Leaderboard

Welfare checks, maybe but... There is also nothing in the Paramedic curriculum that would prepare a Paramedic to do what RNs do in home care. When was the last time you staged a wound and applied treatment? What do you know about insulin and diabetes teaching? Nutrition? Tube feedings? Various vacuscular access devices for the long term? Chemo? Stoma care? Various ostomies? Evaluated BP medication effectiveness? Administered all the typical medications many, many times to be familiar with them? Did family education for all of the above procedures? To be effective, one should have enough knowledge and experience where all issues involving long term patient care should come easily for the practitioner. For the CCEMT-P, some ambulance services hand out those letters after a two hour inservice. They may even call them that so the truck can be a CCT but due to protocol restrictions they may not have any more skills or knowledge than a regular 911 ALS truck. Some Paramedics, such as in FL, can have an expanded scope to do IABP and ventilators. However, again, the training/education will vary from 2 hours to 2 weeks. And yes, some doctors have refused to let some Paramedics take the patient unless a nurse went with them when they appeared clueless or overwhelmed by a critical patient. We have also had some very back adverse outcomes from Paramedics transporting patients that were way out of their expertise. Unfortunately the Paramedics didn't understand enough to ask questions or what even what questions to ask. The UMBC CCEMTP is a very basic overview of a few critical care concepts. In two weeks it is very difficult to teach one to be a competent critical care clinician. Several RNs and RRTs have taken the program only to be disappointed in the material but most already had critical care experience and found it to be very basic knowledge. For the Paramedic, it is a decent program but should NOT be taken as an end all or even a good beginning for all there is to know about critical care medicine. Too many have come away from the UMBC class thinking they know everything there is to know and that leads to very bad things for the patient they are assigned the responsibility of. There are only about 5 states that do recognize the CC-P/CICP/CCEMT-P credential in their list of levels. I believe Ohio has a decent setup for their CICP but less than 100 hours of training is required. That pales in comparison to the training other practitioners get for critical care even without the experience. If you look at the degree of the RT, it is essentially an introduction to critcal care medicine and even at that it barely scratches the surface for all one can experience working an ICU. The Canadian Flight/Critical Care Parmedic program is very impressive. Their training is adequate enough to where nurses do not need to accompany them. But, it is built off of an already impressive education foundation. U.S. Flight Paramedics can also have an expanded scope and often do get a decent amount of education and additional skills from their employer. However, the ideal candidate should have at the very least college level A&P. Pathophysiololgy and Pharmacology would also be a big plus. As it is now, an RN is usually paired with the Paramedic if they do CC IFT. It is even difficult for CCT and Flight RNs to keep up with all the advances in Critical Care medicine unless they are hospital based or continue to work in an ICU on their off days. Paramedics do not have that opportunity nor to they have the base education required to fully grasp all the critical care concepts if they graduated from a Paramedic program that just did the minimum "hours of training". Just learning a few "tech skills" to be a knobologist for the IV pumps and the ventilators are not sufficient to manage an intensive care patient. Unfortunately, those that have gotten a CCEMT-P patch from their employers with little training rely on speed to get from point A to point B if taking a nurse is not an option or they bluff enough to make people think they are well qualified. There are of course exceptions. Rid has explained his program for CCT and it appears to be quality.

In one of his books, at the time I read them he'd written three, John Douglas claims that staking should be one of the police's highest priorities as very often it concludes in murder. (I shouldn't have offered Journey Into Darkness as the source as I don't really remember which one these thoughts came from. Sorry about that.) So it follows, according to him, that if you terminate the stalking, then very often you will prevent a murder. Again, he claims the stats to make such a claim and it seems if anyone would know, he would, so I simply accepted his statement at face value. I found all three of his books riveting, for what that's worth, should you ever want to take a look at them. Dwayne

