crotchitymedic1986

No, i am not saying get rid of emtbs, even with them, we still have a shortage. I imagine this would drive their salaries down. We could do the same in nursing as far as hospitals and doctors offices too, alot of the patient care that they performed could be done by a non-RN.

I am not saying it would be painful, but it would be for the good of the world's economy. Did you read how many layoffs were announced this week between Home Depot and Microsoft alone. I predict all of the big "mall" department stores will be next. If america gets into a true depression, the whole world will suffer.

The wage really isnt the issue, it would be getting these thousands of unemployed back employed quickly. They would just need a driver's license and some on the job training. Over time, we could mandate they take some training to become certified. We are an industry that is short of personnel, would be a win-win for the short term.

As you are aware, I have predicted a fairly gloomy 2009 for EMS, and if you read the thread "is EMS recession proof", you will note that some predictions are starting to come true. I think as we approach summer time, most municipalities will have a difficult time paying for ambulance servie, and a great many of our patients will be unemployed and uninsured. The private and hospital based services are already struggling. This may call for drastic action, in order to keep services afloat for the next two years. My thoughts are that maybe we should go back to just having "drivers" on the ambulance, maybe with an EMTI or Paramedic partner. This way, we could open jobs up to all these unemployed folks, keep our ambulances manned with lower payroll (maybe have medics on rover cars). I know your first thought is, that would destroy EMS, and on some levels you are right, but sometimes you have to amputate the limb to save the body. Your thoughts, or alternatives.

Time to put your money where your mouth is. All I have heard from this forum is about the need to improve EMS regulations and education. Dont be shy, put your two cents in.

It is the preferred route for medics who are too scared to start an IV on a kid. Poking a hole in a bone should be the last choice, not the first. And if I am bleeding to death internally from trauma, please dont try to bolus me through an IO, when my jugulars are working fine. And yes, you can apply a c-collar over an EJ.

every journey begins with a single step.

I waved my magic wand and got US EMS removed from the DOT, and it is now under the National Emergency Medical Services Regualtory Agency. All US ambulance services must be licensed by this body, and have 12 months to get in compliance with the new minimum standards that have been established. You are on the advisory committee of this agency, and are charged to come up with the new MINIMUM standards for ambulance service. If you wish, you can break it down into 911 and non-911 services. What are your NEW MINIMAL standards for operations, vehicles, personnel, and training:

I think alot of our problems stem from not having a national body that provides oversight. Look at how JCAHO has improved many hospitals, and how the fire department has to follow the standards of its national body and ISO. When you have a national standard of what constitutes minimal "EMS standards for any agency, you will see improvement. Until then, it is free-range EMS.

As much as I agree with alot of what is being said, you cant lump all "hose-monkeys" into the "unprofessional / uneducated" label. Many good medics chose the Fire Dept for job security that is almost non-existent in an Independent EMS agency. I can not fault someone for putting their family first, and opting for a better retirement plan from their years of work. I think before we go trying to fix the Fire Department, we might want to fix EMS first -- ie... medics who ride in glass ambulances, shouldnt throw stones.

Lisa Dean Ryan was in Twisted Love (1995) with Clint Howard who was in Frost/Nixon (2008) with Kevin Bacon Kevin with Randolph mantooth of emergency fame.

No, I am admitting your point that spanking does induce fear, and is used to modify behavior, much the same as threatening to take away the playstation. Clear guidelines are drawn, "x" behavior produces "y" result. The two are no different.

In my opinion, if your employer states that if you do not improve, you will lose your job and health benefits, that is a "fear tactic" that is used after logic and reasoning have failed, like spanking. But this debate is much the same as abortion, you are never going to get the other side to come over to your side, so we should probably all just agree to disagree.

akflightmedic wrote: I do ask this question? If spanking is so effective, why do we stop doing it? If I am late to work, shouldn't I just get a few smacks and all will be well? If I fail on a project or neglect to secure a new contract, a few swats and everyone moves on? Its called progressive disipline, you get an oral warning, a written warning, a suspension, and then terminated. It is still a spanking.

Sure it is evidence: Child throws a tantrum in the store: Hands on, either smacks their bottom right then, or takes them to the car or bathroom to administer discipline. Non-hands "single-mom" (that should offend someone --- lol), listens to the child scream and cry for 10 minutes, then finally gives in and gives the child what it wanted. Dont need any science to figure that one out.

SAY WHAT ? You prefer an IO site over a venous site ? Please explain the rationale for that.

I dont have any statistics to back up my arguement, but I do know this: When I go to the grocery store or stores like Kmart, walmart, and Target, it doesnt take me long to find the "hands-off" disciplined child. You can hear them from the other side of the store.

I believe he was referencing the gay character on Will and Grace.

The conversation is regarding when you could not find a vein, and glucagon did not work. Obviously if you had a vein anywhere, you would go that route first (unless the only vein was the vein in the penis, but due to homophobia, you wouldnt attempt that one). So you are left with: Drinking D50 or other sugar substitute PO if conscious enough. D50 rectally. D50 via IO.

And the snowball starts rolling downhill: http://www.wdxe.com/wdxe.php?rfc=narticle.php&id=12212 http://www.news-tribune.net/local/local_story_027141416.html http://www.tribune-democrat.com/local/loca..._026232559.html http://www.wivb.com/dpp/news/council_votes..._service_090126 http://www.kval.com/news/local/38430399.html http://www.reporter-times.com/stories/2009...s.nw-857710.sto http://www.chestertontribune.com/PorterCou...tudy_ambula.htm http://money.cnn.com/news/newsfeeds/articl...ire/0466742.htm (this one and one above involve hospital based providers) http://www.kimatv.com/news/38035894.html# And these are just this week's

not at all storm, but you need to leave a new challenge

The best thing you can do is to show real life examples. Go through your 2008 calls and see if you can show real life examples of how your suggestion would have improved care. In any proposal, a cost benefit analysis is a mandatory requirement, you can google that if you do not know how to do one. Most political types are only concerned with the increased cost, so you have to provide an arguement (or benefit) as to why it is a good decision: Example: Hospital employee wants to do free glucose screening exams at the local Walmart. It will cost the hospital: Payroll: $30.00 hour for 6 hours = 180.00 + 15% for benefits/taxes = $ 207.00 Fuel Cost: $ 5.00 Supplies: Will stop at 200 patients or 6 hours, whichever comes first = Cost of supplies for 200 tests = $220.00 Total cost $432.00 Their table with sign and logo will be seen by approximately 3,000 people that day, to get the same reach with newspaper advertising they would have to spend $600.00, so they may decide to do it, or not. That is the kind of arguement you have to make.

good advice everyone, thanks.

Shirley Temple was in Rebecca of Sunnybrook Farm (1938) with Ada Lynn who was in JFK (1991) with Kevin Bacon Kevin to Boris Karloff (probably spelled wrong -- the horror movie guy)

A stretcher van is just that, a van (even a minivan) with a stretcher in it. Most are used to transport dialysis patients or patients to doctors office, some will also have a wheelchair lift. No certification of personnel needed, trucks registered with DOT, most will carry oxygen.