fireflymedic

If you really want to get around the high school diploma rule, get a GED. Of course, most employers will not look at you seriously if you don't care enough to finish high school (this is NOT an insult to older providers - this applies only to current generation). Frankly I think in high school you don't have the maturity or experience to be a competent EMS provider for a career. There is a reason the national registry requires you to be 18 to test - it's called good common sense. Unfortunately some states bypass this testing and have created their own allowing those younger to be certed and I'm not seeing a positive result from it. Take the class, if you want, keep reviewing, then test when you graduate. Or better yet, finish school, then take the class through a college, and test. Remember average college student changes majors 3 times so yeah - what you want to do today might drastically differ in a year from now or even a few months. It may not. But finish school first, get an education, and then consider doing this. You might have the maturity by then to do it and will certainly be viewed in a better light as an applicant IMHO. Good luck.

Update: All are in good condition and released. KSP and internal department investigation in progress. http://www.wlky.com/news/19696393/detail.html

6/8/09 Meade Co. KY - Brandenburg Volunteer Fire was responding to a call requiring extrication when the driver of the engine lost control flipping the truck and landing in a ditch. The crew of 5 aboard were all injured with injuries ranging from minor to severe. All were airlifted to University of Louisville Hospital. No updates as of yet and names have not been released as of this time. I will update as I know more. Prayers for crew and their families and coworkers. Link to story : http://www.wkyt.com/home/headlines/47264682.html

Here the state troopers are car seat inspection trained and if you look on the highways it's actually advertised at each of the post sites. Also several of the FD and county EMS services are technician trained as well. It's actually mandantory for you to have your seat inspected and properly installed before you go to pick up a newborn from the hospital (though I've rarely seen them ask for the inspection sticker). The trooper posts actually do clinics a couple times a year where they teach you how to properly install one in your seat as well as all the safety aspects. Really great program, wish more states had something similar.

My most recent change prompted a six week orientation covering literally anything and everything complete with skills verifications, med director meetings, safety information, how to handle PR stuff, emergencies, etc, along with other stuff because it was an arena I'd never been in before. Prior to that, my service had a "progressive" orientation. You got the initial orientation to a transfer truck and all the routine stuff. During this time, you rode for a month as a third person to get oriented to the service prior to being cut loose. You were on full probation for 6 months from date of hire. After those six months, a skills evaluation was done, clinical competencies proven, an overall assessment, sit down with med director and service assistant director and main director. If you passed that point, then you were progressed into a 911 truck during which you rode as a third for a month allowing you to orient to any new protocols you were not familiar with as well as the area. You then went onto functioning independent 911 and with that 6 further months of probation. So essentially a year of probation. Following that you underwent another evaluation and if successful, you were full privledges and given a permanent partner for the duration of your employment. I liked how the orientation there went as it progressed people that came from different types of services orientation into rural aspect and also the different demands and protocols we had in place as well as a safety net for newer medics and EMT's to get acquainted during the transfer truck period.

Sorry there squint - You're still on page 19 !

That's awesome ! How can you not love it ?

I am just left shaking my head.....what possesses this guy I dont know, but the whacker demon is living strong in him. There must be some kind of therapy for this, there has to be. This is NOT healthy.

This is sad that there was such a lack of professionalism from both sides. I still haven't figured out why there were telling the ambulance personnel (I'll leave it at that as I don't know cert status lol) that he was arrested ? That was before he started fighting with them - after that fact, yes I could see a reason for arrest. If they didn't directly endanger anyone's life, and the incident passed over, a phone call to the service would have been more appropriate for disciplinary action or if they felt they MUST address allow them to drop off the patient to keep the family and the patient calm and maintain professional attitude, then address it privately with the crew. In most areas I've worked EMS and PD work very closely and well with each other, and it's sad to see it come to this in this situation. Granted we don't and more than likely will never hear the whole story (dash cam may end up on one of those police shows one day - who knows) as there is always two sides, but could certainly have been handled better. A sad day for both sides, just hopefully lessons have been learned from this.

This thread is the definition of a zombie - YOU CAN'T KILL IT ! Anyone have any suggestions?

