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A case like this reinforces the need for investigation of any and all allegations of Police misconduct to be done by an outside agency, rather than internal. I am a big proponent of the Special Investigations Unit (SIU) that operates under the Ontario Ministry of Justice. This civilian agency automatically investigates any case of injury or death involving Police as well as any complaints received. By having any possible case receive automatic review transparency and accountability are maintained, furthermore the public can be put at ease. The vast majority of SIU cases find no wrong-doing (either criminally or under the Police Services Act) which allows the public to have faith in their Police Services without the appearance of a white wash. Look at the RCMP lately and their refusal to be transparent and how awful the force is coming off as a result. Here EMS complaints investigated by the Ministry of Health and Long-term Care's Emergency Health Services Investigation Branch in addition to the usual Service CQI and chart audit's by Medical Direction. When we allow any service that requires the public's trust in their most vulnerable times (PD, or EMS or Fire) to investigate themselves we create a recipe for disaster. The Chief/Management of these services have conflicting obligation. They want (or should want) to thoroughly investigate for the sake of the public, but they want to do so in a way that won't damage their service or otherwise make their own job difficult. How then can a frank and honest investigation really be expected?

I see your point. It's just how the fire service sees it. I worked single role for over five years before going over to the "dark side". I believe that 911 paramedicine alone is quite simple to maintain provided you've been educated well prior. IFT medicine, CCEMT-P and flight are a whole other side to the paramedic profession. The medic who can do it all with the requisite knowledge base is truly bada$$, a professionally complete individual. I'm going to get myself to that level at some point. Too many 911 medics fail to understand the lasting effect of their treatment and interventions have on their pt's hospital course and time to discharge. The professional medic should have a solid knowledge base to that end. Many don't nor are they really required to. As such, 911 EMS has been reduced to a "specialty" of the fire service in general, rather than it's own profession. It's up to each dept, and more so each individual to strive to be better than that. I wouldn't even know of dual role systems if I wasn't driven by greater job security and a lucrative defined benefit retirement than was available otherwise. My choice was due in large part for the desire to provide well for my family. When I took the job, there was a dedicated EMS only track (starting with the first promotion above FF) up to BC. If I felt that fire wasn't truly for me, I planned to branch off to EMS only. Same job, way better benefits and all. The thing is, the promotional track is now "all hazards". Good thing I like fire.

Here's the situation - I'm currently employed at the Fairfax County FRD. I'm eligible to test for either the apparatus tech and/or EMS tech position in another two years. I'll be eligible for an Lt promotion in another 4-5 years, depending on when the test is given. There are currently only all-hazards officer career tracks. 90% of your score on the tech promo list is the written test. The remaining 10% is based on education. Medics get 12% of that right away, and additional credits and degrees allow you to hit 100%. Education makes up 20% of the Lt score, and Capt I and above weigh education at 25%. The FRD currently pays for one class per semester, including summer classes. This should increase as the economy recovers. The FRD has deals with local universities where some classes are held twice weekly, so employees from opposing shifts will be able to attend. Otherwise, the FRD lets you use leave while on duty to make classes. For example, you can use leave on every Wed that you're working from 1800 to 2300 to attend class. There are also numerous online classes, basically anything that doesn't require a lab. I could also go to day work to free up evenings for class, although this would result in me never being home for my family. A fire science degree should be completed prior to becoming an officer, for the additional knowledge of building construction and other relevant topics. I'm also trying to decide between going for RN vs RT. Either of these will also satisfy the educational points for promo purposes. I don't have to worry about completing fire science for at least five years. I'm asking for input regarding comparison of RN vs RT. I'm asking about pre-reqs, salary comparison, job description, availability of work as a per diem, length of program, evening hour availability, is any portion of either class available online, what amount of con-ed is available to recert, etc. I would like to eventually get into flight, either an a medic or maybe RN if it's necessary to get hired. This would also be per diem. I'm planning to retire at age 55, then do three years in the DROP before leaving the service altogether. I currently weigh 225# at 6'3" lean. Any thoughts/input/questions about the above? I'm going to look into what's available locally through the FRD. I'm figuring that I'll get some decent input here in the meantime.