http://news.yahoo.com/s/ap/20091017/ap_on_re_us/us_encouraging_suicides Minn. man suspected of encouraging suicides MINNEAPOLIS – A nurse who authorities say got his kicks by visiting Internet suicide chat rooms and encouraging depressed people to kill themselves is under investigation in at least two deaths and could face criminal charges that could test the limits of the First Amendment. Investigators said William Melchert-Dinkel, 47, feigned compassion for those he chatted with, while offering step-by-step instructions on how to take their lives. "Most importatn is the placement of the noose on the neck ... Knot behind the left ear and rope across the carotid is very important for instant unconciousness and death," he allegedly wrote in one Web chat. He is under investigation in the suicides of Mark Drybrough, 32, who hanged himself at his home in Coventry, England, in 2005, and Nadia Kajouji, an 18-year-old from Brampton, Ontario, who drowned in a river in Ottawa, where she was studying at Carleton University. While the victims' families are frustrated that no charges have been filed, legal experts said prosecuting such a case would be difficult because Melchert-Dinkel didn't physically help kill them. In the meantime, he has been stripped of his nursing license. "Nothing is going to come of it," Melchert-Dinkel said of the allegations during a brief interview with The Associated Press. "I've moved on with my life, and that's it." The case came to the attention of Minnesota authorities in March 2008 when an anti-suicide activist in Britain alerted them that someone in the state was using the Internet to manipulate people into killing themselves. Last May, a Minnesota task force on Internet crimes searched Melchert-Dinkel's computer and found a Web chat between him and the young Canadian woman describing the best way to tie knots. In their search warrant, investigators said Melchert-Dinkel "admitted he has asked persons to watch their suicide via webcam but has not done so." Authorities said he used such online aliases as "Li Dao," "Cami" and "Falcon Girl." The Minnesota Board of Nursing, which revoked his license in June, said he encouraged numerous people to commit suicide and told at least one person that his job as a nurse made him an expert on the most effective way to do it. The report also said Melchert-Dinkel checked himself into a hospital in January. A nurse's assessment said he had a "suicide fetish" and had formed suicide pacts online that he didn't intend to carry out. In excerpts of a Web chat between Kajouji and Melchert-Dinkel, provided by Kajouji's mother, he allegedly gave the young woman both emotional support and technical advice on hanging. "im just tryin to help you do what is best for you not me," one message said, posted using the alias "Cami." Kajouji's mother said she was given a transcript by Ottawa police. In another exchange, "Cami" tried to persuade Kajouji to hang herself instead of jumping into a freezing river: "if you wanted to do hanging we could have done it together on line so it would not have been so scary for you" Melchert-Dinkel, who lives in Faribault, about 45 miles from Minneapolis, worked at various hospitals and nursing homes over the years and was cited several times for neglect and being rough with patients, according to the nursing board. Task force spokesman Paul Schnell would not say when or if charges would be filed and stressed that the investigation is complicated because of the anonymity of Web chat rooms. He said the task force is also looking into whether Melchert-Dinkel was involved in other suicides. In obtaining the search warrant for Melchert-Dinkel's computer, Minnesota authorities cited a decades-old, rarely used state law that makes it a crime to encourage someone to commit suicide. The offense carries up to 15 years in prison. The law does not specifically address situations involving the Internet or suicides that occur out of state. George Washington University Law School professor Jonathan Turley, who follows the issue of physician-assisted suicide, said he has never heard of anyone being prosecuted for encouraging a suicide over the Internet. Typically, people are prosecuted only if they physically help someone end it all — for example, by giving the victim a gun, a noose or drugs. Last month, a Florida man was charged in his wife's suicide after allegedly tossing several loaded guns onto their bed. Turley said if prosecutors file charges against Melchert-Dinkel, convicting him will be difficult — especially if the defense claims freedom of speech. The law professor said efforts to make it illegal to shout "Jump!" to someone on a bridge have not survived constitutional challenges. "What's the difference between calling for someone to jump off a bridge and e-mailing the same exhortation?" he said. But Kajouji's mother, Deborah Chevalier, said in an e-mail: "He is a predator who is responsible for several deaths and needs to be held legally accountable for them."

The major difference between EMS and other allied health professionals is EMS believes it is so different and forgets it is part of medicine. For the RNs and RTs, there were a few hold outs but the majority of RNs and RTs already had their degrees long before the 2 year degree became mandatory or even before they had licensure in their State. FL and CA just got RT licensure in 1986. The RRT just established their 2 year degree mandate and many now have 4 year degrees. Exercise Physiologists have a Master's degree and have license in only one or two states. But, eventually that will change. Athletic Trainers with a 4 year degree do have licensure but have been around a little longer. Do you see how education plays a role in the career you have chosen? Why put the Paramedic at the far end of nowhere with just a tech cert when it deals with patients' lives? Many RNs also now have 4 year degrees. The majority did not have to be told they needed more education. They sought it themselves. That is part of being a good clinician and professional. The one advantage of working in a hospital is you get to mingle with other degreed clinicians. You also get to see the differences of those with a tech menatlity and those who realize they need more education since medicine is ever changing. EMS has alienated itself to where it does not relate to the world of medicine. The "oh we are so different" crap has seriously played a role in warping attitudes against education. Since you, who tries to say you are pro education but have not made any attempt to get a degree, you do not represent those who are pushing for higher standards. In fact, you are part of those holding it back. You spout off one way but state "make me" or offer every excuse not to get an education until you are forced. It is a mere 2 year degree. No one is saying you must even get a Bachelor's degree. What is so difficult about taking a couple of A&P classes and a few additional classes? Why don't you set an example instead just using "EMS" as an excuse not to get a degree? Maybe if you actually got the degree and saw what you are missing, you might be a better pro education spokesperson or at least have a little credibility when you do try to talk about it. 46young should do the same. Since you and herbie are hung up on saying the RNs did not want to get educated, let me given you an example of how you are not correct. In Dade (Miami) and Broward(Ft. Lauderdale) counties, there are 2 community colleges (2 year) that offer the nursing program. Miami-Dade Community College Broward Community College There are at least five major 4 year colleges that offer the program and all have a waiting list. University of Miami FIU FAU Barry University St. Thomas University Nurses are already preparing themselves for the future. If nursing students thought a BSN was a waste of time, they would just wait for an opening in the community college. The other programs are very expensive but most are willing to do what it takes to get a good education and secure a future. But then, that is also what every parent wants for their child also.

