funkytomtom

Yeah sorry, I'm rather quick to get defensive over the internet sometimes. My mistake.

Yeah sorry, I'm rather quick to get defensive over the internet sometimes. My mistake.

Yeah sorry, I'm rather quick to get defensive over the internet sometimes. My mistake.

Yeah sorry, I'm rather quick to get defensive over the internet sometimes. My mistake.

Yeah sorry, I'm rather quick to get defensive over the internet sometimes. My mistake.

Yeah sorry, I'm rather quick to get defensive over the internet sometimes. My mistake.

Yeah sorry, I'm rather quick to get defensive over the internet sometimes. My mistake.

Yeah sorry, I'm rather quick to get defensive over the internet sometimes. My mistake.

Yeah sorry. I'm quick to get defensive over the internet. My mistake.

A little surprised at this flak...I've done my homework guys... Why even bother with EMS? I guess a fair question, but truth be told, EMS is where I discovered my love for medicine and I do love what I do. Plus it does pay some small pittance and I could use the cash and the job. As far as the bachelors degree and pre-med requirements go, there is no pre-med major, you simply add those classes in to whatever you're already doing. You are encouraged to study "what you love." Many people go the biology route because much of the pre-med coursework applies directly to that degree. The other school of thought is to do something unique as biology majors are dime a dozen for admission committees and you truly need every leg up you can get. My thinking is it would be something incredibly unique that could make my application stand out. That being said I haven't picked a major and the emergency medicine degree is more of a pipe dream if we're getting right down to it. In my fantasy world (where my intervertebral discs are intact) I would love to take my medic and wait a few years to do the med-school thing. And to truly explain EMS's continued relevance...there are essentially six extracurricular areas required for medical school in addition to the mcat. These include leadership, healthcare experience (this takes many forms for many different pre-meds) involving actual patient care, and volunteering. You have to show convincingly and be able to explain succinctly such as things as "why you're a leader," or relate pertinent stories about caring for people. I feel EMS makes me extremely competitive in all these fields as well as allowing me a great deal of personal growth. And if I decide to go PA, those schools specifically select for people with a prior medical background. Hell, I even got in to shadow an MD not normally fond of undergrad shadows because of my EMS experience. It has turned out to be a great shadowing experience and will hopefully turn into a great letter of rec. I have more to say, but I feel I've made my point. Thanks for the continued input.

I'm aiming at medical school, or at least PA school, so I don't see extra medical education as wasted. The medic would allow me a bachelor of emergency medicine which would set me apart from the crowd. Also, I'm working quite a bit already so I feel like I owe it to my patients not to be that EMT who decided they knew enough. Thanks for the advice! I was already planning on taking A&P and now I'm even more excited. Still though, any recommendations on a medic book?

So...I disappeared from the site a little while ago after a certain thread aggravated me to no end. I come to you all now purely as an EMS provider who recognizes all this site has to offer. I'm strongly considering taking my medic next year (when it is offered again and after I've had time to complete the rest of the pre-reqs). It would put me in college probably an extra year, however, and sadly long term EMS is not an option for me (back injury). Thusly I am conflicted about it. What I am not conflicted about is my search for more knowledge. I am currently an NREMTI, but I feel woefully unknowledgable relative to the vast amounts of different pts we are expected to care for. Add in minimum 45 minute transport times (that's for an air-ambulance) and I really want to know more; we get stuck with some very sick people for a very long time. I'm trying to fit acronym classes into my schedule and budget (pals, phtls, itls, etc) but I know there has to be other ways. I'm fairly sure there might even be better ways. So my question is this...how do I gain more knowledge short of taking my medic? I've been re-reading my EMTI book, but I feel like it's fairly low yield at this point. I really want something high-yield and challenging. Thinking of upgrading to a medic book and just teaching myself. Any other ideas besides trolling the city? What medic book?