Herbie - Air Angels is no longer in service - they shut down after the crash and were never able to recover. EMT - you've got a long way to go and a long time to get there. Don't be in such a hurry. Audit an ACLS class - especially if you work with a medic that is willing to teach. If so, you can learn a good bit - granted I come from a bit different mindset than many on here. But I hold a bachelor's degree in the states in emergency medical care/fire science. I've also worked almost every variety of EMS. I will say though - the majority of 911 running in chicago is fire based - very little opportunity for private outside of critical care/pedi transport. There are a few hospitals which offer that option, but most require a good bit of experience as a 911 medic before they'll consider you. The nursing thing is a good option - if you can get on with an ER or in an ICU as a tech - it's worth it. Many will pay for your education and there is the bridge option out there. I know Illinois does recognize this still at this time. Get the degree - well worth your money for the goals you have in mind. Also, check the search option like many others have suggested - alot of good discussions on here about what you're asking. And definitely gotta have a thick skin around here ! Some of us are a bit prickly, but just make sure you've done your research and you'll be fine. Questions are great and we welcome them but don't be suprised if some challenge your answers. Good luck and welcome to the boards !

To whoever made the comment regarding "no sensoring" with Trauma life in the ER - evidently you missed the University of Louisville episode.... They pissed the people off there so bad they threatened to throw them out and not give them the show. Get the hell outta my way was said more than a few times and they just decided to show the fluffy version of it. I can't speak for other locations, but I do know (as does anyone else who's made a room 9 trip) that they aren't the happiest campers around there....

Hmmm, this has a bit of a taste of a show that was promo a while ago on with the title Mercy Air - it was focused on air med, but many of the things I see have the same impression from it, just they directed so much focus off the air med side of it due to the fussing from the HEMS community. I can't help but wonder if this is not the same deal, just changed around a bit ? Right now I'm taking the seat with it that I did with the others I've seen offered. It supposed to be drama, in very very little way does it reflect actual life, so I'm not really expecting it to make the public go wow so that's what they do. If anything it may give them false impressions as to how exciting our job is. For entertainment, those of us that can look at it and laugh and enjoy it for just that it'll be fine, but I'm not expecting wonders, nor a major disaster. It's TV - the world didnt come to an end with ER when it was turned into a soap opera and people still frequent them just fine (I have yet to see university empty). Perhaps it changed some perceptions and people started expecting warm fuzzy docs like Dr. Greene to come in. But it didn't massively change opinions overall. Nurses are still nurses, docs are docs, and that's just how it is. It was before and it will be again and I highly doubt a show like this to do much for public opinion of EMS. We didn't see a massive overhaul with Third Watch did we? Uh no - so I think some are getting their pants in a ball over nothing.

Oh my does this bring back memories lol. I've done more than a few things on the list (I threatened to run a doc over with the stretcher that wouldn't move not long ago ! ) With time it all becomes good and you learn to laugh, though the you let go of the stretcher your partner was holding and your patient almost rolled away was left off the list. Usually these lists are completely without taste, but this one was funny and we can all relate. good post.

We had a situation similiar but was related to an EMS response. I work in a very rural area and yes there are a prevalence of snake handling churches and those that believe in faith healing. Had an incident with a child who was bitten, a concerned church member called for EMS for the child, but after arrival, group members refused to allow EMS access to the child as the parents wanted him "faith healed". Took the intervention of state troopers to defuse the situation, and due to the delay the child died. The parents were charged and convicted. As far as alternative therapies - I think they can compliment a traditional medicine therapy very well. Caring for the mind as well as the body is important and if faith provides them a positive attitude to cope with the illness great. Also, the benefits of good nutrition can't be denied - giving the body fuel to help heal itself has it's worth. However, I wouldn't neglect known proven treatments unless all were proven futile after a reasonable attempt. If it were my child, I would be pursuing both ideas simultaneously provided there were no contraindications with the herbs, etc if I felt that strongly about it. I would want them to live and give them every opportunity. As for adults - they are free to make their own decisions and I don't feel we have the ability or should have the ability to step in otherwise. But when children are concerned, it's a different story.