Dear Fireflymedic, Thank you for the understanding. If you are ever in San Francisco, please allow me to show you our department's hospitality. Seb Wong

Here's what I propose for the new levels... Paramedic - Certified (PM-C) Paramedic - Advanced Practice (PM-A) Critical Care Paramedic (CC-P) Eliminate "technician" from the job title, make PM-C equivalent to EMT-Basic in terms of skills, maybe give them a few extra tools, and make it a one year certification program. PM-A would be equivalent to the current EMT-Paramedic and would be a two year associate in applied science. CC-P would be a four-year bachelor's. This is my perfect world. As long as we have "technician" in our name, we will continue to be treated like technicians and continue to earn a technician salary. Look what happened when RTs became Respiratory Therapy and upped their educational standards. Besides, everybody calls us paramedics already anyway.

I've asked several times on this forum and others as to how this positive change will come about. I only get vague answers claiming that education will force change, education plus organization will force change, but no concrete plan of action. I've suggested that EMS learn from the IAFF's success and employ a similar strategy. Or form unions to better their deal at their particular agency. Just think, the union will demand higher wages, better retirement, working conditions, medical, so on and so forth. Management will scoff, of course. The union can come back with a suggestion that management meet them in the middle if they all up their education to a degree level in an agreed upon time frame, as a condition of continued employment. A higher quality provider deserving of this generous deal. Having successfully bargained for a better deal, other EMS professionals will seek employment there. They'll also need degrees to apply. Other agencies will lose their best employees to this one. Other employers will be forced to increase their salary, benefits, education requirements, etc. etc. to match. Just one possible scenario. At the present, I don't see many in EMS going the degree route solely for a career in EMS. Not without a federal mandate or a livable wage and decent retirement to attract the more highly educated. EMS missed the boat on increasing education. Many use the field for a quick way to make some cash without spending years in school. Since most that enter the field are doing so to earn a living without having to go to school for several years or so in the first place, then it's quite a stretch to believe that individuals in the future that enter EMS for the same reasons would voluntarily go the degree route without an immediate lucrative payoff for their efforts. RN's, RT's and others went the education route first, citing pt benefit, then increased insurance reimbursement, then salary/benefit increase, but the EMS workforce is of a different mentality.

