Guest guest Posted January 9, 2001 Report Share Posted January 9, 2001 American Medical has been the sole ambulance provider in the Las Vegas area since 1954. The company operated under the name Mercy Medical Services until several years ago but now operates under the corporate name AMR About a year ago Southwest Ambulance ( Which at the time was at least partially owned by Rural/Metro) won a law suit and was given a city franchise to compete for calls in Las Vegas but at the time I believe this was only transfers but I am not absolutely sure. Also as far back as 1998 the Las Vegas city council passed an ordinance to allow the fire Dept. to begin transporting along with AMR. As to date I believe AMR still provides emergency service. Frieze [texasems-L] questionq Importance: High Does any one know the name of the service for Las Vegas Nevada? Is it Mercy Ambulance? Joby Berkley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2001 Report Share Posted January 9, 2001 I just found the web sight for Southwest ambulance and according to their sight they are set to either take over all or part of the 911 service for Las Vegas in early 2001. Their URL is http://www.southwestambulance.com/index.htm It does not say anything about them being partially owned by Rural/Metro but according to an article 11/22/99 in the Las Vegas Sun they are, not that this matters but just a bit of info to pass on. [texasems-L] questionq Importance: High Does any one know the name of the service for Las Vegas Nevada? Is it Mercy Ambulance? Joby Berkley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 9, 2001 Report Share Posted January 9, 2001 On Tue, 9 Jan 2001 07:26:07 -0600 " Frieze " writes: > I just found the web sight for Southwest ambulance and according to > their sight they are set to either take over all or part of the 911 > service for Las Vegas in early 2001. (SNIP) It does not say > anything about them being partially owned by Rural/Metro but according to an > article 11/22/99 in the Las Vegas Sun they are, not that this matters but > just a bit of info to pass on. > Southwest Ambulance is owned by RM. I worked PT for them, when I wasn't flying, in the PHX area on a CCT that did backup 911. They have had a presence in Las Vegas since mid 1999. I found them to be fair in their dealings with the troops (pay is never great for the EMTs and CEPs (paramedics in AZ parlance), but they paid prevailing rates to the RNs on the CCTs. A little monolithic in terms of management, but we were running 6-8 CCTs, 35-40 911, and 15-20 transfer units per day. Guess they needed some order in chaos. " Leadership is action, not position " Larry RN CFRN NREMTP ....and some other stuff ________________________________________________________________ GET INTERNET ACCESS FROM JUNO! Juno offers FREE or PREMIUM Internet access for less! Join Juno today! For your FREE software, visit: http://dl.www.juno.com/get/tagj. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2001 Report Share Posted January 30, 2001 - First of all, congratulations for not becoming every medic's worst nightmare and handling yourself with composure... I know how much that must have helped the situation. I've never heard of additional seizures from cooling a febrile patient down too fast, but it sounds like you did the right thing using wet rags (cool, not cold). Children spike temperatures VERY fast, and febrile seizures are a common reaction to high fevers. They can, in fact, happen serially. The fact that your daughter was experiencing increased levels of consciousnes was a good sign. It looks like the doctor did his due dilligence, although I would question the immediate need for an LP without altered consciousness not related to the seizures (see my earlier post on that topic). But, he is the doctor, and if your PCP confirms the need for an LP, by all means, consider it. I'd look at the serious infection(s), plural, that your child has, though. Sinus and ear are probably related, as is the possible pneumonia, but also a UTI. I'd have your PCP look at the overall state of your child's immune system and nutritional health. Not that you're necessarily doing anything wrong (as a parent with a child who gets sick occasionally, I'd NEVER suggest that a parent is doing something wrong because their child is sick - kids get sick), but there may be an underlying problem that is making your child immunodeficient. That's not me the Licensed Paramedic speaking, that's me the concerned parent speaking. Is my child having problems fighting off infection? Is my chlid having problems absorbing vitamins and nutrients it needs for a healthy immune system? Probably worth checking out... If you're ever in doubt about a procedure, don't hesitate to get a second opinion. Mike [texasems-L] Question Had to call 911 for my little girl yesterday. 