I mean the old people part, that should be obvious that you'll have to deal with that, but I was surprised about the amount of bums I had to deal with even in a decent area. These homeless drug addicts are such a burden on our society it's ridiculous.

Anyway I quit after several MRSA scares and bringing bed bugs back home twice.

>>34673596
>then drag him to a real doctor.
that's exactly the dilemma I've been trying to address: what if there is no doctors? What if there are no hospitals? What if I'm a motherfucking POW and need to try to save someones life from a bleeding and potentially infected wounds? What if I'm the one that's fucked, and there is no one around to do anything about it?

So far, it seems like the general consensus is just "Tough luck. Swallow some 9mm painkillers."

>>34671690
This board used to have EMT threads almost every night. Some really fucked up stories

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>>34673717
Yes, of course. If there are no doctors you are fucked.

Have you never seen ballistic gel tests? Do you see those massive fucking wound channels? Newsflash: in your chest or stomach, there is no nondescript "meat" that can be pushed around. It's all a solid wall of organs, all of them more or less absolutely vital to your survival. Getting shot into the torso is utter doom unless high skill and low response time medical attention can be brought to bear.

Wounds on your limbs can be (barely) dealt with in the field (temporarily) unless they go straight through a major artery (good luck with broken bones you faggot) but it is, again, a matter for trained professionals. Maybe not a real doctor necessarily, but at least a more advanced stage of EMT or field medic, all of which you need a tradesmanship or equivalent for.

You are not fucking qualified.

>this was your scheduled reality check, now proceeding to memery and pipe dream crushing

SHTF is a scenrio so weakly defined that it means nothing. Assuming realistic levels of SHTF, such as Hurricane Katrina, dragging the ass of your buddy that got shot across the flooded city to the nearest hospital is still the best bet you have for saving his life.
If you're a POW, it is presupposed that you used to be a soldier once. Soldiers get training for these situations. Stop talking bullshit and get real.

>ew field of work, and I'd like something that would also confer a SHTF type of skill.

I hate people like you. You're just as bad as Ricky Rescues and Hero Complex asshats. Go back to your paranoid prepping bunker.

Letting fuckers like you into this line of work is part of the problem preventing us from advancing as a medical profession.

>>34673765
Yes, I have served, seen gel tests (they don't exactly represent IRL flesh and bone to the T), and been interested in biology and medical shit since I was a kid. None of this exactly surprises me, but what does boggle me is that the hospital/doctor is always the last necessary step.

My most likely SHTF would be a complete occupation of my nation by an external armed forces, and/or total collapse of the society.

And no, being a soldier and now part in reserves does not prepare for this shit at all, unless you've worked as a literal Medic. Our instructions were pretty much the same as all these near-copypasted replies: patch that bleeding up quick and tight, elevate wounded part, keep victim warm, ship his arse to the hospital.

tl;dr: I was retarded only to expect any better answers from 4chan of all places.

>>34673806
>I was retarded only to expect any better answers from 4chan of all places.

What better answers were you hoping for? You got the truth.

>>34673806
>tl;dr: I was retarded only to expect any better answers from 4chan of all places.
There is no better answer. Without professional training, that is the best answer, because otherwise you are dabbling in stuff you may very easily make worse by fucking with it. If you want to know more, go pay money to get advanced medic qualifications. This shit isn't to be messed with my memelord amateurs.
>My most likely SHTF would be a complete occupation of my nation by an external armed forces, and/or total collapse of the society.
You're a fucking American aren't you? By the time literally any nation in the world can do that you'll be eighty years old and all the help you'll need is for getting in and out of your wheelchair.

>>34673824
>otherwise you are dabbling in stuff you may very easily make worse by fucking with it
When the alternative is painful death, I doubt I could make things much worse.
It is my honest opinion that knowing at least something about various things is better than being totally oblivious. And so far, it seems like there is simply lack of deeper understanding on what those "more advanced" stuff the "pros" even are.

>you're a fucking amercian aren't you
Nope.

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>>34673853
>If you want to know more, go pay money to get advanced medic qualifications. This shit isn't to be messed with my memelord amateurs.

