tcripp

Our service recently learned a new technique for lifing. Instead of the traditional "lift with your legs, not your back" there is something out there called "Power Lifting". You can go read up on it to see if there is any magic. To be honest, I don't see how that will help us in lifting a patient whose weight exceeds the capabilities of the two people doing the lifting. Yes, know your limitations and don't be afraid to call for help even if that means a delay in transport. Toni

I agree. Not sure about free speech...but definitely poor form.

Okay - so I'm cluess as to how to do the multi-quote so I can respond appropriately. Sorry about that. I'm also going to say that I'm not sure if some of what you are asking is pointed to me...or is rhetorical and in general. So, first things first. My experience with Percom was the instructor course, not the paramedic. My involvment at this point is grading papers, updating curriculum and sitting on scenario chat rooms. I'm still learning how the program in general works. I attended a Community College to get my LP. For 5 semesters, I had my butt in a seat. In addition, I started as an ECA back in 2004 and then moved up to Basic in 2006. I started paramedic school in 2008 and worked as an Intermediate for a year before getting my red patch. Most of my learning has been the additional OTJ training. I'll bet I had been a first responder for nearly a year before I felt comfortable in doing blood pressures or even changing the regulator on an O2 tank. And, now that I'm a working paramedic in the field...well, the learning never ends. Now, to the point of my last post which I think got lost. If it were between a 10 week course and an online (which, by the way has hands on components - the student doesn't get away that easily), I would vote for on the online. Yes, there is a limit on how slow you can go. I just like that there is an option. Now, as to my tag line. I'm glad that I can amuse you. tlc

I'm very much enjoying my work with Jane. As to getting accreditation...Percom is still moving forward in that regard. Dwayne, thanks for the kind words regarding your respect. And, I do agree with your statement, there are those out there who are honorable who turn out whackers. While only words on paper (um, a computer screen), it is my intention to only turn out quality medics, at any level. My two cents about a brick/mortar vs. on line vs. a shake-n-bake program (those would be the 10 week classes, IMHO). I personally believe that each person learns by different methods and each person will have to determine which method works better for them. I, personally, do MUCH better with a butt-in-seat type of class. I simply fair better with that personal interaction during the lectures. However, when it came to skills building, I actually did much better in a vacuum - just me and the mannequin. There are others who will do better with an online so that they can work at their own pace. That is what I both like and respect about PERCOM. If you need to slow the pace so you can better understand the material, then you don't lose out on the education. You can't do that in a classroom setting - especially in that shake-n-bake class. You either get it...or you don't. I am working at a service where we have various types of graduates. The ones who are still there are those who gave the effort needed regardless of the program. These are the same people who continue to learn and grow. Some came from the 10-week class, others are in the 15-week class, at least one took an online course and then there is me...19 months. Ultimately, it's the person...not the program...that makes the medic. All that aside, I firmly believe in accreditation and national standards. I want for us to be a single profession.

http://atcemsce.org/home/ This should help to answer all your questions.

Keep doing what you are doing. Study hard. Don't get cocky. Go do some rideouts with them to start the networking process. And, remember, this industry is small. Don't piss anyone off 'cuz he/she might just be your commander in the next job. Toni

I've been asked to write course work for a company, but have not done this before. Would love to hear from those who have. What kind of $$ do you charge? Do you maintain copy rights or do you in turn share them with the company that's just paid you for the job? What about simple edits and not new works? Any little tidbits would be very helpful.

Vbob, email me offline. Just graduated at 45 and am gainfully employed and loving it. Toni_Crippen@suddenlink.net.

Quite comical, Dwayne. What's even funnier is how the show TRAUMA portrayed the female paramedic as you just described. Even funnier. I'm a new paramedic sitting on the couch with my husband of 25 years watching that the first time turning all shades of colors trying to explain to him that is NOT how we dress or act.

AK is right...if it weren't liveable, no one would do it. HOWEVER, you can't get in to this career for the money. You get in to it because you have the desire to make a difference. That's what will get you through the long shifts and sleepless nights. And, if you are in it for the right reasons...none of that makes any difference.

I, too, am a fairly new medic working in a rural area with transports up to as much as 1.5 hours if we have to drive. However, we are usually alone in the transport. So, intubation for us might be the better course of action to avoid aspiration. Were you the 'lone medic' on this run? If not, how many other hands did you have? Now, as to an antiemetic...that would have been the first thing after the IV I would have given. No reason to tempt the aspiration fates if I'm not going to take ownership of that airway. Besides, my practicum in my final semester had me with more than one ETOH patient. I learned the hard way on that one...if you catch my drift.

Congratulations, Florida! I think one thing that many do is to panic when they don't hear the precise minute they think they should have heard "something". It's great to have a support system, even if it is by people you've never met! Have fun in your new job!

