Kaisu

I am just a medic.. and believe me, I appreciate my limitations on just about every call. The fact is that of all of the health care professionals those of us in EMS have an extremely limited scope that covers the life threats and emergent conditions we need to treat. We know very little medicine. There are other aspects to the job - tons of them as a matter of fact - that are pretty darn important. We have to know how to handle difficult situations out there in the field when people are not at their best. Problem solving ability is critical. (Exactly how do we get this spine injured individual out from under the ATV and up the 40 degree slope?). There is a profound lack of appreciation in ERs by people that have never been out there in the field of the skill set and personal qualities required of the EMS professional. I am just a medic when it comes to the medicine - but I am damn proud of what I do and how I do it. Drop the defensiveness - try to work out the issue with your partner. If you two are not getting along, it will definitely impact patient care and affect your abilities. Pretty hard to focus on your patient when you are fuming over a perceived slight from your partner. Good luck to you.

It is an issue. We have a situation where we will be exhausted and have to take a transfer of 6 hours. It is only a matter of time before someone wrecks...

I moved across the country for my first medic job. Went from a progressive EMS system that was hospital based to a regressive system working for a private. Used to run dual medic rigs, now medic-emtb - from pine trees and snow to cactus and sand.... Holy s*** - talk about culture shock. The rigs looked like crap (high volume - rugged terrain), no 12 leads, limited drugs in the box, a medical director that fixes problems with a few by restricting protocols for everyone, the list goes on and on. The people were especially suspicious of outsiders - book larnin - my only strength was disrespected. I figured I had ruined my life. I came very close to quitting. I figured I will run, but I'll be damned if I get run off. I am really glad I stuck it out. I run some gnarly calls. It would have taken me years to get the number of calls under my belt as the highest level of care on the scene in a more civilized place. I have formed friendships that I am grateful for every day of my life. I plan to spend another year, then re-evaluate. Bottom line - a level of discomfort in any new system is normal. It is up to you to decide what you can live with - just don't pull the pin too soon. Like most things in life, timing is everything. Good luck to you.

To satisfy your curiosity - I am a fairly new medic with 1 year of experience. I run in a very high volume environment and in the year, I have about 1200 calls under my belt. I am scrambling as fast as I can to become a good street medic. The challenges of this position leave me exhausted. I personally run an AVERAGE of 20 calls in a 48 hour shift. Standup 48's (where we get little to no sleep at all) are not rare. I figure another year on the street, then whammo - more education.

There is a rare adverse reaction to benadryl (not the dye). It is characterized by seizures. Unless your patient went into seizures, I would say the development of anaphylaxis was coincidental to the administration of benadryl and not an effect.

I really don't believe that without previous 12 leads on this patient that you can make any determination as to what is "normal" for this patient and what is elevation. I appreciate your obvious knowledge re: 12 lead interpretation but my statements are directly related to what I can and cannot do in the field. If I was in the hospital setting with history on this patient, then I guess I would learn this cool stuff. The same goes for LBBB. 12 lead interpretation stops. That does not mean that I don't treat the patient. Signs and symptoms of acute cardiac will be treated per protocol. I just wouldn't make any statements of ST elevations, etc.

Did you not read the preceding posts before reviving this dead post? It is a paced rhythm and thus you can make NO conclusions about ST segment - abnormal depolarization means abnormal repolarization - Look at V4, V5 for the spikes.

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I'm going to sound like a broken record here, but if the educational requirements of EMS and thus the scope of practice were increased, then we could triage these patients to the appropriate care. That would mean a realignment of current practice to serve the public, as opposed to the vested interests that put a stop to these types of measures each and every time. Are our public officials really so in the dark about what this is all about? Has no one told them?

Wrong - as per my answer in the news bot thread

The man had the cognitive ability of a fourth grader. How does that constitute informed consent regarding decisions about his care? At the very least, the guardian should have been consulted. It is not the job of hospitals to enforce immigration policy. It is the job of health care providers to make all decisions in the best interest of the patient - not the government, not their own bottom line, but the patient. Holes in the system need to be addressed within the system and NOT at the expense of individual patients.

Great stuff Rid. I will check it out in detail after I have shaken the cobwebs out of my brain. Thank you for posting. One question - what are the chances that the role of prehospital health care will someday involve a triage type situation where paramedics can be the front line in the allocation of health care resources - ie. sometimes referring patients to their own physicians, mental health clinics, etc. as opposed to the current transport them all to the ER? I realize this requires a LOT more education before we can expand the scope of pre-hospital medicine. I am very interested in your thoughts.

I don't see it as a big problem on this forum. If a term and/or acronym is used that I am not familiar with, I just ask. I've learned a lot that way.

Ditto... uniform states Class A's or company issued Polos ONLY - mandatory T-shirt with company logo on back ONLY.... However, I agree with the poster that states it was bad planning on the part of the union - unless they have 80% + participation, it will backfire. Obviously, the majority value their jobs more than supporting the union.

you kill me man.... what did the woman on the beach say to MJ? get out of my sun

My service was a "mom and pop" organization that ran about 30,000 calls per year. It was purchased by AMR approximately 9 months before I started. The transition was difficult for some. AMR sent evaluators in. The upshot was "it isn't broken - leave it alone." The local middle management was left in place, with some reshuffling, and anyone that left did it because they chose to. No one was fired. Over the year that I've been there, I have watched some really good changes, including accountability and implementation of professional FTO programs, etc. Opportunities for people have expanded, giving employees the chance to grow if they want to. The benefits are outstanding - medical, dental, eye care, 401K, etc. The pay still sucks. The paid time off is terrific. After 8 months, I took 2 1/2 weeks off (two 48s) with full pay and still have 50 plus hours at my disposal. Are there still problems? Well yeah - it is EMS, but all in all, the takeover has been good for the employees and for the public we serve.

What are Michael Jackson, Farrah Fawcet and Ed Mcmann getting for Christmas? Patrick Swayze

2 1/2 week old infant (born 5 1/2 preterm) in full arrest, delivered to the hospital crying his head off - stabilized and released 2 days later with no deficits. I will put up with 5 years of crap for that one.

The operative term there is professional... 120 hours followed by a 9 month certificate program does not a professional make.

Nice post - good role model.

You guys totally rock! This is the sort of information I was looking for in an earlier thread. I have downloaded and saved these files and intend to print them out and share them with my colleagues. Thank you for posting.

The mannequin gag I have seen before, but the idea that swallowing a kitten gets you an award from an animal rights group is downright hilarious.

I guess that's one of the problems with discussions in internet forums. Without the addition of facial expressions, body language and the give and take of "in the flesh" exchanges, these things become difficult. I did not read what you did - not to say that your impressions may not be correct - I just didn't read it that way. Can you provide some links to the information you cite - I would be interested.

The original poster is an EMT. He/She is not questioning his/her medic. He/She is trying to learn something and has asked this forum to help him/her. In the process, a very good discussion has ensued. Field cessation of effort, as well as declaring dead is within the protocol of our paramedics.

Time frame is NOT irrelevant. A 20 or 30 minute down time with no improvement is important for determining cessation of efforts. In our area, just because we start working something does not mean that we don't decide to stop working it.