Like II said, vent was building strawmen. You can't argue with a strawman. As for solutions, a minority group cannot by definition directly implement change. We can be the most professional and educated providers possible, but certain things will not change. Among them... First and foremost, the biggest obstacle to overcome is the organizational culture of the fire service, which is becoming more and more dominant in EMS. This is the underlying reason why it is so difficult for EMS to establish their own separate identity- independent of the fire service. EMS gets is not a self determining entity- we receive our marching orders from a medical director, and we can be quite educated and still require medical control. We will never be allowed to operate independently, unless our standards are elevated to the point of a physician. Even nurse practitioners, who are far more educated than EMS providers, do not operate without some physician oversight. IAFF is the premier and most powerful public safety organization, and receive the most publicity, the most funding, and have the most political clout to effect change and implement policies with their PAC's and lobbyists. EMS cannot compete with that and I see nothing that suggests that will change any time soon. Like it or not, fire departments are still absorbing EMS into their fold- with various degrees of success and quality of care. Fire departments have an established and necessary infrastructure- manpower, locations, apparatus, a dedicated revenue stream via taxes, but thanks to EMS also generate revenue via billing. That increases their political power and makes them even more valuable to a municipality. From a management standpoint, fire based EMS is more cost effective than EMS. You have one person able to do 2 jobs(note I am not discussing quality of that care here), which is attractive to a city's bottom line, and these days, that is job one. ALthough many areas have seen FD takeovers, there are still many independent EMS agencies, which makes it difficult to have a united front. Yes, the altruistic answer is that everything is about doing what's in the patient's best interest. Reality is quite different than that. Does that mean we change how we do our jobs- nope. It does mean we need to try new tactics. In too many instances these days, an EMS provider who becomes cross trained tends to emphasize their fire duties over EMS- despite the fact that EMS is the bulk of their work. Too many people also use EMS as a vehicle to get to the fire service- for better pay, better benefits, less call volume, or simply to fulfill their "true desire": to be a FF. As much as I hate to say it, I feel the only way to effect change is to work within the framework of the fire service system. The problem is, how many members of that system are willing to push the EMS agenda? I think the culture is slowly changing, and gradually fire leaders are realizing their profession is changing, and that they need to adapt to that new paradigm- one that is dominated by medical care. That will benefit the patient, but I am afraid that in many cases, single role EMS providers will become a casualty of the process, and will be reduced to more of a transport-only entity after initial treatment by a fire EMS provider. If the fire service truly embraces EMS-not just lip service at the national level- then quality of care will improve, but EMS will be fundamentally changed. I'm not happy about the direction of this, but I'm merely facing reality. This is about dollars and sense, and yes, patient care, but the almighty dollar is what drives this whole process- for a community, for the fire department, for EMS, and ultimately the town that employs them.

Nobody disagrees with you on this point... for the hundredth time. You agree , I agree, Herbie agreed, Kookabura agrees, we ALL agree. Now let's stop yelling for the purpose of yelling, and come up with a plan to fix it. For all of your bluster, you have not once tried to come up with a Global solution, just banging the drum for incremental, personal change. You are so into griping about your perception, you have failed to look at this issue in the manner that it was initially presented. What do you think of the changes, and how can we make it better? Instead you have spent the majority of your time arguing in circles, blatantly changing the argument to fit your narrow view, and providing nothing substantial toward furthering the discussion. Despite that your reputation meter keeps going up... I think my mind must be going wonky... You've made more spelling mistakes in your last two posts than I have in all of my posts combined, yet you are the highly educated "alphabet soup" provider, and I the undereducated fool. If you want the standards raised, start with the spell check.... besides I've never liked the number 14 anyway.

EMS also provides inhouse education especially if you work for county, city EMS or a FD. As well many private services also offer their own CEUs. And, don't confuse a union with professional associations. They are NOT the same. We also have medic mills that offer 1 1/2 year medic programs. They meet one night a week and stretch out the "hours" of training. Our most famous medic mill also offers an Associates degree which transfers to nowhere. I believe NH still requires only 1000 "hours of training" to be a Paramedic just like many of the other 48 states. For the teacher's salary: NOTE the work AVERAGE. Go back to that post and look at the word "maximum" and the classification. It is not an appropriate comparison... your numbers are useless. Based on your entry level EMT base pay of 12.41, with a regular 40 hour work week that is $25,812.80.

cldutcher, Brother head the warnings........ Triple Canopy is a top notch service. However, like previously stated, they pay the going rate to the most qualified. Also, I can personally atest. Not all interactions between Military and Contractors oversee's are good ones. Things happen, people get hurt. Understand what you are getting into. TC has a better reputation than most, but be very cautious. Have you looked into any other agencies? Although they are on the chopping block once again (Black Water). The last time I checked they had a training program for people in your situation (motivation/willingness, but no experience). I would at least consider this as an option. Getting your foot in the door, is always the first step. Good Luck, be safe........and remember to duck. cheers

If she goes to the hospitals and tells of her plans to be a nurse, they will welcome her. In the meantime they may provide more training for different positions within the hospital with the CNA cert or even get the PCT. There's also OR and Ortho tech which can be done OJT with the CNA cert in some places which she is going through RN school which most hospitals will pay for much of the nursing program.

Not mine, but still funny.

Just because it wasn't done sooner doesn't mean that it hadn't been reported. I reported a case where a CNA manhandled my mildly uncooperative ("Why am I going there? I don't want to go?" and so on. No violence. No threats.) long term care psych patient to my gurney without even asking if I needed help. Yea, the investigation concluded that nothing bad happened.

Well, I passed the CNA exam this afternoon, anyway. Not hired anywhere yet. My first step into the healthcare field! Now I just have to find a place in Orlando that will hire me with no prior health care experience.

