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Mazrin, Exceptional first post! Welcome to the City! I noticed that you're not naive about the whole 'glory and teary eyed thank yous' that is so commonly associated with entry level EMS people. Since you appear to have your feet on the ground, let's get right down to 'brass tacks': EMS can be a rewarding career. It's got its 'up sides' and its 'down sides'. A lot of people aren't burned out on the helping people aspect as much as they are on the bullshit that's associated. Depending on the service you're with, you've got: 1. Small vollie politics and ass kissing to get ahead 2. Clicques that you'll find any place you work 3. The "You're nothing more than a warm body in a uniform" mentality of some of the larger services 4. The "You're just a mere Basic, while I am a PARAGOD!" mentality of some of the levels of EMS 5. The 0300 "I've got to go to the ER for this stubbed toe!" call Then there's fighting the 'trauma junkie' mentality that is very pervasive in this field. The disappointment of not being able to 'save the world' because you've got your EMT-B, and have been turned loose with peoples lives in your hands. Depending on the call volume of the service you're on, you may or may not get breaks, you may or may not get 'sit down meals', and you may or may not be returned to quarters between calls. In GA, (and other areas of this great country) the average wage for an EMT-B is about $10.00/hr. By the time you factor in taxes and other expenses; no, you're not bringing home a lot of 'bacon' at the end of the week. Because of this, you start 'jumping open shifts' as they come available. This can lead to relationship problems because you're never around, and you're sleeping if you are. Another 'relationship hazard' is not being able to talk to your 'significant other' about the calls, because a) they won't understand a thing you're talking about or you're trying to shield them from the 'yucky stuff' we deal with in the field. EMS is demanding work, and it takes a special breed of person to be able to deal with all that we come across in the field. Many will tell you that once it 'gets in your blood', it's hard to get rid of the urge to 'jump in and take control of a bad situation'. A lot of EMT-B's get 'burned out' because they're relegated to the IFT trucks, where you're not always viewed as a health care provider, but more of a 'horizontal taxi cab'. Because of this, most people tend to lose sight of the fact that for any private service, the IFT is the 'bread and butter' of the company. They also tend to lose sight of the fact that on an IFT truck, you're getting a myriad of exposures to establish and hone your 'bedside manners' and really get your 'hands on' experience. Then there are those that go into EMS 'blind' until they are called to their first MCI and realize that this is NOTHING like they thought it would be and can't handle the patients screaming in pain. (Why does it always seem that the patients with the minor injuries scream the loudest and longest?) EMS is never a 'steady pace', it's either 'feast or famine'. The calls may be hours apart, or they may be back to back....it makes it difficult (especially with a volly or on call service) to make plans for anything. Sick and injured people don't take holidays off, and usually the 'low man on the totem pole' gets to pull all the holidays... Bottom line: EMS is a field that takes some 'tough as nails' individuals that can learn very quickly how to separate the 'business' from the private life. Many people can't do that, and they end up taking the job home with them. You have to be able to balance being compassionate to your patients, and being able to 'shut it off' at the end of the day. This ISN'T a good career choice for those that want to just do 'eight and skate', who can't leave work at work, and who are just too 'soft hearted'. It is also not a good 'fit' for those that complete EMT-B and think that they're at the top of their game. There is no 'top of your game' in EMS, because our patients rarely, if ever, read the textbooks and act accordingly.....

Actually, people call you a troll because you continue to derail threads and focus solely on race as an issue, when it is not the issue in the thread. Get over yourself. Wow – first you say that others don’t quote the facts, and then you do exactly what you belittle others for. “...I was unable to find actual response time records but if I had to bet which community had the worst public safety response times,….” You are making this up as you go to support your opinion. And, when I went to the official Jackson, Missippi site (http://www.jacksonms.gov/government/planning/demographics/) it reports the population as 70.6% black and 27.8% white, not the 61.6% black and 29% white that you quoted without a reference source. Agreed – THIS IS THE WHOLE POINT OF THE INITIAL POST, PLEASE KEEP WITH THE PROGRAM… You post opinions, and demand that others PROVE their point, and when they do, and provide links and articles to support it, you ignore them. For example, on page 3 of this thread, ERdoc provided a number of examples of ambulance shootings to refuse your comments. You chose to ignore that. I requested that you refrain from hijacking this thread for your own agenda of arguing race, and you chose to ignore that. You wonder why you are considered a troll. Look at your own actions.

