46Young

Are the FF's at the station cool, or do they still give EMS the cold shoulder there? The whole thing seemed ridiculous to me.

So, when someone calls 911 and says "I just want you to check me out" they can charge now?

Are the FF's still hiding the card for the cable from the EMT's/medics? Or does everyone get along at the station now? Does Brookhaven still have the 3rd floor bariatric unit? I used to go there often when I worked for Hunter back in the day.

How about tutorials regarding PCR writing? That seems to be a common cause for concern with those new to the field. I wish that I had such a guide when I was starting out. There ought to be seperate sections for IFT, 911, refusals, and suggestions for wording (catch phrases, disclaimers and such) to deflect liability should you be required to testify in court.

This is what my FRD advises us abour Air Medical Transport: The routine use of Air Medical Transport based SOLELY on mechanism of injury (MOI) should be discouraged. The decision to transport by air must take into account a number of factors. 1. Logistical factors - access and time/distance variables. -Proximity to the receiving facility -Traffic congestion -Topographical factors limiting patient access by ground or water transport units -Availability of and proximity to an acceptable landing zone 2. Patient factors Trauma - MOI significant enough to require transport to a trauma center plus one of the following anatomic/physiologic abnormalities - Compromised airway, cannot be maintained or managed -Respiratory distress/failure -Signs/symptoms of hypoperfusion/shock -GCS of 10 or less; GCS decreasing two points from 1st and 2nd assessment -Loss of consciousness more than five minutes -Neurological signs/symptoms suggestive of spinal cord injury -Two or more long bone fractures/deformities Medical/Surgical (suspicion of the following) -Acute ST elevation MI with S/Sx of shock or severe CHF -Ruptured AAA (abdominal pain/back pain and hypotension) -Aortic dissection -Acute ischemic CVA (stroke) less than 3 hours from symptom onset Contraindications to Air Medical Transport -Pt has no obtainable vital signs upon initial assessment and remains without vital signs during the course of the resuscitation effort -Pt is contaminated with a hazardous material -Patient's condition requires multiple caregivers and/or space to provide CPR -Pt size (consideration) -Patient's injuries (grossly angulated fractures)

Many working professionals nowadays find it exceedingly difficult to complete a degree while working FT, and certainly can't afford to take a few years off work to pursue said degree. I'm facing that same issue myself at the moment, although my employer makes it easier than most. Things like medic mills, online medic-RN bridge programs, and other online dergrees have come about to address this population, but are frequently slammed for being inadequate. What's a working professional supposed to do when faced with legitimate financial/social constraints. damned if you do, damned if you don't. Completing a degree seems to be geared to the young adult population nowadays, who typically still live with their parents, and don't need to work FT. If you don't have the time, the profession doesn't need you anyway. Plenty of young individuals aiming for the healthcare field in general. Completing a FT, full speed program for ASN, BSN, RRT, PA, MBA, and such aren't compatible with those that absolutely must work FT jobs. What about the single parent that wants to do better for their family? Educational requirements for these fields weren't what they are now 15 or 20 years ago. Working professionals in healthcare fields are offered chances to upgrade their education to the new minimum standard, such as CRT to RRT, in a reasonable time/career friendly fashion, while newcomers have no choice but to complete the dergree in it's entirety at full speed, no other options available. So, before anyone knocks this program for not being a degree, remember that it IS 16 months, and addresses a business need while helping out those that wouldn't be able to attend otherwise. It's interesting to note that the article advises that there still exists a paramedic shortage. I know that I can move almost anywhere in the country and find work, especially with my resume. It's going to be an uphill battle to lobby for an increase in educational standards to a minimum of a 2 year degree when there exists a shortage of medics as it stands now. Until then, there's always going to be those that seek the quickest/easiest route, and employers that do the same. I don't see many employers requiring a two year degree minimum as a condition of employment without being forced to do so through legislation. That's where we are at the moment, like it or not.

