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So, I took the NREMT-P written test yesterday, and found out this morning that I passed (pass/fail results posted on the website). Now, let me preface what I am about to say with the following disclaimer: I completely understand for individuals going through Paramedic school (or EMT school, for that matter) that the final written test can be nerve-wracking. 15 months ago, when I took the New York State written, I was confident I could pass, but was still scared about it, because it was the "moment of truth" so to say. My thoughts on the matter. I went in, with almost no pressure at all. My wife and I would like to move, which is why I am obtaining my Registry certification. However, as I'm already a State certified Paramedic, and NYS doesn't require the NR, I really had no big "pressure" to pass. That probably helped. I did find the test somewhat harder than the NYS written, but not much. It was shorter, however. The CBT cut me off after 80 questions. I finished in about 25 minutes. Now, I COMPLETELY agree with Dwayne, Dust, Lone Star, et. al. on the topic of increased educational standards in EMS. That being said, is the NR (or state written that I took just over a year ago), really the minimum standard that needs to be passed? I, for one, don't really think it truly assesses what Paramedics need to know - it doesn't even begin to assess that, IMHO. Now, I would hope that most Paramedic schools would teach far above and beyond what is required to pass the NR, but the sad fact is, they don't. Many of the Patch mills out there teach to pass the test, and that's it. I am reasonably certain that my basic partner could pass the written test without ever having set foot in a Paramedic classroom (admittedly, he's one of the best BLS technicians I've met, but I digress). I remember after taking the state written exam, my nervousness about passing was over. To be honest, I almost felt insulted by the content on the exam. I truly think it's scary to think that there are medics out there that are ONLY taught the MINIMUM to pass this test. That, coupled with a lack of an adequate QA program in many agencies... it's scary to think about how many patients we could be seriously harming through a lack of knowledge, through just being a "skills monkey." I seriously hope that certifying bodies such as the NR and various state Offices of EMS wake up and "smell the coffee" and raise the bar. They don't even have to make the classes harder! Based on what is supposed to be taught in the curriculum, the tests could be much more in depth. We talk about raising educational standards, but it makes me wonder whether the "standards," such as they are; are even being fully explored in class, or whether many programs are simply "teaching the test" and teaching the bare minimum that will allow their students to pass the NR. And by some reported first-attempt pass rates, it makes me wonder whether the they are even teaching that much! Excuse my ramblings, but after being through both the state and NR written tests, I really am kind of scared at exactly what the competence level of some of the people that could be showing up at my door step if I ever had my own medical emergency. Your thoughts and inputs are appreciated.

As usual, Dust brings up a few good points. Just because someone is not doing something the same way you do does not mean it is wrong. Always be cautious with the advice from senior people in EMS. Unfortunetly this is a field where, "This is the way we've always done it," is pretty common. Medicine is constantly evolving and EMS is not keen on keeping up due to this attitude. Sometimes it's best to smile and say OK, but look it up yourself. Take everything you hear from those in the field with a grain of salt. Want an example? Look up the history of MAST.

I agree, that from the limited information we have here, it doesn't sound like your assessment was off-track at all. If a patient is conscious, breathing, and vocalising, your ABCs are done. No need to go through any pointless steps to satisfy any checklist in order to determine that. Assuming that immobilisation was actually warranted (which it sounds like it was), then you were absolutely on the right track to go straight to it. Not sure why the other tech felt like s/he needed to take over. Did you ask him/her? It's possible that s/he simply sensed your discomfort and stepped in. But it also sounds possible that s/he may just be a cookbook monkey who does things differently from you, but not necessarily any better. Not everyone with more experience than you is going to be better than you, so while it is always wise to critique yourself, don't do so at the cost of your own self confidence. Get off the energy drinks and get more sleep. Relax. And don't run your sirens any more than absolutely necessary. They don't get you there any faster, and they put everyone's life in jeopardy. I know it takes time to get over the initial excitement, but it is the most important step you could possibly take right now. This job isn't about sirens. It's about people. And if you don't arrive calm and confident enough to care for them properly, then you'd just as well not show up at all. Good luck, and welcome! P.S. It says "New Users - READ This First", not POST here first, lol. Chose your post locations carefully.