I hope the parents didn't discipline Falcon for telling the truth on TV.

Its sad when many utility, oil field company's, etc require that a cone be placed in front and back of their trucks when parked so they have to walk around to get cones out of way. Thus they see that no one and nothing is in front of or behind. Maybe fire should learn from them.

Can't wait to see what the charges are. I'm livid about the whole situation, let me tell you... Poor kids. Stuck with idiot parents like those... Wendy CO EMT-B

(-)

Dear Phil: Sorry to send the postcard to your Mother ...

I don't know what points you are missing. I have given many examples of how nursing and other allied health professions encouraged those entering and already in their profession to get a degree long before it was required because they KNEW that was their ultimate goal. They didn't wait for some union to say it was okay or wait for someone to MAKE them get a degree. Most saw the need themselves. Once the educated become the norm or increase in numbers enough to show a difference between the grads from a medic mill and a degree program, those with legislative powers will get the message. Thus, it is up to those in EMS to start controlling their OWN destiny and that of their profession. The other thing, as I have also mentioned many times in this thread, is to raise the educational standards for the instructors and make them true educators. That could within reach more realistically but at this time since there are few with even a 2 year degree, it will take a while to implement that. Once the instructors become educated, they can be role models for education rather than relying on "fish" tales to prove their value in the classroom. Honestly this is not a difficult concept but if those who are providing the patient care fail to see the importance of an A&P class, what hope is there. Unfortunately too many are like you who just want to wait and be made to get a degree instead of taking the initiative yourself to set an example. If you already have a degree as you say, why do you think a mere 2 year degree is so unrealistic? Once there are more educated people to speak for education, the IAFF and private ambulance complanies would be foolish to point out education is a waste if it puts them in a bad light with the tax payers. But, you can just sit back and continue to make excuses so you and the herbies of EMS can complain about the FDs. But, I think this speaks volumes for your stance. You are an EMT and not even a Paramedic but yet you are trying to tell us about a degree as a Paramedic. This would be like a CNA telling an RN that his/her BSN shouldn't be obtained until they are made to get that degree. But, you are not even pursuing the Paramedic or even EMT as a career. After 30 years I still have hope that the Paramedic will become a recognized professional health care provider but that is only if we stop catering to the weakest links and listening to the excuses or blaming someone (or the FD) for our failures in EMS. I have been around to see first hand the many changes in medicine and that includes the many professions which are a lot younger than EMS. Medicine is not fantasy. It is a very much a reality which is based in the sciences. If a profession doesn't understand a few simple sciences, it becomes stagnated. That being said, thank you for the compliments and good luck with the restaurant. I wouldn't mind having a wine bar and bistro for my retirement hobby. But, I am not oblivious to the fact it would take considerable education and dedication just as EMS should.

Here's a question - how far up must one be in the medical establishment to be a force for change? Are there doctors who would be allies in working to mandate increased educational standards? Or would Paramedics and EMTs who wish for prehospital care to become a respected profession need to leave the field behind and go to medical school in order to be in a position with sufficient leverage? Are medical directors able to require that all Paramedics working under their license have an AAS? And VentMedic's reputation meter keeps going up because people recognize that she is saying what needs to be said. We're dealing with people's lives here - no room for mollycoddling. I may be a rookie, but I can tell when someone is speaking from a place of experience. Like I said upthread, I came into my EMT/Paramedic program expecting the people in it to be the best of the best. While it's too early to tell in the Paramedic program, I was appalled at the lax attitude of many of my fellow students in the first year. I can also say with confidence that I would have learned more if those students had been washed out early in the program. Their presence was a constant drain on those of us who took the course seriously. Getting an AAS really is not that hard - most of my classmates have families, and there are several single mothers who also work full time in slave wage positions. They are some of the most organized and dedicated students. If they can do it, anyone can. The biggest obstacle people have is in their own mindset of "can't".

Excellent Post. A couple of years ago we got into a similar education debate on this forum, and after we went on for ages exclaiming the need further education, and stop volunteering our time, I asked how do we fix it? The Thread petered out rather quickly s/p that question. I agree with all of what you say, and have long held the belief that through organization, cooperation, and negotiation, we can reach the goals of independent profession. Obviously it would be difficult to completely flesh out the template in which to proceed because things never work the way in which we foresee... but I like the skeleton format that you have presented in your second paragraph. I also agree with your assessment of the general workforce in EMS (the same that Ventmedic has been correctly espousing). These are real challenges to change, especially if we continue to be a fractured and fragmented industry. The major difference, in my view, between EMS of today, and Allied Health professionals of old, is the presence (or lack thereof) of a progressive guiding force. I feel pretty certain that not all RN's and RT's were on board with increased standards and responsibilities without immediate recompense. They were required to make those changes because both the medical world and their professional leaders were mandating these changes. EMS does not have this coordinated leadership to enact change. At this point in the game, it would be difficult to accomplish these changes in the same manner because of past practice. JPINFV- Far be it from me to speak for someone else... but as I read Herbie's post, I interpreted it to mean exactly what you said. Independent practice in the US system is not an appropriate goal for EMS because it isn't allowed in almost all of US health care. We are a Nation of Check and Balances... at least that's what we are supposed to be.