If this is true (which I'm suspecting it is, but I refuse to deem guilty until proven so as I haven't read everything about the situation), then this guy not only needs to be fired (not retired sorry AK he should pay for his irresponsible actions TWICE !). Had he requested retirement (if he was eligible for early retirement) it should have been granted. Once is a poor error in judgement and maybe just a bad day. Twice is inexcusable. If he is placed back on the streets after that they are releasing a loaded gun on the street set to go off at the smallest thing at any time. That thought terrifies me. I will NOT be visiting OK anytime in the near future that's for sure ! It is irresponsible for them to allow this trooper to continue in this manner. He should have been referred for anger management classes previously - if they did obviously they didn't take. Either take him off the road and put him in a non direct contact position ie driving a desk or else let him go. Anything else would be stupidity.

Already a topic. http://www.emtcity.com/index.php/topic/16484-here-he-goes-again/page__p__225077&#entry225077

Pre-req courses are very similar for both programs. Nursing school is full of busy work while RT school seems straight foreword but more technical and physiology based. Nursing school has a broad focus, where as RT school seems to have a narrow but indepth focus. On line nursing programs seem to be the latest and greatest thing, online RT programs do not appear to be as popular. Pay for both providers is highly variable, RN's will make a bit more; however, this gap is not wide and does not exist in some areas. I am not sure your plan to attend school for promo purposes is a great plan. Both programs are full time and not piece meal class here and there educational experiences. I am a RT student, and I am in class five days a week. My shortest day is four hours in class with my longest being around six. In six weeks I had written three large papers and completed several large reading and homework assignments. In addition, a four page APA article review is required each week. So far, I can say the commitment is similar to my prior experience as a nursing student. Take care, chbare.

Just for being spenac. Good point, conisdering I got one point for my -5 to spenac and you got -1 for your above post. I guess I shouldn't say anything else about spenac, since he has more points than me.

Unfortunately it's already proving to be a popularity, not productivity contest... If we can now just get folks to vote based on post content instead of warm fuzzies, life will be good. Or at least better. Dwayne

Why?

Is there any way to tell which posts earned us our points (or demerits)? -5 for spenac!!!

Don't you hate it when you catch yourself thinking and saying the same things your dad thought and said to you as a kid?

How many of us have respoded to MVA's where something was involved other than concentrating on driving? How many of us have seen the car in front of us/beside us weaving because they were doing something other than concentrating on driving? We've seen what this behavior leads to, so why must you INSIST on doing it? If my partner is seen on the phone or texting while driving, they'll be VERY lucky I don't take their phone and throw it out the window! I'm NOT going to let some joker that has to read, text, put on makeup, yap on the cell phone, etc endanger MY safety; or that of my patient! If you MUST talk on the cell phone, text, read a book, etc while driving....be stupid on YOUR OWN TIME!

We have had patients tell us that the EMT(P)s were on their cellphone the whole time they were in the back with the patient. We've had EMT(P)s take a call on their personal cellphone during report in the ED from a 911 transport and during IFTs by "CCEMT-Ps" picking up a patient in the ICU. Even our physicians do not answer their personal cellphones during a report or rounds in the ICUs. IPods are another pet peeve of mine as I removed one from an EMT who had transported my mother from a SNF to the hospital. It is rather difficult to take a BP with earpieces stuck in your ears or even listen to what the patient is saying. I gave the iPod to a nursing supervisor who was only going to release it to a senior supervisor for that ambulance service. Some might consider what I did an assault or theft by the way I demanded the iPod but on the bright side, I let him live despite his behavior and lack of care. It would also be these same fools who can not understand why some car drivers do not immediately move out of the way even with a siren blasting.

Lifetime immunity? No. The varicella (chicken pox) is an example. Those of us who had the disease as a child and then had high titers for many years may find our titers are barely detectable later. The same is being said of mumps which is why the MMR is given together and not separately more often than not. Smallpox is another example as those of use who got vaccinated prior to 1972 were told we had "lifetime" immunity but then were told differently in 2003 when Pres. Bush wanted everyone to get the smallpox vaccine. Our immunity has probably expired.

Oh wow ... we haven't transmitted an ECG since what, the late seventies? Our Ambulance Technicians (BLS) are able to give GTN without acquiring a 12 lead ECG first (they can acquire a 3 lead) while our Intensive Care Paramedics (ALS) can obtain and interpret a 12 lead. In reality I think it's inappropriate to withold GTN until a 12 lead can be acquired as the nitro can provide some pain relief. We were talking about this topic on my last night shift and came to a consensus that we did not want to cause so much reduction in filling pressure that the patient became shocked but also that some GTN prior to a 12 lead was acceptable as 1) the patient (if they have thier own GTN and are having an inferior STEMI) will not perform a 12 lead prior to taking GTN, 2) it provides some pain relief and 3) a small fluid bolus may reverse any adverse reduction in cardiac output (caution here is required to not cause a pulmonary edema). One service here is already using 12 leads in prehospital thrombolysis and we are trialing the same (with good results).

