Arctickat

IV starts aren't the only updates. The PCP program here was already behind the old NOCP curve, now with the 2011 NOCPs they have more catch up to complete because the College has decided to bring us in line with them. Even the CCP designation.

Sometimes I miss that old "dislike" button, EMT-ParaBrown. Your sense of entitlement just because of the uniform you wear is a disgrace to your profession, an embarrassment to your co-workers, and by extension, a risk to your patients, I've seen A-holes with attitudes like yours come and go quickly in this profession, and I sure hope you're gone soon before you do any serious damage. One thing for sure, you'll never have the privilege of wearing the uniform I wear....EVER! That attitude disgusts me. I "put my life on the line for my patients" (no melodramatic BS at all in that statement) because it's my chosen profession, not so I can get a free cup of coffee once in a while. If you are that desperate for recognition, find another job and get help. You may want to read beyond the first three comments in a thread before posting a comment of your own next time.

That was EFFING awesome Beebs!!!

"And give him some morphine." Sure glad we don't have to worry about orders for Morphine.

Just remember guys, he's not trying to invent and market the machine. He's putting together a school assignment that will likely not go beyond the prof's desk. He doesn't need FDA approval or medical oversight for this.

No worries Richard, I just wanted to make the point that not everyone works in a location with reliable radio service and almost as many police cars as taxi cabs. Libraries...snicker.

For those of you who are required by law, statute, or other legal requirement, could you post a link to the law that supports your statement? It may be an interesting read. If the portable is in range to actually transmit, and then you still have a wait for the police to show up. In our most risky location it's a 20 minute wait.

And Dylan's team is in the lead amongst all the others. His team members had better step it up though, I see a lot of $0.00 raised. Looking at you Dwayne.

Welcome, are you new to EMS or new to the forums only? Feel free to join in any of the discussions which interest you, or create one of your own.

Quakefire, all current PCPs will be required to bridge up to the 2011 NOCPs or revert to EMR status. This training will include IV starts, additional pain meds, and more. This is beyond the ability of the employers to teach. Besides, SCoP has made it clear that it is no longer the responsibility of the employer to provide CME or protocol updates. That is the responsibility of the practitioner.

I believe it is a timed exam that is written for the purpose of gaining a national registration of some sort in the United States. I've never taken it. But I do know how to use the search engine on here. When I put NREMT into it I get 5 pages of results which may answer your questions.. If you can't find your answer there, then come back here and formulate an intelligent question that addresses what you specifically want answered. NEXT!!!! Oh, and welcome to the forums, nice to have you with us.

It's crap like this that makes me want to put a camera in the patient compartment. Not to keep an eye on untrustworthy staff, but to use if a client ever makes a false allegation against them. Before you Hippa, Hipa, Hippo, HIIPA, whatever people jump down my throat, the video would never see the light of day and no one ever would watch it...not even me...unless there is a specific complaint.

First Aid training includes care for the seizure patient, doesn't matter what causes the seizure, the care is the same at that level. Apparently, First Aid training also includes chest decompressions for Police Officers also.

Bump

Hey there Mike. That's a great question, and like the others have said, much of requirement for pacing requires a substantial foundation in education related to the topics Island had mentioned. That's the reason it's an ALS skill, if you were to learn everything there is to know about pacing, well, then you'd be able to do that skill, but you'd also be in school for much, much longer. EMT school curricula simply does not have the educational basis for many paramedic level skills. I believe that the biggest difference between the EMT level skill set and the Paramedic level skill set is that if used wrongly, it could kill your patient. Without the knowledge to understand what we are doing, why we are doing it, when to do it, what should happen if we do it right, and finally, what to do if we did it wrong, we'd be killing people left and right. Pacing is just not a case of slapping on the pads and turning a knob or pushing a button, it's much more involved. To answer your questions now.... Pacing is the use of an electrical current delivered through the defib pads to the heart when pharmacological therapies do not work or the patient is too unstable to wait for meds to work. Typically, the electrical conduction is in the area of 100 - 140 milliamps (mA). slightly less than half that used in defibrillation. The indication for pacing is a symptomatic bradycardia, often a 3rd degree block or a 2nd degree type II. If the patient is conscious, alert, and has otherwise normal vital signs...just a low heart rate in the 20s or 30s, transcutaneous pacing is not indicated...but if the patient begins to decompensate, then it would be. Pacing is an extremely painful treatment, so sedation is also required. Usually midazolam. Therefore you'd also need more pharmacological training. When we pace someone we start at a low amperage setting and increase it slowly. We are looking for a change in the ECG rhythm that is known as electrical capture. Once we see this change...and it will be a drastic change, we evaluate the patient to determine if the heart is actually beating at the same rate we see on the monitor...usually it isn't, so we have to increase the amperage until we have mechanical capture, ie a pulse rate equal to that being paced. Finally we increase the power level 10 mA more to ensure mechanical capture is maintained. Following this we will continually monitor the patient and ensure that mechanical capture is being sustained. I hope this answers your question appropriately.