The North Shore LIJ CEMS, where I used to work, experienced two LODD's. One was Carlos Lillo, a FDNY medic who worked per diem at the CEMS, who died on 9/11. Paramedic Bill Stone died while running a vollie call in his spare time out on the island during an accident. http://cms.firehouse.com/content/article/article.jsp?sectionId=39&id=41502 NYS has a memorial to honor EMS LODD's http://www.health.state.ny.us/nysdoh/ems/emsmemorial.htm I'm in the fire service now, where we study LODD's, learn from them and recreate the situation and drill on them. Examples learned from fire LODD's include two in/two out, RIT, level 2 RIT, Columbus Drill, Denver Drill, maze training, PAR checks, the Heart and Lung Bill, constant revisions to our operation manuals, backing procedures for apparatus, and plymovents to suck up diesel fumes in the bay. I shudder when I think of the 5 years of diesel fumes I've sucked in while sitting on street corners waiting for jobs to come over. As far as EMS, I would think that likely LODD's would include MVA's, needle sticks/other exposures (just drop the sharp on the floor until you need for a BGL or are able to dispose of it properly!), trauma sustained from lack of situational awareness regarding scene safety, suicide related to traumatic work experiences, and the way underemphasized physical health leading to MI's, CVA's and such. Those causes should be drilled and incorporated into the agency's SOP's where applicable, and enforced. An ounce of prevention is worth a pound of cure.

Okay, you've finished EMT/medic school. Now what? Are you looking for FT work as a career, PT side change, or a stepping stone to bigger and better things? Salary is the first thing that comes to mind. It's important to realize that the starting salary isn't your only concern. Some places pay well to start, but it may be that way to distract one from their horrendous working conditions, lack of career development, or low potential for raises above that. The FDNY and NYPD start their employees at almost a welfare rate (for the region), but their 5 year + personnel are rewarded for sticking around. New employees eat it at first so that tenured employees may benefit with higher compensation than might be possible otherwise. An important thing to ask at the end of the interview, when they ask if you have any other questions, is "How do you determine hourly (or annual) compensation and merit increases"? That particular wording requires a straightforward answer. http://www.nypdrecruit.com/NYPD_BenefitsOverview.aspx http://nyc.gov/html/fdny/html/community/ff_salary_benefits_080106.shtml A yearly salary quote can be misleading. Are you working 40 hours/wk? 44? 48? 56? Are you FLSA (fire based dual role) or not? Let's take a quoted yearly salary of 49920/yr as an example. If you're working 40 hours/wk, you're getting 24/hr. If you're working 56 hours/wk, getting 40 straight and 16 at 1.5 time, you're earning 15/hr straight and 22.50/hr built in OT. If you're FLSA like me, all of your scheduled work hours are straight time at 17.14/hr. Your OT will be 25.71/hr however, over 3/hr over the 40+16 scenario. Is your schedule fixed, as in MON/0600-1800, WED/0800-0000, SAT/0700-1900? Or do you rotate as in a 24/48 and the like? Once you get your schedule is it yours permanently, or does management change it up every six months to a year? Is there a mandatory OT policy? Is it capped at 2 hours, or is it 8, 12, or even an extra 24 hours? What is their leave policy? Do they approve when the staffing ratio allows, or do they make it prohibitively difficult to use any leave? How many sick days and paid days off do you get per year? Can you roll over, or do you lose your time? What medical/dental plans are available? Deductibles involved? 401k/403b (defined contribution) with matching? Or do they have a defined benefit (pension) with hopefully a 457 deferred comp. Our multiplier results in a nearly 75% compensation rate based on one's highest three years of earning for each year, with COLAs. We also have a three year DROP - http://benefitsattorney.com/modules.php?name=Content&pa=showpage&pid=14 By my calculations, my pension will outweigh what I would have otherwise had under a DC plan (under the best of circumstances) in about 6 or 7 years tops. Every year thereafter I'm making out like a bandit. I'll discuss working conditions, differences between private IFT, third service, fire based, as well as career development/career change utilizing EMS in later posts.

How about tutorials about what to look for when searching for a job, such as benefits, salary, built in OT, retirement, opportunity for career development or paid schooling, negotiating tactics, differences between private IFT, third service, fire based, so on and so forth. I'll post some stuff in the general EMS discussion forum. Move it to the tutorials if you feel so inclined.

Is your parent's medical insurance valid overseas and in the countries they expect to come in contact with? I'm thinking in terms of restock, expired meds, validity of their doc's Rx in other countries and such.

To be honest, I've only watched episode one up to when the kid gets cric'd on the bird. It kept getting more and more outlandish each second, and my head was starting to hurt. It sounds like this series is going to be so bad that everyone feels compelled to watch every week just to see how much more awful and outlandish it gets. It'll probably get great ratings. That would be awesome. We're already tuning in every week, right? I'll probably play catch up online at some point myself, just for kicks and giggles.

Check out this thread on FH.com http://forums.firehouse.com/showthread.php?t=110833 None other than Marcel, the BC on the show weighs in and answers questions about the show. He begins at post #23, username upnsmk.