Yes. Yes. Yes. I am a college student myself. I work a 48 hour shift nearly every weekend to pick up some extra cash. That being said, I wouldn't look into EMS for riches. It sounds like a surefire thing on at least two of your points, and probably/hopefully all three. I say go for it.

And then, if you really wish to stop looking silly, take a look at some of the actual 'science' supporting your dearly held ideal...I'd love to talk to you about it after. I read the links you posted. The link from the Heartland Institute is little more than a statement of a viewpoint. It contains no more evidence than my initial post on this matter. The link from the telegraph was slightly more scientific, but was still an opinion piece. Some of the points are valid and worth discussing nonetheless. I like how you took away my science card as if I'm a complete idiot. I'm not one to latch onto the issue of the minute and never saw "an inconvenient truth." What I have seen has been presented to me in college science classes by well respected professors and phd's, read in various scientific journals, and in the newspaper as well. Is there a discussion to be had? Yes, but am I a doe eyed follower on mythical journey to candy mountain? I sure hope not... http://www.ipcc.ch/publications_and_data/ar4/wg1/en/ch9s9-7.html#table-9-4 http://www.sciencemag.org/cgi/content/full/306/5702/1686 The first link contains some areas where Christopher Booker would certainly have some criticism. At the same time, I'm not going to immediately reject an international panel of scientists for the words of one skeptical journalist. Again...discussion? yes. refuted? far from it. The second link spells out my view on the matter. Science, being generally quite cautious and slow to make sweeping statements, has gotten about as close to a consensus as it gets. And I'm sorry Dwayne, but I'm again having trouble rejecting these huge organizations of professional scientists because of your post. I would truly love to see a peer reviewed paper that confirms what you're talking about. One last point. Evidence of slight cooling trends can be a red herring due to terminology. Global warming, while the most common term, should be more accurately described as climate change (guilty as charged). Just like the body, the earth has complicated cause and effect relationships, and while the general trend IS warming, you are going to see variations in both directions. Just like we trend vital signs. Sorry for all these posts in a row, but there's a lot to address. As for following our biological instincts and controlling population, I would say we stepped away from what is biologically sound when we started mass agriculture. At this point, we also made the step to decide bigger is better and that further increases in population were always desirable. We COULD hump everything before because it didn't matter, we couldn't feed what we humped into existence. The difference with lions and hamsters isn't that they have family planning clinics (hahaha), but that they haven't been able to isolate themselves from their ecosystems by stockpiling food and practicing agriculture. And in that way, we've taken a step away from the mechanisms that regulate all other populations. And finally, something we agree on. Saying whether something is desirable or undesirable, good or bad, never did anyone any favors. Edited to add in a plug for a book which really changed my outlook that you might enjoy (or hate)...it's called Ishmael and it's by Daniel Quinn. It's kind of about a talking ape, but not really.

Perhaps I was a bit vitriolic, and for that, I apologize. I can see where you would think it arrogant to assume we have such control over the biosphere, but, in reality, we do. http://upload.wikimedia.org/wikipedia/commons/7/7f/Oldgrowth3.jpg http://www.taipeitimes.com/News/editorials/archives/2010/05/15/2003472977 http://www.un.org/apps/news/story.asp?NewsID=34779&Cr=Biodiversity&Cr1= I'm sure the link from the UN will be popular. http://www.planbureauvoordeleefomgeving.nl/images/development%20of%20world%20biodiversity_tcm61-38885.jpg http://www.learner.org/courses/envsci/visual/img_med/terrestrial_habitat.jpg and to sort of sum it up: http://www.biodiv.be/GraphicsArchive/Figure4.2.jpg/view Anyways, this is just what I was motivated enough to find at 0130 hours. One thing that hits home with me is energy flow. Yes it sounds awful and cheeeeezzzzy, but it's true. The autotrophs which form the basis of all food chains take energy from the sun (less than ten percent of the available energy in sunlight). Each further level only has ten percent of the energy at the previous level to work with (due to loss of energy as heat). What this means is that in a healthy ecosystem, the creatures at the top will be sparse, while there will be exponentially more as you travel lower on the food chain. So...I find it rather unhealthy that we are approaching 9 billion people (!) while doing our best to hack away the occupants of the lower levels of our biosphere. Yes species go extinct, but the rate at which we are seeing today is phenomenally rapid. Combine this with irrefutable loss of habit for many animals caused by us, and the link is clear.