Holy mother!! My ambulance can't even drive that fast when it's floored!!!

I tend to keep an eye on the crosswalk light. If it stops flashing I prepare to stop. I am curious though. This guy was trying to beat the light which had turned red by the time he arrived. Usually there is a second or two after your light turns red before the other light turns green. Even if there wasn't, there had to be time for the other driver to accelerate from the stop and into the intersection. I guess what I'm thinking is that he either badly misjudged the distance to the stop light and it was red for a few seconds before he even entered the intersection. Or he was going much too fast to stop at all.

Sorry, I mis-stated myself, I should have added "a few minutes wouldn't make a difference in most cases." It just seems redundant for people to be donating their money to multiple services performing the same task when they could donate it all to your service which, in turn, could take over transport duties as well. That way the patient gets ALS as usual but is transported earlier while Joe public knows exactly what is going on with his money. But, as you say, the people you serve don't see a problem with it so what I think is moot.

So people are donating to duplication of services...in a sense. An ALS response service and a BLS transport service. Has no one discussed amalgamation?

Welcome, feel free to join in any of the discussions which interest you, or create one of your own.

lol,@ the website comment. I understand better now. So you have 2 medics per response vehicle, which is a utility box on a truck. That addresses all the concerns I had with the exception of the quicker transport time. In my experience though, a few minutes likely won't make a lot of difference. Who pays for your services? Is it all through county taxes or is there a user fee? If two ambulances or an ambulance and a fly car are sent to a scene from two different agencies, then there are two bills for the client to pay.

Dwayne should be able to have a plethora of information for you.

I just don't like the position this puts you in Patton, for several reasons. I assume the medic is alone in an SUV or something of that nature. This leaves you with no support if you're attacked. If the patient needs to be moved you'll need help. Doing ALS treatments is typically a two person job. Sure, one can do it, but it takes much longer. If your company can get there sooner it could transport sooner if it had this capability Like Richard says, we're not familiar with the way your system works and I may be way off base. With 2 exceptions I've never seen a valid purpose for an ALS fly car. Either it provides extra hands for an ALS unit already on scene, or it can meet a BLS unit enroute to the hospital. It makes no sense to delay BLS transport to wait for an ALS provider and it makes less sense to have an ALS provider stuck on scene all alone, unable to transport. This sounds like a system set up on that TV show "EMERGENCY!" but at least Johnny and Roy worked together. Looking over your website it looks like your organisation is well equipped and well funded, it seems the only reason that your organisation doesn't transport is to avoid pissing off the IAFF. To me, that's a poor reason when patient care is the priority. http://www.sussexcountyde.gov/dept/ems/

Hmm, how do you feel about this response model? To me it doesn't seem to be in the best interest of the patient. Are these ambulances ALS agencies as well? Does your agency accompany the patient to the hospital with the ambulance or do you turn care over to them and return to your base? I'm not trying to harass you or anything like that, I'm genuinly curious and trying to get a firm understanding of the concept. Up here we have jurisdictional areas assigned to us, it's pretty much impossible for an ambulance to beat another one inside their own jurisdictional boundary.