That's the problem. Unless I go down with an injury, I won't be working FT, so I don't think a hospital would be inclined to pay my way. I've also discovered why I can't find any info for salary caps and related info. When you apply, there's a sliding scale regarding salary that dictates what the Gov't will pay out. I'm going to contact the FRD's education coordinator tomorrow and hopefully get pointed in the right direction.

By not turning it down he effectively endorses the decision, acknowledging that he deserves the Prize more so than anyone else (many of who are far more deserving by evidence of their past actions). He'll have to live with the stigma and negative political ramifications that goes along with that then, seeing that his actions haven't caused any real change, at least not at the close of the nomination period, 11 days into his term and all. Ideas and thoughts of peace are great. Really. I wonder then why the Ms America or Ms Universe winners of days past haven't monopolized the Nobel Peace Prize every year. You know, when they ask the contestant to state what they would wish for, with the generic response of world peace, or an end to world hunger or something.

I broke it all down on the thread regarding RT vs RN. Career development at my FRD gives much weight to education for points on promotional exams. I intend to complete fire science, as well as either an ASN or RRT. I'm looking to go with fire science last, as I want the ASN or RRT for side work, or as a fallback career should I sustain a career ending injury landing me on permanent disability. I don't plan on testing for a Lt spot for at least 6-7 years, as all the OT is at the FFM/technician level, and the job responsibilities are far less, freeing up more time for studying. Fire science is wholly necessary for a LT promotion IMO, but I intend to defer seeking a LT spot until I complete both the RN/RT and fire science. I also plan to get into EMS education at some point, and I believe that optimally the educator should be a level or two above the field that they're teaching. I would like to enter EMS education regardless, however. The thing is, I can get my RN at the NOVA CC if I so choose, and it's wholly affordable. For RRT, I haven't checked yet. However, we're looking to purchase a house in the near future. the FRD will pay for only one class per semester, and I'm not inclined to pay out of pocket for more classes at the moment, at least not until I go up a few steps in pay. OT at my job is over 32/hr (more when we earn step increases in years to come), which is equivalent to working per diem at a job that pays around 67k/yr (which is roughly my yearly base). I've been told that RN's start in this region at around 50k or so, and RRT's get around 60k. So, I'm not losing any ground financially by chipping away at a degree piecemeal until I absolutely have to go school FT. I don't want to drag it out, rather complete as quickly as I can provided I do well, which brings me to the reason why I started this thread.

I read this on another forum today: The true culprits are the members of the Nobel Prize committee, Obama will get the attention for accepting an award that most do not see him as worthy of. I rather he acknowledge this fact, and say, "I reject this award on the reason that I feel many others deserve this award for their lives work for peace, I am just beginning." In my opinion such action of valor will gain him much more favor with many people worldwide and put the Nobel Peace prize committee to shame, and they will think twice next time they hand a free gift to a non-deserving person.

Thanks. When I search the web, all I can find are sites featuring links to applications for various programs. what I can't find are eligibility criteria. I'm wondering if I'm compensated too well to qualify for any aid, even though my wife isn't working, and I'll soon have two children. I can't find any links advising the upper limit cutoff on salary for any of the programs. Also, our credit is excellent, so we won't having any problems in securing loans. I'm not looking to go that route, however, as we're prepared to purchase a house next year.

I'm a 33 year old FFM , married with one child and another one due in late Jan. My wife doesn't work, my base salary is around 67-69k/yr, and I'm on pace to make about 85k or so in total this year. My job is only covering one class per semester at the moment, who knows when they'll allow more. I intend to ask HR for any leads regarding tuition assistance through grants and such. Would anyone have any insight as to what's available at the moment, and what the salary caps would be for certain programs?

Maybe next year Ahmenijad will win the prize for building a nuclear bomb so his country will be safe. Said GOP Rep Gresham Barrett, who is currently running for Governor of SC: "I'm not sure what the international community loved best; his waffling on Afghanistan, pulling defense missiles out of Eastern Europe, turning his back on freedom fighters in Honduras, coddling Castro, siding with Palestinians against Israel, or almost getting tough on Iran." I found this article amusing: http://www.nydailynews.com/blogs/flashpoint/2009/10/trashing-america-nobel-peace-p.html