Man, Lone Star just killed your thread brother, as that is nearly a perfect post in my experience. There is no way to describe here what the job means and entails to everyone, but if you choose this path you will instantly recognize each and every point that he made. I'm going to highlight a few simply so that I can feel superior and believe if I've added something pertinent to the conversation... I never get tired of pts.in general. There are moments, but they are incredibly rare. My coworkers sometimes make fun of me, mostly in a good way, because I tell them that my theory is to 'love all of my patients. If I love them then I talk to them right and all of the other decisions become easy.' And I believe this, that I share my life with each and every pt that I encounter. (Understand that I have never worked a high volume system with the exception of being overseas, so others may feel differently, and justifiably so) I forget most of them almost immediately when I leave the ER, or in my current gig send them off to the hospital or clinic. But for the few minutes/hours/days that I am with them I try and open myself up and truly see them... I love that. Some here will tell you that that is just a bunch of wanker bullshit. And they will also be right..for them. But sometimes we all get tired of the bullshit we work around. I recently came into contact with a medic that was telling me that the only use he had for Hydrogen Peroxide in his ambulance was convincing the drug addicts that it is an HIV/AIDS test. You bring it into contact with blood, and if it foams, that that is a positive test. I completely destroyed him in front of God and everyone. I forced him to try and explain in front of about 15 people how convincing someone that has almost nothing to live for that they now have absolutely nothing to live for was proper care? I asked him to define the role of a paramedic in healthcare, to define the word compassion. It's wasn't pretty, but I'll bet he's more careful about talking idiotic macho TV crap around people he doesn't know in the future. He doesn't like me much now, and that's ok, because I don't like him at all. Unfortunately he will tell that story to many, many of his coworkers that will think that it's hilarious and will use it on their trucks. Of course the flip side is that you will also run with many providers that will almost take your breath away with their kindness and competence. And for me, that keeps me working, and thinking and studying every day, so that I can try and throw my hat into their ring. But the truth is, if you truly want to be a rockstar provider you will always be in the minority. You will always make others at least a little bit uncomfortable. But fuck em...This isn't a popularity contest. Akflightmedic, chbare, billygoatpete, Mobey, hell...there are probably 30 more here that I could name if I took the time..Being in a profession that allows me the priveledge of having folks like that to council and guide me? Priceless. Yeah, I'm not sure where you're at, but these wages sound well above the national average. I do pretty well now, by my standards, but I work a min of 14/12s in a row in some pretty cool, but weird places. Yeah, this is the down side of having a career that is dominated mostly by kids. They are willing to go crazy, burning themselves out working a gazillion shifts a week. It's not healthy, but it pays the bills they would say. I'm thinking that if you have a family, a house, a boat, a motorcycle and a jetski, that you need to redefine your priorities and what it actually means to pay the bills. Another great point. Plus, if you have a hard time keeping your dick in your pants there is plenty of opportunity to cheat on your spouse or sleep with someone else's. Judging from the quality of your first post though, you don't strike me as someone that has trouble with logic and focus. As far as stories...yeah, mostly they are best left at work unless you have something that hurt your heart, and then of course you should share that with your mate. My wife could not possibly care less about EMS. She's proud of me for being a medic but has no interested in the blood and gore stories, etc. Once, early on I had 6 patients in one day and three of them died. After the last pt was delivered dead to the ER (two were end stage pathologies that died during transit and one arrest.) I swore I was going to duck calls for the rest of the day. As I was walking back to my ambulance, another pulled in so I reached out and opened the doors for them and they had a pt in arrest. My partner was waiting at the truck and saw me riding in on the cot doing compression and almost died laughing at the coincidence of me getting stuck on another dead person. I was laughing my ass off telling this story to my wife who said, "Honey, that story is very funny, I'm sure it is, but please don't tell that to any of our friends or family." Heh.. It's a crazy world... I wish if firemen really needed to get whacker hero tattoos that they would replace the 911 nonsense, (unless of course you were actually there) with some of the words in bold. Ok, not the IFT part, but you know what I mean. Lone Star has pretty much created an EMS primer for you as it relates to your questions. I've got almost nothing to do in the clinic at my current job, which is why I feel the need to chime in and give long winded answers where there often weren't really any questions. But you know what? One of the things I love about being a paramedic? Is that those here get that I'm bored out of my mind, they will allow me my drivel, even support me if I need it, until enough is enough, and then one will be kind enough to say, "Ok man, it's way past time to stop being an asshole. you've had your time, now suck it up princess and go do something productive!" Heh...I love my job.... Dwayne

also this

Well Eyedawn, men do LOVE to dance. Problem is, women keep insisting that it be done vertically instead of horizontally...

