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You could always work as a tech in the Emergency Room with a Certified Nursing Assistant cert. Question for you, why do you let Chemistry keep you from something you would like to do? Why exactly do you want to work in an emergency field? I have always been under the opinion that if you truly want something, you'll find a way to get it. Welcome to EMTCity. I hope you enjoy your stay. Matty

1) Lifting is going to be a big part of EMS work. Please take that into consideration, as I am sidelined by a back injury from, ironically, lifting a back injury patient. 2) Your veterinary experience might come in useful here in the EMT City, as we sometimes have discussions on dealing with animal interaction with EMS teams, and the patients they handle, such as pets or work partners (Police Dogs and Horses, guide dogs, for example). 3) Welcome aboard, if this IS the direction you want to go.

You mean especially considering that it seemed like there was absolutely no care administered during transport? On the other hand, I'll give credit to NBC for not going after the obvious incident that I think most people believed was coming with the build up to that call.

You do bring up a good topic as many are trying to come up with safe and effective delivery systems for nebulized meds and O2 without risking exposure to others. We do not have that many isolation areas in the EDs or even in some hospitals. IV Albuterol is approved in Canada and a few other countries but not in the U.S. I believe a few years ago IV Albuterol was part of EMS protocols in at least one area of Canada. There is some research for it, and that includes what was also done in the U.S., but it is inconclusive as far as it being a better bronchodilator than the nebulized or other IV medications. Of course the side effects such as hypokalemia are beneficial to some patients more than the nebulized form but also has other potential complications. Nebulizing meds and O2 devices allowing exhaled particles into the surrounding area has been especially controversial since the recent SARS and in years past with TB becoming prevalent in some areas. We do have filtered nebs which have been used for Pentamidine and some of the antibiotics which offer some protection. Simple masks, NRBMs and definitely BiPAP/CPAP devices are in question. There is a recent editorial in the Canadian Medical Journal concerning the use of BiPAP/CPAP as it may prevent intubation in some Influenza A patients. However, the patients I have seen lately need to go straight to a High Frequency Ventilator for ARDS. In the hospital we can use a closed limb system with filters for BiPAP/CPAP by using a nonvented mask with the ICU ventilators. We are also trying to determine which filter is most effective with least resistance for our transport ventilators such as the LTV which can also be used for BiPAP/CPAP.

Guess EMS standards are higher than fire. Seems like he got the best of everything. Got to play with breasts, got to get off the ambulance, and got to remain fire chief. What more could a fire fighter want out of life? http://www.kwes.com/global/story.asp?s=11130728 Eunice Fire Chief Accused of Sexual Misconduct (9-14-09) 2:34 By: Sarah Snyder NewsWest 9 EUNICE, NEW MEXICO - Eunice city leaders are putting out a fire of a different kind. There's strong allegations of sexual misconduct by the City Fire Chief with a patient en route to the hospital on board a city ambulance. To understand where it all started, you have to go back to May. The Eunice Fire Chief and several EMT's were on a medical run and on the way to the hospital. Those witnesses accuse Chief Grogan of heavily medicating a female patient then inappropriately touching her chest. "Ron basically medicated her, with in my opinion, a lot of pain medication," Tony Fuller, Eyewitness and former Eunice EMT, said. "She asked him to feel her breast implants and he did. [i was] uncomfortable with that. I went to my supervisor." Mayor White tells NewsWest 9, after receiving the complaint from the EMT, the City began an investigation then put the case in the hands of the New Mexico Department of Health. "It really hurts the City for it to be for a full year, so basically I would like to see it reduced," Eunice Mayor Matt White said. NewsWest 9 obtained a copy of the letter sent to the New Mexico Department of Health. They suspended the Fire Chief's paramedic license on the grounds of sexual misconduct and unprofessional behavior. "I felt like the City Manager and the Mayor just swept it under the rug and blew me off and didn't take this issue seriously," Fuller said. "He made a mistake," Mayor White said. "He did something he wasn't supposed to do. Unfortunately, there are some other facts to it, at this point I'm not going to say what they are, ecause I don't believe I should." Mayor White says they have hired a new EMT and the city emergency response won't be affected. They plan to keep Grogan on as the fire chief and appeal the allegations. "Ron Grogan has been a great fire chief," Mayor White said. "This is a great disappointment. I disagree with the penalty they assessed him. I do believe he needed to be punished. He did something he shouldn't have done. That's why we're going to appeal it. We feel like it was a little bit harsh for the circumstances." But Fuller says this jeopardizes the relationship with the community. "He's what the public sees whenever they think about our department," Fuller said. "I don't think he's representing the department well. I think it's kind of embarrasing actually." NewsWest 9 spoke with Chief Grogan, but he refused to comment on camera until everything is ironed out in the courtroom. "I guess the big thing is we lost a little trust in him because of this issue," Mayor White said. "Is this going to affect his job as the fire chief?" NewsWest 9 asked. "No. It will not," White said.