I would just be curious what the kid's perspective is. They didnt really elaborate on what he thought - they just said the actions they would take if he decided to fight it. I think he has a say in this as well as the parents. Of course, most kids are going to go with their parents influence, but if they really think he has a chance to live this way, and not the other I think having a sit down with him may be a good thing. He probably understands much more than we think...Whatever the outcome, all will be hurt in one way or another and it will be sad all the way around.

What I think of this guy and his actions is not able to be repeated here....fortunately he does not work in this area with those tasteless actions he probably wouldn't last very long.

Most important - patience, and lots of it. They have to be willing to deal with a multitude of attitudes, learning styles, and backgrounds. A good preceptor should be able to adapt how they teach and deal with the students/new employees based on how the person reacts. Some require a gentle hand, others require you to be quite firm. Someone who definitely doesn't think they know it all and is motivated to learn something new every day and takes in what the student has to say. I've precepted both new employees and also students and I have to say, I've had a few show me some great things I hadn't thought of. I look at it as an opportunity for us both to learn. I love it also because it forces me to keep my skills sharp and not slack. I had some excellent preceptors during my time and I think quite a bit of many of them. I can really say I only had two bad ones, and then I don't think it was so much them as a medic, it was more a personality clash between us. No harm done though. Also confidence in their own abilities and above all tact in dealing with situations that may arise with the student. Being available to answer the multitude of questions and really examine calls with the student are also important factors. Too bad we don't have more out there like that. We sure could use them.

Okay, most people on here know where I stand with this, but since it's been brought up again, for your sake of being new I'll repeat myself. I was young when I first got into EMS (tested day I turned 18 - my state is a NR state so you have to be 18 to even test and be certified though you can start class at 17 but cannot test until after your 18th birthday). When I started the majority of the services would hire at 18, but you could not drive until 21 for insurance reasons. There are a few places which have cadet options for those 16-21 that are interested in EMS as now the majority of services won't hire until 21. Where I work part time requires you to be 25 to even be hired and truthfully it is one of the most professional services I ever worked for. I can speak from a young EMS person's perspective - I felt overwhelmed and very ill prepared. Now I think alot of that was the same as any new person in EMS that gets thrown out there. Add the youth of an 18 year old or younger, and it's not a good mix. Also, alot of the garbage that goes on within services I think is contributed to by the youth of the people working there. As I stated earlier - the services where I have worked that required older applicants tended to have a more professional attitude leaning towards what I would see as a more ideal work environment. Understand I am still the youngest anywhere I have worked and am really waiting for the day I can say I'm not ! Now everybody I work with has 5 years or more on me ! I'm not speaking against you as a younger EMS worker. I think it's great you've got the motivation and ambition. That's fantastic, but if they are going to pick and choose your calls you need to be riding as a third (which frankly I think any responsible service will do for a new employee for at least a month or more regardless of experience level). At this point, you are not able to sign any legal contract which yes, that includes the PCR as it is a legal document or any incident report. Because of this, I would have strong reservations allowing you to care solely for a patient (heck I would any new EMT - we did 150 hours of ride time when I got oriented regardless of our level prior to being cut loose). In addition to this, I would allow you to ride as a third on any and all calls coming across giving you the experience without as much responsibility. Finally - I am wondering why they sent you on an active seizures call and had you as a new basic as the attendant and an intermediate driving? The intermediate is a higher level of care and I seriously question your service's judgement on this call. And this statement of seizures aren't a medical call? Huh? Only allowing accident/medical calls? Accidents/trauma can be challenging calls to say the least and in this area frequently require the higher level services of a medic (my state does not recognize intermediates at this time though they are looking at creating a mid level provider). Medical calls can go bad quick, and I've had many a seizure patient that left me quite nervous even with the experience I now have. One could actually face dispilinary action here for downgrading such a patient (and its happened that's why this is in place). I'd think long and hard about where I was working - it doesn't seem they are setting a good foundation for you. I don't come from a large urban service either - where I work PT is a very rural service with roughly the same transport times (I prefer rural medicine though I have worked urban a little bit just for a change most with greater than 30 min transports most around an hour). We aren't huge but decent sized. However, patient care is the utmost concern which is why we have the protocols in place and crew requirements that we do. Good luck.