12 month old female. Healthy, no past medical history, no allergies. Really never been sick, never run over 101 fever. She spiked at temp of 104.5 and began to seize. I began cooling her with wet rags. She had 4 separate seizures within 20 minutes each lasting about 45 seconds long. Between each she was cried and seemed to be aware of her surroundings (as she wanted her mommy) Her pupils were equal and reactive, however between the 2nd and 3rd seizure her eyes seemed glazed some. On the way to the hospital the medic (awesome guy by the way), told me that if I had cooled her down to fast, that could have caused the additional seizures (this was great info to know) . We got to the ER the doc said that there when having a febrile seizure there should be only one. I asked about the cooling her down to fast and the ER doc said that was NOT true. They did a CT of the head that showed a sinus infection. Physical exam showed an ear infection. She also had a urinary tract infection, and a possible place on her lungs that might be pneumonia. The ER doc wanted to do a LP. I informed him that she had 2 rounds of the new meningitis vaccine. He seemed to not know what I was talking about. He treated her with IV Antibiotic and released her. We will be following up with her PCP with an EEG and whatever else. Just curious about the cooling her down to fast and causing the following seizures for my info in case it ever happens again. Also want to know if not doing the LP with those circumstance was an OK choice. Thanks as always for your input EMT-B Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2001 Report Share Posted January 30, 2001 Hello , The various texts differ on the root cause of febrile seizure. Some say that high temperature alone will trigger the seizure, while others insist that it is the rate of temperature rise. I guess it would depend on which of these theories you subscribe to as to whether you believe the medic or the physician. Since excessive cooling could produce shivering, which in turn could exacerbate a fever, the medic could certainly be correct. All the material I have seen recommends slow cooling with lukewarm water. Regards, Donn [texasems-L] Question Had to call 911 for my little girl yesterday. 12 month old female. Healthy, no past medical history, no allergies. Really never been sick, never run over 101 fever. She spiked at temp of 104.5 and began to seize. I began cooling her with wet rags. She had 4 separate seizures within 20 minutes each lasting about 45 seconds long. Between each she was cried and seemed to be aware of her surroundings (as she wanted her mommy) Her pupils were equal and reactive, however between the 2nd and 3rd seizure her eyes seemed glazed some. On the way to the hospital the medic (awesome guy by the way), told me that if I had cooled her down to fast, that could have caused the additional seizures (this was great info to know) . We got to the ER the doc said that there when having a febrile seizure there should be only one. I asked about the cooling her down to fast and the ER doc said that was NOT true. They did a CT of the head that showed a sinus infection. Physical exam showed an ear infection. She also had a urinary tract infection, and a possible place on her lungs that might be pneumonia. The ER doc wanted to do a LP. I informed him that she had 2 rounds of the new meningitis vaccine. He seemed to not know what I was talking about. He treated her with IV Antibiotic and released her. We will be following up with her PCP with an EEG and whatever else. Just curious about the cooling her down to fast and causing the following seizures for my info in case it ever happens again. Also want to know if not doing the LP with those circumstance was an OK choice. Thanks as always for your input EMT-B Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2001 Report Share Posted January 30, 2001 I have actually heard several ER nurses and physicians say that they are unsure of how necessary and/or safe it is to rapidly cool a febrile pediatric patient. I would try contacting a pediatric nurse or physician. I think you may find their answers and reasoning interesting and surprising. -Noah Reiter Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2001 