>>34673865
So information that can literally save people's lives can only be acquired by shelling out lots of cash?
Wew, that's some scary HC capitalism right there.

>>34673886
More like anything that doesn't come with a certificate of you not being some sort of butcher shop retard enthusiast who gets off on sticking needles into people should come with immediate and swift punishment.

You do not have the fucking qualifications. These are human lives we're talking about, not guinea pigs. Treat them with some god damn respect.

>>34673853
Not him, but what do you expect? Patch the wound up, hydrate, look for a doctor and hope for the best/pray.
Give some random antibiotics to the casualty in a SHTF scenario? Now his intestinal flora is fucked up, and he shits himself to death.
Honey/herbal/powder wraps? Meme-tier bullshit, that will do more harm than good.
Dig around in the wound channel to take something out? Great you just pulled the plug and he's bleeding to death.

Honestly, go do a training course, if it's so important to you cough up the money/time.

>>34671690
become a RN. wish i would have instead. or just go for a MD. unless you're a white male. then you won't get in

>>34673898
You're starting to sound like a broken record here.
I'm talking about a highly theoretical situation where everything has gone to hell, nearest human settlement is maybe hundreds of klicks away, and you gotta make do with what you got or die trying. And obviously I'd avoid the dying part.

>>34673904
And what odds do I have on hearing anything new on those courses? Jeez, you fags are a bunch of unimaginative pricks. It's not I'm planning to get shot or poked into guts or kidnapping some poor bastard who has; I simply would like to know how to deal with the absolute worst case scenario.

>>34673211
You're pretty much fucked. Without a cohesive support network to address Trauma you're falling back on 18th / 19th century care techniques; and all the 21st century knowledge won't make up for the lack of proper facilities.

Your best option is to see a collapse event coming, have a plan and act on it; and get the hell out of everyone else's way. Stay out of sight, don't make yourself a target.

To be blunt, youtube videos and advice from 4chan are pisspoor substitutes for the textbook knowledge and clinical experience. You'll learn some of "how to recognize a thing" and "how to treat a specific thing" but you'll miss out on a lot of "how to correctly identify things and why we treat them this way."

>>34673393
>A ballistic projectile (bullet or fragment) to the torso and limbs, while living and operating in a complete "innawoods" scenario; with access only to typical, personal first-aid equipment, and some "real" medicine + raw nature's cure stuff of the area.
>I'm well aware that a shot in the guts out in the sticks may just as well be considered a one-way ticket with very little you can do, but would it really be that pessimistic situation?

You play too many video games. There's no homeopathic bark and herbs that will save you from a GSW in the backcountry.

>>34673596
This guy gets it.
>Only real doctors that studied this shit for more than seven years or so can even attempt to heal.
Some argue that even then, all a physician does is put the body in a position to heal on it's own.

>>34673717
>what if there is no doctors? What if there are no hospitals? What if I'm a motherfucking POW and need to try to save someone's life from a bleeding and potentially infected wounds? What if I'm the one that's fucked, and there is no one around to do anything about it?

If there are no doctors then there are no communities. You've got far bigger problems than healthcare access at that point. Same goes for hospitals.

Stopping bleeding is easy: plug the holes. Fixing it long term is near impossible; there isn't any magic video or kit that will give you skills from a movie to remove a bullet and stitch a wound.

As far as infections go; the pathophysiology can be so complex that you need to be very confident in your diagnosis and interventions. Which you as a lay person are not going to be able to do; nor is a paramedic going to be doing. Rest, keep warm, keep hydrated, and pray the body can overcome.

>>34674058
/Thread

Without hospitals and a medical system even the best Paramedics can only delay the patient from dying. As someone who works in EMS i can see some people here have no clue what they are talking about

think of the question like this "what if we sent the Marines to invade some tiny nation but we only sent rifleman. no logistics, no artillery, no intel, no communications etc"

just using EMS skills is just like that, medics and ambulances are the "foot soldiers" of emergency medicine but they are just part of a system that includes the hospital, dispatchers, mechanic who maintains the truck, tech who stocks the truck, Pharmacy that stocks the narcs and stuff etc..