I make an additional 10 grand in steps and cert pay over a basic FF, and another 5-8 grand in hourly riding pay. That's incentive enough for many of us to stay active as medics. As far as crossing FF's as LEO's, I haven't paid much attention to that, as it isn't an issue here. For one thing, the public is generally trusting of FF's and EMS. The public is generally wary and standoffish towards LEO's. If FF's are known to also be LEO's, it can create conflict in pt care, or any number of situations where you're helping victims. FF's are also stationed in and are dispatched out of quaters, like EMS is, and LEO's patrol the neighborhood. If you had a good thing going, you'd put a spin on things to support your position too.

This is a standard week of questions by both my son and my sunday school kids You can answer any of them except number 10. 1. Why is blood red? Because red means stop... and it is important to stop all bleeding. 2. Where do babies come from? Mommies 3. Why are there craters on the moon Where else would we put them? 4. If you were a super hero who would you be and what would your super power be? Stretch Armstrong... for obvious reasons. 5. Why is the sky blue? The sun's rays hit the Earth's atmosphere, where the light is scattered by nitrogen and oxygen molecules in the air. The blue wavelength of this light is affected more than the red and green wavelengths, causing the surrounding air to appear blue. At sunset, the sun's light passes farther through the atmosphere, deflecting and decreasing the blue in the air. Scattering by dust particles and pollution in the air causes the sunset to appear red. 6. Where do babies come from? Didn't you hear me the first time? Mommies. 7. Tell me about the birds and the bees Birds poop on your freshly washed car, and bees sting you. 8. What is your favorite weapon Preparation. 9. Did you know Barack Obama is our First Black president? What???? Where have I been? 10. Who was the best president, George Bush or Barack Obama 11. Can we go back to Baltimore and do the pedal boats Sure... any excuse to go to Baltimore for a pit-beef sandwich. Yummy. 12. Dad, when are you going to quit being on the ambulance and go back to travelling for work. (tough and loaded question) Are you trying to get rid of me? These are the questions in just one week that I can remember off the top of my head. Now how was your week? Not as difficult as yours Ruff...

Are you trying to get rid of me?

It looks as though vasopressin may cause cerebral vessel dilation and theoretically increase cerebral perfusion. Regarding the beta 1 stimulation: we do not give epinephrine based on beta 1 effects. Epinephrine's primary theoretical action is vasoconstriction and shunting of blood volume. In fact, beta 1 effects may theoretically increase post arrest myocardial oxygen consumption and post arrest arrhythmias. Therefore, in theory, vasopressin's lack of beta effects creates a better profile. Note my extensive use of the word theoretical. This is because studies are all over the place. However, in human patients, survival to discharge does not seem to change with either agent. Take care, chbare.

If you have to use an IO, you have poor IV skills.

Okay, this is starting to irriate me. I can barely eat anything, or drink anything. My throat is sore, and I have a pretty high temperture, and i can barely stay awake, and stay still. When I walk around the block, by the time i get back-my heart is pounding at like, three times I normally am, and I can barely stay focused in School. Any ideas what it can be?

Maybe we all need to pull the gigantic backboard we have out of our ass and realize it's just a TV show.

Ah, I didn't realise it was changed. I thought it was always that way. Good idea.

*Gets his 'reputation finger' limbered up*

Admin, my comp has been touchy today and I accidentally gave a negative point to someone I didn't mean to as I was scrolling across to push the positive my comp accepted the negative and I went OH CRAP ! To that person you had a good post I'm sorry !

LOL! That's why it's good people can't see who gave them what!

I would not expect a physician to also be a plumber, a baker to also be a software designer or a pilot to also be a chef. To that end, why should we expect firefighters to be paramedics or paramedics to be firefighters? You send a bunch of firefighters to school for three years to obtain our Bachelor of Health Science (Paramedic) with the requirement they also meet the con-ed req's to be a Firefighter and I bet you none of them graduate.