frontcrawl

I know the LA County lifeguards provide the paramedic services on Catalina Island. Quick bit of research suggests that Okaloosa County FL and Virginia Beach have Paramedic/Lifeguards and that New Hanover County NC has some sort of swimming paramedic program. EDIT: Almost forgot, AMR in Portland puts EMTs and Paramedics on the Columbia River on a seasonal basis

Check this out Kentucky Revised Statutes 75.160 Yeah, all of em.

Holy crap, really? Hasn't the urine filled up the sarcophagus by now? Probably be hell to pay if he can figure out a way to get out of the thing before he, you know, drowns and all that.

So, in Pinellas the municipal fire department responds first with an ALS non-transport ambulance and sometimes a fire truck alongside the Sunstar PUM people? But in Hillsborough the fire department responds and either transports or turfs calls to private BLS? :roll: I used to live down there but it was like ten years ago and I wasn't paying a hell of a lot of attention to this sort of thing.

First, a request to everyone. If you're talking about an ambulance could you please say so? Because a "rescue" could be an ambulance, some sort of pickup truck or a 70,000 pound mutant fire truck with sixteen reciprocating saws onboard. It this case it might be one of those stupid "squmper" things. It's just another localism. Now, please note the sections of the paragraph below I've highlighted through the use of bold text. Oh, oh, I know, I know, let me answer! Fire them all on the spot, then sell the ambulance to someone who might actually use it properly.

I figured as much. That's where most of the interest in the guidelines seemed to be coming from. I've noticed those wall mounted things popping up in airports and (I think) a shopping mall or two.

I hate to be an ass and I don't want to encourage this idiocy, but is this in fact so, at least from a federal prospective? I understand that the FDA published a draft regulation in 2003 that would have restricted the emergency non-prescription use (sale really?) of oxygen to actual emergency entities but as best I can tell it wasn't enacted. I haven't been able to find the docket on the FDA website or the new federal docket system. As far as I can tell, prior to the aforementioned proposed reg the FDA did allow non-RX sale and use but mandated that that tank be labeled with that "For emergency use only by trained personnel...All other uses by prescription only" verbiage (I'm paraphrasing) in addition to a few other conditions. Anyway, I'm not very familiar with the FDA regulatory system so excuse me if I'm being an idiot, and of course, regulations in many states probably do make it an RX item. Alrighty then, my writing is looking increasingly incoherent so enough of this inane 0300 rambling stuff.

I haven't so much as flown over Oregon, but I like this one a lot. Let's see, accreditation and degree information on the front page, links to pages with application procedures, prerequisite courses, curriculum info and instructor bios with relevant information. Looks pretty good to me.

I've heard this a couple of places but nobody has identified the third state. Anybody know anything? Oregon, Kansas and ????

That reminds me, they have a special recruiting program for qualified RNs. I don't think they have much use for EMTs though.

How in the hell would his lying improve anything? I don't mean to sound like I'm praising the guy, let me be clear, maybe he's a fire department yes-man jackass, but it sounds as if you're critizing him for the modicum of truth in the dalmatian crap. Again I ask you, how would his being consistantly bad rather than rarely, rarely, sorta OK improve things?

Dunno about billing but Google says Grand Canyon; Grand Teton; Yellowstone; Yosemite; Death Valley and Denali do or have done so at some point. An outfit called Medcor runs a couple of clinics inside Yellowstone.

I guess you could try to get one of the portable crew cylinders, wouldn't be such a pain to deal with. Neither the crew cylinders in the back nor the passenger masks have a very high flow rate, something on the order of 2 lpm, maybe 4 for the portables.

Let me think, where have I seen this before? :laughing1:

:roll: Everybody's favorite reactionary whackjob Nancy Grace is apparently going to be "investingating" this tonight.

How many states are even going to change the names? A few maybe, but I'd put money on a decent number of them changing nothing. As for this "we need a national scope" BS, what would that accomplish? Do RNs have a national scope? Respiratory therapists? PTs, OTs, rad techs, surgical techs, perfusionists, psychologists, pharmacists or anyone else? This seems to be an extension of skillz mindset, i.e. that which determines quality based on cool skilz. Further, any hypothetical scope would undoubtedly have to accommodate the lowest common denominator, thus handcuffing the few systems that don't suck.

That is a used one.

