flight-lp

Or the pt. who gets a $1000 bill for interventions that didn't need to be done in the first place......

So you do not believe that courses such as A&P, Microbiology, Sociology, Psychology, and English Composition are not relevant? Sure a decent medic program can produce a COMPETENT medic, but a well rounded academic education will help produce a PROFICIENT medic. There is a big difference. Why focus on minimums when you can take charge of your own future? Think about it.........................................

Uhh no..........absolutely no interest in living or working in Boston.

Yes, it was a nice attempt at early morning humor, however as Bushy stated, your illogical analogy is irrelevent. Listen to your own belief, an English grammar class would do you well.

http://www.aemj.org/cgi/content/abstract/8/5/431 For starters...........It's where Boston got their numbers. Do a search for Utstein criteria studies and you will find what you seek..................

Sorry VS I was typing as you posted...............Similar info posted............

http://www.aemj.org/cgi/content/abstract/8/5/431 http://www.wakegov.com/NR/rdonlyres/B03101...diac_arrest.pdf http://www.wakegov.com/NR/rdonlyres/469BF7..._arrest2006.pdf Actually Boston's numbers from 2006 was 34% on the ONE model they actually made it on.......................... Those numbers are nice and all, but they fail to look at the overall big picture. The numbers are only inclusive of cardiac arrests that meet the Utstein Criteria, which in Boston's case was a little more than 9% of all cardiac arrests (593 / 6512). So their 34% (King County's 40%, or 30% depending on which model you are looking at.......) is off of a total 9% of cardiac arrests. Therefore , the TRUE survivability is around 3%, neurologically intact, discharged from hospital. Far from the pretty numbers that they toot their own horns with.......................... With the implementation of the ITD, an induced hypothermia protocol, direct cath lab access, the use of the Lucas device, rapid deployment of and high availability of AED's, and an outstanding community education program, our numbers are averaging around 17% for ALL cardiac arrests. Our ROSC average is 80%+. But I digress...................... The tiered system isn't all that. And sorry, any system that will not allow a Paramedic to act as one and makes them be an EMT-B for a year, makes them reside in the city and then pays them horrible wages, is absolute crap (Boston EMS in case you are still confused).

Definately talk to a Medic-1 Paramedic................They never hesitate to tell you how good they are! I don't know though, I'm thinking that neither of them (especially not Boston!) are really good examples of an efficient system. King County has had way too many problems with their tiered service. Their "we only transport true ALS calls" mentality has bit them in the ass before.........

Honestly the best response I've seen. If there are multiple patients on the scene and mom wants to sit there and argue, get a refusal and move on to someone who may give a damn about the people who are trying to help them.

Scott 33 hit a few good points that I'd like to expand on........... Lack of Autonomy: I have found that most services that have a higher level of autonomy, have it because of limited government interference. In Texas, the physician decides what a medic can and cannot do, not someone sitting in the state capital. I see many states that have "State protocols" and I have to say, I'm not impressed. Most are way behind the 8 ball. Professional status: 1 level for primary 911 response..........PARAMEDIC. Create an equal level of professional responders who are dedicated enough to complete this course of education. Stop hiring the 120 hour first aid wonders who are looking for a side hobby. Most currently do it because it a) is extremely easy and quick to obtain and offers an immediate gratification and increase in adrenaline release. Neither of which are remotely a decent excuse to be on an ambulance.............. Education: 4 year undergraduate degree preferred or at least a 2 year A.A.S. degree. Get rid of all these "Sally Struthers" programs and fire based programs. The FD only wants medics for one reason, to increase their budget. Volunteers: Get rid of 'em or start regulating them. I'm not going to get too deep into the whole devaluing of employment that occurs with volunteers, but all too often , the volunteers are allowed to do what ever the hell they want to. They should be held accountable to the same standards and policies that a paid employee is. That alone will take care of most of them since many will no longer want to volunteer. Pay: RAISE IT! Communities and administrators listen up! We are performing a service, bill for it! Tax for it! Stop with the excuses, stop saying that the "community won't approve it". If they don't want to pay, then don't use our service. If they truly need it and cannot pay, then we can work with them. But this belief of entitlement in today society has to stop. You want quality service, then you will pay for it. Believe it or not most citizens ARE willing to pay a premium for quality, too bad the powers that be fail to recognize it................. As always, just my humble thoughts and opinions.............

