tcripp

I wonder if there would be less confusion if the US would collectively move to the new National Registrty Terms. Emergency Medical Responder (EMR), Emergency Medical Technician (EMT), Advanced Emergency Medical Technician, and Paramedic. Well, that and a move to edcuate the general population.

Absolutely agree with this statement. My gut reaction is, why not? Doesn't EMT stand for Emergency MEDICAL Technician which would make you a medic? And, doesn't that appear to make it simpler then calling yourself a "Basic" and having to explain what that means to the lay person? Of course, I spend most of my time explaining that my basic partner does more than just drive and the difference between the two of us is that I have the key to the good drugs.

No worries, my friend. No worries. I guess I spend more of my posts trying to figure out how others "do it" so that I can see if what I am doing can be improved upon. Since I am a solo medic on a truck, I don't get insight in to how others work.

Can't imagine it would...just curious to see how others practice this skill.

Bernhard, thank you for your reply. I recently ran in to several who's take on it is that you stop compressions to insert the ET tube. Since that is not how I learned it, I was curious if there were others of the same mindset. It will be interesting to see other posts. Was recently in your fair State of Bavaria. BEAUTIFUL country.

When you have an arrest and you are ready to intubate, do you make an effort to intubate while chest compressions are still happening or do you have everyone stop so you can get the tube?

Never heard of that practice. If we are on duty for our 48 hour shift, we get paid 40 straight time and 8 hours OT. Since we are required to take any call at any moment in the 48 hours, there really are no guaranteed breaks or naps. We just get what we can get. And, last night, I got 7 uninterupted hours of sleep.

On occasion, I will have an energy drink. Those, however, are usually reserved for a late night transfer to the big city which takes on average 4-5 hours from tone to bed; closer to the 5 hours if I get my report written beforehand. My drink of choice is the 5-hour Energy Drink which, hmmm, lasts just as long as I need it. And, I probably consume one a month...maaaybeee two. I no longer drink tea, and coffee makes me pee. So, I'm better off not drinking too much of it.

Hmmm...andhere I thought I worked in a "better system" since we have progressive standards of care and a lot of autonomy in our decision making capabilities...and we work an EMT/Paramedic truck. Dang...guess I'll have to rethink my position.

Welcome!

It would also be a moot point as soon as policies were reviewed if the new hire balked the uniform. Ours reads, "All staff members are required to be in full uniform at all times while on duty or representing the organization". Then it reads, failure to follow said policies can result in termination of employment. After that, it doesn't matter what religion you follow.

Mike, I do agree with your statement, "A proper educational program will cover the necessary education and skills while providing the necessary ride time to ensure a competent entry level paramedic." However, since we can't change the system overnight, and with the system as it currently is, why is it considered substandard if one thinks that a little extra time in the field is a good thing prior to finishing the higher level? We are taught that most of our ALS care is is BLS, so how is taking a little time to get additional experience before moving on a bad thing? Obviously, I'm missing the big picture. To throw in another wrench for everyone...what about those, like me, who didn't really know we wanted to be a paramedic and trained at each level. By the time I graduated, I had 2 years as an ECA, 2 years as a Basic, and 1 year as an intermediate. When I started my clinicals/rideout in school and had my first full time position on a truck, I felt comfortable because I knew I at least had my BLS skills to fall back on. And, if we have only an ALS level, are you suggesting there be no more first responders?

Typing from my phone, so this will be short and sweet. I'm not taking anything personally. I truly was trying to see your point of view and wanted to understand it before I replied. I just found myself lost in the post. Secondly, I used to be one of those who said "straight thru" was the best way and now I truly do believe that some field experience is better than none. And, lastly, my note to xs was to let him/her know that there are some on his side that he/she apparently missed. I'm not looking for a fight and I appreciate all your years of experience. I happen to work in a service where our team is basic/medic. I don't know that we will ever see a dual medic truck. So, I can see where it has been beneficial to work at that level before moving up.

Sorry. Took your phrase as figurative and not literal.

If no one can agree, how could there ever be a mandate?

Go with where your desires lie. I'm sure many will jump in here (one way or another), but it's not all about the money. It's about what makes you happy. Another thing to consider when determining next steps is future earnings. Example, I'm also considering a move to nursing. I'm older and figure there will come a time when working 48 hour shifts won't be in my best interest. BUT, the retirement package has me rethinking that move...at least until much later. We are on the rule of 75 and I started working at the age of 45. So, in 13 years from my birthday, I can retire will full benefits...with a pretty nice monthly pension. Yes, I'm rethinking my next steps. Extra courses and skills? Take any and every extra course you can. Lots of places offer free CEs and many services offer online CEs. Take full advantage. Read articles (JEMS, EMS World, etc). Anytime (correction, every time) you come across something you don't fully understand, find other sources and read up on it. Strike up conversations with your peers. Ask them questions about how they do things...and why. Then read up on the latest research and better hone your own skills. Attend conferences. Jump in the forum and provide your insight. Each little thing you do makes you a better medic.

