In Austria (and Germany) we have a “emergency doctor” system, who are immediately dispatched when it’s a risky situation. About 15% of all calls have an emergency doctor present. But that truck is awesome!

@lukasgiese2331

Жыл бұрын

And now there is also the system of a "Tele Notarzt" meaning "virtual emergency doctor" in a way. They can be called in and decide on medications in more complex situations if the "Notfallsanitäter" (Paramedic kinda) isn´t authorized to give those meds or the case is more complex or the procedure is more involved. It frees up "real" humans and units for the really big ones.

@nicolajaynehodson9223

Жыл бұрын

the UK tends to fly Doctors on helimed plus having ground based Physician / Adcanced Clinical Practitioner units

@Opsgermanysoldier

Жыл бұрын

@@nicolajaynehodson9223 Every emergency helicopter has also Doc on board

@sterlingodeaghaidh5086

Жыл бұрын

This is not uncommon out where I am in the Rural U.S, we have nurses specifically with medical departments as well as area doctors who are cross trained with field medical teams as well. Due to the large size tho its hard to have dedicated doctors that are strictly with emergency services tho, hince why most doctors who do this are hospital doctors as well.

@NochEinKamel

Жыл бұрын

@@nicolajaynehodson9223 UK emergency doctors are awesome too. You guys even have some on motorbikes in london :D

Mike it is great to see how EMS is becoming "results based" in their patient treatment. It is nice to see how hands on the Medical Director is with Tower Direct. Gotta like that. And, how compact IV pumps have become. I thought a Mini Med 3 was a godsend! Rather that lugging the old Abbott pumps.

Nice video, EMS, Critical care/ALS has come a long way since I first got into EMS in 81'-82'! I've been inactive for over 20 years and I'm always surprised by the newer equipment and techniques, thanks for keeping us updated on advancements, especially in the field!!

Great video and showing an amazing service. I hope more states and EMS systems will be open and look at this type of resource and thinking about the PHRN, prehospital registered nurse and the PHMD, prehospital medical doctor as part of the EMS team. In the end, it is all about patient care and getting them the best medical care possible. Keep up the great work.

@HeroesNextDoor

Жыл бұрын

Thanks for watching

Really smart set up! Thanks for sharing.

22:05 I like how they arranged the vaccines bottles properly. Hope to see more EMS and ambulance videos.

Always good to see EMS vids!

Great Video Mike! Trend setters! That what Tower Direct is doing. I see this service being duplicated across the country with more publicity! Incredibly impressive. Very excited for the next video of the MCI truck! Thanks for all you do! Great channel!

@HeroesNextDoor

Жыл бұрын

You are correct

Great innovative team to be a part of! Thanks for posting the vid!

@HeroesNextDoor

Жыл бұрын

Our pleasure!

BEEN WAITING!! THE GOLDEN HOUR JUST GOT BETTER!!

Great job Brad and Mike.

@HeroesNextDoor

Жыл бұрын

Thanks

Great unit. Love the redundancy. Mr. Murphy gets a vote on every call.

Sounds like they doing RSI with this unit. Ground RSI has a troubled history in PA, but I'm happy to hear these folks are doing this on the ground

Pittsburgh EMS is doing blood, but a big part of it is in collaboration with Pitt's docs. Don't know if the medics are carrying it by themselves.

Great video

@HeroesNextDoor

Жыл бұрын

Thanks!

Recall seeing hospital chase units that were long wheelbase Ford Expeditions with full rear doors, not the doors with the wheel cut out. And there have been news stories of hospital closures in areas west of Philadelphia forcing long rides to any hospital still open in business.

I see you, KB!!!! 👀

"That's locked so no one can get into that...." Unless they. have scissors or a knife! 😂

Normal IV saline is 0.9%, not 9%. What they have for the CC nurse is 3% (hypertonic) saline, for severely symptomatic hyponatremia (seizures, AMS), TBI, and cerebral edema with elevated intracranial pressure.

