VentMedic

I have a feeling you are going to drift from EMS and go into another profession or moonlight at something else. Have you read the new Asthma Guidelines; EPR 3? http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm PACU sometimes is like EMS if you look at the standing orders. That could also explain the Racemic Epi. PACU can be like an assembly line and sometimes things get done just because. It drives me nuts when I see the patient (or finally get called to PACU for an assessment) to hear "we tried all this (pointing to a recipe of standing orders) and still have that". I went into RT because I sometimes felt helpless with the protocols I had as a Paramedic and I found out I had unrealistic expectations. That one Albuterol neb was not always going to miraculously take away the wheezes and just putting an ETT into someone did not always make the respiratory distress or air hunger better. There may be another role, in addition to EMS or instead of, for you especially since you have seen what it is like for someone close to you to experience true respiratory distress. Until then, if you can not find anything interesting around you, read the standing orders and protocols books of the units/EDs you will visit. You will find out how they manage sedation, sepsis, BP issues etc. BTW, I am a big fan of Pulmonologists and especially those that specialize in kids.

This I miss something? Is this "cert" of Super EMT now "national"? Why write a person in Congress when this is one little volunteer town that wants attention or another patch by giving themselves an elaborate title. I also believe that if a person is going to do any type of rescue that involves a degree of skill, it shouldn't be done half-arsed. Giving these EMTs this title may actually make them think they are qualified for more than they really are. That is when the patient and other can get injured. Rescue and EMS do go hand in hand but that does not mean those in EMS are qualified to do it. Just holding a title doe not make on an expert. I believe this is also what Dr. Bledsoe has been writing articles about during the past few years. EMS loves the certs that get handed out by whoever or whatever but can not always back them up with proof of training or expertise.

And this has what to do with the Emergency MEDICAL Technician class? The EMT-B barely teaches enough first aid to even be a good entry level job doing just that and now they want to add more "awareness hours" for something that should be taught at length in a course which covers that specialty. The "title" of Super EMT makes it even more hysterical. I'm sure they must have a patch for it too. At least if they get a patch it won't be a total waste of time.

Looking at their website, everythng is an "awareness" type introduction to these skills. They are getting no more training than if they were doing it for the same thrill they would get at an amusement park. They will not be "skilled" enough to be of much use on a scene. I would no more trust one of these "awareness" rope class students to tie my shoes much less secure a line for rescue. Surely the could have found a better way to spend class time learning the medical stuff. However, this is what happens when you get EMT-Bs instructing EMT-B students. They don't know what medical stuff to teach so they fill class time with something that looks real cool to do to pass the time instead of boring A&P things.

Why haven't you gone past EMT? Would you be happier as a Paramedic? Any other healthcare occupation is going to require a minimum of 2 to 4 years of education and you will see 2 - 10x more patients in half the time as an EMT. You may also be taking care of the same patients from the high crime area but for a much longer period of time. Since you have already worked a variety of places in just 5 years, you may need to examine another field outside of health care. While you may think you have gained a lot as an EMT, it is an entry level position and didn't require that much to gain the entry. Don't look back and move on to something that may hold your interest longer. Keep an open mind for all opportunities.

I gotta agree here also with the others. PACU is a great place to learn assessment, pharmacology and some pathophysiology. Either your school did not adequately prepare you with enough knowledge or you may not have enough interest in medicine to take the initiative to get involved. BTW, I see a lot of mothers and fathers of children with asthma and unfortunately many know very little about it. Also, to compare asthma to aspiration PNA is not even in the same ball park as far as the medical issues involved.

Nor should they be allowed to become as rich and famous as the one EMS has supported for over 20 years.

No, this is not a HIPAA think unless numbers and other data are released. For the EMS providers this falls under state, local and department patient privacy laws which have been in place for decades and probably centuries. Of course some in EMS also forget about the EMS code of ethics and EMT Oath. The call probably went out over the scanner waves which every celebrity reporter has along with all the addresses memorized. However, if EMS providers release the information themselves, there will been many violations and if certain information is released that falls under HIPAA, then is will also be included. But in CA, there are enough state regulations concerning patient privacy to keep the courts occupied if someone wants to push it. I would hope it would be dealt with from the ENS departments involved before it would have to go further.

I could have gone into the whole physiology stuff but I have been criticized for talking too technical to "show off".

