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I earned the negative rating it is not linked to this post but rather me. It wasnt easy to get this rating it required alot of effort and I get really upset when someone agrees with me and gives me a positive rating which ruins the whole thing. I was at -21 just a few days ago and 3 rude dogs went and ruined it by giving me positive feedback. As far as cheating on anything the old saying that 'your only cheating yourself' is true, education uses testing to measure whether the approved subject matter has been presented well and that the students have retained it to a level considered acceptable to the governing body in charge of the discipline studied. It is not the end all of the curriculum just a tool to measure teaching skills and student retention. When students fail a course the person at fault is not only the student but the teacher. If you teach a course and your students do the bare minimum or cheat to get by you either did not impress upon the students the importance of your course or did not weed out the students that were not suited for your course.

You'll probably want to talk to anyone local that deals directly with helicopters over those ideas. Also, if you are planning on running a medivac service, do you have the funding to provide the proper people, support services, and licensing (both state EMS office license and FAA licensing)? How about insurance (both insurance for the helicopter and malpractice insurance)?

Is this serious? Honestly? Not trying to be a jack ass. Do either of you have any sort of aviation experience at all? You don't just stick your motorola radio ontop of the helicopter dash and say you are good like you do on a F-150. There are companies that deal exclusivly in providing for public safety aviation. Assuming you are serious in starting this buisness your better bet would be to court the companies, get contacts with sales reps, and then research the materials to find out what you will need.

First and foremost, remember that it is never as bad as people make any new thing out to be. The sun rose this morning, and will rise again, despite all the claims of the pending armegedon. This debate is much like that of the "fair tax" issue. People who are against the fair tax claim it is bad because everyone would have to pay a new huge tax on top of consumables that they buy; what they don't understand is that you are currently paying that tax now when you buy something, it is just embeded. For instance, if you buy a loaf of bread for $2.00, the cost of taxes paid by the farmer, the bread company, and the transportation company (and any other assoicated cost you can think of is in that $2.00/loaf price. The same is true of healthcare. We are all paying the price for the uninsured through higher fees and premiums. Thats why an aspirin cost $10.00 in the hospital, because you (who are insured) are paying for all the free aspirin that was given to others. If they can get everyone to buy insurance, all of our rates will come down.

I think it will make those of us who have to work for a living, broke.. While I may not have health insurance now, because I simply can't afford it, I still don't think I could. They couldn't deny me, because my intestines poke through my abdominal wall ever so slightly. I also feel it will be the end of "little" EMS Services. That's bad for a lot of people who can't afford to be served by big for-profit companies who don't really give a piddly poo about the people. You may have good employees, but with less going to EMS and more to physicians, who aren't going to take a pay cut, the bad will be filtered down through us all. Oh, and I voted for Obama. I support Obama. I do not support this.. and my local congressman can kiss why pink Irish ass. I would put a bullet through my head, before I'd let the government decide how I handle my health. I'm neither democrat nor republican, and I'm a member of a party that would draw much criticism. Furthermore... Oh, who am I kidding. Go peddle your papers in Washington.

Since they are referred to as EMTs, it's hard to determine what their level of training actually is. But in MD, it's a moot point. They all suck. Just to reiterate the obvious, I notice it was -- as always -- a FIRE department.

I do, and they know it. That's why they're poisoning my food.

Do yourself a favor, Richard. There are plenty of sites that offer a summary of the changes this bill will create. I don't know your political affiliation, but if you like the principles this country was founded on, many of these changes will scare the hell out of you. I don't agree with an armed revolt either, but there are always the lunatic fringes on these things Sadly, most people are simply too lazy to do what's necessary to make the changes we need. As for the "vote", too many people vote along party lines and enable Congress people to stay in office for 30 or more years. I'm sorry, but NOBODY is that good. What does it say about a district when they feel that for decades, they couldn't find anybody in their district with a better idea than the incumbent? Term limits, folks. If it's good enough for the POTUS, it should be good enough for Congress- especially since they are actually the ones responsible for how our tax dollars are spent.

