VentMedic

It is a little more than signing off on a "skill". To give the vaccination, there should be a public health clause in your statute which also provides for additional education. When you give an IM,SL, SQ or IV med, you are acting under a certain set of protocols for a field diagnosis as signs and symptoms appear. For a vaccine, you are working off of what if and must provide the necessary education for whatever patient population presents for them. As a parent I would be hesitant to have an EMT(P) who is only going by "I can give a shot" mentality vaccinate my child. That being said, your state may already have established the legislation necessary. Here are some updates: http://www2a.cdc.gov/phlp/H1N1flu.asp One another thread here, MA had passed a very comprehensive Bill which I am surprised LA doesn't have one similiar. Many of the other states updated their statutes for Public Health and Disaster Preparedness after they saw what happened with Katrina. http://www.mass.gov/legis/bills/senate/186/st02/st02028.htm Hurricanes are just one of the reasons Florida has vaccines in its statutes for EMS. However, it has still been controversial for allowing Paramedics to administer them to children. A couple of counties (Lee and Indian River) was even trying to be active in Public Health but eventually some of the momentum was lost and projects scrapped due to a lack of interest from the Paramedics as they did not want to do "clinic work".

San Francisco has no flight services. Whatever helicopters to bring the patients to the city hospitals must land at the airport or just outside the city. San Francisco General, the trauma center has been attempting to get a helipad for at least 10 -15 years but it has been controversial due to the potential for crashes and noise. Their board had been trying to assure the community this is rare as they may have a shot at getting this helipad approved with the new hospital that is in the plans. Now, they have a TV show displaying horrific crashes in every episode. For CA the use of Paramedics on Flight is very rare unless they have an RN with them. Most of the teams are RN/RN or Reach also has RN/RRT. In fact, RNs or MICNs do most of the CCTs in much of CA. As for the EMS staff with SFFD, I feel kinda bad for them. They are at the mercy of whatever mess the FD gives them. They are unfortunately many years behind the rest of the country but more progressive than Southern CA. The Trooper 2 crash had a volunter EMT on that flight who died in the crash. I am against the use of just plucking someone from the ground as it had been a practice with a couple of FD and SO helicopters here in Florida in the past few years. The ground personnel may think it is cool to be asked to ride but many are not trained adequately to be informed enough to understand the risks. Nor, have they prepared their families for this risk. Yes, being in an ambulance is also risky but the additional risks of getting into a helicoptor justs compounds it especially as a volunter.

Have you not looked at the opportunities at hospitals? You get pay, benefits and may even find one that allows for a flexible schedule or even one with a work/learn program where you work part of the hours and attend classes the other part. Granted, it is a tight market but hospitals still offer assistance to nursing students. However, the LPN program will not be of benefit to a hospital and will not be part of this. The reason you can get into an LPN program easily is because others have seen there are few opportunities and the pay is not much more than a CNA. Often the PCTs will now do what an LPN does and the hospital will usually train you to get that cert.

As an LPN in this state, you will be making about the same as an EMT-B or maybe a couple dollars more. The Paramedic doesn't pay much better for the reasons you have chosen it instead of the RN. The education requirements are not there. Have you looked at the universities to see what it will take to get a BSN as a second Bachelor degree? Don't waste time with routes that will actually extend what you must take. Do the quality college level classes and not abbreviated mini courses.

Without those prequisites you will be a lousy nurse and a lousy Paramedic. Neither should allowed without having college level A&P and Pharmacology. As far as the online program, you will spend a lot of money only to have your application scrutinized. There are many new grad BSN RNs coming out of their traditional programs that have made great professional contacts during their clinicals to help them get decent jobs. Taking shortcuts or settling for the least education will not advance your career or secure your future. Get an entry level job as a CNA, PCT or monitor tech at a hospital and let them pay for your education as an RN. You would be surprised at how supportive they can be.

The community colleges are your best bet. They are also about the only ones that have CoAEMSP accredited programs. If you would like to fly or get into more challenging transport situations, Orlando Regional and Florida Hospital are great places to work while getting your RN. The community colleges will also use the credit earned from the RN prgram and apply toward the Paramedic. In the future, you get a flight RN position. Then all you have to do is just take the EMT-B and challenge the Paramedic test. The LPN is a waste of time as few hospitals utilize them. Of course any specialty team for RN be it Flight/NICU/PICU/Heart/Organ Procurement/ECMO will take much more education adn experiencee. The Paramedic programs in Florida can be done in less than 6 months. Many of the EMS departments that do 911 are Fire Based. Polk County EMS has now merged with Fire and are in the process of cross-training. Right now even Lee County which is the most stable for county EMS could go Fire in the next 5 years. Sunstar's future is very unstable. Unless you consider being a FF in Florida, the RN is the best route for job security. Florida also has an abundance of EMTs and Paramedics. Of course, most are waiting to get on with the FDs.