Undead for having the sense to follow logical procedure. Because that is not my experience. Again Crotchity, and I actually tried to enter into this conversation with you and you did in fact ignore me, you allow only for one answer, that if the statistics, or personal experience shows that I am unsafe in an poor black neighborhood, then I am a racist. Am I racist? Possibly, but using common sense and making decisions based on personal experience doesn't make me so. I asked you if you and you're black partner would run into a party of drunk rednecks. Again, you ignored the question because it devalues your entire argument if you'd said no, and you show yourself to be ignorant and dangerous if you'd said yes. No one here will take you serously as long as you choose only to catch the pop flys. I did that in my question. And when the redneck grandma has to wait for 23 mintues because they've created an environment where help is afraid to enter because of past experience then I'll say, "Man, that sucks. I'm guessing that that 90 year old grandmother didn't create the issues that caused the wait. Those folks should be ashamed of themselves." Dwayne

Awesome place to look for the origins of an infection. I'm not sure his afebrile status rules out those issues, I would think so, but I'm not sure, but I like the way your mind works. Agreed, but it did say, didn't it, that he was started on antibiotics and left AMA? Perhaps that was in the solution. Right! What physiologic condition might cause him to sweat and feel cold but not produce a fever? (General question, not related to the answer) I guess it could be..not sure. On the contrary, I believe that the experience on an ambulance conditions you to horses, but that it's the professionals duty to catch the zebras. What findings would lead you to give that report? Normotensive, afebrile, other than pain scale all vitals well within acceptable limits, right? Man, I think you're doing fine!! If this was my issue I'd hope that you'd run it. You may not come up with the answer, but you're asking all of the right questions, and that's vital. For the record, there aren't a dozen people on this board that could come up with the answer without cheating, and I'm certainly not one of them. And there are, as you can see, very few that are willing to take a shot at something so friggin' weird simply for the mental exercise. I have nothing but respect for everything that I've seen from you in past months. Good on you brother. I friggin' hate your screen name though. It doesn't suit you. You need to change it to something that is more likely to cause people come to you as a mentor instead of think that you're a goofy kid, as the first is a good thing and I've not seen any sign that the second is accurate. See? You're welcome brother, though I've learned much more from you in this thread than I learned from posting the question. Dwayne

Sorry Dwayne missed the bilat part. I thought it was only on the hand in the picture. Then you would be right and it isnt a spider bite. Ok now I am totally out of my element with this one. Time to call the ALS boys...

I'll do my best to offer a little bit of the other side. EMS is filled with people who don't like their jobs. Everyone seems to have their own particular reasons why, but I will just touch on a few of the common themes so that you can be a little better prepared. These aren't necessarily my personal feelings, but I think they are all pretty accurate. 1. As an EMT, and even more so as a medic, eventually at some point you will realize that you are at the bottom of the totem pole in a system that revolves around hierarchy. Worse, you will realize that you belong there. Medical training for prehospital providers is like a crash course. There is very little of the background, of the science, of the rigorous study that characterizes most serious medical training. Because we lack this, we are constantly at the tip of the iceberg, knowing just enough to get by but not enough to really understand. Depending on your personality and your background, this may bother you every day or never at all. There is no real solution to this problem but to leave EMS and go back to school, which quickly becomes less and less of an option as people get older and more tied down by debt and family obligations. The result is a large population of dissatisfied EMS workers with no real way out. 2. The rest of the medical community, as well as many EMS employers, recognize the deficiencies detailed above and treat EMTs/Paramedics with a constant disrespect. This manifests itself in many ways both big and small, from relative job insecurity ("you are not special, you can be replaced tomorrow no sweat") to nurses/doctors/medical staff who refuse to acknowledge the vital role we play in the continuity of care. Some of this can be relieved on a personal level by maintaining a good reputation, but this takes years of work and at the end of the day when the chips are down, you are still "just" an EMT or paramedic. You will be reminded of this at the worst time and it will make you feel like shit. 3. There is the constant threat of injury. This is a dangerous job that requires repetitive physical motion. Back, knee, and shoulder injuries are extremely common and often career-ending. If that happens you can count only on a pittance from workers-comp for a short period of time, and then ending up jobless with very few marketable job skills. What are you going to do at age 40 with a busted back and a high school education? Not much. I realize you have a college degree, which is great, but this is the reality for an overwhelming proportion of EMS workers. Believe me, this weighs heavily on the mind of any career EMS worker, and it isn't a pleasant thought. 4. We rarely save lives, and a lot of the time it takes some creativity and imagination to even see that we "made a difference" for our patients. The majority of what you do on the ambulance will be needless transport for barely injured or sick people who have no business on an ambulance nevermind a hospital. The ratio will change depending on where you work, but I would (generously) estimate that 20% of the patients I see have a legitimate need for my services. This reality differs dramatically from the expectations of the newly hired. Even if you "know" it's not going to be all blood and guts, I don't think you can truly appreciate how ridiculous the day-to-day can be. Some people are better at handling this than others, as lots of people will certainty attest to on this forum. I can tell you though, if you take a look at people with 15 and 20 years in this business (a small population to begin with), you will find VERY few people who aren't frustrated with this on a daily basis. 5. The pay isn't great, and unless you work for a fire service or the occasional 3rd service municipality, you can forget about a pension or retirement benefits other than a 401-k. $20 an hour may seem like a decent salary to you now, but that money gets eaten up QUICK with a mortgage, school loan payments, and a family. Unless you are extremely good at managing your money (and most aren't), you will likely come to rely on overtime hours, which will be inconsistent and take you away from home for more time than you'd like. I work with a lot of people who routinely pull 60-hour work weeks just to pay the bills, and once you get caught up in that kind of situation it is very difficult to pull yourself out. There are others, but I think those are pretty much the "big 5." Education, respect, injury, B.S., and pay. You should know that this is, however, an extremely rewarding job. Working on an ambulance gives you opportunity to see things that you never would otherwise, and I think really gives you a perspective into life (and death) that very few people get. I don't think there is any other job out there like this, and those benefits shouldn't be ignored. I am very proud of my job and I am extremely glad that I decided to do it. That said, I'm working my butt off to get out.