I can't tell if you are really against me...or not. I apologize, but I'm having difficulties with your post. What "IS THE BIGGEST SINGLE PROBLEM"? Not providing field experience (which, by the way, is way not what I was saying)? Before I open my mouth (or let my fingers loose), please clarify your point. Fiz - Love your post! Especially the point I copied above regarding prospective paramedics. Yes, it would suck to get through the full program to say, "Ummm. Maybe not." Xselerate - be careful. We didn't ALL jump on you. I count at least two on your side here.

So, one guy thinks that you really should stop and get experience --> "You need time in the back of a bus (ambulance) by yourself with a patient in need to have the clinical experience to make you ready to be a decent medic." The rest of the choir feels that going straight through is the better way --> something along the lines of it won't do you any good and you'll just develop bad habits. Here are my thoughts: Most places really want some type of experience before they will hire you full time. I'm not saying you couldn't find work being green, but something is better than nothing when up against the next guy with equal training. I have just watched 3 people who have been either Basic or Intermediate for several years finish a paramedic program. While they may not have been the lone person in the back with a critical patient, they've been on scene with enough to have a better understanding of an illness/injury than I have with my whole one-year of paramedic experience under my belt. I truly believe that when they get their first "whatever" patient in the back, they very well may fair better than I will the day I get mine. I also believe that it may have assisted them in their education. While I was taking the instructors at face value for most of my education, these same people had hands on experience which gave them a leg up in their training. The bad habits with no training are, in my opinion, just as bad as they guy who graduates from the program with only the book knowledge and will argue with his FTO when a treatment is done just a little differently than he was taught. I've heard it...I've seen it. To me, these are the ones who border on paraGod as they graduate. OP, I'm of the opinion that a little experience somewhere in the middle can't at all be a bad thing. But, you will have to decide what is best for you. For me, I was a Basic 4 years before I started a 2-year program. I did get my Intemediate patch. It, if for nothing else, prepared me for going through the NR for the paramedic piece. I then worked part time as an itermediate while I finished the paramedic program. Did I really get to do much with that "I" patch. Not really. But it sure looked good on my resume. Toni

Question for you. Are you proposing being a part of the 911 system so that you are dispatched out as well or are you talking about special events that require first aid support? In the county in which I work and the two counties bordering where I live, the first thing you need to do is go to the local EMS service and find out if what you propose is even probable. By that I mean, they may have rules in place that will determine if/how one can become a first responder in their service area. Without their support, what you are proposing very well may not have a chance of working. Toni

Rookie, I thought about your post while working my 48-hour shift which just ended this morning. Essentially, I got a new partner who is both young and a fairly new Basic. On our first call together, it was a cluster. Not that either one of us didn't know what to do but rather in the fact that we simply had not gotten our rhythm. By our last call, it was getting much better. We have the month together before we switch partners again...but I wager that by then, we'll be cooking with gas. Moral of my story...maybe part of your "issue" also lied in the fact that you and your partner are still getting used to each other as well. Communication is key. When you feel like something isn't right, ask about it. And, then take everything with a grain of salt and decide for yourself if it has merit. Some times it does...and some times it doesn't. But, at least you both will know where the other stands. Gee...I hope this makes sense. Long shift...so off to bed now. G'night, Gracie.

I don't think that I can add much more to what has already been said. I agree that, without knowing it, you did take care of the ABCs and were on your way to spinal immobilization. You may just have been going faster than your partner comprehended. That is when communication is paramount. As you yourself has stated...you are a rookie. It will take time. I do, however, have a question for you. This being your first emergency call, why the 5-hour energy drink? I believe you said this was an 8-hour shift? Was this a last call in the middle of the night and you were just dragging? Did you consume the drink before the tones dropped or was this something you decided on as you were heading out the door? My two cents. Save the energy drinks for long transfers when adrenaline won't be on board which should be enough for your 911 calls. Then, work on a healthy diet and exercise as you start your new career else you will find yourself dependent on caffeine (or other) to get you through your shift. You don't want to increase the speed of potential/probable burn out.

Before responding, I'd be curious to see what kinds of questions you'd be asking since many will come to you without any medical training whatsoever. Are you thinking basic math, grammar, spelling reading and comprehension skills?

Fair enough. Let me rephrase. I am a public servant. Now, for those who work for a private. Do you not, upon approaching your patient, introduce yourself...at least by first name?

Interesting query. I work for a relatively small, rural county - have been there for a little over a year now. My shirt has both my first and last name in "old people" print. I think it can be seen across the room. In addition to that, I wear a photo ID badge with my full name included. In the year that I've been here, each of us has had our name/photo in the local paper so that the community will get to know the people...you know, the ones who are paid by their very tax dollars. As someone else wrote, we are public servants. I can't disagree that people should be able to know who we are especially since we are being "invited" in to their homes to take care of them.