Report Share Posted January 30, 2001 , The paramedic was right in that febrile seizures are caused by the quick rise or fall of the temp, not the temp itself. Normally you will see only one seizure with fever, at least in a short period of time. I also feel that it would be hard for you to cool your child down fast enough to cause the subsequent seizures that occurred. However, I feel that the physician was justified in his request to do the LP. Your daughter has many points of infection and any one of those could cause your child to become septic or develop meningitis. Also remember that the LP is only diagnostic. If your child did develop meningitis, the treatment would be IV antibiotics (several doses not just one). In the hospital that I work for the rate is probably about 100 to 1, we usually can tell which ones will be positive (prior to the LP) and most of those are viral in nature. We do seem to be seeing an increase in the area. The shot that your daughter took is called " Prev-Nar " (spelling anyone?). As far as advice on what to do next time, follow your knowledge and call 911 and let the medics handle it from there. Verne Had to call 911 for my little girl yesterday. 12 month old female. Healthy, no past medical history, no allergies. Really never been sick, never run over 101 fever. She spiked at temp of 104.5 and began to seize. I began cooling her with wet rags. She had 4 separate seizures within 20 minutes each lasting about 45 seconds long. Between each she was cried and seemed to be aware of her surroundings (as she wanted her mommy) Her pupils were equal and reactive, however between the 2nd and 3rd seizure her eyes seemed glazed some. On the way to the hospital the medic (awesome guy by the way), told me that if I had cooled her down to fast, that could have caused the additional seizures (this was great info to know) . We got to the ER the doc said that there when having a febrile seizure there should be only one. I asked about the cooling her down to fast and the ER doc said that was NOT true. They did a CT of the head that showed a sinus infection. Physical exam showed an ear infection. She also had a urinary tract infection, and a possible place on her lungs that might be pneumonia. The ER doc wanted to do a LP. I informed him that she had 2 rounds of the new meningitis vaccine. He seemed to not know what I was talking about. He treated her with IV Antibiotic and released her. We will be following up with her PCP with an EEG and whatever else. Just curious about the cooling her down to fast and causing the following seizures for my info in case it ever happens again. Also want to know if not doing the LP with those circumstance was an OK choice. Thanks as always for your input EMT-B Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2001 Report Share Posted January 30, 2001 , It is a very controversial point about the cooling down. In my ER, our docs believe in tepid baths only. No cool water. But, as a child, I used to run high fevers very often. My parents would mix water and rubbing alcohol and rub me with it *forever*. I never seized, but I did cry and freeze. I tend to agree with the tepid water in what I've seen, but I think everyone has their own opinion on that, but of 3 ERs I've worked in, all 3 agreed with tepid water only. Just my 10 cents! Jana [texasems-L] Question > Had to call 911 for my little girl yesterday. > > 12 month old female. Healthy, no past medical history, no allergies. Really > never been sick, never run over 101 fever. > > She spiked at temp of 104.5 and began to seize. I began cooling her with wet > rags. She had 4 separate seizures within 20 minutes each lasting about 45 > seconds long. Between each she was cried and seemed to be aware of her > surroundings (as she wanted her mommy) Her pupils were equal and reactive, > however between the 2nd and 3rd seizure her eyes seemed glazed some. On the > way to the hospital the medic (awesome guy by the way), told me that if I had > cooled her down to fast, that could have caused the additional seizures (this > was great info to know) . We got to the ER the doc said that there when > having a febrile seizure there should be only one. I asked about the cooling > her down to fast and the ER doc said that was NOT true. They did a CT of the > head that showed a sinus infection. Physical exam showed an ear infection. > She also had a urinary tract infection, and a possible place on her lungs > that might be pneumonia. The ER doc wanted to do a LP. I informed