NRPinNEPA

Happy to see you join our ranks, Chris. It's about time!! Knowing you as well as I do, I know you will be a valuable asset to this community.

What he said...

The problem with healthcare is a problem of money and system abuse. Firstly, money. Many primary care physicians will not accept medicaid patients because they know that caring for them is a financial black hole. So what do these people who have no access to primary care do? They use the emergency department as primary care. If they don't have a car they call us. And you know it's true... there isn't a single one of us who hasn't been called for a toothache at 3:00am. What we need to do is reform health REIMBURSEMENT so that primary care physicians can care for medicaid patients without going to the poorhouse, and give us as paramedics the ability to tell toothache boy to go piss up a rope. Cut down on inappropriate use (read: abuse) of resources, you reduce costs.

The hardest thing to do is accept the world the way it is, not the way you want it to be. Personally, I think that we are our brains. When we die, we die, and that's all there is to it. Do I want to live forever? Yes. Unfortunately, I see no reason to believe that I'm going to live forever. Just because I want it to be so does not make it so. Is my view very comforting? No. But nobody ever said life (or death) was fair, let alone comforting.

I am now a Nationally Registered Paramedic!!

I've only got one thing to say to you... cost of living 22% lower than the national average... Ok, two... lots of woods...

If you only have two ALS units for 75 miles, there is a simple solution... MORE PARAMEDICS!! Usually the EMTs who complain about Paramedics not respecting them are the ones who are either too lazy or scared to go to Paramedic school, or have tried several times and failed. I'm sorry, 120 hours does NOT qualify you to perform invasive procedures. Sure, you can start that IV, but what do you do if you suspect you've caused an air embolism? For a CHFer, would you attach saline or just a lock? What happens if you give too much Narcan to an unconscious overdose patient? Your patient is having a Right Ventricular Infarction... would you give them nitro? Can you give Bicarb and Calcium through the same IV? How does Bicarb work? What does it do? How does Calcium work? I'm sorry, but 120 hours with a few 16 hour "extra cert" courses should not qualify you to administer ANY medication. You have less education than a hairdresser and you want to inject substances into somebody that will alter their body chemistry? Substances that alter how their body is working at the cellular level? Substances that could kill them? When I finished my EMT class, I had training. Now that I am finishing my Paramedic schooling, I have an education, and I am going to be continuing on to higher education. Yes, there is a difference between training and education... for example, would you want your daughter to get sex education or sex training? Think about it.

I have heard that a nearby service has an individual living in their coverage area that has some sort of external device that pumps their heart while showing absolutely no electrical activity on a monitor. If I'm correct, as soon as this person moved into the coverage area or got this device implanted or whatever, the service held a ConEd course specifically on this device. A paramedic at our service stated that he cared for her while he was a student and, just for giggles, put the monitor on and sure enough... the asystole alarm immediately went off and a flat line marched across the screen. Meanwhile, the patient was alert and oriented. You never know what kind of crazy stuff you're gonna run into.

4lpm via nasal cannula. IV access. Repeat 12-lead. 15-lead and right-sided 12-lead to capture V4R, V5R, V6R, V7, V8, and V9. Labs: Cardiac enzymes, CBC, electrolytes, BUN and creatinine for giggles. Contact the doctor and request a transport capable advanced life support unit. Since the ST elevation is basically global and the chest pain is reproducible, I'm leaning away from ACS.

CHEAP GPS units are unreliable. Get a quality product like Garmin and you'll be at the residence before the old school EMT has even found the proper page in the mapbook.

How I learned heart blocks... http://ambulancedriverfiles.com/2007/06/sex-relationships-and-the-cardiac-conduction-system/

I took out a private loan to pay my rent and have worked part-time through school.

The first stage of cellular metobolism is anaerobic, meaning it occurs without the use of oxygen. Glucose enters the cells and through a process called glycolysis creates lactic acid and pyruvian acid. The second stage is aerobic. Oxygen enters the cells and through a process called the Krebs acid cycle creates ATP and carbon dioxide. ATP is the energy source, carbon dioxide is a waste. Now, when you're hypoxic, oxygen isn't being delivered to the cells. The Krebs acid cycle can't take place without oxygen, so the lactic acid and pyruvian acid continues to build up inside the cell. Eventually, the cell becomes acidotic, resulting in cellular death. In other words, acids build in the cell and cause the cell to die.

I have big, long alien fingers, so I can digitally intubate without much difficulty. I would prefer it over a nasal intubation any day.

Now, THIS is the oldest thread revival ever... almost five years!!!