@HeroesNextDoor

Жыл бұрын

Yep. Good catch. I misspoke. Thanks for watching. There was no way for us to edit that out 😂

Love the zoll❤

Just a quick question. You all said the universal blood type was O+. I thought it was O- can you clarify that for me? Sounds like a nice unit. In Lancaster County, Penn Medicine LGH put Penn Med 1 in service this year using an emergency room doctor who is also my agency’s medical director. That’s another nice unit. Getting units on the ground to provide these services are a great idea and will make big impacts in the lives of their communities.

The squad is great. Short of having rotors, it bring the same level of care for those crappy weather needs.

@HeroesNextDoor

Жыл бұрын

Exactly

The Hamilton T1 is like the Dräger Oxylog 3000 which is widely used in EU🇪🇺.

I don't recall how far you go for videos but another program that would be cool to see deeper into is dartmouth hitchcock's DART program (new hampshire) air ambulance program that has expanded to add advanced ground transport units. Based out of Northern New Hampshire and Northern Vermonts level 1 trauma center

@HeroesNextDoor

Жыл бұрын

We travel any where we are invited. Just send the official invite to watchheroesnextdoor@gmail.com

The UK has had these kinds of things for decades, it's called HEMS and they have ground units that respond to things where the helicopter can't reach it or if they helicopter just can't fly due to conditions etc. But it basically brings hospital level care to the field. You should do some videos interviewing and looking at some of the UK things, like HEMS, specialist fire units and specialist ambulance units to see how they compare to US ones

@michaelborrello9944

Жыл бұрын

We would love to. Just need a sponsorship to get over there. If you know of any let us know 😉

@PTRRanger951

Жыл бұрын

The US has had it as well. It’s just not everywhere because it’s not Government funded to the extent it is in the UK.

@EastSussex999

Жыл бұрын

@@PTRRanger951 In the UK it's not government funded at all, all HEMS organisations and critical care response organisations are charities and get no funding whatsoever from the government. Completely separate to NHS ambulance services which obviously are government funded but they don't operate critical care to this level where doctors and ccps provide hospital level care at the roadside.

@jakedovey7488

Жыл бұрын

Not quite, I am a nhs critical care paramedic, all the hems medics in the UK primarily work for the nhs or military as medics, but I admit there are very few of us although the HART team which I used to be a team member on provides almost the same level of care, but we sort of do it differently but I admit most critical care teams in the UK are operated by charities!

@itsweb1584

Жыл бұрын

@@EastSussex999 Not quote right - Scotland has a fully government funded HEMS

Nice video

@HeroesNextDoor

Жыл бұрын

Thanks

Hey mike I went to one of your station about 3 years ago and i'm coming out to that area in downingtown today and I was wandering if you were going to be there

O+? My hospital considers O- to be the default blood type for all emergent non-cross matched patients. Maybe its different region to region, facility to facility.

@TheRealHectorRavioli

8 ай бұрын

Yeah O+ isn't a universal donor, O- is. I hope they just misspoke cause O+ cannot be given to everyone.

I don’t know your boundaries on how far you would go but I think you should try to get a hold of some of the guys down here in dothan, Alabama to try to get a tour of station 2 or 3 to see the tech rescue and hazmat semis and our 100 foot ladder truck or the wiregrass public safety center which is a $30 million training facility for all kinds of public safety departments, you could also come and your our central station, station one and see our other ladder and gator and brush truck

Why don't you do both ? Any Hems unit is backed up with a car for the doc. (Anestesi) and Hemstec. Same with all airforce SAR helicopters, car for doc and rescueswimmer. Both Airambulance and SAR R.W. Do ambulance and SAR. Using car if near base, or not weather to fly. (Norway).

Interesting. In my state, the "Critical Care" level does not exist in the 911 setting. It doesn't matter whether it is a nurse or a paramedic with Critical Care endorsement, the highest scope of prehospital care is paramedic. That said, our medic scope of practice is very broad. My service is one of the first in the state to allow single medic RSI for experienced medics, assisted by EMT's with special training. Now, in the IFT setting, our RN/CCP scope seems to match up pretty well.

What is that system called that allows you to start a 20g and "upgrade" to a 14g? I want to suggest that to my dept!