>>34673806
>what does boggle me is that the hospital/doctor is always the last necessary step.

>Our instructions were pretty much the same as all these near-copypasted replies: patch that bleeding up quick and tight, elevate wounded part, keep victim warm, ship his arse to the hospital.

That's what EMS protocols boil down to in near every single case. We are not practitioners of medicine; but certified technicians authorized to act as an extension and at the discretion of a physician.

If your country is occupied; save the docs and set up a safe treatment zone for your resistance's wounded.

>>34673865
As someone who's taken UBMC's CCEMTP course and holds an FPC certification there is no knowledge or skills I have learned from them that are applicable or helpful to what op is describing.

>>34673977
>nearest human settlement is maybe hundreds of klicks away, and you gotta make do with what you got or die trying. And obviously I'd avoid the dying part.
>Klicks

Your fucked. Why are you 100km's away from society? Oh the fanat- theoretical situation thing again.

>>34674126
>Why are you 100km's away from society?
Because that's how my country is kinda laid out by default, and a total war situation would result most of our armed forced operating away from the major population centers, spread across the nation like a net.

And again, you people lack imagination and cannot into straight answers. If you don't know what to do, then why bother replying at all?

>>34673886
>So information that can literally save people's lives can only be acquired by shelling out lots of cash?
The best way to save a life is to not put it in danger in the first place.

Anyways, money is exchanged for goods and services. The level of knowledge you're asking for requires a heavy investment to understand and utilize without causing harm.

>>34673937
Much wider and deep knowledge base, but unless you're going to work in the ED or a high acuity floor then having only a BSN/RN is only marginally more useful. You'll be better equipped to recognize medical problems; but once the support network in gone you'll be in the same boat as the paramedics when it comes to fixing them.
In the meantime you'll get paid a hell of a lot more than I do.

>>34673977
>I'm talking about a highly theoretical situation where everything has gone to hell, nearest human settlement is maybe hundreds of klicks away, and you gotta make do with what you got or die trying. And obviously I'd avoid the dying part.
Game over; thanks for playing. Focus on survival skills and getting back to civilization.

>And what odds do I have on hearing anything new on those courses? Jeez, you fags are a bunch of unimaginative pricks. It's not I'm planning to get shot or poked into guts or kidnapping some poor bastard who has; I simply would like to know how to deal with the absolute worst case scenario.
You're not getting it; pull your head out of your ass and recognize that severe trauma or other life threatening conditions is not possible to treat without access to the healthcare system. Look at pre 20th century medicine; because that's the world you're looking at, but worse.

>>34674151
>And again, you people lack imagination and cannot into straight answers. If you don't know what to do, then why bother replying at all?
You're looking for a magic bullet answer when there isn't one. I'm done dealing with your bullshit.

If anyone has any questions I'll be monitoring this thread for a bit.

>>34674175
>The best way to save a life is to not put it in danger in the first place.
again circling around the question and trying to sound smart. Practically the same as saying that you cannot get into a gun-related incident if you don't have guns.

>severe trauma or other life threatening conditions is not possible to treat without access to the healthcare system
Those systems consist of people who utilize gear and knowledge made by people. It's not some dark voodoo magic that simply cannot be performed outside of these established locations.

>look at pre 20th century medicine
I am well aware how it was.
However, the big difference between pre-modern era and those times is the level of knowledge. We didn't have proper antibiotics, didn't understand radiation... everything was still more or less clouded and even hindered by some level of superstition at worst.

>>34674184
No, I'm not. Just simple dos and don'ts when the apparently crucial last step of the main rules is not available.

>>34674246
dude, just KYS (keep yourself safe.) also KYS. I'd call you functionally retarded, but that'd be an insult to those people with trisomy 21 that are making contributions to society.

>>34674246
>Those systems consist of people who utilize gear and knowledge made by people. It's not some dark voodoo magic that simply cannot be performed outside of these established locations.
No but they are highly complex machines that need maintenance and you need years of training to master even a fraction of the knowledge (which is why modern medicine is highly specialized, it isn't 1 dude operating it's an entire team). So stop being a whiny little pussy and get yourself a proper education and training and stop insulting the people who take their time to give you detailed answers, just because you don't like the truth.