This comes from instilling a sense of 'entitlement' to our kids. We've taught them that you don't necessarrily need to expend the effort to get the 'prize'. Couple that with the latest trend to only put forth minimal effort, and look what you get! How many times on this site alone, have you seen people wanting to know the 'quickest' or 'eaiest' way to get through EMT (or higher)? We can spend all day long extolling the virtues and benefits (not only to our patients, but to ourselves as well) of higher education, hard work and honest effort. People aren't listening, because we're not advocating the 'easy way' of doing things. There's too much focus on 'instant gratification'. Unfortunately it doesn't exist. If there's something you want to accomplish, then be prepared to WORK for it!

.....*gets out the popcorn and pulls out a chair for this one*.....

Just a quick rant here and a rhetorical question, but what compels one to cheat? Is it really that difficult to do the work and then test your knowledge? (Argh!) I needed to take a FEMA IS 700.a class for my new job. To find the website, I did a quick google search on FEMA ICS 700. Guess what the first option was that popped up? "FEMA Answers" I get the gist...and go through the course and take the test...but now my curiosity is up. After printing off my successful completion certificate, I go search. I'm appalled at the number of people who have posted something to the effect of, "I need the answers...now." I'm not naive. I saw this in school and thought it was immaturity. I decided that somewhere along the lines those people might just wash out and it wouldn't be a big deal. But, what happened to pride in one's self, in betterment of one's education, in personal integrity? Or is this simply more entitlement? I don't have to work for it because someone will just give it to me. Worse yet...the answers can be found if you look hard enough. Hey...you who posted the answers. Do you really want THAT person on your team who's not going to know what to do? Okay. I'm done with the rant.

Folks say, the only dumb question, is the one that is never asked. Well, I think we've proven that theory to be false.

I will be the pilot.. just pay for my flight training.

I will sell you an EC-135 complete with all equipment. I will provide pilots, crew and mechanics. I will also provide a base and hangar. All I need from you, is 300 million dollars.

Get one of those Vietnam era choppers from federal surplus and run a dustoff service.. using old, retired, corpsmen and combat medics, with no modern training. Say that you choose not to recognize the fact that it's 2010, rather than 1968.

It's a scary step to take but I do believe it's in the right direction to progress the profession and improve patient care standards. Educated professionals providing care to the public without any "mother may I" hoops to jump through will bring more benefits than draw-backs. Continually revised and updated standards of practice to which providers work without requiring further direction are the norm within other healthcare professions. EMS needs to follow suit on this one. I posted this thread looking for exactly the type of respectful productive discussion that has occurred. I would like to extend a big thank-you to everyone for keeping things on topic and productive throughout. Thank-you in particular to our members from the real "deep" south who have done a particularly good job of defending a viewpoint that closely mirrors my own. This is the kind of discussion from which greatness stems. Let’s all ensure it becomes something more than just discourse by petitioning our governing bodies for the better educational standards such autonomy will demand. The first step along this particular path will without question be education. Ed

I am blaming Albert Einstein for this… One of his famous quotes “never commit to your memory what you can find in a book.” I think too many students take this quote to heart, and do not try to learn, forgetting that in the field, taking the time to look things up is not always an option. I agree with the integrity issue as well. Albert had another quote on that, which is far more fitting for this situation “Anyone who doesn't take truth seriously in small matters cannot be trusted in large ones either.” I have seen students use the on-line question information for a number of classes, either for good or bad. I have seen students use these sites to develop quizzes to test each other; when used for this purpose, these sites show value. I have also seen these sites used just as tcripp and JakeEMTP described – as a way to try to shortcut learning. Like Jake, I see this in a number of refresher courses, including CPR and ITLS. Jake, I think you handled those students very well! I tend to give a lecture at the start of my classes: “In this class, you are required to have the mark of 80% to pass. Some of you are already giving me that ‘OMG 80% is awfully high’ look. I want you to think about it for a minute. If you were sick or injured, or a family member of yours was sick or injured, do you want the EMT or medic who just got 50%? Or even just got 80%? Or do you want the person who excelled? My bet is that you want the person who excelled.” (I usually see lots of nods here) “So, my challenge to you is, be the student who excels, not the one who just meets the bare minimum. When you are studying, ask yourself if you know enough to give the kind of care you would want.” I usually have to remind some of them of that short lecture during the course of the program, but it does have an effect on some of the students, and those students I am so proud of when they succeed. I don’t know how to break this cycle of entitlement, as beating it out of people isn’t an option….