Yeah, man, the whole stalking thing sucks. You can't watch a stalker every second, you can't lock them up for ever when they've not usually broken any laws, and attempts at prevention is likely to make the situation worse, as you've stated. It's just a bag bag of luck. But I do think it would be interesting to view this dickheads behavior from the stalking point of view and see if it fits. If he was hounding these damaged people into submission, or simply took individual moments of opportunity and got 'lucky' from time to time, finding someone ripe for his encouragement. Dwayne

I'd seriously love to see that guy interact with his friends. "No! No! Call me 'Mr. Cool Ice'!" "Ok. Whatever, David."

Saying that the crew was "lazy" in this case seems overly harsh. Every service, paid or volly, have their policies in place, whether enforced or not. And that is a management issue, not a staffing one. Management provide the right lead, the crew will fall into line. Personally I don't believe that the crew was lazy, so much as complacent. Yeah, I realise, not much of distinction, but a distinction none the less. Additionally, drive out the bay 1000 times with no incident, what is going to make ANYONE think that 1001 is going to be the problem.The entire situation is definitely going to make me re-think how things are done at my service, because we do the same thing, hop in, open the door, and roll. I do agree with spenac though, that 15 seconds will make no diifference in outcome to a pt. I think that it's something I am going to take to the management at my service. Just my two bits.

Apparently you wouldn't, because you are not listening to what I am saying. I am not saying give them money and hope they get more education. I am saying increase the standard of education, then reward them with more money. I'm not sure how you could see otherwise. Yes, so do we... but theirs is often paid for by their school district in the ubiquitous "work-shop" days. Just like EMS, they can choose how much education they want to receive after the minimum is achieved. Their minimum just happens to be higher than ours, AND, they have a strong union presence and established educational standards. She would... if it were true. There are no 6 month Paramedic programs that I know of in my area. The Medic "trade" schools are 1 1/2 year courses, and a lot of programs are now being offered in technical colleges, awarding 2 year associate degrees for completion. I can not speak for Florida... but if you are putting Medic's through in 6 months... I would be concerned. BTW... you changed the criteria with your reply. We were comparing entry level to entry level, then you gave average salary for Teachers in FL. If beginning teachers with no experience get paid 42k to start... we live in the wrong state. Now you are fixing the numbers. 160 hours a pay period, I haven't been able to work 80 hours a week in a while. It is not an appropriate comparison... your numbers are useless. Based on your entry level EMT base pay of 12.41, with a regular 40 hour work week that is $25,812.80. Based on starting Medic pay of $46,845 on a 40 hour work week, that is $22.52 an hour... Starting medics in FL get paid 22 an hour? Doubt it. This argument has been about entry level education... let's not change it to average just to suit your position. Don't go hiding behind the fact that this is a posting "copy/pasted" from the County either. If you are going to do the leg work, find out what it means first, and apply it to the issue at hand. No one is disputing the benefits of education, despite your assertion that we are... been reading Mein Kamph recently? Finally!!! You have made sense. This statement has been the crux of my argument the entire time... of which you have soundly ignored the entire time. If more energy was put toward this end and less toward trying to intimidate and shame people into education, we might affect some change some day.

Tattoo thread?

I would notice it but I don't think I would give it any thought. Lets face it alot people get tattoos not knowing it's meaning. They just like the design and wanted it on their body.

They were lazy. This is another reason there should be no remote controlled doors at fire, ems, police stations. Make someone stand there hit button, watch ambulance, truck, car pull out then hit close, jump in and then go. This ensures people see what is in front before moving. It also delays less than 15 seconds and 15 seconds in the field will not change patient outcome.

I and probably 95%+ would not even notice the tat so it is of no benefit in an emergency situation.

