HERBIE1

Sounds like you have the right attitude. Good luck.

Welcome, emsfool. I'll echo the others here- depending on where you work, EMS can and will become routine. Even in an emergency service, often times the calls can become monotonous. You need to dig a bit deeper as to why you want to remain and advance in this profession. Wanting to help folks is a pat answer, but as long as you understand that in the vast majority of cases- even with advanced training, your idea of helping someone may be very different than the realities of the job. You could have certifications up and down your arm, yet you end up doing interfacility transfers or calls for a 20 year old's sore toe on a 911 service. Depending on where you work, you may have platoon work, you will have autonomy, unless you are a supervisor, you will certainly not be flying a desk, and you never do know what may happen next. I have around 30 years in the business, have worked my way up from a Red Cross volunteer in a rural area, to a street level provider, been in management, taught EMS and university classes, and made various trips up and down between those jobs. I enjoy using my brain and problem solving bigger issues that affect the street level providers, but the thing that really gets my blood pumping is street work. When you get a "good call"- it doesn't have to be glamorous, blood and guts, or a ROSC save on an arrest, but simply one where your presence/gesture/actions made someone's situation a bit better- it makes all the BS worthwhile. Seeing a kid going from hysterics to smiling and happy simply because you acted like a goof and made her laugh- that's what it's all about. The big drawback- and one I cannot overstate- this is a physically and psychologically demanding profession. It WILL take a toll on your body. COUNT on it. I am living proof. As I sit here, I am recovering from my 2nd MI, with a 2nd stent placed 5 days ago now. I also nearly left this world this- went into V-tach for about 4 minutes until they shocked me back to the living. I have also yet to reach my 50th birthday. The erratic hours, sleep deprivation, the poor eating habits, the stress, the poor lifestyle choices of the past, adrenaline surges and dumps, years of wear and tear- all are taking their toll. Did EMS cause all my problems? Of course not- I am the unfortunate recipient of bad genes on my dad's side of the family, but the lifestyle the profession causes certainly does not help. I also cannot imagine doing anything else, but my circumstances may force me to reconsider. I have no idea how old you are, your family situation, what your background is, your education, or where you live. I would strongly suggest you find a back up plan- another career you can step into if at some point, EMS becomes an untenable option. Good luck in your career.

Too many variables to make a blanket statement. Is the area rural or urban? What are transport times? What are the capabilities of the hospitals in the area? What is the problem with the patient? What type of ETA do you have for an ALS backup? I think in large part, many of our protocols are litigation driven- as is too much of medical care in general. In essence, we are practicing defensive medicine by proxy. That's just how it is. Docs need to order multiple unnecessary tests to "confirm" that a person has a cold, and not some virulent new strain of flu that has been imported from the Congo. I agree with the comment that many times, the IV we establish is merely a convenience for the ER staff, and these days, with how busy they are, it's probably a good thing. Many times we need to wait so long to get a bed for a patient that I will either push more analgesic, another albuterol, etc until we arrive at an ER. I have also carried a pocket full of albuterol to continue an nebulizer treatment while waiting for a bed. On several occasions I have guilted the staff into finding a bed for us when I say- well, our patient is still in a lot of pain, and I just happen to have some morphine in my pocket, how about if I give the person a bit more while we are waiting? Similarly, I have asked- LOUDLY for someone to find me a portable O2 tank because we have drained ours waiting for a bed, or a portable monitor because we have drained our batter pacing and/or monitoring our patient. That usually gets someone moving.

While I think many folks are ethnocentric-they feel their nation is the most important, I do agree that America does have a history of being somewhat arrogant. I also think it's not necessarily a bad thing. We are(or at least were at one time) the most powerful and well respected nation on earth. Good or bad, we are the ones who play world cop, biggest benefactors and the world's philanthropists. We rush in to mitigate problems all over the planet. When it hits the fan, we are the ones who everyone calls, so we better be cocky. We all need to be better educated, and I think that is a problem here. Many folks have no hope of ever traveling far beyond their own little town, so they don't feel the need to learn about the world. Many places teach their kids multiple languages as a part of their normal education, beginning in grade school, while here it's still an elective thing,- US arrogance.

Exactly. There is too much of an entitlement mentality-ie kids who feel they should have the same success their parents have- without the effort. They finish college and expect a 6 figure salary with a corner office, a company car, a golden parachute, 6 weeks of paid vacation, and a fully funded 401K. Even in our business, I see too many new folks who think they have all the answers- even when they don't even know all the questions yet. This attitude did not happen overnight- there has been years of PC ideas like rewards and trophies just for trying- regardless of the outcome. Giving a failing grade became bad- someone's self esteem may be forever damaged. I don't see things changing anytime soon, but I am hopeful but the current political climate certainly is not a cause for encouragement.

To keep it a more general answer, if I had to use one word, to answer the question, I would say- "attitude". It applies to many areas and subjects- work, education, ethics, money- nearly everything in our lives. I think our collective attitudes have changed over the years- even since I was born, and certainly back into the 50's and beyond.

