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A few years ago I conducted an evaluation of various ambulances to determine if hearing loss could be a risk for paramedics. It's a very real possibility, not from the siren, but simply the ambient noise during travel. A brand new ambulance with zero equipment in it was just below the threshold for long term exposure. However, an equipped ambulance that had over 60,000km on it would be in the low 90 dbs. With the siren on it didn't change much unless the siren was a roof mount like back in the 1980s. Looking at this chart, exposure to 90db for 2 hours can cause hearing loss. When I travel at highway speeds with my ambulance, we are well over that threshold for 4 - 5 hours. I wanted to conduct actual evaluations over a 5 year period with rural medics, urban medics, and the standard norms but I couldn't find an audiologist to assist me. Here's a little more info, This may be frivolous, however, there is a definite risk. http://www.dangerousdecibels.org/education/information-center/noise-induced-hearing-loss/ http://www.nidcd.nih.gov/health/hearing/pages/noise.aspx

I am both an instructor and an FTO..a formally trained FTO even . Anyway, there are several issues here. First is the FTEP (Field Training and Evaluation Program....though your terminology may differ) has issues. Is it a Training and Evaluation program, or simply a training /orientation program? From both a professional and a legal point of view, if there isnt some sort of evaluation (daily, end of phase, what ever) prior to being "released"... then the program is setting everyone..the trainee, the FTO, and the agency ...up for failure. In this case, either the trainee was evaluated for his /her ability to perform the job...and legititamately passed..and now has a previously unknown issue...or there was no or poor evaluation and the trainee was simply "passed" for simplicity. . I cant speak to how your FTEP is set up, but here, if that trainee is having consistantnt issues...were these issues documented during FTO? If so... then a "performance inprovement plan" (PIP)is held. This is a Formal "Come to Jesus" talk and process that is both legally defensible and practical. Without cutting and pasting the entire process, here is it in a nutshell: 1- The FTO(s) and supervisors identify the problems in clear terms, and make sure that the problems are documented previously. They also make sure that the "problems" are true issues and not personality issues. We have some specific criteria for what warrents this. 2- A "PIP" meeting is held with the trainee. This is a scripted, agenda led meeting. The reason for this is it keeps all parties on task. It also avoids any "Ambiguity" about the seriousness of the situation. This has been a probelm with previous, less formal meetings with problem trainees. The FTO/Training coordinator or designee evaluated progress. Typically up to 90 days may be given by policy, but most problems we are looking for improvement with in 30 days. if improvement is not seen and it is clearly documented, then we look at why, and termination is a real option at that point. Now, from the trainee pont of view, this may seem harsh, but really this is best for everyone. it keeps a trainee from being caught in "limbo" for ever, it clearly spells out the issue without any sugar coating. Some people simply need to know what specifically they are doing wrong, and given step by step plan for improvement. And if the trainee succeeds, then EVERYONE gets to "move on"...including the trainee..into the rest of his/her career.

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Here is a great program that covers EJ's it is well done and give the anatomical physiology and the indications / contra-indications. http://www.uabem.com/storage/ej_verification/EJ_Verification_Program_Lecture_ver_c.pdf