I wonder if they couldn't pursue, or at least closely monitor him based on his psychological proclivities associated with serial murder? Imagine, investigate, accomplish, practice, improve (something like that). When reading "Journey into Darkness" I think it was (A book written by the man that imagined and then developed the behavioral science unit for the FBI) he states that stalking should be one of our highest priority crimes, as "Stalking is a proved preventable murder." Perhaps there's available fodder there, related to how committed he was to making contact with the same individuals on different occasions? Not sure, but I wonder how far the leap is from fantasizing over these things, to trolling these sites, to encouraging these suicides, to possibly forcefully hanging the less than willing? Of course, I'm making many assumptions based of a few lines in a newspaper mixed with some years old psychology classes, and it is 0400, so that might all just be crap... :-) Either way, should it be Dylan found hanging, I can guarantee that the end of his life would make an interesting M&M. (No, not candy, Morbidity and Mortality review) Dwayne

This isn't about being careful with what you say, it's a valuable lesson in identifying pathological issues in someone who's supposed to be a patient advocate. I'm glad this guy's license has been revoked, at the very least. I'm surprised that it got this far, with allegations of roughness throughout his past... if that is the case, someone screwed up somewhere along the line and this guy should have been identified and yanked a long time ago. Scary stuff to be sure. Wendy CO EMT-B

Why did someone neg 1 the original post? It's a copy of a news story, not an original piece of work.

In regards to the highlighted portion of the text......In the most basic terms....NO, Advanced education is the key, and I will probably offend a lot of people on this board in a second when i say, YOU REALLY DONT KNOW, WHAT YOU DONT KNOW!!!!! There is NOTHING worse with someone who has a little bit of knowledge on a subject to start imparting opinions to the masses as if fact...... Unfortunately, I can easily give an example is the world of HEMS.....You take type A medical people, put them on a helicopter or airplane for 1 year, and all of a sudden they are experts on METAR's, Cloud Ceilings, Prognostic charts, Approach plates, and last but not least, think they can fly the aircraft if ever needed in an emergency.....I see it all the time.....This is why you have the inherent in fighting between pilots and medical crew.....It makes for a bunch of second guessing....However, you never see a pilot lean over and say, " Did you really need to Intubate that patient?" I can speak on both sides because i have the education as BOTH a pilot and flight paramedic! So, the bottom line IMO, Make the EMT-I the new EMT-B, and force all Paramedic programs to a minimum of a 2 year degree, and then give us the option of pursuing the Critical Care Paramedic or Certified Flight Paramedic.....Both latter certs are way beyond the general paramedic and require much more extensive knowledge....I cannot imagine not having taken Pathophysiology, Organic / Inorganic Chem, Pharm I & II, etc.....and be where I am at today....Again, a little bit of knowledge is the scariest thing alive! I apologize in advance if I offend anyone..Not my intention.... Respectfully, JW

What I find frightening is this: Alot of those that are rallying against a 300 hour course as 'entry level' are the same ones that support that 120 hour course as 'entry level', and they're fine with that! I've said it before and I'll continue saying it: EMS needs to back away from the 'minimalistic attitude' when it comes to education! We're talking about peoples lives here... As far as the debate between EMT-I (I-85 and I-99), it's a 'no brainer'. Obviously the I-85 level of education isn't as expansive as the I-99. Could this be why they revised it in 1999? No, not every patient is going to need ALS treatments; hell, they're not all going to need LALS either! EMT-B has a spot in EMS, especially when dealing with the 'boo boo crowd', the 'hey y'all watch this/here, hold my beer crowd' who does stupid shit and recieves minor injuries! (Yes, I even saw my own 'value' as such when I was an EMT-B!) Do I advocate higher educational standards for EMS? You bet I do! Even the systems that have been suggested that we model after have multiple levels of providers! Yes, I may be in EMT-I class right now, but I'm NOT stopping there! I'm pushing for an Associates Degree in Paramedicine. The ONLY reason I'm in EMT-I class is because that's how the program was set up....EMT-B/EMT-I (I85) are one course.....

First off, while not actually dealing with the subject at hand per se, the following study did come to the surprising conclusion that Log-Rolling Pt's produced far more potentially injurious C-spine motion then the "Lift-and-Slide" technique. Anybody else surprised? The Spine Journal Volume 4, Issue 6, November-December 2004, Pages 619-62 C-Spine.pdf In regards to your post Kiwi, this is from an older post of mine. It does not take much force to cause a c-spine fracture. Dust was right on the money when he said: "the unfortunate fact is that there is no recognised, objective criteria available in an unconscious patient with which to rule out spinal injury. "

Yeah man, you make a great point. I love the scoop. Way more comfortable for people, they stay more easily in the center, less movement on our freaky country roads...much better option I think, though again, I can't prove it. All geriatrics, if I absolutely can't clear them, go on the scoop. And I agree completely with the rest of your post as well. Dwayne

We threw out longobards a couple years ago and now just use the Ferno scoop stretcher (we have some of the old metal oes lying around still, used one the other week) with a collar. If you ask me it's probably 70/30 placebo vs benefit Does that mean I don't do it ... no ... does it mean it should go the way of the MAST pants, no, for now at least until we get some very, very large randomised controlled trials done or get portable x-ray in the ambulance. Sorry guys but I just laugh my ass off watching things like Trauma: Life in the ER and see a guy come in all boarded up with blocks and tape and whatnot because he fell over on the sidewalk and knocked himself out.