That's true back in the day they would say IVs, but when you think about it... you don't want to really be giving IV fluid to someone that is bleeding out. Because that dilutes the blood even more Including diluting the clotting factors in the blood.

@bdogg20101

10 ай бұрын

In reality, you should be transfusing the blood back into the person rather than diluting the blood.

Shouldn't the universal donor be O- (O-negative)?

When did universal blood type change from O- to O+? I know O- can only receive O- blood.

@HeroesNextDoor

Жыл бұрын

Good question. I’ll follow up and see if we misspoke or what? Thanks for watching

@Maddawg31415

Жыл бұрын

Still O-. But most O- patients can receive O+ with minimal consequences- Rh factor isn't a huge issue. The one case it can be is in pregnant patients or patients who could become pregnant due to neonatal hemolytic anemia.

What interventions can a RN do that a licensed paramedic can’t? Medics intubate and run vents?

New Zealand operate doctors and helicopter services. Doctors for the city, helicopters for the bush/serious medical emergencies far from specific hospitals needed for the treatments.

@HeroesNextDoor

7 ай бұрын

It would be nice to have docs responding but not many do.

@joshuahill6153

7 ай бұрын

Their occupation is on the cusp of EMS and doctor because you need 1-2 years extra to become a qualified junior doctor in NZ. But I believe both still serve very important jobs at life preservation.

As an O negative patient is there a way for first responders to determine my blood type if I'm unconscious or should I carry a tag of some sort that states I'm O neg

@macmedic892

Жыл бұрын

Good question. No, you don’t need it. They misspoke: O neg is the universal donor.

@Maddawg31415

Жыл бұрын

@@macmedic892 also depends on the patient. For most patients, giving O+ to an O- patient usually has minimal hemolytic consequences to the point that some entities will give them O+ in shortages. The exception: pregnant women or females who may become pregnant in the future. Neonatal hemolytic anemia is bad bad bad with Rh incompatibility

O- is the universal donor NOT O+ as stated.

@HeroesNextDoor

2 ай бұрын

In trauma we are told both work well !

Isn't O- the universal donor blood?

We used those coolers for covid vacs

@HeroesNextDoor

Жыл бұрын

Did you think they worked well?

@paulmatakovich9096

Жыл бұрын

@@HeroesNextDoor Yeah they help up good. We kind of beat ours up due to they got moved alot, in and out of cars, opened closed several times a day. But they took the beating.

O negative is Universal donor

Wouldn’t it be more beneficial to staff the truck with a prehospital physician (as opposed to a prehospital nurse)? You’re not really gaining much of an increased scope of practice with a nurse vs crit care medic. In my opinion, staffing with an MD that has med control authority would be optimal.

@HeroesNextDoor

Жыл бұрын

Pennsylvania does not have many prehospital MD.

@mrichter444

Жыл бұрын

@@HeroesNextDoor Fair point. Thanks for answering my question and, as always, great video!

@Maddawg31415

Жыл бұрын

I know in some regions they do have that though. Pittsburgh's is pretty neat!

@larryweaver7022

Жыл бұрын

@@HeroesNextDoor LGH Penn Med just put a Prehospital MD. chase truck in service a few weeks ago

@FelixBT93

Жыл бұрын

Prehospital physicians are common in Central Europe and I always thought you don't have anything like this in the US. Can someone give me more information about prehospital physicians/ Ems doc's in the US? Thanks :-)

Normal saline is 0.9% not 9%...3% saline is hypertonic. 0.9% is isotonic. 9% would be extremely hypertonic.

@michaelborrello9944

Жыл бұрын

Yep. Just misspoke. Nice catch.