http://www.huffingtonpost.com/2010/05/03/gulf-oil-spill-photos-ani_n_560813.html And, you know what? I am sick of people who work in science completely rejecting science!!! How can you even justify interfering in this "God-planned circle" as an EMT? Obviously God planned for that person to die, how can you possibly interfere with his will?!?!? Global warming is a theory in the same respect that gravity is "just a theory."

I think one of the most ridiculous things we do is ask questions like this. It's just so anthropocentric. The centipede and the tree don't ask what the meaning of life is. That being said, I love the discussion. I think our job is to exist, evolve, and most importantly, obey the laws of nature. Every other species does, but somehow we think we are special and can reproduce indefinitely and manipulate our environment to an infinite extent. All creatures affect their environment, but not like we do. We are destroying the biodiversity of this planet while we continue to devolve. *Getting off soapbox.* One of the most important things I think we can all do is stop defining good and bad. We are so preoccupied with this inane activity, and hell, I do it too sometimes. But recently, when my grandma died, people expressed to me that they were sorry and how it was so "awful." I wasn't sure how to take it. I'll miss her, but she was 92 years old and suffering from late stage dementia. It wasn't GOOD, but neither can I say it was really bad. It just...is. Take a traffic jam as another example. If you sit there and think about how "bad" it is, you will miss seeing it for what it truly is and also miss the opportunity for either introspection, conversation, listening to music, or a million other things. There are so many things in life that we could take so much advantage of if we weren't so caught up in how abstractly good or bad they were. They are.

I like it. Even though I don't have a tanned six pack like all the firefighters, I like to think my translucent keg is sexy too.

