emsboy_2000

I'll reserve judgment until the full details are disclosed; however, where the hell was the backer?

I simply do not understand what’s wrong with cops these days. What a shame.

LOL. Yeah, why is it always a fire dept.?

Noted.

...and round n’ round we go…… Well, I have to agree you—imagine that! That is a pretty ignorant statement. Only one problem: You need to read things more carefully so that you don’t make incorrect assumptions. I never stated it was the “best” way; I simply stated that the reason we do things here, and many other places, is because it “works”. Is it the best way? Maybe, maybe not, but I never said it was. Anyway, Dusty, (you don’t mind I call you that, do you?) I’ve had fun firing you up—that’s what keeps these threads interesting! One thing I’m sure we can both agree on is that this system has been in effect for a very, very long time. And from what I can tell, it works pretty well: that is to say working your way up in steps. Having said that, I’m going to break away from this subject—for real this time, but you may have the last word (you sound like the kind of person that likes to/needs to anyhow).

OK, Dustdevil, let me clarify a few points. First, you are right, most programs don't include the intermediate level; however, I never implied that every program does in those particular steps. That's ridiculous. But I'm going to redirect this thread to my initial point. The context of my threads - and my point for that matter - is that most programs don't jump from basic to paramedic; instead, they progress through a series of steps to achieve the highest title. And again my question is, why? For example, in countries like Canada and South Africa, the different levels are distinguished by the terms primary or basic (e.g. Primary Care Paramedic) intermediate, or advanced (e.g. Advanced Care Paramedic). The United Kingdom also has similar classifications. So, having said that, I again say that most places (and yes, the places I mentioned are not most places, only a few examples few examples, but I think you get my point) go through a process to achieve the highest level because it works. If it didn't then why would it be the standard model for most places? Oh yea, we continue to do it just because... . Really? You're going to stick with that? On a different note, you state that everyone is "blindly following our lead"; however, I ask, why would everyone else want to follow our model when many have a far more advanced model than ours? So much so, in fact, that paramedics in both the U.K. and some Canadian provinces, for example, have been granted the legal status of self-regulated health professions. What is the possibility of that ever happening here? Perhaps we should blindly follow in their foot steps. Lastly, I want to bring up one more thing you stated in your last post. You mentioned there is no "theoretical soundness" to a process that has been in play for a long time; but is there any theoretical soundness that this process doesn't work?

I wasn't going to respond to this thread anymore than what I already have, but I agree with you. It's interesting to note, that the majority of the most respected paramedic programs across the world (including many of our own programs) design the entire process in parts (EMT-B, EMT-I and EMT-P). I wonder why? I know these classifications primarily exist in the United States, but you get my point.

"The word touché is often used in 'popular culture' and general conversation - for example, in an argument or debate. If one person presents an argument and another delivers a clever or appropriate response, the first person may respond with 'touché' as a way of acknowledging a good response. A synonym of this word would be 'good point'." http://en.wikipedia.org/wiki/Touch

So, paramedic and EMT are soo "drastically different", it would make it impossible to render a determination to continue on this field or not? Huh...interesting. Oh, and engineering and carpentry? I'm pretty sure paramedic and EMT have more in common and are much closer related than engineering and carpentry. But, don't worry, I think I understand what you're trying to say; apples and oranges, right? Now, that's sounds illogical. At any rate, as one of the previous posts stated, this is a topic that's been beat to death several times over, so with that said: Over and out.

I whole heartedly disagree with absolutely no experience. Giving yourself some time as an EMT-B will give you a better idea if EMT-P is really what you want. I've met many people, who after acquiring their EMT-B, decided this field was not for them. Granted, most people entering this line of work are pretty sure they're in it for good; however, getting that preliminary experience as a basic is smart. Give yourself the time, I say, and move on gradually -no need to rush. This may not be the case for everyone, but I'm sure there are good reasons as to why most places require you to do it in steps (EMT-B, EMT-I [some places] and EMT-P). If at all possible, give yourself the time to learn, and saturate your neurons with as much as you can. Take it slow, I'm sure you'll be glad you did in the long run. Good luck.

LMAO! Sorry, it may not be that funny for some, but when my girlfriend and I read it (maybe because the way we readi it) it came off pretty hilarious. We just Imagined your partner whistling away driving, while you're in the back blowing someone. HAHA...the whole vision just cracks me up. OK, I'm over it... No I'm not. HAHAHAHA.

I don't mean to play devil's advocate, but two separate incidents from two separate people accusing the same guy? I know the stories sound preposterous, and I'm glad the guy can move on with his life; but no one even suspects a little? Maybe not to the extent of giving a homeless man a BJ, but I'm willing to bet something may have happened; but because it's the word of a paramedic against a drugy and a homeless...well, we all know what I mean. OK, let me have it.