Florida http://www.doh.state.fl.us/demo/Trauma/protocols.htm http://www.doh.state.fl.us/demo/Trauma/transports.htm Adult http://www.doh.state.fl.us/demo/Trauma/PDF...riaMeth1202.pdf Pedi http://www.doh.state.fl.us/demo/Trauma/PDF...oreMeth1202.pdf

LOL! Those are only the ones you think you know about. Do you even know how many special needs children or adults are in your community? At the hospital, we spend probably more hours than some Paramedics spend in their programs educating parents of children who are technology dependent as well the the S.O.s of patient with various cardiac devices. They know when their child or family member needs to get to a hospital and they know which hospital they need to go to. Only in rare instances will they call 911 and usually the primary care giver for that patient will instruct whoever responds what needs to be done. Very few Paramedics have had the pleasure of working a VAD patient in failure.

This is part of the rigor mortis process which causes the muscles to contract and stiffen with the chemical changes in the body with death. It tends to affect the smallest muscles first, and then spread throughout the larger muscles. If the body is unable to complete the cycle of muscle contraction, the muscles are stuck in contraction.

I posted that article to show that neither is without their own personality flaws. What's with the double standard? With all the crap that is happening in EMS to give it a bad rep in some areas, why aren't those in EMS calling for higher standards and better oversight with the same energy some on the many EMS forums are putting into bashing a few LEOs? Imagine what could be achieved if that energy could be directed to turn EMS into a highly respected profession with adequate education. Granted, LEOs should be held to a higher standard as professionals but why shouldn't those in EMS also strive for that? Some are criticizing a profession few in EMS know very little about like they have all the right answers and yet look the other way or get upset if someone dares to hold those in EMS to a higher standard. Both the EMT-P and the LEO wrote their own stories. The both have histories and quite possibly have had previous encounters. Both are grown men and have no one else to blame but themselves for the situations they have been in and are in now. Did the Paramedic also not think his past would be scrutinized by his TV appearance publicly bashing the LEO? Everything will be fair game now and it is shameful that this incident could not have been settled under different terms. But no, we must hear from good friends of friends of those involved to continue to fuel the rage against the OHP.

http://www.emsresponder.com/article/articl...p;siteSection=1 Rough Reputations Revealed in Trooper, Medic Scuffle Embattled rescuers had been fired from other jobs RON JACKSON AND SHEILA STOGSDILL, Staff Writers The Oklahoman (Oklahoma City, OK) Tuesday, June 23, 2009 Oklahoma Highway Patrol trooper Daniel Martin and Creek Nation paramedic Maurice White Jr. - two men thrust into the national media spotlight after a May 24 scuffle - have reputations as bullies and histories of confrontation, former supervisors and employment documents revealed. Martin's defense attorney, Gary James, portrayed him last week as a loving family man and an "American hero" who recently returned from Iraq after a tour of duty as a U.S. naval reservist. Residents of the rural Osage County town of Fairfax have dramatically different recollections of Martin, who was their police chief from March 1999 to July 2000. Martin's tenure ended in Fairfax with a unanimous vote for his firing. "Yeah, I remember him," store clerk Linda Burgess said. "That's a sore subject around here. He left quite an imprint on this community, and not a good one, either. He was a bully with an attitude. "And he was always pulling people over and using the f-word." James could not be reached for comment. White, meanwhile, was fired in June 2004 by Muskogee County EMS after more than 11 years of employment. EMS director Terri Mortensen criticized White in a termination letter, citing his "unprofessional behavior" toward her and "misuse of authority over your subordinates." The letter listed other reasons for his termination: Failure to complete run sheets in a timely manner. Short notice on cancellation of teaching assignment. Failure to schedule a relief EMT to cover his shift while he taught a class in a timely manner. White responded by filing a complaint of racial discrimination with the NAACP, the Muskogee Phoenix newspaper reported at the time. The newspaper further reported the organization originally supported White's cause but later reversed its decision. The NAACP reportedly reviewed the EMS policy and White's termination letter, and concluded he had committed a fireable offense. Forty of White's former co-workers wrote a letter to the editor of the Muskogee Phoenix in support of White's firing. When asked about the termination, White's attorney, Richard O'Carroll, responded by saying, "Mr. White declines to engage in this process even though some of the information is inaccurate, incomplete and/or taken out of context. Martin is asking folks not to believe their lying eyes. When you have neither a defense, nor a sense of shame, you simply engage in character assassination." White was respected in other quarters. In Siloam Springs, Ark., he completed a one-year contract in 1992 as a paramedic for the fire department. Siloam Springs Fire Chief Jimmy Harris remembered White as "a good medic" and someone "pleasant to be with." Gary Padgett, who supervised White as a paramedic in Harrison, Ark., in 1991 remembered him as "a pleasant young man" and a true professional. Martin, meanwhile, served the Stillwater Police Department from October 2000 to March 2007 before being hired by the patrol, Stillwater Police Chief Norman McNickle said. The chief said he was legally restricted from discussing Martin's work history. But no one expressed such concerns in Fairfax. Longtime Fairfax barber shop owner Linda Bevill, who cut Martin's hair, described him as a bullish man who ran off teenagers from cruising Main Street and constantly accused people of drinking alcohol during traffic stops. Former board of trustees member Ted Smith remembered Martin as someone who "didn't take orders very well." Smith recalled one incident he witnessed in which two handcuffed teenagers were lying face down on the sidewalk. Martin stood over one of the youngsters with his pistol aimed at the youth's head. "Yeah, we had a lot of trouble with him," Smith said. "We're not surprised at all by what has happened. " ... I always knew he'd be famous some day." BACKGROUND What's happened →Cell-phone video captured by the son of an ambulance patient was placed on YouTube. →The video shows state trooper Daniel Martin and paramedic Maurice White Jr. in a May 24 scuffle after Martin pulled over the ambulance in Paden. →Martin accused the ambulance driver of making an obscene gesture at him, which the driver has denied. The driver was ticketed for failure to yield. →The Oklahoma Highway Patrol released the dashboard camera video, in which more of the scuffle is seen. →Martin's attorney portrayed his client as an American hero who just returned from service in Iraq. →White's attorney responded by calling Martin a bully, and White went on national television to call for Martin to be stripped of his gun and badge.