Hello All. It has been awhile since I've done much posting here (mostly just been lurking), but I'd like to have a little discussion. First some background info. I've been experiencing back pain off an on for about 6-7 months. I kept on living with it until it became too painful after a fall. Finally I went to my doc and got an MRI; found out I have two torn discs. Why does this matter to our discussion? Well, I've had to take over a month now off the rigs and really reconsider my EMS future. This has lead to a lot of thought. Where do I want to be in five years? Should I still take my medic and assume I can work out my back? Can I be happy elsewhere in medicine? The time has also been used to keep myself sharp as much as possible. I finally took the national registry (nremti) and have been teaching CPR and first aid classes. I also read a book by a doctor named Atul Gawande. It's called "Better" and if you aren't interested in medicine, you probably wouldn't like it. If you are, however, it has some very interesting insights. The target audience is doctors, but I think (perhaps falsely) that there are a lot of parallels between the job of an MD/DO and that of an EMT/Medic. We are, at least for a few minutes, in charge of managing sick people much like a doctor (yes I know there are vast vast differences). The book goes through case studies talking about people and places in medicine that are or were exceptional and outlines why. It concludes with five suggestions I thought were relatively simple and applicable. 1. "Ask an unscripted question." This basically means form some personal rapport with your patients. At least make some effort. Our profession is all about people, and the less cold and sterile you keep your interactions the better. The tendency for both you and your patient to feel like "cogs in the machine" becomes lesser. He makes it clear that you don't need to form deep bonds, but that a simple question about your pt's family, past, or hobbies will do. Where did you grow up? Did you catch any of the playoffs? If they don't want the connection, that's ok, but some/most will appreciate it. 2. "Don't complain." You could have taken the word "doctor" and replaced it with "EMT" in this whole section of the book. I think most of us on the city get this one, but there's a lot of great reasons for it. Focusing on what you hate about the job will leave you bitter and burned out real quick. You have to accept that there's a lot you can't control in this profession and learn to live with it. So, says the Dr., every time someone starts to complain, try to change the subject to an idea, an interesting presentation you saw, a tip, trick, or even a joke. Just not whining. 3. "Count something." This one is interesting and I haven't quite figured out how to apply it. Earlier in the book he talks about the great strides made in the care of newborns after the advent of the APGAR score. Obstetricians started to look at the scores babies were getting and how their own treatment affected it. There was now a concrete way to compare performance. The point being to quantify your's or your agency's performance. It's much easier for a doctor to do this with all the patient follow-up they get, but it could be something simple; how much time am I spending on scene? Or, how often do I form enough rapport that the patient thanks me when I leave them in the ER? Start to assess your own performance concretely and you'll see ways to do better. 4. "Write something." I guess we all on the city already do this. Personally I've found a lot of things of value written by EMT's (and a handful of RN's and a couple docs) from many on this site and on various other sites (like the EMT spot) 5. "Change." I see a lot of this attitude on here, and very little in the field. WANT to be better. Hunger for it. Don't be afraid to change the way you work on scene (withing reason and protocols of course). See what works and what doesn't, change the way you do your job so you do it better. I guess I'm asking for two things. First, what ways do you see to apply these five rules to EMS and your practice? I'm particularly curious about number 3. Secondly, and perhaps more importantly, what tips do YOU have? I'm not satisfied to be as good as I am now, and I don't think any of you should be either. I see from this book that doctors are thinking about this stuff, we should be too. We all know how much crap there is out there that passes for EMS. Even though I think many of us represent the better half of providers, lets not rest on our laurels. Let us all be the positive deviants, the people who define what EMS should be and can be, not what it is. I remember one of my instructors used to say "the only way EMS progresses is by you knowing more than you have to." Lets all know more than we have to. There's a lot of complaining (see #2 again please) about how we're not where we should be as a profession and we don't get paid anything, and while this is all true, I feel like it's put up or shut up time. You want the public to see us as the professionals we are? Start not just "displaying minimum competency," go farther, it might be more drug studying, more intubation practice, or it might just be as simple as #1 up there. I tried to make this coherent and as short as possible. Thanks for reading and mostly thanks for the responses. The book is "Better; A Surgeons Notes on Performance" by Atul Gawande.

I didn't think about it like that. That is very true. I think herbie is correct in being totally up front. If it works, it works. If not, it doesn't.

I feel for you; your story is compelling. A felony, however, is going to really hold you back. No one cares what your words say, they mostly care about your actions and what's on paper. If you really want help with this, confide in someone you know and start talking to people on the ground. This forum can be very helpful...or...very quick to judge. Good luck.

Another ghost from the past! Hahaha. I think my initial post was quite vague and probably insinuated some views I don't really hold. When I said "can't stop" I wasn't referring to the brake pedal as much as to the duty to act. Which I'm still not totally clear on...are we sure about which incident would hold priority in this situation? Anyways, I didn't mean that we drive "balls to the wall." We ALWAYS stop at an intersection before rolling through it. I lost the "won't happen to me" mentality real quick after starting to run calls. Not that I drive anyways, but just wanted to be clear that I'm not a whacker (hopefully).

My service has one. Sadly just one though. I have only good things to say about it. It's reliable, easy to use, and just overall does its job. We have a plethora of random other cots (manual, hydraulic), but the stryker is my favorite.

I was sort of surprised to see this thread resurrected. And amused. Kind of funny all that's happened in my life since that post. Anyways, I am now working as an Utah EMTI and have my NREMT testing scheduled for next week. I ended up looking outside of my area to find employment, so there is somewhat of a commute involved, but I'm loving it. I'm thinking the experience will really help if I want to work closer to home. Thanks for the tips though and stay safe out there!

Wow...I am completely disgusted. Where I work, the fire department CAN BE useful, but nine times out of ten merely provide "the circle of death," standing around a pt until we show up and provide actual care. What a load of BS! I am pissed about it from the other side of the country, I can't imagine how the EVAC medics feel. What self absorbed pr1cks!