Dust, I frequently work with another medic. Sometimes that medic is an attendant, sometimes they are an in-charge, sometimes even a supervisor. I have NEVER had a situation where there has been a conflict. There certainly has been times when I would think to myself, "now I might have done that a little differently", but never to the level where the pt. was forced to suffer less than optimal care. Should there ever be a situation like that, an intervention is made, immediately, and the pt. provided the care needed. I believe the difference lies in the fact that most medics see at an even level. Should another medic say "hey how about we do this for our pt.", most medics would be able to immediately interpret where their partner is coming from. And in my honest opinion, most will NOT react with defensiveness, or sulk and whine about it. I find that they are appreciative of the collaborative effort since there is a level of equality amongst them. Where my problem lies is the all too often occurence when an EMT-B or I suddenly becomes a board certified ER physician and starts questioning why something wasn't done. Or worse, having a belief that something should be done that is in no way indicated............... Case in point.............I work with an EMT-B on occasion who is the biggest "EMT's should be able to do xxx (insert ALS skill here) because we are a progressive 911 service". But he is also the first person to say that every 18 y/o female with menstrual cramps or a UTI needs an IV and is an ALS call. The problem is that EMT-B's and I's rarely have the concept of autonomy or a thought process at a level that can allow critical thinking. Whether they know it or not, they definitely don't like hearing it. Medics are equal co-workers and can understand another medic at the same level. Lower level EMT's are not and cannot always comprehend the "why's" to EMS. Instead of accepting this, defense mechanisms are shown. It is this involuntary and natural reaction to non-equal non-acceptance that I believe is the root of the problem. But as has been stated before, we ourselves have developed the evil from within.

+5 =D> =D> =D> replace 'em with people who will work for their dollar and actually hold value to their job. It is quite apparant that these bozo's do not.

I'm a white male, never had an issue getting a job in EMS...................... Perhaps your age was a factor. Many companies can not insure individuals under 21 to drive the ambulance. If the service is ALS and you are a EMT-B, you have to be able to drive as it would probably encompass the majority of your job duties. If it was BLS, then there is probably several applicants for each open position posted. There could very well be someone more qualified. Whoever told you that your gender would "assist" in getting a job is a moron or a pervert (or both). Hopefully you didn't for a minute think that as factual....................

Definitely time for a new job. Whether they fired you or not. I would suggest against ever refusing to do your required job description, i.e. "telling dispatch where they can stick it". Remember, you are a revenue generator for that company. Tell them you are not going to make them money and they will can your ass. I would too. Hate to be an ass, but your first priority, especially in their eyes, is to the company. Not to your school. Many a Medic student has had to find creative ways to work around their employment schedule. Considering they were consistently giving you multiple calls at the end of your shift, they obviously do not see a value to your increase in certification and education. Being a Basic seems to be just fine for them.................

I too have never had an issue infusing fluids or medications and have had ROSC's and have even induced hypothermia through an I/O. Were you using a pressure infusion bag? That may help you some..........................

Uh O.K?!?!? :-k

Use your G.I. Bill....................................... Or obtain financial aid. There are many programs out there, many with low interest rates. Talk to your local college about these programs..........................

Hey Asys, long time no hear................... Hope you took a huge paycut, cause that bet may hurt........... :wink: I actually do not know any that take them (and I know a few!) Plus, most 135 and 121 carriers have random testing, plus a 1st class medical physical every 6 months. If these don't stop you, then the thought of having your license that you probably spent over $40,000 on and the loss of your career is pretty effective. Get caught lying with the FAA and you can kiss an aviation career goodbye............ Still don't think it is appropriate or safe to have them in your system if your on a truck (or in HEMS). Just my humble opinion as always..............