him that > she had 2 rounds of the new meningitis vaccine. He seemed to not know what I > was talking about. He treated her with IV Antibiotic and released her. We > will be following up with her PCP with an EEG and whatever else. Just > curious about the cooling her down to fast and causing the following > seizures for my info in case it ever happens again. Also want to know if not > doing the LP with those circumstance was an OK choice. > > Thanks as always for your input > > > EMT-B > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2001 Report Share Posted February 5, 2001 For 24/48 shifts, the multiplier is 3328. For 12 hour shifts, it depends upon the # of shifts a week..... For 4 - 12 hour shifts the multiplier is: 2704 For 3 - 12 hour shifts week one and 4 - 12 hour shifts week 2 the multiplier is: 2288 Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 5, 2001 Report Share Posted February 5, 2001 I am not sure but I believe it is W2. Again I am sorry. [texasems-L] question What is the number for figuring out your yearly pay on a 24/48 schedule? Is it 3040, 3220 or what...I just can't remember. Also what is the number for the 12 hour shift? Anyone????? Joby Berkley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2001 Report Share Posted February 6, 2001 If you divide 365 days by 3 (hence 24/48) you'll get 121.66 shifts x 24 hours equals 2,919.84 hours. Where does the multiplier 3328 come from? Ron RE: [texasems-L] question For 24/48 shifts, the multiplier is 3328. For 12 hour shifts, it depends upon the # of shifts a week..... For 4 - 12 hour shifts the multiplier is: 2704 For 3 - 12 hour shifts week one and 4 - 12 hour shifts week 2 the multiplier is: 2288 Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2001 Report Share Posted February 6, 2001 2920 straight hours. but, divide that by 52 weeks and you get a 56-hour work week. since 16 of those are overtime when on a 40-hour schedule (many 24/48 are on 52 and 56-hour work week under FLSA special rules), you're getting paid for 64. 64 * 52 weeks = 3328. Mike RE: [texasems-L] question For 24/48 shifts, the multiplier is 3328. For 12 hour shifts, it depends upon the # of shifts a week..... For 4 - 12 hour shifts the multiplier is: 2704 For 3 - 12 hour shifts week one and 4 - 12 hour shifts week 2 the multiplier is: 2288 Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2001 Report Share Posted February 6, 2001 I think that adds in the overtime also. Eddie on, EMT-P RE: [texasems-L] question > > > For 24/48 shifts, the multiplier is 3328. > > For 12 hour shifts, it depends upon the # of shifts a week..... > > For 4 - 12 hour shifts the multiplier is: 2704 > > For 3 - 12 hour shifts week one and 4 - 12 hour shifts week 2 the multiplier is: 2288 > > Dudley > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2001 Report Share Posted February 6, 2001 Two Options: 1) 365days/3=121.6, 121.6*24=2920, 2920-2080=840, 840*1.5=1260, 1260+2080=3340 (this is what I use) 2) 52weeks*56hours=2912, 2912-2080=832, 832*1.5=1248, 1248+2080=3328 Ken Re: [texasems-L] question If you divide 365 days by 3 (hence 24/48) you'll get 121.66 shifts x 24 hours equals 2,919.84 hours. Where does the multiplier 3328 come from? Ron RE: [texasems-L] question For 24/48 shifts, the multiplier is 3328. For 12 hour shifts, it depends upon the # of shifts a week..... For 4 - 12 hour shifts the multiplier is: 2704 For 3 - 12 hour shifts week one and 4 - 12 hour shifts week 2 the multiplier is: 2288 Dudley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2001 Report Share Posted February 7, 2001 For a 24/48 with OT paid for anything over 40 hr in a week is 3340. In a message dated 2/5/01 7:03:29 PM Central Standard Time, joby@... writes: << What is the number for figuring out your yearly pay on a 24/48 schedule? Is it 3040, 3220 or what...I just can't remember. Also what is the number for the 12 hour shift? >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2001 Report Share Posted February 7, 2001 sorry if this is exhausted...but I just got back from out of town and wanted to clarify my earlier post. A 24/48 hour shift is a 56 hour work week. That is 40 hours plus 16 of OT (which is equivalent to 24 regular hours)...so a 24/48 hour shift works an equivalent of 64 (40+24) regular hours a week X 52 weeks = 3328. Take that multiplied by your regular hourly rate and you get your annual " salary " equivalent. Dudley Quote Link to comment Share on other sites More sharing options...
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