I agree with 'Lone'...Hopefully your partner is providing manual cervical stabilization, and I emphasize the word stabilization, and properly before, during, and after the log roll. The cervical collar does not mean you can release the stabilization until fully secured to the backboard. Of course this is provided after all physical exam has been performed. The c-collar does assist with the neutral alignment when providing this manual stabilization. As when placing the c-collar itself, whenever you think necessary, as long as the c-spine is being attended too.

I've read an article called “cervical collars in patients requiring spinal immobilisation”. The researchers come to the conclusion that cervical collars provide minimal benefit to patients suffering from spinal injury. As with everything I guess it depends on what literature you stubble across, some people preach cervical collars while others say it provides minimal benefit. I think spinal immobilisation is one of those things that just needs to be done to the best of our ability. I've been in an unfortunate situation at a Motocross race were no matter what we did or from what angle we approached the situation if we moved the dude we were going to cause further damage. What can you do? Leave the guy prone in the mud for the rest of his life or get him to hospital. Fortunately there was someone senior to me on the scene who made the call to move him, you need to provide adequate documentation and justification for your actions. I'm a fan of evidence based research and best practise so until some new wiz bang guideline is published and recommended by the appropriate authorities I'm sticking to what I've been taught which is collar on, strapped to the board and head blocks.

Alright you pervs A "sticky test" is basically a quick test to detect the presence of any leaking bodily fluids. It consists of putting the hands on all visible parts of the body (the parts on the ground) and checking for the presence of blood or any other, sticky bodily substances. It has another name, but I have always referred to it as a sticky test. Now get your minds out of the gutter! Eric

I'm scared about the "sticky test" wtf... If you do things backwards you are putting your patient at risk. EMS Standards state to place the collar THEN move onto a backboard.... Follow protocol and SOP's... and wth is a sticky test?!?

I don't think you realize the magnitude of the question you are asking. There is no science behind C-Collars, so it is nearly impossible to answer your question. As a health care provider it would legally foolish of us to tell you to veer out of the "standard of practice".

Almost every safety regulation comes as the result of a disaster. It's pretty darn uncommon for someone to be laying in front of your apparatus IN THE STATION like that, but obviously it happens. If that department does not immediately institute a policy of having a ground guide for exiting the station now, they're looking at big trouble down the line. I expect we will see such a policy crop up many other places too. However, I also suspect that way too many drivers will ignore it just like they ignore the requirement for ground guides while backing.

Realistically, this could easily happen even if no one was in a hurry. Depending on the setup, you might walk into apparatus bay, push the open button, walk to the doors and get in. The doors may open kind of slowly and you're already either inside or opening the rig doors from the side. By that point, you've lost view of the floor directly ahead of you (for a certain distance). Also, why is everyone assuming they didn't recognize their own address? How do you know it was dispatched to their address (especially when the article said they were responding to a location NEAR the station)? I'm down for slamming those who are lazy about their EMS responsibilities, but realistically this could happen to many responsible people. EMS or FD

Apparently some do if you read the comments at the end of the article. This one knows her truck has a blind spot and still "open the doors and go". Anyone working in a residential or urban area knows you check for curious kids wanting to see the big fire truck or ambulance and tourists (Florida). In Florida, you also know there will be someone coming to the station for a BP check at all hours of the day and night especially if there is a condo community across the street. If this had been someone who ran over a person with their POV in their driveway, these FFs would want them locked up for life for being stupid/careless and not looking behind/in front of their vehicle.

You mean you don't exit the station with your eyes closed?

So they didn't recognize the firehalls address as the call location? Maybe looking out the bay door before pulling out the ambulance might have helped?

WTH is a semester hour? Every college I know of in the US uses semester credits... so a typical class is 3 credits meaning you meet for 3 hours a week... But I agree with Dusty... hours don't mean jack shyt if the instruction is piss poor. I know some colleges who I wouldn't trust the quality of their degrees at all but they're still universities and colleges.