spenac

#-o :laughing3: Those are good examples of why we should ask a patient what happens when they take a drug that they say they are allergic to.

So basically there is no change other than title. Basics still can do nothing. EMT-I or AEMT can do just very little extra just like now. So what is all the excitement about?

What I have done and had done to me is have person of lower level ask would you like me to get this or that for you, in order to get the higher level to rethink what they are doing. Or repeat the blood pressure to avoid nitro at low BP. A basic I currently work with that was a military medic but currently is working as a basic will hand you a drug to make you realize what you are missing. None of this gives any reason for doubt to the patient. I have also gone as far as letting patient know upfront I am a student so I will be asking the Paramedic all kinds of questions to help my education unless they object. All so far have said that would be ok, so if I see something I don't understand I ask, at times this has led to Paramedic actually deciding to change what care to give without causing the patient any extra anxiety.

In west Texas some services are paying Paramedics $18/hr paid all 24 or 48. You get benefits and overtime. This pay is for EMS only and is actually higher than many fire/ems in the area get.

Good article. We need to give patients relief. The sooner they receive an antiemetic the more comfortable they are. Patients comfort and well being should be our main concern as healthcare professionals.

I have learned that we are a bunch of egotistical, opinionated, hard headed, obnoxious, stubborn jerks and thats just some of our good points. But really those points have led to some of our best debates. Often leading after we all calmed down to some of the best educational discussions. As a result I have re-evaluated myself, I have changed how I do some things, I have changed my opinions on some things, and developed a much greater understanding of the environments others work in. In conclusion I want to thank all the little people.

Check out study aids under Files and Knowledge on categories page. Glad your talk with dad went well. Hope you the best.

Here at the city check out areas under categories. Here is one location. http://www.emtcity.com/phpBB2/dload.php?ac...ry&cat_id=8 Also do not be afraid to use all the other tools here such as spell check. By the way welcome to the city.

First of all congrats, keep up the good work. As to practicing get other EMS professionals to help. Your dad means well but sadly like so many of us he sounds like he has forgotten what is most important. Please don't hold it against him as what he does is what he thinks is best for you. Talk to him in a relaxed manner. But still expect to have to get others to help you. Hope you the best.

I would be all for using anything that makes my patients feel better. I am a very hands on medic. I feel it is important to look, listen, and feel. If this added method comforts my patients I am all for it. Also as a person with multiple chemical sensitivity, I am a firm believer in avoiding introducing chemicals into the body if there is an equally effective natural method to use. Why risk the complications that can come from chemicals when just a little more hands on can help just as well or even better? So how do we get started?

The reason I took intermediate is it was required for my Paramedic program. The school has it divided up. As soon as completed EMT-I course could start Paramedic program. Other schools have the EMT-I as a requirement or an option while in the Paramedic program. I would always say immediately go on to Paramedic. There is no point staying an EMT-B or EMT-I. As far as EMT-I NR exam is to easy, of course I went to a tough school.

The service shown is a fairly large one. There are also numerous paid and volly agencys in the area that could have been called in to help if needed. There was no need for rapid extrication. The patient was not in immediate danger. Traffic was not an issue. Even if they had felt he needed rapid extracation it would have been better to support his neck and slide him onto a properly placed board, rather than letting him crawl backwards onto the board.

Well Doc glad we can help keep inspiring you to write about and advocate advancement of the EMS profession.

I just stole that for my new signature. Thanks

I Write The Songs Barry Manilow

With time we will see a wider variety and yes sadly many will be not good. Thats life. Look at the quality of posts on the forums, some great, most suck.

I agree with you, but in many small towns 911 ambulance is all that is available. That is why at my current service if it is a transport it waits till we have an extra ambulance available. I personally think nursing homes should have a van equipped to even transport bed ridden non emergent patients to appointments.

Endless Song Aaron

Great idea. We get called for people that could have gone by the nursing home van. We also get calls that say transport and by policy they wait till we have an ambulance free. We do not rush over. Sadly because they just request transport it sometimes leads to people that need immediate care not getting it. We keep asking the nursing home to request emergency response rather than transport. Maybe both sides can discuss when an ambulance should be called and how to request it so it gets proper attention. It will also allow both sides to learn about each others true situation rather than relying on what each other thinks. It really sounds like ya'll need to have a paid service. Any community big enough for a nursing home is big enough for a paid service.

The simple answer w/o stepping on religious beliefs is a shoulder length glove. http://www.sigmaaldrich.com/catalog/search...ALDRICH/Z258164[web:64931cdebd]http://www.sigmaaldrich.com/catalog/search/ProductDetail/ALDRICH/Z258164[/web:64931cdebd]

http://www.newswest9.com/Global/category.a...p;nav=menu505_2 Search for "Accident on Highway 80 sends two to the hospital". ( 2-5-08 ) Might be able to scroll down to find it. If not able to view what happens patient lays himself down on backboard that is on cot. They do not slide board up to him and put him on board. It only takes 2 to place a person his size on a board. Anybody else would have been in the way. You city medics make me laugh. Answer is always need more help. That doesn't fly in rural EMS.