That all seems pretty accurate, generally speaking. I've suggested in the past that EMS take a page from the fire service's book and use similar organization and political action to make gains form the industry. There seem to be several problems, however..... It's difficult to organize a group that is as fragmented as EMS. For every career single role EMS worker, there are seems to be several that are in it for the short term, either completing a degree, waiting on a civil service list (which may or may not make use of any EMS certs), or lose interest and leave due to burnout. Many use EMS as a quick way to get a job and support themselves until a better opportunity comes along. Along with organization, there needs to be higher educational standards. The problem is, nearly every single person (no exaggeration) I've spoken to who opted for a paramedic assosciates degree rather than a cert program (or mill) did so with the reasoning that they can use the degree to help obtain other degrees in the healthcare profession. the common sentiment is that they don't intend to be a FT paramedic as a career, maybe just per diem after they get their next degree. Even if they did two years of schooling, unless they land a job at a stellar agency, they won't put up with the industry standard low pay, substandard working conditions, etc. "Why am I putting up with this BS? I have two years of college, I have all these credits already, I think I'll just knock out RN/RT/PA school, and do this on the side, on MY terms." So, the educated tend to leave for greener pastures (based on what I've been told face to face by those who have done so), leaving those from the previous paragraph. The third problem is that the fire service is absorbing more and more EMS agencies. In some cases it's for a good reason, the best choice for the area. However, I've heard numerous accounts of FD's doing hostile takeovers displacing single role workers, cannabilizing the EMS side to reallocate funds to the fire side, and having an apathetic attitude towards QA/QI in EMS. There will always be groups that oppose increased education for EMS. FD's that don't offer enough of a desirealbe package to attract quality medics, states with expansive rural areas that would rather not pay for medics, getting by with EMT-A's and EMT-I's, really any employer who doesn't offer enough to attract properly educated personnel. I wish that I had a real, workable solution to all this, but unfortunately I don't. Unless there is a large self motivated movement from medics that choose to only get their cert via a two year degree, thereby putting cert programs/mills out of business, I don't see there being any significant organization of serious professionals actively seeking to improve EMS. No one wants to do two years of college to make 10-15 bucks an hour. And I wouldn't blame them. As long as mills are allowed to exist, there will always be more individuals that go that route (easier, and the employer doesn't generally care where you got your cert, as long as it's current) than there are those who choose to complete a paramedic degree.

A few questions What are the educational requirements for a CRT vs a RRT? Is it eaiser (schedule wise) to upgrade from CRT to RRT rather than go right to RRT? Would going from CRT to RRT result in a poorer educational experience than going straight to RRT? I understand that RRT may soon become the National standard, so this may be irrelevant. I don't plan on doing it piecemeal, but if I go out on permanent disability due to an on the job injury or whatever, I may need to start work ASAP, so then and only then I would consider going CRT at first. Did you complete your degree while still employed as a firemedic? If so, what were your time management strategies? Thoughts from anyone on this? http://staging.nvcc.edu/medical/health/nursing/forms/Online%20Nursing%20Program%20Information%20Handout%20For%20Students%20Entering%20Spring%202008%20-%207-07.pdf

I can see why certain FD's would seeks to keep educational standards low. It may be difficult to hire enough medics to fill available positions, so they take FFEMT's off the road to complete medic school. This takes time and money, so it's in the best financial interests of the dept to push them through as quickly as possible. these mills also provide a supply of "qualified" applicants. If I had my way, FD's would require a two year degree and give hiring preference of at least a year (if not more) of single role EMS experience to be hired. Maybe even mandate prior experience in EMS. If you want the bennies, conditions, pension, $$$'s, show us that you're a legitimate ALS provider, not some joke from some fly by night mill who is only using the P-card as a quick "in", only to drop the cert at the earliest opportunity.. The problem with EMS as a stand alone industry, IMO, is that there are so few quality places to work, with a livable wage, bennies, working conditions, pension, so on and so forth. As such, a significant amount of the EMS workforce is transient, either completing degrees or waiting on a call from a civil service list from a FD, PD, DOC, sanitation, USPS, or whatever. This makes political organization, which is needed to effect any real change, extremely difficult. Only political pressure can raise the bar. Organization will be easier to achieve with individuals who have already made that educational investment. But how many will actually do that when there are easier options available, with employers unwilling to raise hiring standards to at least a two year degree? Too many individuals just use EMS for a short period to suit their purposes and then leave, not really caring about what happens to the industry as a whole. It sucks, but it appears that there's a catch 22 situation here. Many look to EMS as a quick way to make money without having to do two or more years of college. I think that Ventmedic said that 70% of FL firemedics hold no degree of any kind whatsoever. I suspect the same for the EMS industry as a whole. I'd like to see EMS grow into a more respected, sustainable, fufilling career, with working conditions improved to prevent burnout and promote retention. I wouldn't suggest EMS to my children as it stands for the moment (as a career), but I would if the profession gains a certain amount of parity with RN's, RT's, PA's and such. I read forums by Canadians, Australians, and New Zealanders, and it would seem that the same problems exist regarding working conditions, mandatory OT, and such. And they have a much more advanced educational bar to meet prior to employment.

