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just get a push bar...

[sarcasm] If that's 'too old', I'd better just quit now! At 45, I'm currently in college pushing for my Associates Degree in Paramedic Technology. I've had several 'setbacks' along the way. Maybe they were 'signs' from above that I should just give up! [/sarcasm] The bottom line is this: What do YOU want to do? If you're physically able to do the job at hand, then there's NOTHING that can stand in your way. I've worked with medics that are into their late 50's - early 60's that were more than able to do the job of people half their ages! The ONLY thing that can prevent you from reaching this goal is you! Not only am I pushing for my Associates Degree in Paramedicine, I'm also considering a second degree as a 'fall back' option.

It has come to my attention as a Professional Driving Instructor and active practitioner that there are significant issues with people not yielding to emergency vehicles. I believe that if we mandate USDOT, Transport Canada and other agencies to change the required decals on the front of the Ambulance from ecnalubmA to one of the choices listed above (in reverse, of course). I believe that a change like this could make a huge impact on our response times and general staff and patient safety. Who's with me?

I've been taking a frequent flyer about once a week lately. Really, nothing new for EMS, actually, he's not as frequent as some others, but this one has a twist. This is a legit patient, post-dialysis hypotension often resulting in fall/ataxia and dizziness. I know what you're thinking... suck it up, these happen... Personally, I don't care if I take him weekly, he's a nice guy, we have a good chat on the way in. Although he is heavy, lives on an awkward 2nd floor apartment (with no elevator, of course) so our stair chair gets a good workout, I don't mind too much because he does try to help us as much as possible. My big concern is for his own safety, he lives alone with only occasional visits from a home care nurse. We are in a Rural Area, and even a full hot response, we're 10-15 minutes out (in ideal conditions) so if something happens, help is quite a ways away. I know I've mentioned to the receiving nurse each of the 3 times I've taken him this month that he should be assessed for placement in a care facility. I'm not totally sure what all is going on behind the scenes, but I tend to get the smile and nod from the nurse, and then we get the call the day after he gets home to pick him up again. IMO, if he had even LPN care in a facility, he probably wouldn't end up in hospital at all (besides for dialysis). As far as my options, I've talked to him about it (he's not really keen on the idea himself), I've talked to the nurses and the social worker. As a sidenote, an EMT in my province was recently sued for using family contact information to discuss long-term care (in addition to having his license revoked and being fired), so family involvement from my position is not an option. I feel I've done everything I can to try to get him the help he needs, and honestly, I'm kinda frustrated by the lack of action on the part of the rest of the system. Anybody else have ideas? Similar patients?

I retired after 25 years in systems consulting, got my emt because they told me I had to have that before becoming a paramedic and enrolled directly into the best paramedic program I could find. I graduated at 50 and hit the streets as a baby paramedic without a day of experience. Im not advocating that as the smartest thing to do, but 2000 calls later, I am the happiest I have ever been in my life. Mind you, I work out with a personal trainer 2 to 3 days a week and keep my weight under control. Healthy eating and living may be an option for the kids but for me it is mandatory. It is challenging, frustrating, maddening, exhausting, demoralizing, uplifting and has given me some of the best experiences of my life. I plan to do it until I am 70 - God willing. Good luck to you.

As a current paramedic student who just finished airway and is about to start clinicals I would like to drop my two cents into this "topic". We spent 2 weeks learning about the anatomy, physiology, and pathophysiology of the airway, when to take control of that airway, what methods we have to take control of the airway. Our instructor focused more on management of the airway as a whole and did not focus on just one way to control a patient's airway. Intubation is best used for total airway control in a patient who can not protect their own airway and is going to be given positive pressure ventilation. Just like there are problems with intubation there are also problems with CombiTubes and King Airways. The King Airway does not provide the same back up method as the CombiTube. If you place a King into the trachea you can not ventilate the patient and you must remove the airway device and re insert, this can be a problem with patients with short airways and lots of inflammation of the GI tract. With the CombiTube and King you can not protect a closing airway such as a patient having an allergic reaction and may have to result to in surgical airway methods. If we don't want to be performing more needle and/or surgical cricothyrotomy airways we need something better than blind devices such as king and combitubes. Now what only a few people have pointed out is improve our training in assisting with intubation with devices such as the lighted stylet, retrograde intubation, bougies, and field fiber-optic scopes. We are lucky to have a hospital that will allow our paramedic students to manage airways on patients undergoing scheduled elective surgery as part of our clinical rotations. We have to get 5 intubations but we also have to perform alternative airways including LMAs, CombiTubes, King Airways, and even good old fashion BVMs with OPA or NPA. It seems to me that more people focus on just intubation as the only form of airway management, intubation is one of many options we should have. From a textbook only point of view a good paramedic should be able to not only intubate but also use blind airways, and perform needle and surgical cricothyrotomy airways. Just because your patient is in cardiac arrest does not mean they need to be intubated, a king is all they need. We also need to remember that we do not have the "right" to do anything as paramedics. We are working under the license of a medical director and he or she gives us permission to perform medical care under his/ her supervision. If the powers that be say no intubation then no intubation and if you want to tube go back to school and become a CRNA or PA or CNP or MD. We should strive to provide the best patient care and give our medical directors reason to let us do more, but we must never get the idea that we have the "right" to do anything we do in EMS. "Skill authorized to the paramedic in their scope of practice are not a right but a privilege given by the medical director." Nancy Caroline's Emergency Care in the Street 6th Edition page 1.15

It is the NR policy not to tell the people testing why they had failed. If you are telling these students this, you could get yourself and the program in huge trouble. Reasoning why, in my opinion why you are not told, is to make you THINK. "Damn, what did I do wrong? What did I miss?" You don't know, so now what? You go back and STUDY EVERYTHING AND GO OVER IT ALL! If you forgot to check a lead after a rhythm change, why should you be told this? You should know better! If you aren't told, you wonder what you did wrong, and you go over the skill/station over and over and over, study the material, study the procedures, study the things that are bad, the things that are right. Telling a person what they do wrong doesn't help you in the long run. Sure, it would be nice to know, but not being told, forces the person to go back and study everything so when they are in the real world, they don't kill someone. by the way... it's pretty hard to fail a station if you pay attention and know what you are doing.