O- is universal not O+ 😬😅

@HeroesNextDoor

Жыл бұрын

There is research that is stating that O+ is better in trauma and does not have the side effect as once thought. I’ll get one of the doctors to explain it. It was new to me too

Dope

Paint that car red with yellow bright yellow tartan and put the crew in orange jumpsuits. This is great stuff. I hope the concept proves itself and flourishes in our archaic EMS delivery model.

that bus is like FDNY have those after 9/11

@HeroesNextDoor

Жыл бұрын

We would love to get an invite to FDNY

@edwardcollins7893

Жыл бұрын

@@HeroesNextDoor I met FDNY Ten house in 2012 and made honorably member since I work for volunteer fire department like my dad his brother my mom's father and brother as well my great grandfather

Chase trucks in PA have had climate control like that for years and years.

@HeroesNextDoor

Жыл бұрын

Yeah but the tech continues to improve

Isnt the idea of a QRS to get there first? I disagree when you state it usually isnt there

@simongreer6179

Жыл бұрын

However, this fire department most likely has multiple stations. This car might be based at Station A but covers the entire area that the department covers. If a call for this vehicle comes in from Station B then an ambulance from Station B will clearly arrive on the scene, before this car which is based at Station A. Normally these cars wouldn't be used for a quick response, rather they will be designed to bring hospital-level care or more advanced level care to the patient in the field, to stabilize before they can be moved to a hospital.

@EricWhiteTheGamer

Жыл бұрын

This car is not a fly car or paramedic unit, ideally this unit should not be part of the initial dispatch unless it is clearly on the call needed. Just like helicopters those are not always first. It depends who's closest.

So no driver for the QRS... if the medic/nurse had to ride in the hospital with the ambulance there really is no one to take the unit in. Also with so many AED companies out there, can someone please make or find a video reviewing them all together? Thanks!

@HeroesNextDoor

Жыл бұрын

So it will depend on the patient if all hands on deck are needed but it’s common to leave the vehicle at a rendezvous place and go back once the patient has made it to their destination. Are you asking to have us review AEDs. Such as a Phillips, Medtronic, life sciences, etc?

@EricWhiteTheGamer

Жыл бұрын

@@HeroesNextDoor Sweet thanks, seems kinda risky I would assume but don't know everything... and kinda, I have heard about Zoll and Phillips, both seem good, and I am talking the best for the public (or someone like me who might want to buy one... if I had a reason to other than being extremely interested), but what would be the best for public places where anyone could use it EX School, shopping malls, hotels. Than what would be the best for medical both comparing features, ease of use, cost, so on.

@mooseriddle

Жыл бұрын

Great video Mike.

@em68855

10 ай бұрын

the ambulance emt will commonly drive the fly car to the hospital, and medic however joins the ambulance

Rather then showing these stations that’s cost MILLIONS OF DOLLARS TO BUILD why don’t you show the stations we’re there members are the ones who preform the up keep and repairs to the station they operate out of. It’s always nice seeing the shiny new don’t get me wrong but there are tons of FD’s in America that can’t afford to build stations that are worth millions and still operate units that are 25+ years old.

@michaelborrello9944

Жыл бұрын

We show all the stations who invited us. Does not matter the age or cost.

Ya sorry, not better than a bird

@HeroesNextDoor

Жыл бұрын

Here’s why. Helicopters fly in fair to good weather. This rig can travel in ALL weather and provide the same services. 😉

@Maddawg31415

Жыл бұрын

@@HeroesNextDoor forgot to mention helo's ain't cheap and there are so many in PA. Also using the helo is not great for 5 min transports.

Helicopter is still better vehicle is to slow in most situations

@HeroesNextDoor

Жыл бұрын

Yeah but helicopters only fly in fair to good weather. This comes anytime !

@PTRRanger951

Жыл бұрын

Not to mention a helicopter is only faster to transport a patient to the hospital than ground, it’s not faster when it comes to getting help to the patient. Helicopter can’t just land anywhere unless an LZ has been set up by people on the ground. Helicopters normally won’t respond to a scene until care has already been started and they can get information about what’s going on. Unless is an extreme remote mountain, or off shore rescue, someone on the ground will beat the helicopter there. And in those cases, life flight type helicopters are not really set up to do hoist rescues, and the ones that are is normally a search and rescue crew, with just EMT or paramedics, not flight nurses. They usually pick up the patient, transfer to an ambulance or medical helo. You can still be waiting for a helo for an hour.