CBEMT

I think ALS providers learn about more potential diagnoses for a given symptom or set of symptoms than BLS do, so that certainly affects assessment. I know from my own experience that the number of potential causes of chest pain at least doubled if not tripled between what I got during my EMT-B school (one of if not the best in the state at the time) and my ALS course.

Since you can't prove having ALS engines makes any difference in patient outcome, I still don't see what we're losing. Why the eff do we need to buy 37 chase cars? If $350,000+ gaz-guzzling ALS engines don't improve outcomes, ALS Suburbans sure as shit won't. Oops. I guess we found our cost savings versus the fire department....

My old job fired a guy (at the point in the company's history where it was practically impossible to get fired) who handed in a refusal with a narrative that read "Pt refused."

I've never understood why billing becomes such a big deal in so many jurisdictions. The EMS services in my area began billing at least a decade ago, probably much more, and to this day there's still citizens who don't know about it. It was never the subject of city council hearings. It was never in the paper or on the evening news. And that was at the inception of billing- some of these departments have probably changed their rates three of four times, without anybody saying a word.

I've worked with a PR paramedic, who told us that because the PR paramedic course skipped the chapter on hypothermia, NR would not certify their graduates, even for work in PR. Seriously. From what he told us, his course was one of the longest and most intense I've heard of, but apparently NR would rather patch some 6-month mill grads than put some critical thinking into the issue.

Gotta spend the money somehow, right?

Keep in mind Dust- you're counting on the media to get his level of certification/licensure correct. When's the last time they did that?

How critical is my patient? What's the ETA of the next-due ambulance for a driver? Sorry, my patient's life means more to me than being able to tell a firefighter to get lost, just so I can say I did.

The only accurate answer to that question would come from the HR departments of the companies themselves. Speaking for my area, all of the local privates hire dispatchers without EMS experience. The pay can only be described as slave wages in many cases, but that might not be true in the Boston area. It's worth a couple of phone calls anyway.

Sounds like a stupid-ass question to demand of someone who isn't even in the field yet. Just my two coppers.

Our European, Aussie, and Kiwi cousins (and I don't specifically refer to any one of them here) often spout off about how violent America is and how we have a "gun problem." I'm a member of several different forums, and see such generalizations regularly. Yet American paramedics being attacked with pool cues and ashtrays is pretty much unheard of. And despite all the awful guns our country is supposedly awash in, we in EMS are not routinely attacked or even threatened with them. If we're so allegedly prone to violence and stupidity, why are you guys the ones getting a shit kicked out of you on the job?

Sarcasm detection FAIL.

You're saying it surprises you that people aren't buying a $10,000 piece of equipment for themselves like they'd buy a stethoscope? Please tell me I'm misreading you.

And that's showing the patient restrained WITH shoulder straps. That's what I meant by "properly secured," and I'm still going with "unlikely."

or, 3. The injuries are in reality more severe than whoever talked to the media knew, which was probably the police. Sort of like the elderly man rescued from a house fire near me; the PD told the media he was transported for "non life-threatening injuries." He died the next day from burns over 60% of his body. It's a long shot, but it IS a possibility. Myself, I wonder what the chances are the patient was fully and properly secured to the stretcher. My magic 8 ball says "Don't count on it."

You're telling me you've never thought some of that stuff?

Who said he did? Milwaukee is, I believe, a fire-based system (am I wrong?). I've never seen a fire department anywhere that runs their dispatch procedures past a doctor, or anybody else for that matter. (Around here they're just signatures on paperwork anyway.) Whether they should or should not doesn't matter. I just don't think they're required to, so their medical director probably has nothing to do with this.

Not even- this is call triage. They're talking about delaying or holding those calls until enough trucks are available. The guys on the street aren't the ones making the determination.

Actually, it's a reference to the fact that there are EMT schools that last 3 weeks, and give the same amount of training that a traditional 2 night a week, 4-5 month course does. Ergo, EMT-B is essentially a 3 week class. It just takes some people longer to complete those three weeks.

I predict their calls for chest pain and difficulty breathing go up.

Hell, somebody reading the run reports would be an improvement for most departments around me.

She's not a paramedic by half, either. EMT-"Enhanced" or something like that. I can only imagine how her skills are 4 years later. No kidding. WTF are they waiting for?

Which hospital?

Never seen an ambulance in my area with an anti-theft device like that. Oh, that's right, they're optional. Which mean they cost more money.

The department can't issue Keith two new legs, can they.