I'm not sure why someone would want to exhibit such an image for public view. Anyone have any ideas? Is it to show off? Sick, twisted, and abnormal. What a disgrace.

Jeepluv, I must recant my original question; I misread it. I thought you had stated the patient was pulseless and "apneic", but I later realized you stated pulseless and "agonal". Sorry about that. And for clarification purposes: Only patients who are pulseless and apneic with evisceration of the brain are considered to be obviously dead in my county.

In response to Jeepluv77's post: Why would a traumatic arrest patient with brain evisceration (gray matter, as you stated) even be worked, or brought in to the ER by the pre-hospital team for that matter? I'm not calling you out, simply curious. In my county that falls under obvious signs of death, and we do not attempt resuscitative measures.

Welcome aboard.

I wasn't aware that the national standard for EMS levels was going to be reconfigued. Anyone out there know where I can find more information on this topic?

Out of curiosity, I'd like to see the 10 worst paying -HA! I'm sure Southern California would top that list. The average salary is around $13/hour in the private sector; some starting off with as little as $11/hour...ehm, AMR. Try making a living on that salary with California's cost of living.

Here is the reference to the meta-analysis: Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903-1913.

Okay, I thought that's what you meant; however, I wanted to make sure before I responded. Yes, you are correct, there are only even numbers on a gauge; however, electronic BP monitors (to which you're not very fond of, I understand) will produce every whole number—except for zero, of course. Mechanical BP units are simply designed to register numbers by increments of two or even numbers. But that doesn't mean that a BP of 120 registering on your gauge isn’t really a BP of 119 or 121. Now, obviously it’s not a big deal in the least. But, like I’ve said, that’s just simply the way they’re built. Even-numbered BP's do exist, though. Hey, thanks for your question.

wrmedic82, I'm sorry, but you'll have to elaborate more on your question? Aside from being vague, it is poorly worded; I did not understand your line of thought. Thank you.

In recent years there has been a continuing reconsideration of what is deemed a normal blood pressure (BP) reading. While most experts believe that 120/80 is an optimal BP reading, current research suggests that 115/75 is the new optimal. But to address your question of hypotension on a “normal, healthy adult” (greater than 15 years of age), a systolic BP of less than 80, OR less than 90 AND exhibiting signs of inadequate perfusion: altered mental status, tachycardia, pallor or diaphoresis is considered shock. So, in other words, a systolic BP between 80 and 90 without physical symptoms is considered normal—keep in mind those petite females and athletes, for example, who can sometimes run a systolic BP in this range normally; however, anything less than 80 with/without physical symptoms is usually considered abnormal. Granted, someone in an earlier post mentioned that to “know what…[a patients] ideal blood pressure [is] or even [know] what a normal BP is…serial readings” must be taken. While this may be true, a pre-hospital health care provider does not have the luxury to sit with a patient all day, take BP readings at certain times of the day—or whatever it may be, and then determine their normal BP. Hospital healthcare practitioners do that. Specifically, you asked what a normal diastolic BP was. Some experts define low blood pressure as readings lower than 90 systolic or 60 diastolic—you need to have only one number in the low range for your blood pressure to be considered lower than normal. In other words, if your systolic pressure is a 120, but your diastolic pressure is 50, you are considered to have a lower than normal BP measurement. However, this is not true for everyone—as I mentioned earlier. What is considered low BP for one person may be normal for another (i.e., petite women/athletes). For that reason, physicians will usually consider a chronically low BP too low only if it causes noticeable symptoms. For an even deeper understanding of hypotension/shock, I’ve attached the following link. www.ems1.com/medical-clinical/articles/479223-Blood-Pressure-Assessment-in-the-Hypovolemic-Shock-Patient I hope this helps, emti2008.

In short, I think the real problem may be your wife’s insecurities and/or trust issues; not your work partner, or any other woman for that matter. Maybe, you should confront her about that possibility—if you haven’t already, and take it from there. Good luck.

NYCEMS, Dystonia is usually defined as a state of abnormal tension or muscle tone. I, too, have never heard of dystonia manifesting so hysterically. If you could cite a source supporting what you've posted in regards to dystonia, I would appreciate it.

Okay, okay, Dudley Do-Right, I get it: you want to do “the right thing". However, I think you already know the solution to your dilemma. If you weren’t going to report it, there would be no post about it. But after making this much noise about it, you've pretty much cornered yourself with only one choice to make—don’t you think? Now...guess which?