I guess it would depend on the underlying conditions of the patient. Is this a "simple" cardiac issue or is the person hypovolemic for some reason? Did they arrest because they were already in fluid overload- dialysis, CHF, electrolyte imbalance? I recall the push in years past for massive fluids for most trauma patients. These people would end up in the ICU with ARDS, massive peripheral and pulmonary edema, and would more likely succumb to the complications from that vs their original injuries. I'm sure we all have had penetrating trauma patients-ie GSW's or stabbings- who were so volume depleted that by the time we got to the ER, they were bleeding pink. They had the fluid, but not the Hg and blood products they really needed, and we do not carry. To me, as long as you are able to circulate the medications with good CPR and proper ventilation, fluid overload seems to be counterproductive.

They call them Japanese lady bugs or Asian Lady Beetles. They are a different variety than plain old lady bugs. As was mentioned, they do bite. A couple years ago we had a bug problem here- they were everywhere, and after a few weeks they were gone. Thankfully I haven't seen them in a couple years.

Congrats, Gypsy! You will learn tons while working in a hospital. Be eager to learn, keep your eyes peeled, and you will be amazed by what you can pick up. Obviously much of what you see is not directly applicable to prehospital care, but it IS knowledge, and the more you know about health care in general, the better provider you will be. When I started in EMS, I was working at 2-3 hospitals AND on the streets. I was able to explain how an angiogram, CT, MRI, echocardiogram, ultrasound exam, etc works. I was able to explain the whole admissions process to the patient- tests, evaluations, and approximately how long things would take. It was amazing how relieved folks would be once they had some idea of what may happen to them next. It's a scary process and a fear of the unknown is a major factor in how people view their health care experience as well as their attitude towards their recovery. You will be able to explain to a patient or family member what will happen to the patient once we drop them off at an ER- which tests they may take, which procedures they may need, how those procedures are conducted, etc- it's an invaluable bit of information. Many- especially those who are not regulars in the health care system are afraid- they have no idea what will happen to them once they become patients. Being able to ease their minds is just as important as any procedure or skill we perform in the field. If you show a willingness to learn, you will be amazed at how happy many docs are to explain things to you and even have you assist in things you would not normally be exposed to. Obviously it depends on what you specific job is, but I've had some amazing experiences working in ER's and a Level 1 trauma center. I've been able to hold a human heart, place chest tubes- with assistance, of course, learn to suture, learned how to place Foley's and NG tubes, learned how to do gastric lavages and DPL's- (diagnostic peritoneal lavages), all experiences I will never forget. I learned how the blood bank system works, how hematology runs the blood for lab work, and how to interpret results. Who knows where this job may lead for you. It may well open doors you never even considered. Best of luck.

I seem to recall him saying he WAS going somewhere, but it was just a passing comment. I cannot recall when or where he said he was going.

There are good and bad teachers- online and traditional. I think we can all look back to teachers who were only in it for the paycheck. I recall professors who literally read a textbook to a lecture hall full of people. No anecdotes, no interpretation- a total waste of time. I always felt cheated and that I was wasting my time and money- I know how to read too. Too often this is exactly how general education classes are taught in universities. I think online teaching is actually more challenging, for the reasons I stated above. Like anything though, it needs to be a good fit for the person. If you KNOW you need a face to face interaction, to properly absorb the info, then online is probably not the way to go. Some folks simply do better on their own, while others need the classroom setting. Different strokes, I guess. I just see online classes as another option for someone to consider. Blackboard is huge- many schools use it, or a variation of it.

Teaching online is not easy for an instructor. You need to learn the proper use of the online interface, you need to set up chat times for Q&A and discussion, have resource materials posted, links to places to find further info, and you also need to be available for a student to contact you via email. Many instructors give out their cell phone numbers in case someone needs a more personal touch- I do this, and it's come in handy. I've had a couple students who were lost- mostly due to a lack of effort, and I was able to get them on the right path. It's also hard not seeing the faces of your students- you get feedback by their body language, their facial expressions, etc. If they aren't getting something, you can change gears and try a new tactic. Online classes do not allow that. Again- people learn in different ways- some are visual learners, some are auditory, some learn better by wrote, and other need a combination of input in order to grasp the material. A good instructor- whether virtual or face to face- understands this.

Depends on where you want to go with it. Hospital based won't be a problem, but if you wanted to go fire service, most have age limits. As for a private provider- I think they would love to have someone with your experience and maturity. When I was hiring, I brought in a couple military guys and they were great. Good luck.