With the upcoming flu season I've been thinking about things we do that become high risk when dealing with droplet transmission illnesses. The preferred method for Ventolin (Albuterol, Salbutamol, pick your favourite name/brand) administration is via nebulizer in most services I'm aware of. This becomes problematic when dealing with a suspected H1N1 patient due to the nature of how it's spread. This doesn't mean that we should fail to treat these patients however. All that said, I began to think about the possibility of IV Ventolin administration. Thus far the downsides found in my recent searches include greater risk of tachycardia, hypokalemia, cardiac dysrythmias, and elevation of BGL. Does anyone use IV Ventolin in their service? If so how effective has it been? What has the prevalence of adverse affects been like? Any links to relevant research and studies are welcome.

I think this will likely be a more appropriate solution for the time being. I wonder if the greater incidence of adverse effects with IV ventolin is due primarily to the IV administration, the severity of illness in the patients this delivery route is currently used on, or some combination of the two? What about a single IV push versus a continuous infusion? So many questions and I suspect the answers won't come soon enough to be of much use dealing with H1N1. I would be interested in knowing the results in Parkland as well. Hopefully Parkland has kept close tabs on the results of using IV ventolin as I'm sure the information would be valuable. Common sense says no valved exhalation for the patient. Of course that could just be me. We actually carry several sizes and types of N95s. Some valved some fold-flat etc.. Did AHS purchase all of these Newport Transport Ventilators without ensuring they could be sterilized or are there not enough trained people to sterilize them properly?

Oooo, "Newbie" fresh meat! Get the ketchup and paprika ready! LOL. Joking! Welcome aboard.

The blond Paramedic stated that the reason she didn't become a doctor was that she didn't want to work with the MD A-Holes like the one that just called her an "Ambulance Driver". Did anyone note that our favorite whipping boy, Rabbit, appropriately yelled at the rookie EMT for practicing moralistic views, instead of triage, when the rookie identified the vehicle driver as a "drunk driver", later found to be a stroke victim? On a different note, while I have placed a patient (one time only) into a Bell Jet Long Ranger 412, like the one shown (on my Ferno 30, mind you!), does anyone know if the 412 could have taken 2 patients at once, with one of the ground Paramedics riding along in addition to Rabbit? That way, possibly, they could have saved both the stroke patient, and the profuse bleed patient.

There once was a lady from Niger Who smiled as she rode on a tiger. They returned from the ride With the lady inside And the smile on the face of the tiger! (author unknown)

The NRBMs offer NO protection at all and were actually mentioned as part of the problem for the spread of SARS at one hospital in China during the 2003 outbreak. Filtered nebs offer some protection but the healthcare providers should be wearing an N95 mask when near the patient. The neb can also be turned off briefly when moving through an area that exposes other patients or staff. For flu symptoms with no pre-existing pulmonary history, we find the nebulized bronchodilators do very little for breathing problems caused by the infiltrates. Patients that have influenza A are isolated. This is nothing new. If they require a NRBM or BiPAP/CPAP, they are put in a room that is capable of negative flow.