An engine company should be dispatched to all MVA's, as well as a heavy rescue for cut jobs. The engine can position to effectively block the scene, and pull a bumper line if needed. What many don't think about is using the thermal imaging camera to search for additional pts who may have been ejected out of sight. This is what my FRD advises us abour Air Medical Transport: The routine use of Air Medical Transport based SOLELY on mechanism of injury (MOI) should be discouraged. The decision to transport by air must take into account a number of factors. 1. Logistical factors - access and time/distance variables. -Proximity to the receiving facility -Traffic congestion -Topographical factors limiting patient access by ground or water transport units -Availability of and proximity to an acceptable landing zone 2. Patient factors Trauma - MOI significant enough to require transport to a trauma center plus one of the following anatomic/physiologic abnormalities - Compromised airway, cannot be maintained or managed -Respiratory distress/failure -Signs/symptoms of hypoperfusion/shock -GCS of 10 or less; GCS decreasing two points from 1st and 2nd assessment -Loss of consciousness more than five minutes -Neurological signs/symptoms suggestive of spinal cord injury -Two or more long bone fractures/deformities Medical/Surgical (suspicion of the following) -Acute ST elevation MI with S/Sx of shock or severe CHF -Ruptured AAA (abdominal pain/back pain and hypotension) -Aortic dissection -Acute ischemic CVA (stroke) less than 3 hours from symptom onset Contraindications to Air Medical Transport -Pt has no obtainable vital signs upon initial assessment and remains without vital signs during the course of the resuscitation effort -Pt is contaminated with a hazardous material -Patient's condition requires multiple caregivers and/or space to provide CPR -Pt size (consideration) -Patient's injuries (grossly angulated fractures)

I wasn't sure if there was a market for PT flight RN's/medics. I got on at Fairfax at age 32. I'm currently 33. Normal service retirement is at either 25 years of service at 2.8% (approx 72% of average three highest earning years minus OY), or age 55, whichever comes first. One can work in excess of 25 years to increase the multiplier, resulting in a near 100% yearly payout. I plan to work a total of 23 years, which will occur when I'm 55, and then do three more years in the DROP, to maximize my retirement. I'm currently living in Garrisonville in Stafford County, just below Quantico. I'm going to meet with the FRD's career development/education coordinator next week and see what we have set up with regional universities/colleges. I'll check out your leads as well, of course. Thanks for that. I worked FT + an OT shift each week on average while going through my 13 month medic program, which was two 8 hour days per week with 16-24 hours of clinicals, flexible. The material wasn't anything as intensive as the RN or RT curriculum, I'm sure. The FFM job + OT will keep us comfortable, so completing the Fire Science dergree first may be the best career wise, especially if you're only meeting once a month. Tackling an RT or RN program head on should be easier on a Tech or Lt salary, along with an ample amount of leave available. The RN or RRT licenses interest me greatly, but can be deferred if the curriculum creates too much with my current schedule and relative lack of leave in the bank. If it works out I'll do RN or RT first, but at least I know that I can do the Fire Science degree in a much more career friendly fashion at first. I also want a fallback with RN or RT if I go out on permanent injury, or to segue into FT post retirement. 20 credits is a full plate, I'm sure. Keep up the good work! FRD is the Fire rescue Dept, Fairfax County to be specific. NSLIJ is the North Shore Long Island Jewish Health System. I worked for their Center for EMS, which does both NYC 911 and IFT. The DROP is the Deferred Retirement Option Plan http://benefitsattorney.com/modules.php?name=Content&pa=showpage&pid=17 WOWOWOOOO is my work rotation. Each character represents a 24 hour block. W=work, O=off. Everything clear as mud? Thanks again. It would have been way easier if I was still working at NSLIJ, where they are willing to accomodate a FT school schedule with a workable shift change, as long as your intended degree would benefit the Health System. I had to go with the FFM position over staying in NY to pursue a degree (or several). This made the most financial sense for my family and I, and I can still fufill my degree aspirations. It'll just be a little more taxing. If I decide to go RT, I'll go all the way. Money won't be a motivating factor in this anyway, so why not take the time to attain the highest level possible? I suspected as much.