Totally NOT what I thought this thread was going to be about.

If you cheat in class or on a test, you are only cheating your patient whos life depends on you. It's unfair and uncalled for to those who have called upon you at a (possible) dark moment in their life.

This is why I like a standard approach to determining death in the field. Mine goes like this: Skin coulor and turgor Resp effort Carotid & radial pulse Signs of trauma incompatible with life and or lividity/rigor Pupil assessment ECG in multiple leads It is easy to add to this list...... But it should not be shorter. All these assessments can be done in 1min. Obvioustly the guy was breathing too. That is 2 systems that were not assessed.

Wow... the Advanced Paramedic website is fancy. http://www.apl4911.ca/ Now we have an idea of where the owner has been spending some of the money he's made off of exploiting those poor people who just want to fly into the blue yonder with critically ill patients under their care. On the Alberta College of Paramedics job postings I see that Advanced Paramedic is hiring for what looks like all positions. Would those who take those positions be considered "scabs"? Mind you, if you want to fly for peanuts then now is your chance to get on with them...

As much as I hate to say it, I'm almost expecting a civil uprising in this country. During his campaign, Barack Obama made the comment: "You go into these small towns in Pennsylvania and, like a lot of small towns in the Midwest, the jobs have been gone now for 25 years and nothing's replaced them," Obama said. "And they fell through the Clinton Administration, and the Bush Administration, and each successive administration has said that somehow these communities are gonna regenerate and they have not. And it's not surprising then they get bitter, they cling to guns or religion or antipathy to people who aren't like them or anti-immigrant sentiment or anti-trade sentiment as a way to explain their frustrations." Unfortunately, our present Presidnent is pushing the American people to fulfill this 'prophecy'. With the Obama Democrats willing to give this country and everything we've worked for to this point to every illegal immigrant, it's no wonder that the American public is getting fed up! Even those that were so happy to suupport his 'Yes We Can' campaign because of the hope for change are now sorry they cast their vote in his favor. I was very vocal about my opinion on how Obama wasn't what this country needed, and was ridiculed as a 'reactionist' and accused of trying to 'stir the pot' when it wasn't necessary. Unfortunately, I've been proven right, he is 'no good for this country'! Obama spent the at least the first six months trying to undo any positive changes that Bush made, so that he could appear to have 'done more', but about the only thing he's done is run us deeper in debt, and has stuck it deeper into the American public than any other President before him. Now that he's done more damage than any President before him, I'm curious to see how he thinks he's going to reverse it, and start actually doing something GOOD for the American public! I've posted it before, but it still seems relevant and applicable:

Great... now you have screwed my chances to take a couple of hemocultures in the ER... Seriously though... do you think this patients warrants aggressive antimicrobial therapy in the field or can he wait untill you get him in the ER and cultures are drawn? Does the transport time to the hospital play a role in deciding this? How so?