EMS education is very limited from a broader view of medicine. Those that take full advantage of the learning experience of IFTs will benefit and can bring more knowledgeable/skilled care to 911. There is very little pathophysiology taught in EMS and IFT patients provide a classroom on a stretcher as well as a quick opportunity to seek out a knowledgeable health care provider in the facilty to give an explanation. There is also an extensive med list that can be more closely examined and understood. Various venous access ports can be examined. Too few 911 Paramedics know what to do with these devices and some end up destroying them which could be the patient's only access besides an IO. Of course, that will only be for a limited time and the patient may have to go to the OR for another port before other issues can be addressed. There are reasons why many long term care facilities will try their best to avoid calling 911 for their patients. They may know those that work just in 911 EMS will have very little knowledge of medical devices and the various equipment that keep patients alive for the long term. 911 Paramedics may not even know these patients exist because they have never been challenged by transporting on of them. Even VAD patients or parents of children with special needs in the community try to keep the number of a hospital approved CCT or ALS transport service rather than calling 911. There is just not enough education about medically complex patients provided for those working in 911 or when there is, some show no interest because "its not a trauma". Thus, not having seen some of these complex patients, they may just pee their pants and drive real fast to the hospital when they do come across one in an emergency. Or, some just stay and play way too long trying to figure out all the accessories. Thus, some transfer experience might not be a bad idea. I also find that the Paramedics who have been pushed through a program in the back room of the fire or ambulance station or through one of the medic mills they sponsor are at the biggest disadvantage. Unfortunately, those are the ones that may be providing 911 service. Those that at least got an education before joining will have more going for them than a few skills and trying to rely on that "street smarts" stuff to understand the medical needs of a patient. For EMT-Bs, if they pay close attention to the patients, do a thorough assessment each time, read the H&P and med list, learn good communication skils and take advantage of being able to talk to health care professionals at the facilities and diagnostic/rehab centers the patients are transported to and from, they will have an advantage when they move on to EMT-P. However, they should be still taking classes while working as an EMT-B to continue they learning experience and not just master the skill of moving a stretcher between the time they finish EMT-B and start EMT-P.

I'm surprised since your own state has 2 or 3 accelerated Paramedic programs.

The alley: http://video.aol.com/video-detail/woman-st...cid=VIDLRVNWS03

All the babies in an NICU requiring a ventilator have an ETT. The smallest baby I have personallly intubated weighed in at 398 grams. The tube sizes usually start at 2.5 although in rare cases a 2.0 has been used. Take an NRP course.