Or live in a little fantasy world with magical fairies in SHTF-scenarios

>>34674290
That's what I plan to do. But sometimes, the trouble comes to you instead. You don't need to own a car to get into a car accident and fucking die.

>>34674342
Just ignore it.

>>34674342
No one has given me detailed answers at all, nor stayed in the topic. All I wanted to know if there's a way to keep a guy alive if doctors are nowhere to be seen and all I got at hand are a basic firstaid kit, some aspirin and a sewing kit. Should I even try to remove projectiles from a friend's ass or just keep him patched up and hydrated.

I appreciate and respect medical professionals, make no mistake; my mother has worked as a nurse and then in some other, tad higher ranking positions, for something like 25 years soon. I know well aware that there is no magical herb that makes ya run & gun like an ADHD CoD kid at the range, and that getting shot may simply render huge parts of your body immobile for all eternity.

>>34674400
>All I wanted to know if there's a way to keep a guy alive if doctors are nowhere to be seen and all I got at hand are a basic firstaid kit, some aspirin and a sewing kit. Should I even try to remove projectiles from a friend's ass or just keep him patched up and hydrated.
This entire thread has been ruined by your autism. Everyone here has told you that there isn't such a way.

The videos you've claimed to watch would have already told you want to do: don't fucking remove an impaled object or bullet; It may be tamponading off further bleeding; and removing it can cause further damage.

Stop the bleeding with pressure; keep him warm and hydrated; and get the fuck to the hospital.

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Just let this thread die at this point. It stands as a monument of fail and bait.

>>34671749
ty

>>34674443
>wanting to know more is autism
k.

Hope you never get stranded in a war-torn city or country side. Would hate to live with a bunch of pessimistic fatalists.

>>34674400
>Should I even try to remove projectiles from a friend's ass or just keep him patched up and hydrated.
I, and other people have answered that question multiple times. Do not try to take out any kind of projectile/foreign body out of any kind of major wound. First priority (besides self-protection) is to stop bleeding. Keep the patient hydrated, elevate the affected extremity and have the patient lie on his back with the legs elevated (shock postition). torso injuries are nigh impossible to treat, keep the patient as comfortable as possible (fetal postion is often the most preferred for stomach injuries). Hope for the body's own regenerational abilities to do the job. Do not give aspirin to a wounded patient (it's a blood thinner). Watch for shock signs (cold sweat, blue lips/pale skin, elevated heart rate, low blood pressure). Iodine is somewhat controversial as a desinfectant, but will do in a pinch.

>>34674482
Thank you very much!

>>34674463
what's autism is your insistence that there is some magical technique to save someone's life if they get shot in the chest 100km from civilization.
If that happens to you in a SHTF scenario,
YOU.
ARE.
FUCKED.
You WILL die, unless you are extremely lucky.
Even if you are a doctor, guess what? Modern medicine requires lots of doctors and very specialized equipment to save someone from a chest wound. One guy can't do jack shit.

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>>34673632
>Anyway I quit after several MRSA scares and bringing bed bugs back home twice.
Hmmm, not liking the sound of that. I'm currently a medical courier($11hr) and I'm going back to school this Fall so I can get a better job, wasn't sure if RN or EMT might be a better route. Appreciate the reply
>>34673775
>SHTF type of skill.
Honestly, I kinda just threw that in there in hopes that the thread wouldn't get deleted. Calm down.
>>34673937
>become a RN. wish i would have instead. or just go for a MD. unless you're a white male. then you won't get in
Thanks man, I think I might go to school to become a PA. I'm going to start writing "Hispanic" on everything from now on.

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>>34673886
>So information that can literally save people's lives can only be acquired by shelling out lots of cash? Wew, that's some scary HC capitalism right there.

There is a difference between information and skills. You could find any info for free on the net or your library. And getting good training in the medical field is buttfucking expensive. CPR dummies, IV's, Lifepaks, stretchers, etc. Go fall on a bayonet, with your statements you've already proven yourself to be a worthless shithead.