I would keep an eye out at Montgomery College's website over the next few years as they are doing a lot in the way of a paramedic program and since they have a pretty good nursing program they might offer a bridge. The nursing school is located in Takoma Park, Maryland, which can be a little bit of a hike from Fairfax (not sure where you live). I'll shoot an e-mail to the program directors over there and see what they are thinking in ways of a bridge course. Montgomery College does however have a great Fire Science degree with one of the classes taught (last I heard) by our Chief Richard Bowers. The fire science course I took through there, equivalent to Officer I, met about once a month and almost all of the work was online. We had a career MCFRS member go through the course. Something to look into. I can not speak much to RN vs RT but I am a full time nursing student and just school alone (20 credits) is really kicking my butt some days. I just pulled an all nighter and I wish I could say it was my first of the semester. We have one woman in our class who works full time as an ED tech and she is barely scraping by with passing grades. It may just be the program I am in, but something to consider. A full time schedule anywhere is the equivalent to a full time job in my opinion and depending on your social life, may be hard to keep up and still do well. Best of luck to you and don't hesitate to PM me if you have any questions about MC's programs. I know both of their department heads and they are fantastic people and paramedic volunteers in Montgomery County.

Cell Phone versus using radio, whats the difference: If you are driving an emergency vehicle, you should rarely have to talk on the radio: 1. Your partner can talk while enroute to the call. 2. You can call onscene after the vehicle has stopped. 3. You can call enroute to hospital or 10-8 before you put the vehicle in gear. 4. You can call out at facility after you have stopped. 5. You can call 10-8 before you put the vehicle in gear. If you absolutely have to talk enroute to the hospital, keying the mic does not require your eyes to leave the road -- texting does require your eyes to leave the road. Anyone who texts while driving an emergency vehicle should have their license (medic and driver's) pulled. If you have no more regard for human life or the maturity to realize the stupid (unneeded) risk that you are taking, then you do not belong in an emergency vehicle.

Hey Jonathan! Welcome to the City! I'm afraid I couldn't read the first line of your post because of that stupid box thingy, but the rest sounds good! There is much to learn here, and always something to teach, but neither occurs unless you participate, OK? Go out on a limb, visit, challenge people's ideas and put yours out there for scrutiny! It's really the best way to learn. Good luck man. Glad to have you here. Dwayne

I totally encourage your pursuit of either RN or RRT degree. Either will open up many possibilities and avenues. I would discourage you from thinking about trying to get a job in the flight arena per diem. I don't know of any flight program that would hire someone without previous flight experience for a per diem position. If they did I would be looking at a different program. People who have already worked full-time in flight are ok to go to per diem but it is not a position that you should be starting and learning about in a per diem position. You will also need 3-5 years of critical care experience as either an RN or RRT or good 911 ground experience as a paramedic before you should even consider a flight position. When you say you are looking at retiring at age 55 is that just the fire service or working altogether?

I'd be willing to bet that he's referring to a possible increased risk of transmission from the exhaled neb. In the future you might want to reach a little and begin by assuming that the poster is not an idiot. To imply that reuse of his disposable nebulizer was the crux of his issue is short sighted, and a little silly. Again, I don't believe he was asking for an opinion as to how 'it sounds' but for people that have experience with it and can offer an educated opinion. Not trying to bust you chops brother, but you've made a poor start... Most of us did when we were new here. Welcome, and I hope you'll stick around. Dwayne

NSFW for language.

I actually looked up the SF EMSA protocol to respond to someone from New Jersey who claimed that there was a "white tag" (no treatment needed). This confirmed my assumption that SF EMSA uses the Simple Triage And Rapid Treatment (START, which, incidentally, was developed in Orange County. CA) system for MCI triage.

Well, it was somewhat more realistic this time. But still a bit off from the real thing. It was better than last weeks ego/whacker fest.

Can it happen? Sure. It is rare, especially when the FDs have close relationships with the Medic Mills, and require new hires to have their Medic cert/license in an unreasonably short amount of time. Now, making Medic an option, rather then a mandate is a start. Further, until EMS makes the living and working conditions and compensation better, EMS only services will continue to loose people at an alarming rate. Who wants to sit on street corners all day/night, eating fast food, and maybe laying down on the cot, when they could be relaxing at a station, eating home cooked meals, relaxing in a recliner, and sleeping at night? How about the benefits, lack of pension, and poor equipment? I work EMS only right now, as an MICP in South Jersey. I also hold certification as a FFI, and licensure as Paramedic in Fla. I am there right now, applying to FDs. I want something to show for my years of service. I want to sleep at night. I want a day off.