If you are considering digital intubation, you should have some access to the cords and therefore it would be very difficult to justify doing a cric. Digital intubation could be considered in dire situations where: 1. for some reason lack the equipment, 2. have equipment that does not work, 3 positioning of provider and patient might be an issue 4. there is a deformity either due to nature or injury that hinders the use of a regular laryngoscope scope or 5. using the BVM is no longer or not an option. Digital intubation has it place but less often now in the adult world since there are LMAs, King tubes and even the OPA that can be used if ETI is not immediately possible. NTI may even be a consideration but only not always the best. Of course the Tomahawk method should still be a technique taught as an option as well. However, for neonates and pediatrics, digital intubation may be a necessary option. Any RRT or RN that does intubation in the hospital or on transport has probably been taught this procedure if they work in the neo/pedi population. That includes the big male nurses and RRTs with large hands and fingers. It does not matter what size your fingers are, you learn to perfect the technique. Your technique may vary slightly from someone who has tiny hands but the goal is the same. Most of the procedures done in that population require a delicate touch which can be acquired through practice and a desire to work with infants as a health care provider. That should also include the Paramedic. Most pediatrics can be effectively maintained with the use of an OPA and BVM which is another technique that should be taught well, but often isn't, since pedi ETI is now removed from the protocols of several EMS agencies. But, they also seem to forget to teach OG/NG placement which then only gives you limited bagging time before the abdomen takes over the tiny chest cavity and the BVM becomes useless where even a tube placed now will be ineffective until the belly can be decompressed. There will also be infants and pediatrics that have deformities either present at birth which have yet to be repaired or may be with them for the rest of their life. This might include some cleft palate malformations or even the Down's Syndrome child whose tongue may require some manipulation. If a neonate is being born with a known congenital defect like a diaphragmatic hernia, the intubator can not dick around looking for another scope if the one he/she is using fails. That baby must be intubated and the BVM is not an option. There was also a discussion here a few months ago where someone said they used or saw/heard someone use an adult MAC 4 in the field in an attempt to intubate a baby. I would rather use my fingers if I had no other appropriately sized equipment and very little experience intubating babies before I would use a large piece of metal and risk damaging the airway to where a cric might then be a necessity or the blood from the traumatic attempt would asphyxiate the baby. Someone with a thousand infant tubes to their credit might be able to pull off just about anything with any type of equipment but then they are intimately familiar with the anatomy of a baby. Thus, learn, practice and perfect as many different intubation techniques as you can for every age group. Know how to score a difficult airway to help you choose the correct device and technique for the patient. Do not become one that says "I always use curved because I like it better" which is something that is too often learned from the classroom by playing with the manikins under poor supervision or listening to instructors who know little about educating for airway emergencies and spout off their own style as "always worked for me" rather than explain the purpose of each blade and/or method. Of course there are a few words of caution no matter what technique you use. Even if you have given a paralytic to a patient, teeth or no teeth, have a bite block in place preferably on both sides of the mouth so you don't get taken by surprise if you plan on putting your fingers into someone's mouth. This can include trying to get a better grip on a FBO. Even those without teeth can leave a nasty bruise on your finger.

...putting down my popcorn to chime in... I agree whole heartedly with this statement. I don't think anyone anywhere thinks that what we have now is perfect...but what this is proposing isn't "it" either. Instead of pushing another bad idea, let's take the time to define a truly better solution. I'm sorry that our president feels that he has to do this hastily instead of appropriately. What's the rush? Righ now, people who need medical care can get it regardless of medical insurance or ability to pay, including those who aren't citizens. So, it's not like we are drowning here.

I suggest the following to prepare for the potential consequences: Take care, chbare.

Finally getting the proof that my voice does not matter to my Government hit hard last night. Watching that witch Nancy Pelosi strut in front of protesters with the gavel made me sick. Every single time I heard "this is for Americans" it made my blood boil. I am actually scared, scared for my family, and for my children. I have NO faith or hope, esp. with Obama and Nancy needing the power as much as they do! IRS agents *edited to add link about new IRS forms, and agents for new health care

I know we have a couple docs here and I would love to hear their perspective on this from an ER point of view. I heard a Family practice doc on the radio saying that they may be forced to stop accepting Medicare patients because reimbursement will only get worse.

We certainly needed to change things like covering preexisting conditions, but it's a HUGE leap from there to a move towards socialist type health care. This is about pushing an agenda, NOT about covering more people or saving money. Mandating insurance coverage, fining people for NOT having insurance- how does this help anyone except the insurance companies and the government? How does cutting Medicare funding help anyone? Once again, the middle class take the hit. The poor and ultra rich are the ones who always benefit most from any entitlement initiative. This is certainly historic, but not in a good way. Not a single Republican voted for this bill, 34 Democrats also thought it was a bad idea, and a whole bunch of Americans are not happy either. I hate to feel like I'm sporting a tin foil beanie, but based on recent events, you have to wonder. This isn't about health care, it's about a fundamental shift in how this country and our economy works, and our ideologies. Couple this with government take overs of student loans, auto makers, and financial institutions, and how can you not read more into this?