>>34674400

Jesus fucking Christ you are stupid. Do not take out projectiles. Do not sew up with unsterile equipment. And beyond that aspirin is a platelet inhibitor. That's why its given to STEMI patients in the field.

Long way from definitive care: Fucked
No antibiotics: Fucked
The only ones going invasive are going to be trauma surgeons. Go get your EMT basic to get a taste of medicine.

>>34671837
If you have a needle decompression kit and no training, you're a idiot. If you use that and someone dies you will have the shit sued out of you, also practicing medicine without a license. Etc etc

>>34673727
I miss those. I have a fascination with medicine, particularly in extreme situations, but not the stomach to pursue it in career

>>34673806
alright you dumbassmotherfuckingretard you're pretty much useless because a doctor/in this case a surgeon, is gonna have to clamp blood vessels which you don't know, avoid puncturing any organs around the area of the gsw, clean it retrieve the projectile and any and all pieces of it without casing additional trauma, the patient is gonna have to be anesthetized so he doesn't twitch and make a bad wound terrible, they have to hydrate him probably transfuse blood to make up for the loss because shock due to blood loss is a thing dumbass. suture, stitch or cauterize the various tissues accordingly and sew everything back up in a way that can be opened and cleaned periodically. there's a million things i'm missing but hopefully this is enough to open your eyes as to how ignorant you really are and why you always will get a "take patient to hospital" in "SHTF" you'll get "take patient to hospital tent" so a competent surgeon can do his thing. Treating a gut wound requires sterile equipment and environment as well as monitored correctly dosed pain meds and antibiotics. There's no "patching up a gut shot" and keep moving albeit slowly.You're out of your fucking mind in a fantasy.

What would some good pieces of equipment to keep in an aid kit be for someone first getting into field aid? Enough to keep someone together until i were to get them to a hospital at least.

>>34671690
EMTfag here, working out of a shithole like Binghamton, NY lets you see a lot of the worst of the worst society has to offer.
Also saw a bloated heroin overdose a few days back, could only say "Finally now they'll stop calling my goddamn department."
Honestly it's interesting work if you're ok with being desensitized to death and decay.

Mind the vomit.

>>34673886
>hurrrrr durrrrrrr I'm retarded

>>34674151
Hey fat fuck fuck face, you ever watch Saving Private Ryan? when kid gets gut shot, what do they do? and they have a mil medic/doc with them. What do they do they make the poor summbitch comfortable and almost Od him on morphine because there's no way he's making it to a hospital tent and there's no way to fix that without that support. It's a game over shot kid, fucking learn to accept reality while you're trying to learn all these skills you're talking about.

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id start by looking up hygene in a medical environment. and then a social environment (harharhar) LARPing with medicine is pretty much the opposite of a porno, its gross, its illligal, and you might die/kill some one who might other wise live.

>>34671749
>>34671894
Everyone should take an EMT class anyway, do it fagit.

Does one pack a bullet wound to the gut? Is the initial treatment to the abdomen the same as an extremity? Pack it and pressure, for both entry and exit?

>>34674400
No motherfucker everyone has told you that there's no possible way to do that. Dp you keep multiple blood bags to transfuse in your fantasy ifak buddy? temp controlled state of the art ifak because this isn't the dark ages? No scrap that no you're talking about having a basic first aid kit "aspirin and sewing kit" hahahaha ask your mom your question and watch her face as she answers.

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>ITT

>>34673886
Commie pinko Hillary shill pls go

If you have a limb that's bleeding like crazy and pressure isn't stopping it, do you tourniquet first and then pack the wound, or pack the wound and then tourniquet?

I'm a certified EMT in the state of Indiana. Took 6 months to get certified. Got a better paying job at the hospital so haven't taken up any EMT jobs yet. The pay is horseshit and the hours are long. Also, it's difficult getting hired as 911 in the beginning. 911 is where all the action is. Most company's prefer you do non-emergency transport beforehand, preferably up to a year in experience. Of course you can go straight to medic school after EMT school, but it isn't recommended. Paramedic school generally runs 18 months, with rigorous on site training.

