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Hi, i'd like to share this educational comic: Source: www.medcomic.com

Hello everyone, My name is Susanna and I'm an Industrial EMR. I stumbled across this forum when looking for educational tips on NAIT. My question is, does anyone have any tips for the multiple choice and scenario? I don't know how or what to study, has anyone recently tried out for NAIT or even better, an instructor? Anyway, I think this website is really helpful and an awesome tool, so I'm glad to have found it. I want to be a paramedic, I have a desire to help people and I'll be honest, I'm attracted to the brotherhood and the fact that we have to keep physically fit, what a great lifestyle! My working situation isn't currently 'ideal' however, its made me even more focused and determined on this career path. Its great to say hello and I hope to follow in some of your footsteps soon, God Bless. -Susanna

Not that we can do a lot about it in the field, here's something to think about the next time you get a sick COPD-er. Food for thought.

Holy cow your a busy guy! It's no wonder why you haven't been real active, if I had your job posistion I don't think I would have time for this site either! Keep on keepin on!

You make me smile! You sound a lot like my dad! Just thought I would add that.

Hello from a fellow Albertan! I can't help you with NAIT specifically, but overall I can tell you that the passion you have already shown in your first post should go a long way at any interview. If you tell them why you want to be in an EMT program (and you are not a total bumbling idiot), if they refuse to accept you then they suck, and you need to find a new school! There are some really good schools with some great learning opportunities here in Ab. Prior to picking your school, I strongly suggest you decide if you'd like your career to be urban, or rural/remote based. Perhaps then I can point you at some fitting schools. I appreciate your spelling and grammar in your post. It comes off very professional. Take care

Let me ask this, I've run thousands of calls but I've never run a toe pain call at 3 am. How many on here can honestly say that they have transported a toe pain call???

Perhaps. But even if you needed two pair of pants to get through EMT school at $20 a piece you're still $25 ahead of where you'd be if you bought the 5.11 pants. And that would be enough to get you through to whatever EMT job you got and the uniform parts they'd supply (or allowance depending on your service). That's why the overall message from my post was to be smart with your money. Yes, there is some truth to the idea that you get what you pay for. But there's also a lot to be said for some basic financial sense as that'll last you a lot longer than the pants will.

I'd do a whole weekend at Bernie's if I had too

A compassion code is not going to make anyone feel better if the pt is dead before your your arrival with obvious signs such as lividity or rigor, Are they cold ? or warm ? Are they cyanotic and have fixed pupils? Do they have a shockable rhythm on the monitor or AED ? was the arrest witnessed and how long ago? greater than 5 minutes? Was CPR started soon after arrest and continued until your arrival? If the answer to any of the above is wrong , then don't work them. We don't abuse corpses for the benefit of the family. The family becomes your patients for you to care for

I will definitely go through the motion of checking a long pulse, breathing, body temp. I will even listen with my scope, check pupils and put on patches. But at that time my attention will go to the family. I can call in help for them. A pale, cold body with rigor is pretty obvious. And I can't provide false hope. In the case of an infant, the parents might need treatment, sadly.

For coral snakes native to the US it's "red on black, venom lack..." There are coral snake species from central and south America that do not follow this pattern. It's a misnomer that there is no available antivenom - the FDA extended the expiration date on the remaining stock until the fall of this year and there is available supply. Without antivenom, a severely envemomated patient might need prolonged ventilatory support. I caught this thread very late and am glad that the original poster did not have any problems, but I thought I'd comment about some of the practices some of the respondents seem to be supporting for bites by pit vipers (subfamily Crotalinae), which includes rattlesnakes, copperheads, and water moccasins. Tcripp, you asked about "what to expect" - it depends on the species, location of bite, patient comorbidities, and other factors. Many patients early on will have pain and local tissue swelling. Some develop signs and symptoms of systemic toxicity (e.g. nausea, parasthesias, etc) early on. Shock is usually from third spacing of platelets and plasma volume. Very rarely, someone who has been sensitized to proteins in the venom (e.g. someone who has handled snakes or venom or been previously bitten) may have a true anaphylactic reaction. We sometimes see anaphylactoid reactions with rapid onset shock and airway edema. Many patients develop coagulopathy, which can range from isolated thrombocytopenia or a syndrome of defibrination or a combination of the two that is DIC-like. Neurotropic findings, which can include neuromuscular blockade, can occur after bite by several species of rattlesnake, not just Mohave rattlesnakes. In terms of first aid, do not apply tourniquets or lympathic constricting bands, or ice packs. Maintain the bite in a neutral position (some medical toxicologists think elevation is reasonable - others thing neutral until antivenom is started and then elevate. Do not apply any kind of suction. If a tourniquet, pressure bandage, or constricting band has been applied, do not remove it in the field. In general, when this is done, we get big lines in the patient, give them volume, and start antivenom before releasing this. At least one IV should be started. Give fluids for hypoperfusion (obviously), but patients with intact perfusion and extremity swelling also need fluid boluses. Extremity swelling early after a bite is usually from the effect of polypeptides in the venom, and these cause tiny cracks in vessels that are large enough to allow platelets to leak out, but not large enough for red cells to leak out. This third spacing can be significant very early and cause significant hypovolemia and hemoconcentration. Very often, we see patients with rattlesnake bites who don't get enough IV fluid in the field. Give antiemetics for nausea, and treat pain (if you have fentanyl, I think it's preferred over morphine as the histamine release from the morphine can cloud close monitoring for development of allergic response to antivenom). The destination hospital may not necessarily be the closest hospital, or even the closest hospital with antivenom, but this would obviously be region-specific. I have seen horrible outcomes when patients are taken to hospitals where arrogant physicians refuse to consult a toxicologist - we've seen patients diagnosed with compartment syndrome who get unnecessary fasciotomy and even amputations that were likely totally unnecessary. Where I work most hospitals have antivenom but we have centers available to us that have onsite toxicologsist and very large supplies of antivenom and we fly our patients to these centers. The 2010 guidelines from AHA and ARC actually mention snakebite first aid, and they advocate using a pressure immobilization bandage for Crotalid envenomations. This recommendation is based on no evidence of any quality - in fact, one of the studies they cite as supporting the practice actually demonstrated worse limb outcomes when pressure bandages were applied (in a pig model). This practice turns what is very rarely a life threatening event into a limb-threatening one. This should be addressed locally, and hopefully administrators and medical directors will consult a medical toxicologist with snakebite expertise when establishing local or regional protocols. Pressure bandages seem reasonable for eastern and texas coral snake bites, and are standard for bites by neurotoxic snakes that cause rapid development of symptoms in Australia, but they will likely worsen injury when applied to victims of Crotalid snakebite. Finally, you can not diagnose a dry bite (fang puncture mark without envenomation) in the field. This requires observation for at least 8 hours (and labs). Especially after Mohave Rattlesnake bite, patient can have a life-threatening, potentially fatal envenomation event with minimal local tissue injury, sometimes without significant pain. Patients with probable Mohave bites are admitted and watched for 24 hours at the tertiary center we work with.