I'm a WFR through WMA. It was by far the best class I've ever taken. By far. I regret not taking my EMT class through WMA or SOLO rather than wasting several months of monday and wednesday nights hanging out with volunteer firefighters who aspired to get "hired on." It's not really aimed at rural ambulance stuff, but at guides or SAR people. If you're planning to ride a cyclocross bike from Provideniya to Magadan or that kind of thing, fantastic, but it may be of slightly less value on the East Nowhere Township Ambulance Squad.

Here is another story by the same reporter Clash mars fire/EMS merger talks (By I.M. Stackel Naples News Copyright 2007 Naples News) Gail Dolan tried to mediate on Wednesday when fire chiefs and Emergency Medical Services Director Bob Tober verbally clashed. “How about we focus less on training and focus on patient outcome?” asked Dolan, who is the Chief Operating Officer of NCH's North Naples hospital campus, and an EMS Advisory Council board member. “Then, you’ll see (the answer, which is) ‘how did patients fare?’ ” Her suggestion came shortly after Tober yelled at Marco Island Fire Chief Mike Murphy for alleging bias against emergency workers with advanced life support training, but who weren’t shepherded by Tober. The ALS workers are licensed by the state. “I didn’t bring this up as an ‘us against them’ issue, but I do believe we have opportunities (and should) seize opportunities to improve the system. We have rural areas of the county (and there’s) fragmentation on patient care,” Murphy said. The inconsistency is due simply to the vehicle on which paramedics arrive and by which agency they are employed, Murphy said. Firefighter-paramedics in other jurisdictions are treated equally, but in Collier, they are not considered capable of the same duties, Murphy said. Tober lashed back. “This is the same exact nonsense about improving training. How much plainer do I have to be about this?” Tober asked, hollering. “I have a right to question it,” Murphy said quietly. “And I don’t have to listen to it,” Tober yelled. The interaction was more public than usual, occurring at an EMS Advisory Council meeting, but it is the same fundamental debate that has mucked up efforts by Collier County fire chiefs and EMS to work out a platform for consolidation, as was requested in spring 2006 by Collier County commissioners. Tober reiterated his rage in an e-mail on Thursday. “You heard me yell because I had very, very good reasons to be outraged, and remain outraged. This is medical public policy that safeguards you and I, pitted against a very organized, national movement of fire departments (attempting) to take over county EMS organizations, regardless of the consequences,” Tober wrote to a Daily News reporter, who witnessed Wednesday’s outburst. Wednesday’s exchange began at the Oct. 30 EMS Advisory Council meeting, when Murphy requested a Tober presentation on county emergency medical protocol, a program Tober designed in the late 1970s. When Tober arrived in Naples in June 1978, Collier farmed out its transport service to American Ambulance. On Feb. 2, 1979, Tober launched the first set of six ambulances, staffed by the 18 paramedics he trained. “Over the years, these six ambulances have grown to 26 ALS units, and, in addition, the emergence of some ALS engines staffed by both EMS and fire departments,” Tober said. Differentiating between basic life support (BLS) and ALS, Tober noted that the system is inconsistent from one area to another. Fire departments in Immokalee, Corkscrew, Golden Gate and Ochopee still only have firefighters skilled in basic life support, Tober said. “I have increasingly heard the statement that a paramedic is a paramedic is a paramedic,” Tober said. “That is, all such medics from both the fire departments and EMS are state-certified and licensed, so why is there any difference in their protocols or clinical liberties? Why are they medically credentialed at different levels within our one protocol, and why do fire departments continue to hire and develop additional paramedics in their own systems? Collier County has but one single protocol.” It is the one Tober created, he said. “If I diluted this system down (to) another 80 to 100 paramedics, I would face serious skills and decision-making degradation,” Tober told the EMS Advisory Council board. “I, personally, am insulted for all medics in Collier County, (that they should be forced back to) helper status,” said Murphy, an EMS Advisory Council board member. But Tober had his defenders. EMS Advisory Council Vice Chairman Nancy Lascheid, whose husband founded and operates the Neighborhood Health Clinic on Goodlette-Frank Road, said there’s no need to interrupt service protocol and she doesn’t think skill levels are equal. Fellow EMS Advisory Council board member Jeffrey Panozzo both came to Tober’s defense but also questioned why ALS couldn’t be considered comparable to EMS. Referring to Tober as his “mentor,” Panozzo — who is the director of Emergency Medicine for Physicians Regional Medical Center on Pine Ridge Road — said he worked as a firefighter during medical school. “Medics can be firemen and firemen can be medics. We’re talking about enhancement of service,” Panozzo said. “I have zero personal bias, except that I'm interested in EMS (so) why don’t we allow the merging of these teams? You mentioned that 80 percent of calls are attended to by fire engines.” Firefighters start the call, Tober stressed, noting his 26 ambulances are “the primary immersion method.” “I don't need 60 ambulances,” Tober said. “I think you underestimate firefighters,” Naples Fire Chief Jim McEvoy told Tober. That was Diana Watson’s take, as well. Once an EMS-employed paramedic, Watson is now an East Naples Fire Rescue chief. An EMS paramedic may be fresh out of training, trying to guide a former EMS worker with 20 years of experience, Watson has said in the past. “Your most experienced medic may not be from EMS,” Watson said Wednesday. “Now, my certification is lower than it was at EMS?” she asked. She called for parity and recourse. “We want to provide ALS engines for our people, but Collier County holds the ‘certificate of necessity.’ I still consider myself a paramedic,” Watson said. EMS Advisory Council board member Dolan said she began her career as a nurse, and there needs to be a committee to talk out these issues. “Bob Tober could go to Tahiti tomorrow. Then what? Things change. In my mind, the patient is No. 1. We need to try to change the system to work together,” Dolan said. But, that’s already happening. Thursday, the Collier County Fire Chiefs Association rolled out the first, very rough, draft of a consolidated, countywide district, which would erase political and geographic boundaries. Representing 10 public fire-rescue districts, including the county-run EMS, assistant chiefs of operations for several districts hammered out a flow chart and plan that will be reviewed in January by the Fire Chiefs Steering Committee. The consolidated fire districts would become one single entity responsible for all fire-rescue and emergency medical responses throughout the county, and would be independent of the Collier County commissioners who suggested it. The position of medical director would be established as a contract employee, reporting to the top fire chief. Former EMS Chief Jorge Aguilera, who moved over to North Naples Fire last year, said the operations team looked at strengths, weaknesses, opportunities and threats. First off, elimination of political and district boundaries will result in better response time to people who need help, he said, although those response time calculations won’t be completed until all the research is finished. Also, there will be one manual, with one single standard of operating guidelines, he said. “There will be a single ALS protocol, countywide,” Aguilera said. While taxpayers will not see immediate savings in the first few years of consolidation, that will eventually follow. Likewise, the disparity in benefits from one fire district to another will dissolve, as there will be one labor union. Thursday, fire chiefs said their unions continue to talk about merging, and those discussions are moving along nicely, although no details were immediately available. North Naples Fire Chief Mike Brown observed that districts, alone, can’t push ahead with consolidation, that public support is essential. “This has to gain a constituency unto itself. It is going to require public relations, newspapers, and a lawyer or two. This is just step one,” Brown said. Also, Brown said he doesn't want to send out a message leading county residents to believe the system is broken. It is not broken, he said. “This will just improve our system for decades to come,” Brown said.

