fireflymedic

That does it for me ! I'm moving to alberta ! You all pay well !

You have what you want in life, but it only lasts a day I wish I had 2500 posts

Hey, WV is a tough area to work - alot of it is rural. However, as someone who has done the all BLS county thing with no backup for as much as 45 min if needed ALS or also been the only medic on duty for a whole county with surrounding being BLS, it's tough. You need to have really strong skills to make it and give the best care for your patients. If you are a new medic, I advise against it. However, that being said, I LOVE rural medicine. Really gives one a chance to learn how to manage a patient for long periods of time and get to know the course the human body can take. People in rural areas also seem to be just pretty daggone cool ! Also, sorry to hear your mom isn't doing well. Hope things settle for you. Good luck whatever you decide !

I don't know terri - maybe you should request cool fortune cookies too?

Hey sporty, There has been a definite emphasis away from intubation in pediatrics. The reason most peds go downhill is respiratory failure first - if you get aggressive and start treating them early great, however, current practice trends say tube them only if you must. The reasoning behind this is you are not given adequate opportunities to maintain pediatric intubation skills (or intubation skills in general) which is why intubation is generally falling out of favor. Also, there is a higher outcome of complications such as failure to recognize a failed intubation, incorrect tube size, or right mainstem intubation. General rule of thumb for peds is O2, bag them if you have to, only tube them if you must. Studies have shown that effective bagging of a pediatric patients is just as effective as intubation in many cases. Reference http://www.caep.ca/CMS/temp/pg207.pdf This study was based in california, so it is quite pertinent to your question directly sporty. There are very few opportunities to tube pediatrics (I would say lucky if there is one a year per person in an average service). Unless you are running with a neonate/peds specialty team you are unlikely to use the skill often, and I didn't even utilize it much even when running specialty. Most were already intubated prior to arrival for transfer. Not to say there won't be the occasional patient that will need it, but on average, effective bagging will take care of the job just fine. Overall, if intubation is going to be kept across the board, greater skill maintenance needs to be kept, more so than is required now and especially the case for pediatrics as their airway is much different from the adult and in general a tougher intubation. Truthfully, I wouldn't be suprised for more services to follow suit. Just some things to think over.

didn't denver consider this at one point? I'm thinking they did, but then the idea got shot down. In columbus, unless you are on the far outskirts of the county out by grove city, etc you are fairly close to a hospital wherever you go. There are quite a few to choose from so would this be an entirely bad idea? Perhaps not. Also, there are private services which could be contracted with if needed to supplement with ALS. But having said that, I can also see it becoming a recipe for disaster with sub par fire providers causing havoc. If the city is in that bad of a financial situation - do away with the high salaries of their city officials and pay for real medical care that's not provided by the fire department !

agreed RR911 - I have a degree and am quite proud of the hard work I put in to achieve it. I do feel it was beneficial, but to be fair across the board, I think there are some excellent clinicians which do not yet have a degree, but I can appreciate their insight. I think being dedicated to continuous learning, be it to obtain a degree, or just maintain or obtain new skills is the ultimate goal. The end point being achieving the respect of our peers and the quality of care to our patients. That's what I would want to define me as a medic rather than a piece of paper.

hey there !

we are addicting - howdy !

welcome !

howdy from your neighbor to the west !

howdy and welcome

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The degree is not what makes the person or the medic - it is the pursuit of education and professional attitude which define them.

Hey ! I could fit in this. Dialing now.....

Dust prolly seen it - he would NEVER do something like that

I know most in here are familiar with the EZ IO, but I wonder how many out there are using the bone injection gun (BIG) and how they think they compare to the EZ IO. Any particular difficulties you have experienced with them (such as easier to bend stylet, harder to insert, etc)? Any benefits you've found over the EZ IO? Just looking for some info as I'm not as familiar with them as most every service I know either carries the old style IO still, or they EZ, so anything is appreciated. Thanks !

The first and the fifteenth of the month - ie welfare check days. Time on the clock wise it seems between 8-9 am and around 5 pm. Usually wrecks related to morning/afternoon commute OR the offgoing doc is shipping them off or the incoming doc doesn't want to deal with them . Other than that, it seems Wednesday is the busiest day for some bizarre reason. Though with trauma season begining, it'll kick up on the weekends guaranteed.

VENT - I too have seen the paralytic pushed without sedation, however it was due to medic ignorance thank God. Heaven help if I EVER came across someone who did it for spite or to "teach the patient a lesson". That is one of the worst forms of punishment I think one could give a patient. If they neccessitate a tube and RSI in my book, they deserve compassion. Even if I am doing so for their and my safety it still warrants consideration. I have very little tolerance for the cowboy mentality that EMS has become. Yes, there are some truly good professionals out there, but after having read many of the threads there are many here I can say I hope I never get sick or injured in your town. As far as the pushing narcan by the doors, charcoal then, etc yes we can all laugh about it and blow off steam saying we would like to do that (especially when you experience an extremely cranky staff on the receiving end and you have a highly belligerant patient) however to do so will not only lead to bad communication between you and the hospital, but also they will no longer view you as a profesional. We keep claiming that it what we want and better pay, yet we are refusing to step up to the plate to require it. Why should they respect us when we can't even respect ourselves? I hardly think these actions are warranted. We all get frustrated, but the mark of a true professional is to overcome those frustrations and treat as you would want to be treated. After all - that narcan patient you had? That may have been my grandma who has severe pain and got overdosed on her first pill etc. I promise you if that is the case and you treat her like that - there WILL be hell to pay. The "what happens in the truck, stays in the truck" mentality must go. Poor providers reported not only service wide, but referred for state disciplinary action and weeded out. Then we can say we treat with respect.

Spenac - mare's name Class Act sire's name Let Me Loose Jeep - I like it ! Especially considering he was conceived April Fool's Day !

Hmmm, the head injury is a bit concerning to me? Are we seeing any signs of cushings triad? Let's get some vitals ! BTW - what is the dosage for ducks? Should I break out my broeselow tape?