That 5 week ventilator course just introduces you to what a ventilator is. The following semesters apply what you learned from that course to the courses for introduction to critical medicine and bring it all together later. You will also get a semester of specialty ventilation/critical care theory for Peds and a semester for neonatal. As well some programs may have electives in HBO, Cath Lab and ECHO. I did all three because I just couldn't get enough. I also repeated Cath Lab later when I did my B.S. in CardioPulmonary just to see how another center known for caths did it with technology. The first was in the 80s were we still did all the calculations and manual drawings. It is difficult to have a flexible schedule because the clinicals may actually be monitored by physicians along with the clinical educators. Most of my classes, especially ath the B.S. level, were taught by physicians. Nursing of course can have more opportunities but the RRT can have many also. I can travel on short or long assignments in any state I care to get a license in. I have also worked PRN as an RRT most of my career as a FT Paramedic. For specialty programs such as Neonatal, they did require a serious commitment especially if you wanted to work at a higher level of competency and be on transport. RT is a very active profession politically when it comes to lobbying for benefits for the patient and the therapists. The benefits for the patient includes home care payments from medicare for extended services. By that, whatever benefits the patient gets it helps the RRTs' future. But, the patient is always emphasized first which the profession took notes from NPs, PTs and PAs in that areas. They didn't use the "me, me, me" approach and have managed to make great strides in the past 20+ years. The biggest thing against the Excelsior program is the clinicals. You really need to know basic nursing skills and time management. Few RNs precepting you will want to talk you through gait management and the various lines when there are so many other things to learn about the facility. The clinicals also allow you to network for a decent job.

I am down a perky point - where's my corner I can go cry in? Somebody didn't like me, what did I do? Maybe if I went into my next shift with my uniform down to my navel my points would improve. You think?

You could definately do the PRN gig in nursing in almost any specialty, however I cannot speak intelligently of the RRT field. All of the RRT's I work with on the neo team are full-time, but Vent would be a great resource for that particular question. the problem isn't so much of working when convenient, but more getting to that level. As chbare states, the education is a full time one, regardless of the field. Excelsior will not prepare you for the field clinically, they expect you to come prepared. Nor does their program adequately provide the delineation from medicine and a strong foundation of the nursing process. That is the reason why many State's are thinking twice about licensing their graduates and why a good number of Paramedic's fail the CPNE. Even in an articulating students or transition program, you have to dedicate the time for class, skills, and clinicals. Can you get creative with your schedule? Sure! Will it take its toll after a while? Probably! I'm working fulltime at two jobs plus taking a 12 semester hour load. Quite honestly, it is kicking my a$$. But I have the determination to see it through this time. Having communicated with you in multiple threads elsewhere, I could see you getting it done as you have a passion and motivation to succeed. I'd say do it! In reference to working in the flight environment, I would strongly recommend becoming familiar with the height / weight restrictions of the agencies you are interested in. Many have a 220 - 225# weight restriction wet, meaning with suit / equipment / helmet / etc. Many also have height limitations as some of the smaller single engine airframes are not so accomodating to you taller types! I know I was tight in a Bell 206 and I'm only 5'7"!

Were the second semester clincals flexible, or were they set days, such as every Tu/Thu, or could it be Mon/Fri one week, and Tu/Wed the next? How many hours per week, on average, were you spending on nursing clinicals? Were the hours flexible, or fixed? A five week ventilator course, huh? It makes the three hour inservice I had seem paltry in comparison. Ventmedic has mentioned that a medic needs to have, at the bare minimum, a two year medic degree to even be able to absorb and thrive in the IFT arena, let alone CC or flight. I see her point. My medic program barely even touched on vents. I had to get up to speed once in the field.

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

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.