Why? Do you really believe you are qualified at 15 with medical professionals about your medical needs? Do you believe your parents do not know what is best for you? What are going going to say when you go to court? Bash your parents as incompetents?

Apparently some do if you read the comments at the end of the article. This one knows her truck has a blind spot and still "open the doors and go". Anyone working in a residential or urban area knows you check for curious kids wanting to see the big fire truck or ambulance and tourists (Florida). In Florida, you also know there will be someone coming to the station for a BP check at all hours of the day and night especially if there is a condo community across the street. If this had been someone who ran over a person with their POV in their driveway, these FFs would want them locked up for life for being stupid/careless and not looking behind/in front of their vehicle.

St. Petersburg firefighters accidentally run over victim they were sent to help By Jamal Thalji, Times Staff Writer In Print: Friday, September 25, 2009 http://tampabay.com/news/publicsafety/accidents/st-petersburg-firefighters-accidentally-run-over-victim-they-were-sent-to/1038961 ST. PETERSBURG — The callers to 911 Thursday afternoon said there was a man bleeding from the face near the fire station. Two firefighters piled into Rescue 5 to go help him. They opened the garage bay door, turned on the emergency lights and pulled forward. Then they heard a "thump." The firefighters accidentally ran over the very person they were sent to help. "They never even saw him," said St. Petersburg Fire Rescue Lt. Joel Granata. Authorities said the man who was run over is Ted Allen Lenox, a 41-year-old homeless man. He suffered life-threatening injuries and was at Bayfront Medical Center Thursday night. Alcohol was a factor, according to a St. Petersburg police report, which was not specific. The accident took place about 3:45 p.m. outside Master Fire Station 1 at 400 Dr. Martin Luther King St. S. The facility houses St. Petersburg Fire Rescue's headquarters and two fire companies. Lenox was struck as he lay outside garage bays on the north side of the building. Vehicles coming out of those bays exit onto Fourth Avenue S. According to police and fire officials, Emergency Medical Technician Jason Springer, 36, climbed into the driver's seat of Rescue 5. Paramedic David Bucholz, 32, rode shotgun. But neither apparently knew that Lenox was lying just 2 to 3 feet in front of Rescue 5's bay, authorities said. It was unclear Thursday whether the 911 callers said how close Lenox was to the station, and if they did, whether that information was relayed to the crew. "Neither Springer or Bucholz saw, or could have seen, Lenox in the position he had placed himself in," the police report states. The vehicle that ran over him is a Ford F-650, a 10-ton truck with a boxy rear bay used to store medical equipment and treat patients. The vehicle sits high. "They couldn't see him in front of the truck," said Lt. Granata. "You can't see the ground." Rescue 5's front wheels didn't hit Lenox, but the undercarriage caught and rolled him. The crew stopped after they felt the truck's rear tires roll over his legs. He was pinned underneath. Firefighters raised the vehicle, pulled the injured man out and treated him. His condition was unavailable Thursday. Lenox often hung around downtown, police said. His family could not be reached for comment Thursday. The firefighters involved in the accident remain on duty, Granata said. He wished that the crew would have been told prior to leaving the station that the man was right at the foot of the garage. "We would have just walked out the door and looked," he said.

There are other ways to cut for time management but checking meds is not one of them. Licensed professionals are generally educated enough to know mistakes happen. If you did not take the time to confirm the medication whether you draw it up yourself or especially if someone else does, then you have no defense. A med error may still occur but if one makes it a habit of checking regardless of how offended their EMT-B or P partner gets, that person will be less likely to make a deadly mistake. EMS also did studies on the time/steps it took to do an IV and eliminated as much as they could, including proper cleaning, which may also explain part of the reason why field IVs are removed in the hospital. ETI was another area. I cringe when I hear new students wanting to race each other for starting IVs or sinking a tube during their clinicals. Those are the ones that will not be left out of the sight of a licensed professional.

No really hijacking. It just shows how easily mistakes can be made if people don't stop and think a few seconds before they act. If the OR team has followed the safety guidelines that were in place, a missing surgeon would have been noticed. If the paramedic in the epi situation had taken time to check the "Rights" before giving the Epi, the med error would not have been an issue.

JCAHO and Time Out: http://www3.aaos.org/member/safety/guidelines.cfm

This was a headline on the EMS newswire recently: http://www.southcoasttoday.com/apps/pbcs.dll/article?AID=/20090916/NEWS/909160333/-1/NEWSMAP Paramedics cited in flawed emergency call However, as the medical error system is set up in the hospitals, if the staff member discovers and admits to the error, no displinary action is taken against that person although they may have to take some additional education depending on the error. All the "rights" must be confirmed by the person giving the medication. This article appears to be more of a fail to assess situation.