. I've also seen babies covered in petechia and cold extremities from sepsis that could look like they have lividity and are dead. I've also seen babies with bradycardia and with extended periods of apnea or even agonal breathing that look like they could be left for dead. However, with the proper care, they may have a chance to turn around. What was the cause of death? Was the patient fully covered or just wearing a diaper? Outside temperature? How much pedi experience did these two have? There are too many unanswered questions that the media didn't provide or wasn't released. But then this would not have gotten this far if they has provided documentation of a proper assessment to show signs of death. If the ME placed the time of death long before the call, then there should not have been any problem. I would also give the benefit of the doubt to the ME, ER doctor and Medical Director as well as those in the State EMS office that they did their homework. Surely somebody in that state knows the definition of dead. I can't believe all of the MDs involved in this situation are missing the point or are out to get these two EMT(P)s. This also happened before the supervisor was laid off since he was at the scene in that capacity.

Exactly! You wouldn't expect a FF/Medic from Southern CA to work as a FF/Medic in Miami, Ada County Idaho or any other progressive system. You also wouldn't expect them to be able to work at the acuity of most ALS IFT transfers which is why MICNs are used in CA and not Paramedics.

Where did you get the information about having dependant lividity? We had already discussed their protocols and they were posted on an earlier thread. As with any situation, if one is going to declare death and especially with a child, one should document well enough to cover their butts as well as contacting the med control as listed in their protocols. It really shouldn't have been difficult for them to do that instead of sitting in a truck with a dead baby. If they were going to declare death, they could have allowed the parents a chance to hold the child and comfort the parents as well. Instead they allowed everyone else (parents, LEO, supervisor) to run the show and didn't document well enough to back up their actions, inactions or declaration of death.

Do you think the public would be any happier knowing their tax dollars are supporting thieves on the payroll that steal from patients? While the FDs of Southern CA may look the other way about alot of things especially when it comes to patient care, there are agencies in other parts of the country that do look out for the patient.

The needs of your children should be addressed before just looking for a cool medic job. You are correct not to choose CA since that state can barely afford to cover the very basic educational needs of kids. Florida isn't doing much better since Jeb messed things up. Both of those states are very expensive. FL is even expensive for basic rental and car insurance. Plus, you may be running AC 24/7 x 360 days/year in some parts which can get very expensive. Florida is also largely Fire based EMS and the market is saturated with medic mill grads waiting for a job with a FD. CA is stuck somewhere in the 70s with very limited opportunities for Paramedics to be Paramedics even if you do work for a FD. That being said, Lee County EMS (FL) is decent but again there is the cost of living and so-so schools. Another forum member here, croaker260, is always saying good things about his service in Idaho(?). http://www.adaweb.net/Paramedics/tabid/75/Default.aspx/ Being from Oregon, do you have a 2 year degree in EMS?

Stealing is stealing. Preying on the sick and injured is in bad form and when it is done by someone who is supposed to have the public's trust, it is even lower. Scum sucking bottom feeder lower. Several services stage this type of investigation. It usually just involves the crew that has been watched and there may be a just cause to stage it carefully. If the EMT(P) has any integrity, he would have done the right thing and turned the money in with the patient's belongings and asked for a receipt. Drugs have also been used as bait. This profession has lost quite a few due to taking drugs such as cocaine from their patients' belongings. There have also be staged incidents to check on the assessment or lack of assessment skills of certain crews. These may be done after several complaints and most do perform as expected so it is not a waste to smoothly remove these individuals from the profession.

So the others made him go on the talk show and make those comments? How much did he get for doing that talk show in at least expenses paid? Is the money for the legal funds being handled in a secure trust or are people just writing him checks? On a couple of blogs there are even comments by "people who know him" that there is a book deal in the works. There's a lot of hearsay from people "who know him". By him making his comments now heard worldwide about wanting the LEOs badge has put him into a new light and now opens his motives up for scrutiny. He is attacking one LEO that may have stepped out of line. How is that helping EMS? What about those in EMS that cross the line? Why don't other professions demand that they be removed? Many professions leave it up to those in a particular profession to do the right thing because others usually know they do not have enough knowledge to make a career ending judgment against someone in a completely different profession. This may also be a good thing for EMS because some in LE have probably witnessed many things at scenes that could and should easily end the careers of some EMT(P)s but they may put faith in those in EMS that they will do the right thing to police their own profession. Yet, that is something EMS still fails to do in many cases.