There are things that I won't deny. There are FF's that have gone to a medic mill only to get the patch for an easy in. There are firemedics that are apathetic towards EMS, and pt care suffers as a result. There are depts that push their FF's through recerts, sometimes falsifying documents or cheating on tests. There are FD's that have taken over EMS only to justify jobs, and siphon off EMS $$$'s to the fire side at the expense of EMS. There may be a lcak of QI and accountability towards some firemedics at some depts. Some union may have an interest in blocking any advance in EMS education. These examples aren't indicative of the entire fire service, however. IMO it isn't difficult to maintain proficiency as both a medic and a FF. A firemedic will be appointed to the position having already completed their medic cert. Bonus points for having several years experience as a single role medic prior. The FFM will also go through a fire academy, followed by a one year probationary period, where their proficiency will be improvrd by regular drilling and testing, as well as real life calls, of course. Medic CME's and drilling are done on duty as well, freeing up the FFM's time to do additinal study and attnd CME's off duty if desired. SoWhy mix EMS and fire? Theyhave almost nothing to do with each other" The fire service looks at EMS as a specialty, much like Tech Rescue, Hazmat, Water Rescue, etc. Personnel are regularly given sufficient training in that discipline while on duty to ensure proficiency. Here's why a mixed fire/EMS system works, if run correctly - fire calls are way down. No disputing that. A FD will seek to integrate EMS resulting in dual role personnel to save FF positions, among other things. Some ask why FD's aren't being made to downstaff given the reduction in call volume. Response times. With the new type 5 lightweight construction, it's maybe only 12-15 minutes from ignition to structural collapse. If the 911 call was to initiate immediately (it rarely does), it takes a minute or two to dispatch FD, another minute or so to get on road, maybe 4-6 minutes to get onscene, and another minute or two for the officer to take a lap and pull/charge a line. Now we're at 9-10 minutes on a good day. But this is just the first due engine. What about the rest of the box? what about RIT? Maybe units are stacked. What about if there are FH closings, brownouts, or overnight downstaffing? The first due may not make entry as quickly, and the remainder of the box will be that much more delayed. No first due truck to ladder the building, no second due truck for roof ops, no engine for water supply or RIT, no rescue for primary search/VES. Fireground tactics will be severly hampered by lack of units. Lives will be lost, both FF and civilian alike. Yes, it's a what if scenario, but you don't purchase car insurance after you crash, or life insurance while on your deathbed, do you? Dual role fire personnel are quite versatile as they can fill either role, which ensures adequate staffing on both sides, reduces holdover, recall, OT in general, thus preventing burnout. Maintaing proficiency in both disciplines isn't nearly as difficult as some would make it out to be, especially with many in station drills (both for EMS and suppression). Having dual role personnel makes the best possible use of a FF's otherwise large amount of downtime. It's logistically and fiscally efficient. The two jobs hold few similarities, but guess what? It happens to work well if run properly. I'm fully capable of getting things done with just me and my partner, like I've done on numerous occasions in NYC 911. However, many hands make light work. Having an extra medic or two onscene (not two dozen, just one or two) and competent BLS make things go much more quickly and smoothly. It may not be financially optimal, but it's best for the pt. It's not always about the bottom line. There is also a way lower proportion of transient employees when compared to private, third service, and hospital based EMS. The typically lucrative employment package, with a pension, 457, decent medical/disability, DROP, and superior working conditions allow FD's to hire the best possible candidate, not the LCD. Newcomers to the fire service know the importance of EMS, and any FF's that were forced to add EMS to the job description will eventually retire. With more individuals like the Medical Director from Collier County willing to sack up, accountability for the firemedic will be upheld. With an increase in educational standards (hoping for it, but not holding my breath), new firemedics will be that much more knowledgeable and proficient in EMS. It's getting late. i'm going to work in the morning, so I'll post about how my dept is run at some later date. Sorry about the several duplicated posts. It wasn't going through, and I hit the button a few more times. My bad.

