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New hires, and newly certified Paramedics ?

Has any one else noticed this? 2007 - Chinese year of the Chicken .......... Bird Flu Pandemic devastated most parts of Asia .. 2008 - Chinese year of the Horse .............. Equine Influenza decimated Australian racing. 2009 - Chinese year of the Pig ................ Swine Flu Pandemic terrifying people around the globe. It gets worse next year, 2010 - Chinese year of the Cock ......... what could possibly go wrong?

You mean we arn't unprofessional sex crazed sexist adrenaline junkies??????????????????? SPEAK FOR YOURSELF!!!!!!!!!!!!!!!!!!!!! Some of us are loved because we are just that..........

No idea, but I'll tell you one thing, I'll be getting THAT vaccine! Dwayne

There are many free sites you can look for regarding grant/scholarship/etc., however, I can't think of them right now. Maybe check with your local community college financial aid personnel. They may be of assistance in your request. Look for previous EMS benefactors also.

A good link for Elder Abuse laws throughout the U.S. and advocacy: National Center for Elder Abuse http://www.ncea.aoa.gov/NCEAroot/Main_Site/Library/Laws/InfoAboutLaws_08_08.aspx If the patient was in immediate danger and was not capable of making any decisions then the PD might need to get involved. However, there is nothing sadder than seeing an elderly person being forcibly removed from their HOME. I have had the displeasure of doing this when working as a Paramedic on ground EMS and you often wonder who the real criminals are. If another solution can be found through Social Services and Home Health to where the patient can maintain some dignity and independence, at least in their own minds, that would be a better situation. Other health care professionals do actively participate in the advocacy for home health and Social Services issues. RT, Nursing, PT, SLPs, OTs, NPs and PAs all have a vested interest in advocating for legislation to protect the patients and provide more services. Unfortunately EMS has not gotten a large voice in this area or they are too focused on their own agendas.

Personnally, I would take the time to clean and linen the bed. This is the way I perceive the job, to help those in need. However, this also can be a potential elder abuse situation, that in our state must be reported. Do not confront, but realize the situation and try to do the best with what you have. If the primary care giver cannot do the job, or is unwilling, this needs to be reported. Provide what the patient needs. Yes, I know, not all services will do this, but do what you can for the patient.

Does this mean I am finally popular? YES!!!

They are catching on in the southwest as well. Phoenix is pumping them out with ever increasing numbers of destination therapy patients. The Heartmate II seems to be the device of choice. Many EMS considerations such as non pulsatile blood flow, CPR, electrical therapy, and even giving nitroglycerine.

I think your right. Terbutaline is just the first medication that I started to look at in greater depth. There's more to come for sure. Again, absolutely true. If past flu's are any indication I expect a huge portion of patients requiring hospitalization and or presenting in respiratory distress will have underlying pulmonary history exacerbated by H1N1. Excellent point. I think this really strikes at the heart of the matter. Flu patients could easily be hypokalemic already. Giving such a patient medication with significant potential to cause hypokalemia could concievably have drastic negative effects on the patient's condition. I'm with you in thinking filtered administration devices will be the better solution. This has really turned into a good exercise in research for me which is why I've continued to gather information. Given the increased risk of adverse effects which is proven, I think IV administration would have to prove to be more effective (which has yet to be shown in most cases). I think this is the reason IV administration thus far has been reserved for the more severe exacerbations where the patient's airway is so far shut down inhaled administration is not viable. What would be interesting is a comparison between IV Ventolin and administering enough epi for inhaled routes to become viable in the event of status asthmaticus. Interesting study. Looks like IV Ventolin should remain on the docket for further study based on those results.

Yeah, it's starting to look more and more like a 'popularity contest' than anything else....

Don't worry Doc,someone bumped ya back up! Our orientation usually lasts about 3 mths. This includes being cleared to drive by a State approved EVOC driving evaluator, not just your partner, at least a 4 shifts riding as a third but that timeline is flexible, not everyone needs this much time. It all depends on the individual. Yes, we have guidelines but that's exactly what they are. Not everybody fits into the same mold. Why hold someone back that is capable of working as a second? Conversely, some require more time to get comfortable in that role.