We do the time outs for the bigger invasive procedures such as central venous or arterial lines. Since we can run 8 ventilators (prefer not to) in the ED I have stopped residents from doing a CL on the first ventilator patient they saw because their identifier was "vent patient named Garcia". It is a good day if we only have to sort through the occasional John Smith rather than a sea of Jose Garcias, some are alias, with different languages/dialects. For other invasive procedures, we use the JCAHO recommendations for identifiers. However, ID bands are not always reliable. If the patient is not verbal, two licensed staff members make the initial ID and the following. We still get the occasional foley, IV or arterial stick done on the wrong patient. Medication errors are of course an issue. The RN may have 6 - 10 patients as any given time. We are still working out the issues with the IDs scanners. For all the chaos, I am surprised things flow as well as they do. But there are times someone mucks up and headlines are made.

After the messes at the Tampa hospital a few years ago we take the TIME OUT very seriously in the hospitals here. From working in the ICUs, I also know some of the screwups at the hospitals I hang around. I had a little surgery on my right foot a couple years ago. I even wrote "NO" on the other leg and foot. At least the word "NO" means the same in English and Spanish since English is not always our primary language in the hospitals. I also like the practice of scanning the equipment and supplies used for a more accurate count.

EMT(P)s have their own oath and it is not called the Hippocratic Oath although some wording was borrowed. Although, there are probably not many that paid attention to this little announcement of responsibility that is found in more EMT(P) textbooks. If you are impaired in anyway and that includes fatigue (as mentioned previously and in other threads), it is your responsibility and/or your partner's to see that you are taken out of service. Of course, EMT(P)s also work on one call at a time and are notified at the time of the call. ORs may schedule several days or even weeks in advance. Neither computer or paper scheduling are infallible. Now for this news article, regardless of the scheduling error there are check lists to follow to prevent this type of incident from occurring. No patient should have anything done to them until a TIME OUT is done. This is done to prevent screw ups such as wrong patient and wrong body part being cut on or off. If one had been done someone should have noticed they were missing the surgeon. For Paramedics, there have been an increasing number of medication errors or at least more are now being admitted or caught. A Paramedic should also take a few seconds to check if all the "Rights" are in place.

But in reality in the U.S. the Paramedic is still a tech cert with only 600 hours of training in some states and does not have professional recognition. In the medical directors aren't going to be overly open to extending advanced practices to someone that has all of 6 months invested in their education and for some, only 3 months. Until the Paramedic gets some credibility through education, not much is going to happen. The employees that go to a hospital have already invested at least the time and money it takes to get a two year degree and sometimes 6 year degrees. So yes the hospital will invest a little more to hang on to these professionals. Paramedics in the U.S. may whine about the cost of their initial education but for some, they chose the fastest and most expensive route to avoid any additional education a college might require such as A&P for a Paramedic program. Unfortunately this pattern has repeated itself over the past 4 decades to where it is difficult to think in terms of "education". When one's Paramedic program was only 600 hours and that was way too long as some would lead you to believe, it is hard to consider taking even 30 - 70 CEUs every 2 years. The RRT, RN and Paramdic may all make $60k/year but the total number of hours will be different. RNs and RRTs don't normaally do 24s with the exception of a few flight services. Most will do 36 - 40/week. In Florida and California, our EMS is largely fire based and funded through taxes. All Paramedic CEUs and sometimes the initial cert itself is paid for by the FD. Unfortunately, they prefer to use the $16K - $25K per student route with a contracted medic mill to see that every one of their FFs are Paramedics as quickly as possible instead of $3K to a community college. They will also often contract with these expensive medic mills to get the CEUs for their FF/Paramedics also. They feel the tax payers owe them and will willingly pay whatever increases in taxes they demand. Your RRT is still way ahead of ours in the U.S. The U.S. RRT is slowly catching up but then we are are relatively young profession with licensure being established in 1986 for some of the states and then it took over 10 years to get it in the majority of the states. Massage Therapy was passing us up. BTW, I just heard about the education requirements, both initial and CEUs, for Massage Therapists in Canada. The U.S. Paramedics who fear education had better scratch that off their list as an alternative career possility. That even goes in the U.S. as MT's education requirements are advancing since they gained recognition in hospitals. Heck the MTs that are self employed have to pay for their own education and CEUs which may be as many if not more than the Paramedic.

Aren't your certs and and license good for 2 years? Don't you want to have EMS recognized as a health care profession which may require more education requirements? Or, would you prefer it remains at 1968 level? I don't really see anyone complaining here. I am just glad I don't live in Canada and have tniugs' requirements for RRT.