Beat me to it! From what I've been told, each bus typically has one EMT-P or EMT-CC, who work 12 hour shifts, and get an hour break during their shift where they can actually turn off the radio. My understanding is that when a job comes in, the lone medic will drive the bus to the scene, an LEO crosstrained to EMT-B will come to the scene, leave the cruiser there, assist in pt care, and drive the bus to the hosp. If another medic is needed, another ambulance will be dispatched to the incident. The bus will need to return the LEO to their cruiser after the run is completed. Now, for everyone else..... The privates just hire any medic with a pulse and a patch, the LCD. Every private system is profit driven only, and their medics are slugs, not serious at all about their jobs, and provide horrible pt care. No one cares at a private because they're either skells or waiting to finish a degree or get picked up off of a civil service list, like FD, PD, sanitation, corrections, etc. Hospital based medics think they're superior to all others in every way, they steer insured pts to their home hospital, and dump the uninsured off to city run general hospitals. Third service agencies all use system status management to run their employees into the ground, they all pay lousy, promotions are done only on favoritism, who your drinking buddies are, also hire anyone with a pulse and a patch to replace the frequent burnouts, their employees are only working there because they couldn't hack it or get on at a FD or PD. Every firemedic went to a 12 week medic mill just to get "the patch" to get an easy in at an FD. As such, all firemedics are apathetic towards EMS, and their pt care sucks. Every FD that takes over EMS siphons off $$$'s to the fire side at the expense of the EMS division. these fire monkeys (hose jockeys, or whatever jealous term used) don't do anything but sit around all day on the taxpayer's dime. What good are they doing? Got your attention? Good. These are all generalizations about each type of service. They all sound silly when you think about it. There are real life examples for each generalization, but they're certainly not indicative of the industry as a whole.

I vote once someone has enough negatives they should be banned.

I agree that time-outs are very important in certain parts of the hospital. Unfortunetly, the administrators who have no pt care experience whatsoever, have decided that it is such a good thing that it should be done everywhere in the hospital, including the ER. It is a completely different environment in the OR where people are sedated and unable to speak. If I come at you with a big spinal needle to do a spinal tap, in the ER you may say, "Doc, it appreciate your concern, but really, I don't think that will help figure out if my toe is broken." If I go in the wrong room to suture someone, I will probably realize I am in the wrong room when I cannot find that gaping wound that was there 5 minutes ago. I'm pretty sure I can identify who the multi-system trauma pt is that is circling the drain and needs some help without aking everyone in the trauma bay (including said pt) if we have the correct pt. I could go on, but I think you get the point. It is the typical story of administrators seeing a good thing and taking it too far.

Speak for yourself. Unless I am physically unable to continue to work because of fatigue, I will remain at work to cover until I can get someone else to relieve me. My station has two ambulances, a MICU that runs 24 hours a day and a day shift BLS ambulance. I'm not deserting my post as the sole ALS provider on shift until I find someone to cover me. Besides, my supervisor isn't a tool, and he routinely works shifts that he can't cover with part time providers (attempting to save overtime for when it is really necessary). There are still people out there that value their integrity.

Heres more. http://www.koat.com/news/20938434/detail.html Fire Chief Suspended For Inappropriate Touching Eunice Mayor Wants Reduce Suspension For Fire Chief POSTED: 1:38 am MDT September 16, 2009 UPDATED: 1:47 am MDT September 16, 2009 ALBUQUERQUE, N.M. -- Controversy surrounds a fire chief because of his actions in the city of Eunice, N.M., on May 23. "I guess the big thing is we lost a little trust in him because of this issue," said Eunice Mayor Matt White. White said it started with a medical call. Fire chief Ronald Grogan was in the ambulance with other paramedics -- taking a woman to the hospital. By phone, Tony Fuller, a former paramedic who said he was there, claims what the fire chief did next was completely inappropriate. "Ron basically medicated her, with in my opinion, a lot of pain medication," Fuller said. That medication was Demerol and Valium. "She asked him to feel her breast implants and he did. Uncomfortable with that, I went to my supervisor," Fuller said. At the New Mexico Department of Health a commission decided unanimously that the chief's behavior was unprofessional and warranted a one-year license suspension. It is a decision that the city's mayor disagreed with. "It really hurts the city for it to be for a full year so basically I would like to see it reduced," White said. A letter from the health department supports the year suspension of the chief's paramedic's license -- stating there was no therapeutic reason to feel the breast implants -- so it's considered sexual contact toward a patient. "I do believe he needed to be punished. He did something he shouldn't have done," White said. However, the mayor said there's more to the story he is not going to discuss, but he said the city will appeal the chief's year-long suspension. The mayor said he has hired a new EMT so the city will not be short staffed and the plan is to keep Grogan on as fire chief.