It is fun though

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>>34678756
>>34677955

If it spurts, TQ immediately. Thats an arterial bleed. If it oozes/flows then its venous and you put a trauma bandage on it. Packing comes into play when its penetrating wound profile gunshot, stab, etc. And even then youre still gonna put a trauma (Izzy, H&H, or Oales) bandage over the top of the packing. Packing is also only done on extremity wounds, NEVER ON THE TORSO OR CHEST.

>>34677608

>Also saw a bloated heroin overdose a few days back, could only say "Finally now they'll stop calling my goddamn department."

LOL, I narcanned a junky a couple months back and he shit himself while trying to punch me. Had to go IM on it which sucked because you can't titrate it properly. IN: no go because his nostrils were caked with blood mud and mucus. IV: no go, and I tried even going as small as 22 ga. but he had more tracks than Union Pacific. I wanted to IO the bastard but couldn't get permission. So IM it was. 1mg nothing, 2mg nothing, 3mg and he's up and shitting and swinging. At that point it was "PRIORITY 1 NOW GET HIM OFF MY FUCKING BOX!". We took him to the hospital he was discharged from 24 hours prior. He even had the 12 lead stickies from that stay when we initially found him. Good fucking riddance.

>>34678756
Arterial bleed? TQ high and tight asap. Venous? If it doesn't look like direct pressure will stop it; TQ high and tight ASAP. Then make it look pretty. Of course; that only works on extremities.

tamponade hard with direct pressure and occlusive dressings for injuries to the trunk.

>>34674116
Fellow CCEMTP here (July 2010), who walked away from FP-C prep to become one of the first community paramedics in my state (with a broadly similar scope of practice), and you're 100% on the money.

Even being at the far, bleeding, controversial edge of what a paramedic is, could be, and might be allowed to do on my own, my scope of practice and ability to actually, comprehensively heal people was only on par with your average walk-in urgent care clinic.

Even in the critical care flight services, there's a reason why the pilot gets paid as much as the RN and the medic combined, as the helicopter and the speed it offers is the only part of the flight team that's actually making any difference whatsoever in patient outcomes.

>>34678756
Torniquet. Hemostatic gauze and pressure stops most extremity bleeding. Don't be afraid to use a tourniquet though, it isn't a "life or limb" decision like we used to think

Ohio IFT medic here. For once this JEMS article is worth a read

http://www.jems.com/articles/2017/07/ems-must-be-fixed-with-bulldozers-not-tweezers.html

>>34679665
Community paramedic again, none of that will ever happen so long as Medicare/Medicaid are barely solvent (meaning any reimbursement reforms that give EMS more money than the table scraps it already gets will never happen), so long as the IAFF continues to exist (so that 90% or more of EMS providers who are in unions are in unions designed to protect a completely anachronistic industry with no intensions or desires of modernizing itself, whose leaders still simultaneously look down on EMS while seeing it as an existential threat to their mouth-breathing "brothers" back at the station and as such will never, NEVER lobby for anything that moves the professional forward or leads to improvements in pay/prestige for EMS providers), and so long as nursing schools keep pumping fresh grads out like the slurm worm in that Futurama episode, straight into union jobs, with no concerns for the supply/demand aspect of their profession and its labor pool (meaning that the Nurse's Associations will viciously fight anything, ANYTHING that strengthens the Paramedic position to the point where it begins to threaten nursing jobs inside and outside the hospital, improved patient care/outcomes be damned, because it might lead to nurse layoffs and a resulting oversupply of nursing labor that ends up tanking nursing wages/union dues and threatening the willingness of new nurses to join unions and pay for the pensions of all the Boomer and GenX nurses as they roll ever closer to retirement).

EMS is fucked. Do your time, enjoy it, and work on an exit strategy that hopefully leverages your extremely valuable skillset as a paramedic into something, anything (preferably NOT related to healthcare, as the entire industry is about to go into some turbulent waters) that actually stands a chance at appropriately compensating you for the hard, draining work that you do, while maybe even giving you a shot at something resembling career advancement.