Hmmm... wonder what got the negative? Was it A ) Drawing attention to the fact the my work orientation was longer then an EMT-B program? B ) Poking crotch in the eye? I'm going to guess B ). Oh well I can take a joke as I tell them. Inconsistently and incomprehensible.

Three weeks of classroom covering a wide range of topics. (just to be clear that 120 hours is not some EMT course. It's just employee orientation.) Three shifts as third. 20 shifts on driving restriction (L&S to a call, but not with patient on board; partner initials after each shift, reviewed by Superintendent before sign off) Six months of probation. And crotch, just because I've grown impatient with so much coffee today, what issue in EMS are we being blind to, how is it costing lives and how can I be made to feel guilty about it?

http://www.jems.com/news_and_articles/articles/jems/3208/the_high-tech_heart.html http://www.chfpatients.com/implants/lvads.htm CPR & other treatment: Due to the location of the LVAD and its proximity to the heart, there may be risks associated with performing chest compressions. CPR may damage the LVAD itself or dislodge tubing, resulting in massive hemorrhage. The use of hand pumping in place of CPR is possible and may be indicated in some situations. Decisions on whether or not to use CPR should be left to medical control.11 Further treatment considerations focus on physiologic changes related to their underlying disease process, such as dysrhythmias, electrical therapy (defibrillation/cardioversion), ACLS or trauma care. The use of electrical therapy depends on the make/brand of the LVAD. Keep in mind that the patient and family will be well versed in emergency procedures and know how to manipulate the LVAD system in case of an emergency. The patient and family will also be educated on which kind of therapy the patient can or cannot receive, so emergency care providers should always keep the patient and their caregivers together during treatment and transport.

Does it really matter? If it's a choice between using NS or D5W as a vehicle for D50, I cannot see where the conflict is coming from. If we are talking about tonicity, electrolyte imbalance, and solvent/solute shifting and the implications for patients with various conditions, we have a discussion. However, I dare say the topic at hand does not relate to such concepts. Seems like the "I was told this and he was told that" situation. The best thing to do is ask the following questions: 1) What was the reasoning behind using NS when you were taught? 2) What was the reason for teaching D5? If the answer was something like,"because they said or medical director preference" a comprehensive argument or discussion does not exist. Take care, chbare.

PART 2: Commissioner: Not anytime soon. Fire Chief: Fine. I'll buy some ambulances out of my current budget and staff them with fire medics. Commissioner: You don't have a transport license. Fire Chief: Yes, but eventually you'll have to give me one or the public will wonder why YOU are stopping the FD from saving lives. (This is why Fire will always win)

Explain to him that the problem is NOT the FF-EMTs or FF-Medics, it is the Fire management and the bean counters. Management wants EMS call volume and income to subsidize and justify the fire side where calls are down thanks to building codes lobbied for by Fire. Part of that plan is to quickly and easily make and keep as many FFs as EMTs/Medics as quickly and easily as possible. Increasing the barriers for their FF's (who they want to wear many hats) to become and remain medics by increasing education standards is not in their plan. The line Firefighters are usually plenty professional. I think most Fire EMS people who actually want to do EMS (and there are plenty who don't want to do EMS) are people with no problem with increased education as long as they get out of it what they put into it (in opportunity and pay for time). However, most Fire Management isn't that interested. They are FIRE Management, right? Remember, it is Fire-EMS, not EMS-Fire. Nevermind which side gets more volume.

Umm ..... OUCH .... I guess when your standing in the sunshine your bound to get burned a bit. You make some good points: I too believe that any PR is good PR ... I have spoken with others in the medical community and because generally speaking because of the "hype" generated this has increased the viewers just to see for themselves. cheers

It was so tempting to hit negative there.

sounds like some of these people need to lighten up alot. dont take crap and themselves so serious!!!!!!!!!!!!!

YES YOU ARE

So if I majikally lose 5 reputation points every night after the counter resets... I guess that means I permanently pissed off an elite member, right?

Great info and a great link... sometimes I really think I should go RRT instead of RN...

This looks mighty useful for rescue situations where bagging the patient is very difficult, much less regular bagging. Sometimes bagging is even a hindrance to extrication (think confined space, MVC entrapment, high angle, wilderness).