No it is not, the federal government and all 5 branches of the U.S. military do it every day.... This we agree on. If someone is currently taking a potentially altering medication, then they should not be performing front line work in EMS. Put them in dispatch, put them in education, or put them behind a desk........... Again, see my first comment. Several employers do require you to disclose this information. HIPAA has nothing to do with it................... You should give yourself more credit Wendy, you understand me just fine. That is exactly what I mean. Therapeutic treatment does not always equate to drugs. Therapy, meditation, social groups, etc. All of these are perfectly fine. But when you attempt to play with brain chemistry, then you have too high of a potential to not make sound judgement calls. Yes, I do realize that this may be placing some individuals that tolerate these meds just fine into a "black and white" descriptive group, but so be it. My safety and the safety of the crew, and the safety of the pt. (in that order) will always be my first priority............... Also, just a little FYI...............the FAA forbids any flight crew member from taking any antidepressant medication. Some air medical services consider their medical crews to be flight crew members (as is allowed under 14 CFR part 135). Hence, some Paramedics are strictly forbidden from taking them. Even recreational general aviation pilots are prohibited from taking them. If the FAA recognizes the danger (and they are usually pretty slow to recognize things, just look at the accident rates for HEMS), who are we to argue?

No one said anything about the diagnosis, the medications are the aspect being discussed............... And no it is not discimination. If a medication alters an individual, then restrictions can made to that individuals' duties. There are many jobs out there that prohibit antidepressant use and even some that bar employment based on the diagnosis alone. So, yes there are people and agencies out there that "has the right" to tell you "where you will or will not work". Coping with a disease is one thing in EMS. Medication is another................

All antidepressants, whether they be SSRI's, benzo's, or TCI's, have serious potential side effects that can alter an individuals judgment and capabilities. It is my personal belief that they should not be allowed when operating in an EMS capacity. To have management or any other employee even suggest it to "prolong" a "happy" medic, is just moronic. It sounds like maybe management should look at other options, perhaps attempting to create a better working environment would produce better results................................ There will be no "happy pill" takers on my ambulance unless they are a patient. 8)

Here lies a big problem. You are performing a service, why would you not charge for it? Obtain the services of a 3rd party billing service, cost is minimal, especially with your call volume, and it would provide some extra assistance. If the powers that be won't listen, take it to the community. Get their thoughts and opinions. Explain the benefits to them, let them come forward to the community officials. If that doesn't work, explain the consequences of not having any EMS. That usually gets some attention. Another thought would be to apply for a grant for funding............

Yea that would be nice, but as long as you have for profit operators lining the government's pocket and spewing their BS to underserved America, they will have the support of both. Despite numerous crashes (hard landing my a#*, it was a crash) and several fatalities, the FAA still isn't intervening. Give 'em time, they will again kill, maybe somewhere down the line someone will give a da*# and start doing something about it. Another detail of the 206.................In addition to being underpowered (even with the C-30 conversion), very few of them have A/C (L-4 models only). I feel for their pts. What really needs to happen is for state EMS offices to get involved and say "No", we don't want your unsafe a#*es operating in our state. Someone needs to put a foot down, we are losing too many helicopters........................ It was a Long Ranger, very very few Jet Rangers converted for EMS (thank god!). Gandering an educated guess, I'd say the pilot lost control after the winds got underneath and he went throught the wires. Wind was from the south, the lines he hit appear to be north / south and he crashed on west U.S. 54. So it seems he made a crosswind approach, which, with the winds as high as they were (and he should have been aware of it as it is his home airport's automated weather service, unless he just didn't listen to it), was not appropriate. Time will tell, the prelim NTSB report should be out soon................... I wonder if this was the same pilot that thought landing on a grain silo was a good idea? That one occured with this same company about a month ago. Sheer stupidity.................

I like FEMA, they're funny................. No I wasn't there. We were prepped, all hurricane precautions in place. But we stopped Sunday afternoon when it was clearer than day (no pun intended) that the hurricane wasn't going to hit the US. I bet that was a long drive................and for nothing at that............... Oh well, its the governement's money (courtesy of my taxes!) Ohhhhh FEMA, can't ever get it right............... But on a serious note, thank you for your dedication and assistance, it is always appreciated even if the coordinating agency is the laughing stock of the U.S. Government....(closely followed by the executive branch!)