How far we have come in EMS per Dr Bledsoe. Do you agree or disagree? Discuss. http://www.jems.com/news_and_articles/colu...ig_Picture.html The Big Picture Bryan E. Bledsoe, DO, FACEP 2008 Feb 7 Now that EMS is more than three decades old, a body of research has started to evolve that will define the future of the profession. More often than not, EMS practices that made perfect sense when the industry was in its infancy have been found to be ineffective or, in some cases, actually harmful. Thirty years ago, we gave large volumes of IV fluids for trauma. Today we only give judicious amounts. Endotracheal intubation was considered the "gold standard" for airway management. Today, many of the alternative airway devices are considered just as effective and even used in lieu of endotracheal intubation. Thirty years ago, we stressed the need for a rapid response and quick intervention. Today we know that in very few instances does speed and response time truly make a difference. Thirty years ago we pumped every possible drug into a cardiac arrest patient. Today, we only administer epinephrine -- and that practice will probably soon cease. Thirty years ago, the purpose of EMS was primarily to resuscitate victims of cardiac arrest. Today, we're starting to recognize that, for the most part, cardiac arrest resuscitation is futile. I know the saying is cliché, but the paradigm is really shifting for us. If you look at the big picture -- what the sum total of research is telling us -- it's that the best use of EMS is to intervene earlier in the disease process. Instead of trying to raise the dead, we should be applying treatments that prevent cardiac arrest. You'll save a lot more patients with a bottle of aspirin than you ever will with a defibrillator -- I've been saying that for years. The treatment of trauma is changing from the old "load and go" to a more steady approach. While a small percentage of trauma patients need immediate surgery, most do not. Thus, the importance of prehospital procedures that help to minimize secondary injury is becoming increasingly important. The rapid and adequate treatment of pain improves outcomes. Proper hemorrhage control and splinting improves outcomes. Preventing hypoxia and hypercapnia improves outcomes. And, when there is little that we can do, we’re starting to provide therapies that prevent secondary injury, such as inducing hypothermia. Truly, it's a different ball game. Intervening earlier in the disease process means that EMTs and paramedic must be better educated -- not less. It's more difficult to detect the signs and symptoms of illness and injury earlier in the illness/injury continuum. Thus, EMS personnel must have a better understanding of anatomy, physiology, pathophysiology and medicine in general. The paramedic of the future can't rely upon rote memorization or utilize algorithm flow sheets to direct care. They must be able to recognize the patient’s problem, determine the appropriate intervention, apply that intervention and monitor the patient for improvement or deterioration. EMS personnel must think and do so independently! They must recognize that each patient’s different, and medications and treatments must be customized for the patient in question. It will no longer be satisfactory to justify administering a drug because page 134 of Wanker EMS's protocols state that the drug should be given. Prehospital care has evolved to a point where EMS personnel aren’t practicing as an extension of the system medical director. They're practicing within a well-defined scope of practice. Protocols should become clinical guidelines. On-line medical direction should be limited and used for consultation with a physician for difficult or problematic cases. Furthermore, EMS personnel must take responsibility for their actions -- not point at the protocol book, the dispatcher or a textbook as the reason for their decision. Becoming better educated means spending more time in the classroom, It means spending more time reading, more time working in the clinical settings and more time in supervised field training. It means reading and following the scientific literature of the discipline. EMS programs now require the assets and capabilities only present in academic settings. These include such things as a reference library, access to cadavers and tissue samples, access to specialists in medicine and allied health, high-fidelity human simulators, computers, multi-media material and much more. The old days of buying a textbook, reviewing old tests and simply going through the motions during clinical rotations and field internships are a thing of the past. At the same time, academic centers must develop outreach and satellite programs whereby their faculty and resources are brought to an area that doesn't have such resources. Distributive EMS education, primarily over the Internet, will become commonplace. To quote Bob Dylan, "Times they are a changin'." A lot still needs to be determined. Do we need as many paramedics as we have now? Should we no longer transport medical cardiac arrest patients who we've failed to resuscitate in the field? How involved should EMS personnel be in preventive medicine? Do we need paramedic practitioners to ease the load on hospital emergency departments and 9-1-1 services? Do I have all the answers? No. I'm not sure I have any of them. But, I have been in this business for more than 30 years and I follow the literature. Regardless, over the next few years, if nothing else, the journey will be interesting.

Hold Me, Thrill Me, Kiss Me, Kill Me - U2

kiss - prince

Could be Texas. If granted an emergency variance an EMS system can run with one certified person and a driver. My old paid service started this after myself and some others left. Scares the hell out me since my family might need the ambulance someday.