We welcome the lost sheep back to the fold ! Glad to hear it , bet you're excited. Treat those patients well and have fun.

Ruff - good point there. The way I look at it - it is a deviation from accepted practice (being as the accepted and recommended practice is to flush with lidocaine). As I recall that is one of the things which must be proved to gain damages from malpractice - so potentially I think we could be held to that standard. I wouldn't be suprised to see it happen, especially in the day and age of everyone is sue happy and all is available on the internet. When it comes to being put on a stand in court and being told "the manufacturer says to flush with lidocaine, this was done after extensive research, why did you not feel the need to do so?" I think it would call into question to be a critical thinking medic as opposed to a cookbook medic. If you are capable I would say after reading this, I would have a discussion with your training officer, medical director and see if there is an ability to change the protocol based on what has been stated along with the recommendations. As mentioned many times before, we should not blindly follow and I think more need to actively participate in writing and reviewing of protocols rather than saying, this is what our service does, so this is what we do. Don't be afraid to question or challenge things - do your research and question it and get discussion going within your services independently ! I consider that as much of my job as picking up patients from the scene and treating them because this ultimately affects how I will treat them. Any other thoughts?

Thanks for the UK perspective there Hertz ! Rectal is an option, however due to adult pt size it typically is not as viable an option though it has been used for peds. In my area along with several others surrounding the US there is a trial of an auto injector of Versed (I know IM is already an option, but they are trying to put the science behind it saying it is just as quick as attempting to get an IV established). Here we have several varieties of tools in our tool box depending upon the patient. Your frequent seizure patients may not even have veins due to the repeated caustic drugs pumped into them which have destroyed them (ie dilantin, phenobarb, etc). Here's our potential line up for choices 1. Ativan, Valium, and Versed are all in the aresenal though truthfully valium is probably the least used out of the bunch. Versed tends to be favored, but I'd say depending on the area it's a mix between it and Ativan. Both are able to be given any route and are long acting with short onset. 2. IO, MAD, or traditional IV. If all else fails or for pedi - rectal. I would not hesitate to go to an IO in a seizing patient I could not get a line on within a reasonable amount of time, and for whatever reason MAD was not an option. That's my personal though. As far as conscious patients - burn patients I feel could benefit probably the greatest from it. As far as others, there are instances but the majority of the time you can find something. If conscious, lido please - don't torture them. The periosteum is extremely sensitive and rich in nerve endings - this is actually what they numb for bone marrow aspirations in addition to the skin. You have heard how painful those are, imagine that for a conscious patient and then pushing medications through into a space within the bone. I have never experienced it, but I can only imagine it would not be a pleasant feeling. Be kind to your patients - a little lido will do alot of good !

That sucks Eric - I almost took a job for GE several years ago, but went elsewhere as I didn't like their scheduling for the security/ems/fire deal. Seemed like it was decent pay though and not too bad of a demand. I can sympathize though - the job I took in place of it I lost when they outsourced to another company but all well, that's life. I know if you don't mind transport, there are a few looking right now....yellow in particular (course they're always hiring it seems lol). Anyhow, good luck

Sorry to hear that but I thought you were in local fire? Am I wrong in that? If you are - dang I'm sure there's more to come !

So let me get this correct - this is not a tag along show similar to the "paramedics" show that was on TLC it is more a drama/soap opera mentality of Saved? I think few shows will reach the popularity of ER - despite how off real life it could get many times. When I first saw the show, I was 15 and thought it wasnt too bad. THen I went to work in an ER, and boy did my opinion change lol. Terri - there actually was a show based on flight medics that was proposed called Mercy Air (yes based off the real EMS company though entirely fiction) it's promo is on myspace however, I think because of negative comments by HEMS community and then a dispute with the real Mercy Air I doubt it will ever come to fruition. I may be wrong though - there was also another one that was a "tag along" show for a british HEMS service I believe that showed on BBC. So if you have satellite - may try to find it. http://vids.myspace.com/index.cfm?fuseacti...0c-08da996b814f link to mercy air promo on myspace sorry - can't find link to other one. I'll keep looking though for ya terri !