Not all hospitals pay for all CEUs. Many EMS providers do pay for CEUs. Maybe before accepting a job one should check out the benefits. If they are not happy with them, they can find another employer. No one forced one to enter this profession not is one forced to work for an employer they feel is treating them unfairly. Now for the hospitals, some those that had generous benefits for education have taken that "perk" away this year due to financial problems. If it keeps the hospital from closing, that is a small contribution from the employee. Some professionals may need over 150 CEUs to maintain their licenses and certs. This may not include ACLS, PALS and NRP. That is also considerably more than the Paramedic. spenac, if I remember correctly you are in the middle of nowhere. Sometimes hospitals have to add CEUs to their benefits to attract employees or to keep each licensed employee from racking up several thousands of dollars each license period for travel expenses to CEUs. Now for those of you who believe you have "free" benefits from your service when you work for a county or city service, you are still paying but indirectly. The costs for all the "freebies" are trickled down to the tax payer. The FDs here in Florida generally pay for all the CEUs and that is a huge part of their budget. So yes, the taxpayers do pay for their education and not necessarily the employer.

Plague providers? If you want to be in any profession from healthcare to construction, you may need to take responsibility for obtaining a license and accepting the responsibility that goes with it. I seriously hope this is not another "we're not increasing our education until they pay us more or they pay for all of our education" thing. There are too many excuses now coming from EMS providers that keep it from advancing. Giving some another excuse to not go the extra step for themselves as health care professionals is not what this profession needs. It is because some did enter EMS after watching too much TV with crap shows showing more heroes where brains aren't required that some whine about their responsibilites. Had they actually investigated being a Paramedic as a real health care profession they might know they have to get a license and maintain it. Sorry but if this profession is to grow, the people in it has to accept some of the responsibilites for being considered a medical professional. If your employer doesn't pay for everything you may have to get creative in finding cheaper CMEs or going to equipment company sponsored workshops for your inservices. One may also have to learn tax advantages and if they can itemize their expenses. Also, based on number of hours worked, Paramedics in some states do make more than RNs and RTs. Both the RT and the RN are held responible for renewing their own licenses and signing up for CMEs whether they are hospital sponsored and paid for or not. No company should have to hold the hand of a professional and tell them what they have to do to maintain being a professional. Spoon feeding should have ended with Paramedic school.

That's hysterical. Did anyone notice the ad for the Ace School of Massage Therapy by his photo on the news channel link? You might have to refresh the screen if it is on an alternating ad setup.

Good luck with finding a career in the health care professions that is cheaper. Being a Paramedic is much cheaper than my other profession as an RRT and that is even with the hospital picking up the tab for some of the CMEs. RT is also probably cheaper than RN or PT. The licensure is definitely more expensive ($200+) and that should be your responsibility as taking care of your own license is just part of being a professional. You will have no one else to blame if it is not done correctly or in a timely manner. Don't trust others with your career. Additional national certifications may also need to be obtained in RT to work in certain areas of the hospital such as neonatal or pedi which usually requres the NPS and that is another $250. PFT has two certs at $250 each. The specialties now bring more required CMEs. The Asthma Educator course usually recommends the 2 day seminar ($350) which may require travel ($400+) before taking that test ($275). Additional college classes to get the next degree for advancement or job maintenance and security must be factored in. National, state and just professional update seminars may need to be taken. I attended 2 week long sessions ($800 each/hospital paid half) for just the HFA inhaler conversion. The part not paid by the hospital will be itemized on my taxes. Don't forget the tax accountant fee. As well, there is a personal time factor. Even for the mandatory inservices that are provided, they may not always fall on a day where they can be done at work since leaving a critical care area for 3 hours is not always possible. Other health care professionals are also encouraged to belong to their professional associations which will include at least one national and one state (total about $200 depending on state). In fact, that is usually one of the things employers look for on your resume. Very few employers will settle for someone who is not promoting and supporting professional advancement. BCLS, ACLS, PALS and NRP are of course required. RNs also have their professional certifications which are not cheap and must also get additional CMEs in addition to what the state requires. Let's just say professional participation and expectations cost more in other healthcare professions that take providing quality patient care seriously and maintaining high standards for employees. The hospital will pick up $1000 of the cost for CMEs and college tuition with the average expense being about $2000 - 4000/2 years depending on number of out of area conferences and if you are doing work on a graduate degree. For Flight, all of my expenses were covered for additional training and the basic required certs which included the BCLS, ACLS and PALS which eased the cost for RT. BTW, which program is calling neonatal resuscitation NALS? Does it include the actual placement of the UAC/UVC and chest tubes?

Tell your parents and let them take you to the doctor if they feel it is necessary.

That could be true if the person is a student or lay person and holds no medical license.

Yes, that comment was by the EMS Chief or so it stated.