Just Plain Ruff

let's not also forget "If you drop the baby pick it back up" another thing that they don't teach you in emt school. I would also like to mention, if you have a pregnant patient who's water has not broken and she is screaming then I would not be on the feet end of the stretcher, board, stair chair when moving her down any stairs. if you have to be on the feet end then a plastic gown is in order. Trust me "I SPEAK TRUTH"

Dont feel horrible. Just remember to ask next time. The only time you should feel horrible about a mistake is when you don't recognize you made the mistake.

D-stick immediately Temperature EKG 12 lead Look around and see if the medications he is taking are empty or if they don't look like they have been taken. I'm suspecting initially infection resulting in blood sugar issues. Could also be a CVA or bleed of some sort MI is in the back of my head too.

So true but don't these things just have a release thingie(technical term - similar to a whatchamacallit) ? It isn't like you just grab hold and go or is it?

absolutly letmesleep we are not really that far away on most things.

he ran away. I'm working on getting a new avatar.

I agree but for many they only require one ride to make their decision, is that the wrong way to go about it, probably but many will make the decision based on that single ride along. For a transfer service that runs transfers day in and day out I believe one 12 or 24 hour shift would be enough to make the decision. not rocket science here, the person looks at the service, sees that allthey run are non-emergency transfers and that it's not likely to be any different any other day of the week, month or year and yes a decision can be made based on one shift. But what the OP never has said is if they have the means to go back to medic school right now or in the very near future. If they have the means then why wait for a year or 6 months when they could be both working at this service and honing that very very elusive bls patient evaluation and assessment on Gramma who is just going back to the nursing home and also gaining valuable medical knowledge to get there medic license. it can be a two way street here, the OP can work for this service, do the best they can and also learn ALS in medic school. It's not a all or none proposition. what I don't understand is the resistence to the idea that You can't be a good medic without getting that all important year of experience under your belt. so let me put it another way, would you recommend that same year of experience to the new EMT if you knew that all they were going to do was to be the driver of a transfer truck? I would be curious as to what experience you think they would gain if they were simply the driver of the truck?

It appears that a updated news story is that Supersufer went home from the hospital. you know, if there weren't any buildings in the immediate area I might have tried it but only with water ski's and the ability to cut the parasail loose if I got in trouble. the guy was quoted as saying "Damn, I missed the Darwin Awards by thissssss much!!!"

thats just ducky, what did you gain from this experience? Did it make you decide either which way to go for the job or go back to medic school. From this experience did you see whether you will get any valuable experience doing transfers on Gramma going from the ER to the nursing home or back to her home or to the doctor's office or do you think it will be just a job. Hopefully this experience as well as the postings of recommendations will point you in the right direction. If all you gained was a fun ride along and you take nothing from it you are no closer to where you need to be than you were when you hopped out of your car inthe services parking lot? I'm curious as to what you think now.

I have also read the book now, I have watched the lecture and I cried when I found out that Randy passed. His passing moved me to the point that I have begun to write my own last lecture. It's pretty emotional to do this but I recommend it ifyou are looking to have insight into yourself. As a matter of fact, it's so emotional for me that I had to stop writing for a while just so I can rethink a couple of things. If you do write one, just put yourself in the mindset that you actually do have a terminal illness and you have 6 months or so to live. You have to be in the mindset that you have the terminal illness or it won't mean much to you.

I wholeheartedly agree with you Doc. He was a tool and a fricking moron and I hope the woman sued his butt and his service's butts. Jerk

what makes this a hipaa violation??? No names just the location of the incident. I can't see this is a hipaa violation. Correct me if I'm wrong.

I was thinking more of the heavy set woman at the church in Ray Stevens song about the squirrel getting loose in church.

But we are not talking 911 service here, we are talking about the experience gained from working a non-emergency transfer service. the experience from a 911 service trumps non-emergency transfer services any day. That experience is very valuable.

I think that the flight services experience requirements are based in two fold. First they want good seasoned medics but I think there is a second aspect that we have to consider and it's not well publicized. There are so many people wanting to be flight medics that they can use that requirement to keep the applicant numbers down. I think that if you require a set number of experience it will keep those with less experience from applying. I have a good friend on the helicopter and he says that even if they required 10 years of experience they would still have lots of applicants. His service uses the experience requirement as a partial tool to weed out the applicants.