That was my thought too. Actually pretty cleaver, leading us to assume the obvious set-up, then throwing in a twist, even if it was a lame twist. At least tells me they're capable of thinking outside the box. The 206 is the Jet Ranger. The 412 is a Huey, although it is usually not called by anything other than it's numeric designation in civilian service. And I can't tell exactly how the interior is set up in that helo, but yes, I would expect that they can carry at least two patients. Of course, not if you're taking kids along for a joyride every time. Rabbit completely screwed the pooch on that call, and it was obvious from the beginning. As JPINFV observes, all he did was sit in the co-pilot's seat the whole time on the patient he did transport. I'd have fired him for that run. Also, the portrayal of both the patient and the care of the guy who bled out was just as horrible and inaccurate as it could possibly have been. I liked the scene at the end with Rabbit and the pilot. Kind of humanised them both in a more realistic light than up to that point. I'm a little confused by what exactly the drama is about with the pilot being expected to know and render medical care. While there are some systems that send their pilots to EMT school, I don't think I have ever seen one that required patient care as part of their job. In fact, that would likely result in some serious FAA attention if they did. What I also do not see in real life is helos being first on-scene, with no ground responders there to request them in the first place. Happens twice an episode on this show. They're making HEMS look even worse than the rest of us.

Re the blonde bimbo.. did you catch it in the first episode where the big shot doc tells her she needs to get out of EMS and start using her MD because "you gotta grow up sometime" ? F'n insulting as far as I'm concerned.

discussing in chat if you are interested... its fun so far!

as much as last week was just so unrealistic, i decided to give the show another shot. So far tonight its getting a little better, but could still use some work. But we'll see.

Apparently the obligatory MCI is going to be the equivalent of the 5-alarm chemical plant fire that was in every episode of Emergency! I already hate the blonde bimbo. Even more than Rabbit.

Umm... how bout using a new neb each time? What's the problem here? IV ventolin? For respiratory? Sounds less effective and more dangerous...

Not being harsh here, but once you realize it's no good get the heck out. Sometimes you don't know what you're going into. Sometimes you do. If you go stupidly into something with no cops that has a real chance of getting you hurt, then no. If you end up in a scene that goes bad, get out. I've had two friends of mine (same call) that started off routine and went downhill quick. One was shot and killed trying to run to behind a tree for safety. My other friend and former partner was shot in the head - lucky it just grazed him hard. Perhaps that's why I feel a bit differently than you Dust, perhaps you've had similar and still feel that way, I'm not sure. Maybe this is one we just have to agree to disagree. No one said they weren't athletic. Heck there are pole dancing classes for workouts and they're challenging (not like I would know). And I have known a few that used it to get through law/medical school as well so no one is calling them ignorant. What I am saying is they have no place coming to work like that. The two former pole dancers that I knew - you would never know unless they told you or you were privy to their "off" time. At work, they were very respectable, classy, ladies. These two bimbos on the show could do well to learn from that. Leave the stripping for the stage or the bedroom.

In response to Ruff and for us to air our opinions here is my reason that I for the most part oppose fire based Paramedics. In the illustration Ruff gave the fire Paramedics were strictly working on the ambulance, fine that allows them to be focused health care providers. But when forced to be multitaskers it is hard to believe they can be the best when divided, ie jack of all trades master of none. Also the Paramedic that is forced to fight fire may just do the minimum because their heart is not in fire and the fire fighter that is forced to be a Paramedic may as well. I also get frustrated when I see so many fire services just raping EMS by taking the money brought in by EMS and instead of making more improvements on EMS they spend it on more fire toys. Another gripe has been seeing the fire services and the fire union actually stand in the way of advancement in EMS. OK that is just a start of this topic look forward to a peaceful discussion.