You were too close to see it. Throughout your career you will be the one who instantly figures something out, that the patient's family never saw. "Hummmm you weigh 400lbs, are 30 years old, and have been incredibly thirsty", I am guessing you are diabetic ! Wife to you, my husband is too young to be diabetic, and has no history of it in his family ! Don't beat yourself up. Whatever goes on in your life becomes your "norm". It is very difficult to read other's minds. Cant blame yourself for not being psychic.

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.

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

Good observation, I do not know why the people in our industry are the absolute most negative, gossiping, backstabbing set of folk in any industry, but we excel there. Whenever I hear it, I ask the simple question, "With the education you have right now, what other job could you do and make as much as you do ?" They use to answer construction, painting, landscaping, but that has all died in this economy, but when they answered that in the past, I would say great, quit and go do that, cause you are not doing anything here but bringing down morale. There is an old joke that still rings true: Do you know what the difference is between a puppy and a paramedic ? Puppies quit whining after 6 weeks.

I did not ignore ER docs 5 or 6 shootings nationwide that have occured since the 50s-60's. It actually makes my point. If you gave a drug that you knew worked without complication 99.9% of the time, over a 50 year period, but your partner argued that you should not give it because he read a post on an internet blog yesterday, would you still give it ? For all the fears of our unsafe scenes (code for minority neighborhoods), where are all the dead and wounded medics ? I am not denying that medics get assaulted or find themselves in dangersous situations on rare occassions. Why not wait for PD on every call ? How do you know that the nice home in the suburb you are about to enter isn't a methlab ? How do you know the rich white guy in the mansion doesn't beat his wife ? Actually, if you wanted to do something about deaths and injuries in our industry, you would do more driving training, as you are far more likely to die in a vehicle accident. To those who say it isnt about race: Like Mathew said in the clip, pretend he his white. You put a white victim in a white neighborhood, and then give it a 23 minute public safety response time, and see how it is treated differently ?

Thank you for calling me a troll, in this forum that is "code" for "I can't argue the facts, so lets just label the person who had the nerve to disagree". I thought you might want a few facts that support both sides of the issue: 1) The 2000 census puts the population of Jackson at 61.6% black or A/A. 29% white. I was unable to find actual response time records but if I had to bet which community had the worst public safety response times, Beverly Hills CA, or Jackson, MS. I am going to go with Jackson. Funny how the burbs always seem to have superior public safety to that of the inner-city, but of course race has nothing to do with it. 23% of the population in Jackson lives below the poverty line (that was before the downturn in this economy, I am sure they are all doing much better now). 2) Facts for the other side: In 2007 Jackson was rated as the 23rd most dangerous place to live, and violent crimes rose 238% between 07-08. I read an interesting quote from a medic about the incident that stirred all of this up: He asked why aren't you upset that it took your police 23 minutes to get to a shooting ? Good Question. I am not asking any medic/emt to go into a known violent situation without PD. I was raising the point that many departments do not respond as timely to bad neighborhoods when there is no violent crime involved. Maybe you respond non-emergent to give PD a little more time, maybe you stage around the block. The 80 year old grandma that lives in Compton has just as much right to an 8 minute response time when she has chest pain, as the 80 year old who lives in Beverly Hills. But if you have forgotten, I remember a movie based on a Mississippi crime that might explain my logic a little better (although totally different than this situation): http://www.youtube.com/watch?v=C7f-BgDgpmE