Leaderboard

True Mike, A leader leads by example and empowers the people he leads. A manager manages his people. It's possible to do both but you can't truly do both exceptionally well. I have a manager who manages very well but she is NO leader. My team leader leads our team by example and helps me want to be a better analyst. See the difference?

To be fair there is a difference in being a leader versus being a manager. Perhaps you could agree upon which of the two terms you best think fits and move forward from there.

Oh I can't disagree more. I am so sick of this treating the patient not the machine thing that everyone is so hung up on. How bout an UnCx diabetic??... just intubate & transport? What about perfusing V-Tach? What about silent STEMI? How many diabetics have you seen that can go as low as 1 mmol without having any read symptoms? Your saying just wait till they become altered?? To be honest I think the crap that is spewed in this "treat the symptoms" is a catch-all for those who can't critically think for themselves. The machines are an assessment tool, they should be used to guide Tx. Reactive medicine treats symptoms. Proactive medicine treats signs. You decide. As for the bold text above; I would be interested to know if these same Dr's could diagnose without the "fancy tests". I gotta tell you though...... feel free to ultrasound, draw blood, or CT me anyday to ward off "exploratory surgery". Each to thier own though.

Ummmmmmm. I cannot even comment. I am less intellegent for reading this.

Welcome my friend, welcome to the other side. Now, I know I'm going to be preaching to some of the converted here but still: If it is one thing that annoys me the most about EMS it's this American attitude of "BLS vs ALS" and its like you blokes think they are somehow an actual procedure to be carried out like splinting a broken arm "oh I gave this patient BLS" mmmm yes .... Because this patient is stable he is a "BLS" patient even tho he's been shanked in the stomach but only has a teeny-weeny hole despite the fact he is gonna crash ten minutes into his "BLS" transport. All patients to not require "life support" and I think this is an outdated term, as you said they require care. Most care is very simple and carried out by all levels of Ambulance Officer be they a "BLS" level Technician or an ALS level "Intensive Care" officer. Included are the essential primary elements of practice like communication, safety, history taking, vital signs, physical assessment etc and does not vary between practice levels except maybe for 12 lead ECG monitoring, you can also include fundamental patient care like splinting and transporting, oxygen, salbutamol etc. This is one of the reasons I am really pleased with the way Ontario has structured its education program for Pirmary Care Paramedic; it's two years and includes the in-depth education in A&P, patho etc so that they can go in and conduct a good, detailed assessment and differential diagnosis of a patient and begin to hone and develop thier skills and knowledge rather than just a two page four hour class on how to take a few vitals and ask SAMPLE questions, for example. Australia with it's Advanced Care Paramedic (ILS) internship and post-graduate qualification for Intensive Care Paramedic (ALS) also offers a good comparison to draw here as they should offer simmilar outcomes. Ask your basic EMT to tell you how to differentiate between say indigestion and .... a gallbaldder attack for example. Some care that ambo's offer patients is quite invasive and advanced; such as rapid sequence intubation, thrombolysis and chest decompression. These advanced skills require a solid grounding in bioscience and extensive experience, competency and overall a high level of confidence which is inherently linked back to the other competencies I outlined. It takes four to five years to become an Advanced Care (Canada) or Intensive Care Paramedic (Australia/NZ). Contrast this with some dude who has 700 hours of education over 14 weeks at the Houston Fire Department's Paramedic-R-Us patch factory. You mentioned fundamental skills like bag mask and this is often a problem I see with people. They bag the snot out of patients and don't understand the reasons why they shouldn't. Try to explain to them about hyperoxemia, hypocapenia or dynamic hyperinflation and they just give you a glazed over look. Ask any ambo how GTN works and they'll tell you "dialates blood vessels" and no more. So who does which? Which what? Well if we want to refer to "life support" my argument is that ambo's don't really do that and I am sure a lot of intensivits and ICU RNs will agree with me. My spin is that "care" is provided. Therefore we should do away with this "life support" nonsense and embrace what Canada has done; term everybody some level of "Care" (ehem, Alberta and Manitoba excluded, whacky Albertobaians...) because that's what 99% of my jobs have been .... providing CARE and not "life support". Two level systems (US) Primary Care (old BLS) Intensive Care (old ALS) Three level systems (US) Primary Care (old BLS) Advanced Care (old ILS) Intensive Care (old ALS) Everywhere else in the world smart enough to not have a "BLS" level Advanced Care (old entry to practice) Intensive Care (old ALS) Until you guys fix that whole BLS vs ALS crap it'll continue to be what makes your system a joke.

One time I pushed a McDonalds straw inside another McDonalds straw.... I am pretty sure I could insert a stent.