Hey I stopped at an MVA last night on my way home... car had been hit and spun 180. guy hit windshield was wearing seatbelt. A0x3. - airbag c/o L hip pain, stiff neck, and his wrists were hurting... When i got there they had already called the police, thought the assignment was on the way... 30 mins later the police show up.. and then he has to request a BLS truck once onscene... (there was a huge ped struck w/ fly out that was going on at the same time so things where a bit hectic) upon my arrival... i turned off the car that had the damage, put the break on.... found out if everyone was okay.... got the information about the pts. ... and all the other good stuff we do... by the time the BLS truck had arrived.. I already had gotten an initial assesment done, found had NKDA, No Medications, No History, etc. and taken C-SPINE Now here is the question i have for everyone.... what would you have done if you were the responding BLS unit. Do you just ignore the person sitting there holding C-Spine, and talk only to the pt. or do you find out who they are and what they know? and also talk to the pt? just wondering what yall would have done... ***on a side note the a common theme for this Counties EMS agency (not mine next one over) is one of a paragod (whether they are medics or not) syndrome*** just wondering what yall would have done

Primary care physician's offices are flooded too. Just an FYI.

I dont think I can improve on the opinions expressed here on cheating on tests. What I would coment on is that to many Emergencey responders take ICS as a joke. NIMS is a management technique very similar to systems used to manage big corporations. ICS got its start with FIRESCOPE after California got tired of killing off people with bad management practices. It is know adopted in whole in 19 states and in part in many more. To many managers see this as a invasion of there sovereign domain and will only give it lip service or blatantly ignore it. Did I mention it was mandated by presidential executive order. Any agencies not complying is not eligible for federal funding. Having a common command structure so that we can all work from the same sheet of music can unquestionably be of great help for the next "Katrina" or "911".

I would love to hear from the Dr.s in this forum as well cause there point of view would be nice to know....but like I stated when I first started this thread "first do no harm" I may not be cert'd yet but still I would treat the pt. no matter what the commander in chief said, yes he is the leader of this nation but he is ultimately not my boss and unless someone is holding a gun to my head saying do this and don't do this, that pt. will get the best treatment that I can provide at my level. Just for the record I am not cert'd as I said but I do have training as an EMT-B and as such I am still covered by the Good Samaritan Law

that figures...but I actually am not going to start anything...I stated my opinion and scubakate stated hers...that is why I started this thread...but by all means pull up a chair and watch the thread and maybe even comment if you want Don...unlike my gov't I don't force ppl to do anything

this is what I wanted about this thread is one that ppl can talk about there views and not get jumped on...in my city Portsmouth, VA there is a restaurant near me with all this Obama stuff and I had an "Impeach Obama" and all I did was of course cover my face, but I held it up to the window (not banging on it or anything threatening) and just shook my head yes and just leave....the owner comes out and says "are you trying to tell me something" and I said "its just freedom of speach" next thing I know I have 3 squad cars...anyways I felt like if I did say I did that, that I would have been taken to jail for my freedom....but in my few yrs. I've been a member of this site ppl always jump on someone for there views or something and this thread I think that has not happened so props to everyone on this thread for not jumping on the other person who disagrees with you...keep this thread going cause its helping me also in my opinion of this bill...which Pres. Obama will be signing 2morrow

A friend of mine wants to start a medivac/search and rescue service in our area. The area that I live in is about 1-1.5 hour(s) away from the nearest available helicopter service. What we need are ideas on setting the service up. What kind of radio would we need to purchase to put in the helicopter to allow the pilot to talk to fire/rescue? Our area works on high band and low band radio's. The state EMS frequency is 155.340 which is the frequency that would mainly be used to talk to one another. What kind of thermal imaging camera could be mounted on the helicopter for the pilot to use? What kind of spotlight? I need any information that anyone can offer. We really would like to start this thing up here. It would really be to our advantage to have a closer service to fly critical patients out to the nearest trauma center (which is 2 hours away by ambulance). Any and all information would be helpful.

I first want to say to all the EMS workers and ER workers "first do no harm" I say that because that healthcare reform was passed, and we need to realize that were looking out for the patient and not big gov't. With that said what are your views on Obamacare.