Quite right, Richard. There are 2 "Phases". Phase 1- You can test out of up to 82 hours of classes- gen ed and prerequisites. Phase 2- THEN you enroll enroll in a university to complete your degree. http://www.college-net.com/works.asp It seems legit for what it claims to do, but I would still be very leery of this. If an online thing is interesting to someone, I would check out a reputable school and see what they offer. An added thought- This idea has been around for quite awhile. Years ago, my mom went back to school at a university which had a adult education program. They would give you course credit for life and work experience- especially if your job was in the field you were studying. I know there are limits, and I also think it's pretty arbitrary on how they made their decisions on how much "experience" they would accept. Just an FYI-

Online education is the new fad. Many top notch universities are pushing towards this- they can charge the same tuition but do not incur the costs of a brick and mortar building for the classes. Saves them money, they do not need to stock texts in their bookstore, they need less staff/faculty, etc. Schools are trying to attract a world wide student body, and for someone who is willing to pay the tuition, but not move to a new country, it's perfect. They are also targeting military personnel, stationed overseas. Blended classes are also popular now- the majority of your lectures are online/chat based, but you meet once or twice a month for a face to face with an instructor. The university I teach at is in the middle of a HUGE push for online classes right now. Obviously, with a subject which requires hands on- as in a chemistry lab, anatomy, physics, clinical disciplines, etc, you will always need a traditional classroom setting, but for most classes, it's simply a lecture- especially with the general education requirements. Clearly this approach does not work for everyone- learning styles differ and some people do better in a traditional classroom setting and I think there will always be a demand for tradition lectures, but I think this is a good thing. With the fast paced life of many, sitting in front of a screen is easier and more practical for folks-especially those currently working full time, have families, and are not able to take time off for school.

Sounds like this clown needs to find a new profession. It seems he has probably guaranteed that this will happen.

Well, the reaction to what happened on 9/11 transcended all nationalities, ethnic groups, and civilized human beings- not only here, but all over the planet. Emotion IS the issue. We are supposed to ignore what happened on that day in the name of being PC and "tolerant". We are supposed to ignore that fact that all of those terrorists on that day WERE Muslim. What they did was in the name of their "religion". No, not ALL Muslims are terrorists, but the vast majority of terrorist acts committed ARE by Muslims. Thus, for a Muslim group to suggest they erect this "shrine" at the WTC site- regardless of their claimed intent of unity(IMO the reason is pure BS, but I digress) is the height of absurdity. We're supposed to be tolerant of another group, yet they are not required to have that same tolerance? Come on.

I don't know how far along you are in the planning, but the operative phrase here is "Sounds like a great idea, dear." If she asks about a color scheme, type of flowers, menu, etc, don't just say- "whatever you want". PRETEND you give a crap, even if you don't. You think you are being agreeable and helpful by deferring to the mrs, but they become overwhelmed. Make a decision- even a minor one. It will work wonders. My biggest worry was the reception. I couldn't care less about the flowers, dresses, color scheme, decorations on the tables, party favors, seating chart- but I soon found out ""Whatever you want, dear" was NOT acceptable. The groom has it easy. We rent a monkey suit, bring the ring, and that's it. No hair appointment, no makeup, no nails, no multiple fittings for a dress. Biggest caveat- come the big day- don't worry. As long as you two are there, the priest, judge, or whomever is officiating the event is there- the rest is gravy. Little issues will happen- let them go, and enjoy the day. Congrats!.

Glad your dad is home, Ug. Hopefully you'll get more information- and good news- soon. Keeping you and yours in my thoughts...

Critical airway? Wow. The only thing this person needs is a chest tube because of being decompressed. Barring unknown internal injuries, this person is pretty darned stable. RSI? How about malpractice?

Tough to do this long distance. You need a face to face with the doc so he/she cannot brush you off. Get a list of questions, treatment plans, prognosis, efficacy of each, etc. Be armed with as much information as you can. Ask tons of questions, and if you are not satisfied with your answers move up the food chain at the hospital and start asking to speak with supervisors and administrators. No doctor should be ignoring you, and trust me, if you make noise, higher ups WILL pay attention. Just be respectful, objective in your questions, and as tough as it may be try to stay away from name calling and/or personal attacks. Explain your concerns. I promise you will get answers. Even if you are across country, you can still get answers via the phone. Many hospitals now have patient advocates who's job includes things like this. Good luck.

Good one! Thanks for the chuckle!

My deepest sympathies on your loss. Much too young, but you will always have memories of your time together, and I pray that you find comfort in that fact.

Crap, dude. Lousy situation. I'll echo the sentiments of getting the PD involved. Unless she was on your accounts, You were a victim of theft. Good luck.

I'm just going by the documentary I saw. They followed a Coast Guard chopper on their search and rescue patterns. They followed a USCG cutter as it steamed towards the drill site. I distinctly recall seeing 2 fireboats, spraying water on the burning rig, and recall the narrator saying these vessels were from nearby oil rigs, so I assume they were owned either by an oil company or private contractor leased to the oil company. The fire and continued explosions were so intense, nobody could get near the platform. They also followed a Dutch and a Texas fire rescue and suppression company as they geared up and headed to the Gulf. Their expertise is getting on a burning rig, and fighting the fire from there to save it. They never got the chance. Literally, as they arrived on the scene with all their gear and manpower, they watched as the rig finally collapsed and sank, leaving nothing but a burning patch of oil on the sea. From what that program said, there is an established set of industry protocols to be followed when there is a fire and/or blowout. Certain calls are made- obviously to the USCG, but also to private firms. These companies are immediately mobilized as soon as they are contacted by the oil firms to come in, put out the fire/blowout, mitigate damages, and save the well/rig.