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Joined: Aug 8, '10; Posts: 433 (41% Liked) ; Likes: 379

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  • Apr 23

    It depends on the level of support. V60s are considered BiPAP machines and ventilators. They can be hooked up to an ETT, trach or face mask. The Vision and most BiPAP or CPAP machines can be also attached to trachs. Many people in home care and long term care are dependent upon BIPAP machines for ventilation and would die without it. This includes ALS, MDS and many other respiratory compromised patients for whatever reasons including neuro and cardiac. The long term ventilations can be through a trach or a mask. Many children are in the home setting with a trach attached to what some would consider just a sleep apnea machine but they do provide enough support to keep the patient's CO2 and O2 within a normal range. Some patients such as those with ALS know their life expectancy is not long and prefer not to be trached. They can still be very "vent" dependent with a BiPAP machine. Even those with a trach are dependent on the ventilator support of a BiPAP machine. CP children and adults are also dependent on BiPAP and CPAP machines to keep their airways open when they are prone to obstruction. Some are also trached and must be on ventilation with a BiPAP machine due to hypoventilation from some form of restrictive disease. Patients with CCHS or Congenital Central Hypoventilation Syndrome (formerly Ondine's Curse) might use a BiPAP machine with or without a trach to maintain life when they sleep.

    Depending upon the settings some hospitals will consider a BiPAP machine the same as a ventilator which is why they must be moved to tele, a stepdown or an ICU. Check you hospital's policy to see at what point a BiPAP machine is crossing the line of support or when some patients must come off the BiPAP and onto a ventilator.

  • Aug 14 '17

    Quote from Ace587RN
    Lots of good information in this thread . Im also an ED RN looking into pre hospital medicine just to volunteer at my local FD. im from FL and i was told i could challenge the paramedic exam after getting my EMT. Anyone else from FL here? i have BCLS, ACLS, PALS, TNCC already
    Yes you can challenge the Paramedic after EMT. All the info is on the DOH website.
    EMS Home

    The exam is only the written part and what makes it different from the NR is it asks specific questions about state specific trauma, DNR and IFT protocols which can also be found on the website. Definitely read the statutes also.

    Division of Emergency Medical Operations - Home

    If you feel you need a quick review, take a cheap Paramedic refresher course at one of the community colleges or state votechs. Don't pay a huge price at the private medic mills. You can also find a refresher online.

    EMS Free Course Search

    Testing and Training Resources - Bureau of Emergency Medical Services

    If every FF in Florida can pass the test, a decent ED RN should be able to.

    The EMT will give you the basics of the ambulance. The only skill you might fall short on is intubation but many student Paramedics don't get that opportunity either. You will find there are practicing Paramedics who have never intubated or haven't since doing one in school. If you get on with a decent flight or specialty program after some ICU experience, they will get you into an OR or ED to get some intubations.

    I also recommend taking a basic and advanced burn courses through a burn center and taught by burn RNs and doctors. Of course for EMS you might have a simpler protocol for burns but if you do CCT or Flight with the RN credential, you may expected to do more.