JUST TO CLARIFY I WASNT IMPLYING THAT YOU WERE BEING A PRICK I'M SORRY IF THAT SEEMED LIKE I DIRECTED THAT COMMENT TOWARDS YOU SIR. I DID FEEL YOU WERE PRETTY MUCH TELLING ME WHAT I KNEW I JUST GOT THE JITTERS A LITTLE AND WANTED A WAY TO OVERCOME THAT. BUT THANK YOU FOR TAKING THE TIME TO READ AND RESPOND TO MY POST. AGGRAVATION MIGHT'VE SHOWN ITSELF IN MY LAST POST BUT I AM GRATEFUL FOR ALL THE ADVICE> THANKS GUYS! thank you sir. I apologized to that gentlemen I wasnt implying that he was being a prick I've just seen some seniors be pricks in the little time I've worked and I'm still a little agitated but I am grateful for this advice. I really appreciate it

A confident, dexterious Ambulance Officer requires a solid grounding of praxis to solidify theoretical concepts, it sounds like you have neither nor the opportunity to obtain the former. I suggest more experience. Correct spelling and grandma, woops, grammar would go a long way too mate. The primary survey always comes first, consider immobilising the cervical spine if exclusion criteria are not met but always perform the primary survey first. It is inappropriate to immobilise the cervical spine or perform a secondary survey if the primary survey is incomplete or has major abnormality.

http://emsseo.com/2011/01/free-ems-downloads/

We used to have name tags, but no longer. We now have our last names displayed on our bunker gear coats, but nowhere else. Have I had a problem with a patient or family member in the past? Yep. Working in the ghetto, we had a preacher have a massive MI while at the pulpit, and he was triple zero upon our arrival. (Probably dead when he hit the floor- he was around 300lbs with an extensive cardiac history) It was the usual chaos and insanity at the church, we did the best we could, but to no avail. I have no idea how, but one of the "God-fearin" church folks tracked down my name and phone number(he had to have had help from someone within the department since that information is not readily available) and found my home number. I began to receive threatening calls, claiming we "killed his reverend", and he would kill me and my family. AT the time I was single, but I figured if someone was able to find my information, they may be able to find my family. I filled out a police report and also notified the local LEO's. After a couple more calls, they stopped. Nothing ever happened, but I was fairly paranoid for quite some time and was indeed looking over my shoulder at work, as well as at home. In the ghetto it is not uncommon to be threatened while working(warnings against saving a rival gang banger, "do your m' f'n job or else", or "save my momma!"). All part of the fun of working in a busy urban setting. This was different- it was personal. Point being- there is always an element of risk involved in what we do. Does it generally go beyond work? No, but it is possible. I see no purpose to having name tags, nor do I give someone my full name. i don't give a rats behind if we are "public servants" or not. If something can put my family in harms way, I draw the line- rules be damned. If someone has a beef, I always give them our ambulance number and with that and the date, it's a simple matter of finding out who we are. I even give them the number to call to file the complaint. On a couple occasions I actually offered to dial the number for them- they really didn't know what to do about that. LOL

The only 'conclusion' I can foresee coming from this little 'social experiment' is to see how many will attach labels and how fast they can do it. At the end, I fully expect 'flaming' to show us the errors of our ways by revealing just how WRONG we really are for judging and labeling people based on nothing more than appearance. Once this has been done, I fully expect a scathing lecture on how we're so wrong about labeling the GLBT crowd based on appearances. There's a difference between advocacy and just looking for somthing to fight about, and it looks like this is just looking for trouble. He can tell me that there's no 'hidden agenda' till he's blue in the face, but I'm not buying it. A 'social experiment' like this only serves to bait the participants into a big knock down drag out fight because 'flaming' had to stir the pot one too many times... I fail to see how asking the participants to 'label' someone based on appearances only, will serve any productive purpose; and for that reason, I will refrain from playing. From where I sit, this smacks of nothing more than a game of "I Told You So" combined with an opportunity to throw words like 'prejudice, bigotry and discrimination (in all of its variations)' around.

Bullcrap, I'm professional and courteous in all of my interactions and have still been threatened and assaulted. Your spouting typical administrative BS. "We can't control the publics reaction, so therefore the problem must be you".

Yes thanks for the spell check. I was in a rush. But getting advice was the intentions of this post. I understand what I did wrong now after the fact. I guess I should be more specific. What is a good way to prep myself for a call as such when one has that adrenaline rushing and tunnel vision kicks in. I'm an EMT but i'm a regular person too so straight up advice is what I want. I don't need senior EMT's to get on the post and be pompous pricks just some pertinent criticism and advice to calm that rush and stay level headed. I know exactly what I did wrong your explaining everything in my textbooks. i know it. I just failed to apply it as I shouldve...