Monday...as in day before yesterday? No, I wouldn't worry. You never know what else came up that they had to deal with. Wait until next week before you take any action.

That's just it. I'm not looking for a right answer...which makes this exercise entertaining. The point I was making in my response was that you (I believe) were the only one to say, "I would..." whereas everyone else worte, "You should".

Very interesting comments from everyone...some more than others. Herbie...thanks for actually using the word "I" in your response. Since the question was, "what would you do" and not" what should I do"...I appreciated reading your answer.

I was having a discussion with a peer on a hypothetical situation and thought I'd bring it here to see what you think. You have an elderly patient who is 97yo, her b/p is 107/84, RR 23, pulse is 182. (Pulse stays between 180 - 190). She is A&Ox2. Her GCS is 14 (4/4/6) and she doesn't express that she is in any pain. ECG show SVT. She has an active OOH DNR. Attempting to do vagal maneuvers is difficult - so you decide to give adenosine as per your protocols. The adenosine puts her in to cardiac arrest. Do you honor the DNR or do you begin resuscitative measures since you, technically, caused the cardiac arrest? Again...this is hypothetical. I'm just curious as to what you'd do?

My recommendation? Talk to your physician about this.

Most services won't let you use symbols/abbreviations not on their approved list...so start there.

Yep - you need the size of your fluid bag + the meds. Example for the dopamine drip...standard is either 400 mg in a 250 mL bag or 800 mg in a 500 mL. gtts = 60 gtts x 250 mL x 10 mcg x 100 kg x 1 mg I'm getting 37.5 or 38 gtts/min. min 1 mL 400 mg kg/min 1 1000 mcg This is using dimensional analysis - the only way I know how to calculate meds...so hope it's not too confusing...and gives you a starting point for the epi.

You know...I'm kinda in the same boat with you. What I hear from others is, "they'd be more worried if we didn't get this way in the beginning" and "it will get better with time". I also work a truck with me and the a basic...so, it's usually all me in the ALS part of the world. But, I have some really GREAT Basic/Intermediate partners...so I've not worried too much on that. I've started taking deep breaths on the drive to a call and even keep my SOC book in the front with me so I can do a quick review while in transit. I work rural, so sometimes we have several minutes before getting to the patient. Good luck to you...and stay in touch.

Hmmm. I think I meant, be assertive but not overly aggresive. Oops. And, you are welcome!

Great first tips of "take a deep breath". Just be sure to exhale between them. ha ha I had the same questions on my first shift which wasn't all that long ago. So...what do you bring? Aside from your full uniform, watch, stethoscope,pens, etc., bring a book (suggest your school book) for down time. Bring cash as well as a food until you get an idea of what your crew does for meals. In my experience, if I bring food, we tend to go out and if I don't, well...you get the picture. Bring a sleeping bag or blanket and pillow until you know what the sleeping accomodations are. Bring toiletries (and towel) in case you have to decon yourself during shift...as well as a second uniform/change of clothes. Bring your enthusiasm for your new job and a willingness to learn. Check your ego at the door (if you have one). Be sure to learn from your FTO to start with. Don't pick up the bad habits from others until you are cleared and you have a better idea of what is right...or not. Ask questions. Don't be afraid to get in there and do what you've been trained to do. Be aggressive but not over assertive. Have fun. And, let us know how the first shift went for you! Toni

I agree with armymedic571. Sometimes, it's just over analyzing the questions. Don't read in to them...read them as they are written. Look at the answer and read ALL answers before deciding which is the correct one. If it doesn't jump out at you, the play the elimination game. Eliminate the ones that really don't belong, and that is usually 2. Then, reread the question and look at the last remaining answers. With the basic test, you really do want to step through the ABCs. I took my basic and felt like too many of my answers were "airway" when, in fact, that is all they were looking for. As to whether or not you should take the NR...go for it. You never know when you might want to leave your state and the NR will transfer nicely to most other states...especially Texas. Good luck on that retest.

Before I read the next line in your post, I yelled out "But you ARE a hero...in someone's eyes!" I'm glad someone set you straight. During EMS week, St. David's hospital here in Austin put up a banner that reads, "Not all heros wear an S on their chest."

You just decribed the reason I got in to this business. I recognize that when I am on duty and in uniform, I walk a little taller...a little more confident in my abilities. I don't think that I save lives, but I sure like knowing that I can be with the patient (or family member) when God decides that patient's fate through my actions and abilities. I attended a call the other day. Without going in to any detail for HIPAA reason, know that I think I was of more help to the wife than I was the patient...even though I'm not certain he really needed my services that day. I'm not afraid of hugs...in the waiting room...after I've delieverd my patient for definitive care. Thanks for your words...and I'm glad Dad is doing well.