0% wacker. I have a scanner but it only covers aviation frequencies, so it doesn't really count.

Oregon, Kansas or is there a third one now?

Very interesting! You hold your hands up as if to demonstrate that you do infact have gloves on, right? I'm looking into expanding this technique, pointing at traffic signals and shouting out the indicated signal seems like a good place to start. I've learned a lot by watching videos of Japanese train drivers on Youtube. I'm glad I'm a failed-three-sections-of-the-EMT-B-practical-going-back-to-retest-in-febuary! I can concentrate on stuff that the EMTs with all high-falutin advanced skillz don't do, like breathing and blinking. Now if you'll excuse me I have to exhale. BSI SCENE SAFETY EXHALE *exhales* BSI SCENE SAFETY INHALE *inhales* BSI SCENE SAFETY BLINKING STAND CLEAR *blinks*

Dust, What other courses would you want to see as part of this curriculum? Microbiology? Pathophysiology? Sort sort of chemisty?

Whoa, so they PITed him? The whole thing seems odd.

DirtyBlackSocks, First of all I'd like to apologize for being an ass, I'm having a bit of a weird day but that's no excuse. Actually I agree with you that one might as well become an RN. That's probably what I'd do if I wanted to go deeper into the healthcare thing, but I've long since decided to go in a different direction. Requiring paramedics to have AS degrees won't per se bring about some king of paradigm shift in EMS. Proof of this can, I guess, be found in Oregon and Kansas. Deeper systematic changes are necessary to bring about a truly significant shift. I suppose that in making a statement like that I should at least attempt to define exactly what the desirable destination of the shift might be, but I'm not 100% sure what it is. All that said, from my perspective, and to be absolutely clear, I'm not a paramedic, the thought that there are paramedic programs out there that don't require so much as a single credit in anatomy and physiology is less than comforting.