Can you guarantee that they have perfected bls like you posit that they have? I would have no problem with a brand new medic taking care of me if they had no experience as an emt before going to medic school. I do not think you need a year of emt experience before getting your medic I think that is hogwash. I also do not believe that being an emt for a year before going to medic school makes a better emt. Be serious, are you telling me that doing transfers day in and day out that the emt will do a full patient assessment on every single patient just to keep their skills up to date? I think not. Maybe they will do that for the first couple of weeks but when they see the same types of patients day in and day out, those who are just along for the ride to get home from the hospital to the nursing home or their residence you honestly want me to believe that you will do a full complete assessment on every patient each and every time. Balderdash. By the time you have run 30 or 40 transfers in a week the average Emt will sit back in the jump seat, take one set of vitals and then write their 3 line report. Trust me I've seen it time and time again and this is how it happens.

but arizona was clueing in on Marfans I suspect. He wanted to know more about the build.

the big build is what got me thinking pneumo as well as the pain in the side and decreased lung sounds. The guy I had was a amateur body builder, no six packs on him but he was solid. When he said he felt a pop and we heard diminished lung sounds I narrowed in on pneumo. By the time we got to the hospital I had darted him after he got much worse. He bought a chest tube and 3 days int he hospital and then to home. He did fine. I suspect this guy did fine too. But who knows, the OP usually has some really good snafu's in his scenarios though.

Ok, I'm suspecting spontaneous pneumothorax. I had a patient in this nearly exact presentation yet he sat up in bed and felt a pop in his side. The reason for the diminished lung sounds is that his lung is collapsing. IV, High flow Oxygen and prep for decompressing the chest. Let's get going to the ER.

I think what the fire chiefs are saying "YOU can't fix stupid so lets block one of the most important and good things the NREMT has done in 20 years" The chiefs don't believe what spock said "The needs of the many outweigh the needs of the few or the one" but they believe that it's the few and the one that they have to protect. It's time that the IAFF or whatever governing body represents them that it's time for change and this is the right step to take.

did he just turn on his heater? Where was he before this started?

I believe that the standard rule of thumb for studying is 4 hours of studying per one hour of class. So if you are in class for 8 hours a week. 4 hours monday and 4 on thursday then you owe the study gods 32 hours of outside studying. I never got that high though.

is being a dumbass a exclusionary criteria? I still want to know if our mobile intensive care catheterization unit of the future (miccuotf) is functional and what the catheterization showed prior to and post opening of the vessel.

Ruff, heres what I don't buy, can you honestly say that a "brand new" EMT is not going to be able to hone their different skills by doing basic NH to hospital transfers? I know that you have precepted students before, yes? How many times have you had a medic student come ride with you who had no clue how to take a BP? count resp? any of those basic skills that we feel they should possess at that point in their education? It happens, how about those that can take a BP, but not going down the road? Don't take this wrong, I'm just asking you to think about how nice it would have been for that one student to have done some transfers, and practiced those skills. Quote from above If you are not going to go on to medic school or you don't have the means right now then by all means go get the job as a transfer jockey and put in your time. I never said not to take the job, I just said that if you have the means, go get the medic rather than put in time as a transfer jockey. If you can do both at the same time then by all means do that but to use as your sole criteria to get experience and then go to medic school is in my opinion a waste of a year or so. I have precepted many many students and teaching them is where I come in. If they don't have the foundation then I spent countless hours with them working on getting their skills up to par. But shouldn't they have gotten the basics down in emt school. I mean in my emt class it was expected that we were able to take vital signs in a dark room, in the noise of the garage, in the back of the ambulance, siren on and off, and vitals while trapped (simulated) in a car. If they don't have the basics down, then they need remediation and their instructors need a good thrashing. Isn't emt school there to "get the basics"??? If they came to my truck as a medic student and couldn't take a vital sign to save their life then time was spent on how to get it right. Over time those students became more confident and adept at doing it right. Discussions were had with the teacher and the excuses I heard were legendary. But I'll go back to my previous posts - if you have the means to go back and get your medic right out of EMT school why not take that opportunity and do that. It will save in the long run and it may help keep you from failing the medic portion of the national registry. You get someone who is so used to doing this type of assessment on their transfer patients that they revert back to what they do at work while in the practical portion of the testing. If you do not have the means to get your medic right away, and many do not, then going to work as an EMT is the RIGHT thing to do. Just know that you are behind the eight ball in habits and those habits are hard to break. If you do your patient assessment on those nursing home patients like you did in your emt school to prepare for the registry then great but I know from experience, that never happens. All good intentions are there, it just sometimes doesn't happen that way.

I decided after 14 years in the field that I was not gonna be like my friend Ron who suffered a career ending back injury and I started to go back to graduate school and got a masters degree. I'm not out of the field but.... I stay current in ems and in june of next year I will let my license lapse and finish my life out as a civilian.